Establishes "Comprehensive Geriatric Fall Prevention Pilot Program" in DHS; appropriates $11.7 million.

A2428

ASSEMBLY, No. 2428

STATE OF NEW JERSEY

222nd LEGISLATURE

�

PRE-FILED FOR INTRODUCTION IN THE 2026 SESSION

Sponsored by:

Assemblywoman TENNILLE R. MCCOY

District 14 (Mercer and Middlesex)

Assemblyman CODY D. MILLER

District 4 (Atlantic, Camden and Gloucester)

SYNOPSIS

���� Establishes "Comprehensive Geriatric Fall
Prevention Pilot Program" in DHS; appropriates $11.7 million.

CURRENT VERSION OF TEXT

���� Introduced Pending Technical Review by Legislative
Counsel.

��

An Act

concerning geriatric falls and making an appropriation.

����
Be It Enacted

by the Senate and General Assembly of
the State of New Jersey:

���� 1.��� The Legislature finds
and declares that:

���� a.���� Geriatric falls, which
are the leading cause of death and hospitalization among people 65 years of age
or older in New Jersey, constitute a costly public health crisis for New
Jersey;

���� b.��� Reducing preventable
adverse events, such as elder falls, is an important aspect to improving the
safety of elderly people in the State;

���� c.���� Approximately 85
percent of fall-related hospitalizations and 77 percent of fall-related deaths
occur among people who are 75 years of age or older;

���� d.��� Nationwide, it is
estimated that
approximately 400,000 hip fractures
occur each year, with 90 percent of those fractures occurring in patients older
than 65 years of age
.� Moreover, it is projected

that this number will increase by a factor of 50 percent by the year 2025;

���� e.���� The Medicaid program is
funded equally by federal and State money, and increased costs from the falls
of elderly people receiving health care benefits under the program mean
additional costs to the State;

���� f.���� AARP estimates that
each year over 55,000 older New Jersey residents suffer fall-related injuries
resulting in emergency room visits, hospitalizations, and long-term care.� It
is estimated that the New Jersey Medicaid program will spend in excess of $1
billion per year on geriatric fall-related injuries;

���� g.��� The State should devote
additional resources to research regarding the prevention and treatment of
falls in residential and institutional settings;

���� h.��� A Statewide approach,
which focuses on the daily life of elderly people in residential, institutional,
and community settings and includes input from a wide range of organizations
and individuals, including family members and health care professionals, is
needed to help reduce elder falls;

���� i.���� Since 2000, several
states have implemented fall prevention programs for the elderly to reduce the
number of falls and fall-related injuries and to reduce associated costs to
their Medicaid programs.� A program in Pennsylvania reportedly reduced fall-related
hospitalizations by 64 percent and cut acute care Medicaid costs by 80 percent
for 2,394 elderly Medicaid recipients over a three-year period. �Florida reportedly
achieved a 60 percent reduction in injurious falls among 6,060 older Medicaid
recipients, and its Medicaid program achieved a return of $2.40 for every
dollar invested in the program. �New York State�s Medicaid fall prevention
program enjoyed similarly successful results, with a return of over $3.00 for
every dollar invested in its program;

���� j.���� New Jersey should join
these states in reducing the frequency, severity, and cost of geriatric falls
by establishing a comprehensive geriatric fall prevention pilot program modeled
on successful programs adopted in other states; and

���� k.��� This act is intended to
be financially self-supporting, as it is anticipated that reductions in the
number and severity of fall-related injuries, as well as resulting nursing home
admissions, will result in savings to the State Medicaid program.

���� 2.��� a.���� There is
established, in the Department of Human Services, a three-year "Comprehensive
Geriatric Fall Prevention Pilot Program" under which at least 6,000
Medicaid recipients 60 years of age or over will receive proven fall-prevention
services, including, but not limited to, proven interventions that prevent
falls and rehabilitative services for fall victims that help prevent subsequent
falls.� This pilot program shall provide intensive fall prevention programs for
the elderly Medicaid recipients most in need of such services, as determined by
the Commissioner of Human Services, and shall provide a less intensive but
effective program for all Medicare-Medicaid dual eligible beneficiaries.� The
purpose of this program shall be to develop effective strategies to reduce
elder falls and the associated costs of those falls.� The pilot program shall
also designate at least 6,000 Medicaid recipients 60 years of age or over to
serve as a control group to measure the comparative effects of the pilot
program.

���� b.��� The Director of the
Division of Aging Services in the Department of Human Services shall contract
with a qualified organization to administer the pilot program principally to
elderly Medicaid recipients, their families and caregivers, and health care
professionals.� The program shall focus on ways to reduce the risk of falls,
and to the extent practicable, shall incorporate strategies to achieve the
following goals:

���� (1)�� to increase awareness among
elderly recipients, physicians, pharmacists, allied health professionals,
community-based health organizations, and others, of fall risk factors and
actions that can reduce falls;

���� (2)�� to provide
state-of-the-art individualized fall risk assessments, including computerized
dynamic posturography, application of logistical aggression models for
pharmaceutical fall risk, occupational and physical therapy analysis of gait
and balance disorders, and effective risk assessment;

���� (3)�� to provide proven
individualized counseling on risk mitigation strategies, including consultation
with family members of elderly recipients, caregivers, and providers, where
appropriate;

���� (4)�� to implement strategies
that are proven effective in reducing subsequent falls by elderly fall victims;

���� (5)�� to expand proven
interventions that prevent falls by elderly recipients;

���� (6)�� to improve the
diagnosis, treatment, and rehabilitation of elderly fall victims; and

���� (7)�� to assess the risk of
falls occurring in various settings.

���� c.���� The director shall
establish the pilot program in such counties as to be proportional to the
number of Medicare-Medicaid dual eligible beneficiaries

in the State and in such other
urban areas as deemed appropriate.

���� 3.��� The Commissioner of Human
Services shall undertake a review of the effects of falls on costs to the State
Medicaid program, and the potential for reducing those costs by implementing
proven fall prevention services.� This review shall include, but not be limited
to, a review of the reimbursement policy of the State Medicaid program in order
to determine if additional services should be covered or if reimbursement
guidelines for fall prevention-related services should be modified.

���� Not later than three years
after the effective date of this act, the commissioner shall evaluate the
cost-effectiveness of the pilot program and, pursuant to section 2 of P.L.1991,
c.164

(C.52:14-19.1), report to the Legislature any findings and recommendations,
including recommendations for Statewide implementation of a geriatric fall
prevention program.

���� 4.��� There is appropriated $11.7
million from the General Fund to the Department of Human Services for the
purpose of carrying out the pilot program in accordance with this act.

���� 5.��� This act shall take
effect immediately, and shall expire upon the filing of the report required
pursuant to section 3 of this act.

STATEMENT

����� This bill establishes a three-year
"Comprehensive Geriatric Fall Prevention Pilot Program" in the
Department of Human Services (DHS), which will be modeled on successful
programs adopted in other states.� Such programs have reportedly reduced falls
and fall-related injuries and have significantly reduced fall-related costs to
the states� Medicaid programs.� Under the bill, the pilot program is to target
at least 6,000 Medicaid recipients 60 years of age and older to receive proven
fall-prevention services, and is to designate at least 6,000 Medicaid
recipients 60 years of age and older to serve as a control group to measure the
comparative effects of the pilot program.

����� Specifically, the bill directs the Director of the
Division of Aging Service in DHS to contract with a qualified organization to
administer the pilot program principally to elderly Medicaid recipients, their
families and caregivers, and health care professionals, to focus on reducing
the risk of falls.� The program is to be established in such counties as to be
proportional to the number of Medicare-Medicaid dual eligible beneficiaries in
the State and in such other urban areas as are deemed appropriate by the
director.� To the extent practicable, the pilot program is to incorporate
strategies to achieve the following goals:

�

to increase
awareness of fall risk factors and actions that can reduce falls;

�

to provide
state-of-the-art individualized fall risk assessments;

�

to provide
proven individualized counseling on risk mitigation strategies;

�

to implement
strategies that are proven effective in reducing subsequent falls by elderly
fall victims;

�

to expand
proven interventions that prevent falls by elderly recipients;

�

to improve the
diagnosis, treatment, and rehabilitation of elderly fall victims; and

�

to assess the
risk of falls occurring in various settings.

����� The bill also directs the Commissioner of DHS to
review the effects of falls on costs to the State Medicaid program and the
potential for reducing those costs by implementing proven fall prevention
services.� This review is to include, but not be limited to, a review of the
reimbursement policy of the State Medicaid program in order to determine if
additional services should be covered or if reimbursement guidelines for fall
prevention-related services should be modified.� No later than three years after
the effective date of this bill, the commissioner is to evaluate the
cost-effectiveness of the pilot program, report any findings to the
Legislature, and include recommendations regarding Statewide implementation of
a geriatric fall prevention program.

���� Finally, the bill appropriates $11.7 million from the
General Fund to DHS for the purpose of carrying out the pilot program.� This
bill, however, is intended to be financially self-supporting, as reductions in
the number of fall-related injuries, and resulting nursing home admissions, are
anticipated to result in savings to the State Medicaid program.