Bill > A5020

Introduced Session

This bill establishes a three-year "Comprehensive Geriatric Fall Prevention Pilot Program" in the Department of Human Services (DHS) 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 10,000 Medicaid recipients 60 years of age and older to receive proven fall-prevention services. 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 deemed appropriate by the director. To the extent practicable, the pilot program is required 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 $26 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, due to the anticipated savings by the State Medicaid program, as fall injuries are reduced, and nursing home admissions are likewise reduced.

AI Summary

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Annette Quijano (D)*, 

Introduced, Referred to Assembly Human Services Committee (on 02/07/2019)