This study is a comparative analysis of community dwelling older adults who were hospitalized after falling in five Los Angeles Region counties: Los Angeles, Orange, Riverside, San Bernardino, and Ventura. It provides a current demographic assessment, future public health projections, and a planning response for local governments. Nearly 30,000 of the Los Angeles Region’s 1.8 million older adults were hospitalized for falls in 2006. Aging Baby Boomers will cause the Region’s older population to swell to over 5 million by the year 2050. The Region’s hospitalizations for fall-induced injuries cost Medicare and Medi-Cal over $1.3 billion in 2006. However, according to projections, the costs will increase dramatically by 2020, when over 40,000 older adults will be hospitalized for falls each year. By the year 2035, hospitalizations for falls will reach 60,000 per year, increasing through 2050. The older population of the Region is more diverse than the national population of older adults. Analysis of fallers’ billed charges, sources of pay, and discharge disposition in the Los Angeles Region found that White fallers are most costly to the federal Medicare system and non-White fallers have lower rates of Medicare utilization. Higher billed charges and high Medi-Cal utilization for falls among Latino, Asian, African-American, and Other race fallers are costly to the State of California. The majority of fallers are discharged to a Skilled Nursing Facility (SNF), and those with SNF discharge were older, had longer lengths of stay, and higher billed charges. They were more often White. Patients discharged to their homes were younger, had shorter hospital stays, and had lower billed charges. Asian and Latino fallers had high home discharge rates. While the primary public economic impact of falls is on federal and state programs, it is in local jurisdictions where falls occur, where rehabilitation and long term care after hospital discharge must be provided, and where repeat falls and injuries can be prevented through targeted programming and urban planning policy that supports aging in place. Fall prevention initiatives for local governments are presented.