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Final Report on Activities

Improve Public Policy Response and Medicare Coverage for Fall Prevention and Intervention
July 2010

Developed by the American Occupational Therapy Association under a contract with the National Center for Injury Prevention and Control (2009-Q-11452)

This is the final report of the project Improve the Public Policy Response to Older Adult Fall Prevention. The project was completed by the American Occupational Therapy Association (AOTA) under a contract with the National Center for Injury Prevention of the Centers for Disease Control and Prevention.

Deliverables for the project and the status of those deliverables are:

1A. Conduct a review of existing or pending fall prevention as well as policy barriers:

A consultant was hired who has expertise in home health, Medicare, reimbursement, and related issues. The consultant also attended the American Society on Aging, “Aging in America” Conference in March 2010 in Chicago to gather information and meet with key people in the fall prevention arena. Another consultant was hired to conduct an environmental scan of key agencies, organizations, and individuals who are expert or interested in fall prevention and related policy questions. More than 40 individuals and organizations were contacted. In addition, nine providers of services in the community participated in a survey, which asked a series of questions about how policy affects direct practice. Project staff met with a National Council on Aging/Falls Free Coalition representative to obtain additional information about policy and contacts for this effort

1B. Provide a summary of the review.

A report was developed and presented to Centers for Disease Control and Prevention (CDC) for review. A draft was presented to the individuals invited to the stakeholders meeting under 2A. See Analysis of Medicare Policy in Relation to Preventing Falls Among Older Adults.

A record of the interviews was prepared and a summary of common themes expressed in the interviews was developed. See Pre-Meeting Interview Summary

2A. Conduct a meeting of key stakeholders to assess policy barriers and needs

A meeting of nearly 50 individuals was held in Washington, D.C. on June 8, 2010. AOTA and its consultants organized and held this national meeting with representatives

of organizations and individuals to review and discuss the policy issues and related report and identify additional policy issues and directions. AOTA completed the following tasks for the meeting: handled all logistical details including selected hotel and made all related meeting arrangements; identified meeting speakers; identified, prepared, and supervised a facilitator for the meeting; developed letters of invitation for meeting attendees and worked with organizations to finalize guest list; made arrangements as needed for specific meeting attendees; developed all meeting materials—including agenda, overview of interviews, preliminary policy report, and participation list; and managed meeting on site.

2B. Provide a summary of the meeting results.

AOTA prepared a meeting summary and distributed it to participants for review, incorporating comments. AOTA also reviewed the meeting with CDC and key participants (i.e., the National Council on Aging) to ensure a thorough compilation and set of recommendations. See Meeting Summary.

3. Provide recommendations for addressing barriers and gaps, including an action plan for addressing recommendations.

AOTA included a summary of proposed policy changes in the policy document. This was also distributed to the meeting participants. In addition, AOTA wrote a series of documents to address other aspects of the problem. Those include: a description of the roles of occupational therapists and occupational therapy assistants in falls prevention/intervention; a policy summary that can be used as a simple handout; and a summary of the evidence for the suggested “bundled” fall prevention benefit. See Summary of Recommendations and Evidence for Falls Risk Prevention/Intervention Bundled Benefit.

In addition, AOTA is continuing to work with the Falls Free Coalition to engage their advocacy workgroup on some of these issues. The first accomplishment was the submission of a letter to the Centers for Medicare & Medicaid Services (CMS) on a proposed rule on the new Medicare wellness visit benefit, even as the CDC funding has ended. In addition, AOTA is continuing to work with federal agencies, Congress, and other stakeholders on this issue. AOTA arranged a meeting between CDC NCPIC and the CMS Office of Clinical Standards and Policy in September 2010.