HR5575-119

2. Findings Congress finds the following: According to the Centers for Disease Control and Prevention (CDC), about 14,000,000 falls are reported each year nationwide among adults age 65 and over. These falls result in 38,000 deaths. Each year, approximately 3,000,000 older adults are treated in emergency departments for a fall injury. Falls are the top cause of injury and injury-related deaths for adults over 65. Falls among adults aged 65 and above result in over $80,000,000,000 per year in medical expenses. More than 95 percent of hip fractures are caused by falling. Falls are the most common cause of traumatic brain injuries. According to the National Institutes of Health (NIH), over 70 percent of falls occur in the home. Falls can often be prevented, including by implementing simple home modifications. Fire department personnel can play an important role in preventing and responding to falls.

3. Firefighters assisting seniors to emergency response The Administrator of FEMA shall make grants directly to career fire departments, combination fire departments, and volunteer fire departments for the purpose of implementing programs to improve home safety and prevent falls for older adults, including through fall prevention programs. Grants made under this subsection shall be for three years. In awarding grants under this subsection, the Administrator of FEMA may give preferential consideration to applications that involve non-Federal contributions that exceed the difference between 100 percent and the maximum percentage allowable Federal contribution specified in paragraph (5) for a year. The Administrator of FEMA may provide technical assistance to States, units of local government, Tribal governments, and other public entities in furtherance of the purposes of this section. The portion of the costs of implementing programs to improve home safety and prevent falls for older adults provided by a grant under this paragraph may not exceed the following: Seventy-five percent in the first year of such grant. Seventy-five percent in the second year of such grant. Thirty-five percent in the third year of such grant. Grants made pursuant to this subsection shall be awarded on a competitive basis through a neutral peer review process. No grant may be made under this section unless an application has been submitted to, and approved by, the Administrator of FEMA. An application for a grant under this section shall be submitted to the Administrator of FEMA in such form, and containing such information, as the Administrator of FEMA may prescribe. At a minimum, each application for a grant under this section shall— explain the applicant’s inability or challenges to implement without Federal assistance a program to improve home safety and prevent falls for older adults; and specify long-term plans for continuing such a program following the conclusion of Federal support provided under this section. Grants under this section shall be used for any of the following purposes: Procurement and installation of devices, including lock boxes, that can be installed on homes in order to allow emergency responders quicker access to a home in case of an emergency. Recruitment, retention, salaries, and benefits of community paramedicine personnel, including firefighters, paramedics, EMTs, social workers, case managers, administrators, or other professionals for the purpose described in subsection (a)(1). Installation and replacement of smoke detectors and batteries. Compilation of health information to permit emergency responders ready access to vital health data in case of an emergency. Minor home modifications to reduce fall risks, including the following: Flattening of rugs. Removal of tripping hazards. Installation of hand rails and grab bars, including supplies, labor, and insurance. Risk assessment and reconciliation of medications. Referral to classes, medical professionals, and other community resources that educate seniors on reducing fall risks. Funds made available under this section to fire departments may not be used to supplant State or local funds, or, in the case of Tribal governments, funds supplied by the Bureau of Indian Affairs, but shall be used to increase the amount of funds that would, in the absence of Federal funds received under this section, be made available from State or local sources, or in the case of Tribal governments, from funds supplied by the Bureau of Indian Affairs. No grant shall be awarded pursuant to this section to a municipality or other recipient whose annual budget at the time of the application for fire-related programs and emergency response has been reduced below 80 percent of the average funding level in the three years immediately preceding the date of the application for the grant. Funds appropriated by Congress for the activities of any agency of a Tribal government or the Bureau of Indian Affairs may be used to provide the non-Federal share of the cost of programs or projects funded under this section. In a case of demonstrated economic hardship of an applicant for a grant under this section, the Administrator of FEMA may— waive the requirements of subsection (d)(1); or waive or reduce the application of subsection (a)(5) or (d)(2). The Administrator of FEMA shall establish and publish guidelines for determining what constitutes economic hardship for purposes of paragraph (1). In developing guidelines under subparagraph (A), the Administrator of FEMA shall consult with individuals who are— recognized for expertise in emergency medical services provided by fire services, community paramedicine, fall prevention, or the economic affairs of State or local governments; and members of national fire service organizations or national organizations representing the interests of State or local governments. In developing guidelines under subparagraph (A), the Administrator of FEMA shall consider, with respect to relevant communities, the following: Changes in rates of unemployment from previous years. Whether the rates of unemployment of the relevant communities are currently and have consistently exceeded the annual national average rates of unemployment. Changes in percentages of individuals eligible to receive food stamps from previous years. Such other factors as the Administrator of FEMA considers appropriate. The Administrator of FEMA shall establish a performance assessment system, including quantifiable performance metrics, to evaluate the extent to which grants awarded under this section are furthering the purposes of this section. The Administrator of FEMA may require a grant recipient to submit to the Administrator of FEMA any information the Administrator of FEMA considers reasonably necessary to evaluate the implementation of programs to improve home safety and prevent falls for older adults. Not later than two years after the date of the enactment of this Act, the Administrator of FEMA shall submit to Congress a report on the experience with, and effectiveness of, grants awarded under this section in meeting the objectives of this section. Such report may include any recommendations the Administrator of FEMA may have for amendments to this section and related provisions of law. If the Administrator of FEMA determines that a grant recipient under this section is not in substantial compliance with the terms and requirements of an approved grant application submitted under this section, the Administrator of FEMA may revoke or suspend funding of such grant, in whole or in part. The Administrator of FEMA shall have access for the purpose of audit and examination to any pertinent books, documents, papers, or records of a grant recipient under this section and to the pertinent books, documents, papers, or records of State and local governments, persons, businesses, and other entities that are involved in programs, projects, or activities for which assistance is provided under this section. Paragraph (1) shall apply with respect to audits and examinations conducted by the Comptroller General of the United States or by an authorized representative of the Comptroller General. In this section: The terms Administrator of FEMA, career fire department, combination fire department, and volunteer fire department have the meanings given such terms in section 33(a) of the Federal Fire Prevention and Control Act of 1974 (15 U.S.C. 2229(a)). The term community paramedicine means the operation of first responders, including firefighters, emergency medical technicians (EMTs), and paramedics, in roles that serve to proactively make communities, homes, and residents safer and prevent future medical emergencies. The term fall prevention means the use of evidence-based measures that decrease fall risks in older adults. The terms fire service and local have the meanings given such terms in section 4 of the Federal Fire Prevention and Control Act of 1974 (15 U.S.C. 2203). The term firefighter has the meaning given the term employee in fire protection activities in section 3(y) of the Fair Labor Standards Act of 1938 (29 U.S.C. 203(y)). The term State has the meaning given such term in section 2 of the Homeland Security Act of 2002 (6 U.S.C. 101). There are authorized to be appropriated for the purposes of carrying out this section, the following: $1,000,000 for each of fiscal years 2026, 2027, and 2028. $2,000,000 for each of fiscal years 2029, 2030, and 2031. $4,000,000 for each of fiscal years 2032, 2033, and 2034. $7,000,000 for fiscal year 2035. Of the amounts authorized to be appropriated pursuant to paragraph (1) for a fiscal year, the Administrator of FEMA may use not more than five percent of such amounts to cover salaries and expenses and other administrative costs incurred by the Administrator of FEMA to make grants and provide assistance under this section. This section expires on September 30, 2036.