Allowable expenses for Chronic Disease Self-Management Education (CDSME) grantees are not simply administrative costs. They are investments in strength, resilience, and continued contribution across the lifespan of evidence-based CDSME programs.

Over 1.5 million older adults have participated in CDSME programs nationwide,¹ and these programs have been proven to reduce emergency department visits and hospitalizations.²

Each year, the Administration for Community Living (ACL) provides opportunities for community-based organizations to request discretionary funding to implement and expand evidence-based CDSME programs. Each year the list of allowable programs under the funding opportunity may change; always review the notice of funding opportunity to see the funding cycle’s allowable programs.  All program listed are considered highest tier evidence-based programs, approved through a rigorous review process and approved by ACL as meeting strict evidence-based criteria for health promotion and disease prevention programs, including:

• Chronic Disease Self-Management (CDSME)
• Si, Yo Puedo!
• Enhance®Wellness 
• Health Coaches for Hypertension Control 
• Program to Encourage Active, Rewarding Lives (PEARLS)
• And many more proven CDSME programs for your community

Because they are directly tied to approved program activities,³ required for delivery, and compliant with federal cost principles, to make the most impact and comply with federal regulations, it’s crucial to understand which expenses are considered “allowable” by the ACL and the U.S. Department of Health and Human Services (HHS).

Ensuring all expenses are allowable not only complies with federal regulations but also increases the number of older adults who can benefit from evidence-based health programs, builds trust with partners and the community, and promotes the sustainability and expansion of the approved evidence-based CDSME programs.

At its core, health promotion funding is designed to support evidence-based strategies that help older adults maintain independence, manage chronic conditions, and remain active in their communities. Allowable expenses are those that make this possible—by ensuring high-quality program delivery, removing barriers to participation, and maintaining fidelity to proven models.

Allowable expenses: What can CDSME grants pay for?

Eligible costs generally fall into categories that directly support the planning, implementation, and evaluation of CDSME programs. In federal compliance with the Office of Management and Budget,⁴ these can include:

Program Implementation and Delivery Costs

• Workshop Supplies: Materials that are required for participant engagement and learning are generally allowable because they are integral to workshop participation and outcomes. Books, participant handouts, toolkits, and materials required by the evidence-based protocol. Other examples can include:
  • Participant manuals and workbooks
  • Licensed CDSME curricula materials
  • Leader facilitation supplies required by the model (e.g., flip charts, markers).
  • Printing of evaluation tools and self-management plans.
• Participant Marketing/Recruitment:⁵ Reaching older adults who can benefit from CDSME is central to the fundings mission— allowable outreach materials, advertising, and costs associated with enrolling eligible older adults may include:
  • Printing and translating outreach materials (flyers, social media, etc.)
  • Community outreach about CDSME programs (virtual/hybrid events)
  • Instant/E-Communication (text messages, newsletters, etc.)
• Technology: Modest technology expenses that are necessary and directly tied to program delivery may be allowable. Small technological expenses that are commonly allowable when tied directly to program delivery could include:
  • Software licenses used for virtual CDSME workshops
  • Tablets or devices used by facilitators for data collection or instruction
  • Modest IT tools needed for scheduling, participant tracking, or reporting
• Host Sites: When they are necessary and properly allocated, host site fees for accessible locations where workshops are held are allowable. They may include:
  • Room rental for in-person workshops
  • Virtual platforms for online delivery
  • Equipment rental required for facilitation
• Reminder: If the host site and/or technology supports multiple programs, costs must be prorated to reflect the CDSME program use.

Personnel and Training

Expenses that ensure program fidelity⁶ and support personnel costs for staff time are allowable and may include:

• Leader Training: Registration/certification fees, training materials, and travel costs for staff or volunteers to become certified program leaders.
  • Leader and Master Trainer certification fees
  • Required training for specific CDSME models (e.g., CDSMP, DSMP, CPSMP)
  • Reasonable travel for required training or recertification.
  • Reimbursement for mileage or meals in alignment with federal per diem,⁷ travel policies, and is clearly justified.
  • Required travel for two program staff to attend NCOA’s annual Age+Action conference. Please note that the Project Director is required to attend the annual conference. 
• Staff Salaries: Proportionate salaries and benefits for staff directly delivering or managing the CDSME program (e.g., workshop facilitators, coordinators) are allowable. These may include:
  • CDSME program coordinators or managers
  • Certified workshop leaders and facilitators
  • Master Trainers supporting workforce development and fidelity.
  • Data and reporting staff (proportionate to CDSME duties)
  • Tip: If a program coordinator spends 60% of their time managing CDSME workshops, then 60% of their salary and fringe benefits may be charged to the grant, with appropriate time-and-effort documentation.
• Indirect/Administrative Costs:
  • Administrative overhead (Staff supporting recruitment, scheduling, and participant follow-up)
  • Shared IT, HR, and finance services
  • General program support proportional to CDSME activities

Data Collection and Reporting/Evaluation

• Data-driven delivery supports continuous improvement and demonstrates the value of CDSME to funders and partners. Allowable expenses may include:
  • License/Program Fees to obtain or renew program licenses from the developer. Monitoring tools required by program developers.
  • Evaluation tools measuring self-efficacy, health behaviors, or functional outcomes.
  • Staff time for data entry, reporting, and quality monitoring
  • Data systems required by ACL, NCOA, or state contracts.

Supportive Services

• Accessibility Accommodations: Costs for translation, interpretation, and materials in alternate formats (e.g., large print, Braille).
  • Accessibility supports such as captioning or assistive technology
  • Reasonable participant supports (e.g., transportation assistance or approved incentives⁸ when included in your workplan and submitted budget and there is a clear pathway for long term sustainability of the support beyond the grant).

What expenses are not allowed for CDSME programs under federal funding?

Certain costs are specifically unallowable under federal rules. If an expense does not directly support evidence-based CDSME delivery or compliance, it is not allowable under grant funding. These can include:

• Entertainment or social events unrelated to CDSME delivery
• Medical equipment, clinical care, or direct health services
• Food and beverages (unless as part of per diem travel expenses)
• Capital expenditures or facility renovations.
• Lobbying or political activities
• Supplanting costs that are already covered by another funding source
• Cash gifts outside approved incentive policies.

How do I make sure my expenses are allowable?

Grantees can confidently manage CDSME grant funds by following five core steps:

1. Clearly identify program needs and ensure expenses directly support CDSME delivery and fidelity
2. Verify costs align with ACL, federal, and state guidance
3. Document rationale and keep receipts
4. Track expenses consistently in real time
5. Maintain organized records to support audit readiness and ongoing compliance.

To ensure the expenses are allowable, the following serve as additional guidance:

• Review your corporative agreement with ACL for specific funding restrictions
• Review your submitted and approved budget, talk with your ACL Project Officer if you have questions or need to shift allocation of line items
• Budget revisions that impact more than 10% of your total budget need to go through a formal budget and workplan update and approval process with ACL grants office.
• Budget revisions under 10% of total budget require a budget and workplan update and revision, require the approval of your ACL Project Officer
• Regularly check the ACL guidance⁹

Strong documentation is essential for compliance and sustainability and to build trust with partners. Document everything, including keeping receipts to clearly track and indicate your rationale for how each expense directly supports CDSME programmatic delivery. Best practices can include:

• Line-item budgets for CDSME activities
• Time and effort reporting for shared staff
• Receipts and invoices with clear program context
• Written justification for less obvious costs

Compliance empowers impact

Evidence shows that CDSME improves self-efficacy, physical activity, medication adherence, and symptom management, while reducing health distress and enhancing quality of life.^10,11 Every dollar invested in evidence-based CDSME programs helps older adults live healthier, more independent lives.

By knowing your allowable expenses, you champion the responsible use of resources, fostering a future in which aging is recognized as a time of growth, purpose, and contribution.

Explore the following resources for additional tips and tools on allowability basics, participant supports, workforce, data and reporting, outreach, and sustainability:

• NCOA National CDSME Resource Center
• CDSME Evidence-Based Programs Fidelity Hub
• CDSME Program Promotion Toolkit
• How to Use Incentives: A Guide for ACL CDSME and Falls Prevention Grantees
• Strategic Partnerships
• Opportunities for Partnering with State Medicaid for CDSME Coverage
• Cost Calculator for Chronic Disease Self-Management Programs
• Tip Sheet: Increasing Completion of Chronic Disease Self-Management Education Workshops
• Embedding Students into your CDSME and Falls Leader Networks: Tips for Success
• Tip Sheet: Maximizing Complete and Accurate Data
• Tip Sheet: Collecting Participant and Partner Data for ACL CDSME and Falls Prevention Evidence-Based Programs
• HAPID FAQ
• Guide to Using the Program Sustainability Assessment Tool (PSAT) for Evidence-Based Programs

This project was supported by the Administration for Community Living (ACL), U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $10,000,000 with 100 percent funding by ACL/HHS.  The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by ACL/HHS or the U.S. Government.

Sources

1. National Council on Aging. Get the Facts on Chronic Disease Self-Management. Found on the internet at https://www.ncoa.org/article/get-the-facts-on-chronic-disease-self-management/

2. Centers for Disease Control and Prevention. Managing Chronic Conditions | Self-Management Education Programs. Found on the internet at https://archive.cdc.gov/www_cdc_gov/learnmorefeelbetter/programs/general.htm

3. Office of Management and Budget. 2 CFR § 200 Subpart E: Cost principles (Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards). Electronic Code of Federal Regulations. 2025. U.S. Government. Found on the internet at https://www.ecfr.gov/current/title-2/subtitle-A/chapter-II/part-200/subpart-E

4. Office of Management and Budget. 2 CFR Part 200, Subpart E—Cost principles (Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards). Electronic Code of Federal Regulations. 2025. Found on the internet at https://www.ecfr.gov/current/title-2/subtitle-A/chapter-II/part-200/subpart-E

5. National Council on Aging. CDSME marketing toolkit. Found on the internet at https://www.ncoa.org/page/cdsme-marketing-toolkit/

6. National Council on Aging. CDSME evidence-based programs fidelity hub. Found on the internet at https://www.ncoa.org/page/cdsme-evidence-based-programs-fidelity-hub/

7. U.S. General Services Administration. Per diem rates. Found on the internet at https://www.gsa.gov/travel/plan-book/per-diem-rates

8. National Council on Aging. How to Use Incentives: A Guide for ACL CDSME and Galls Prevention Grantees. Found on the internet at https://www.ncoa.org/article/how-to-use-incentives-a-guide-for-acl-cdsme-and-falls-prevention-grantees/

9. Administration for Community Living. Chronic disease self-management education programs. U.S. Department of Health and Human Services. Found on the internet at https://www.acl.gov/programs/health-wellness/chronic-disease-self-management-education-programs

10. Administration for Community Living. Chronic disease self-management education programs. U.S. Department of Health and Human Services. Found on the internet at https://acl.gov/programs/health-wellness/chronic-disease-self-management-education-programs

11. Centers for Disease Control and Prevention. Self-management education: Learn more. Feel better. U.S. Department of Health and Human Services. Found on the internet at https://www.cdc.gov/aging/cdsme/index.html