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What’s at Stake

As Congress debates legislation to repeal the Affordable Care Act (ACA), funding for Falls Prevention and Chronic Disease Self-Management Education (CDSME) is threatened.

The ACA created the Prevention and Public Health Fund (PPHF), which sets aside a specific amount of funding for Congress to allocate to a variety of public health and prevention initiatives in communities across the nation. The PPHF’s total currently stands at $1 billion, and $5 million is slated to be allocated to Falls Prevention and $8 million to CDSME FY17 grants overseen by the Administration for Community Living (ACL).

PPHF funding was first made available for CDSME in FY12. It then totaled $10 million but sequestration cuts eroded the funding to the current $8 million annual funding. Senate appropriators proposed as much as $10 million for Falls Prevention, but only $5 million annually was provided once the allocations began in FY14.

The Administration’s FY18 budget request also affects Falls Prevention and CDSME funding. It proposed to eliminate funding for Falls Prevention activities at the Centers for Disease Control (CDC) and reduce ACL CDSME funding from $8 million to $5 million (a 37.5% cut). It should also be noted that the request does reflect the elimination of PPHF resources, and calls for these ACL programs to continue with regular appropriations. Yet Congress will have the final say on how FY18 funding is allocated.

Current Status

After a lengthy delay, the House passed its version of ACA repeal, the American Health Care Act (AHCA), in May. Among the provisions that affect seniors is the complete elimination of the PPHF as of October 1, 2018.

Efforts to move the initial Senate bill, the Better Care Reconciliation Act (BCRA), stalled, but the Senate is currently focused on passing the Cassidy-Graham proposal before the fiscal year ends on Sept. 30. Similar to other proposals, the PPHF is repealed in this latest legislation.

In the midst of this debate, the House Appropriations Committee has moved forward with FY18 funding bills. The House Labor, Health and Human Services, Education appropriations bill
(Labor-HHS bill) level-funds CDC Falls Prevention at $2.05 million, and similar to the Administration’s request, funds ACL Falls Prevention and CDSME with appropriations rather than PPHF allocations, with $5 million for Falls and $5 million for CDSME (a cut for CDSME). The legislation is expected to pass the House as part of an eight-bill FY18 appropriations package the week of Sept. 10.

On Sept. 7, the Senate Appropriations Committee approved its version of the Labor-HHS bill. It level-funds CDSME and Falls Prevention at both ACL and CDC. In fact, it calls for continuing to fund CDSME and Falls Prevention at CDC with PPHF allocations. Future action in the Senate is currently unclear.

Check this page frequently for the latest legislative updates and how that influences advocacy strategies.

Take Action

There are a number of ways you can help defend the PPHF and funding for Falls Prevention and CDSME.

It’s important for individuals and organizations in all states to educate members of Congress about CDSME and falls prevention, and the impact that loss of PPHF funding can have. Advocates in Arizona, Iowa, Maine, Missouri, Oklahoma, and Tennessee and those with members on the Senate Appropriations Committee and House Appropriations Committee can make unique contributions by reaching out to key members of their Congressional delegations. Contact NCOA Advocacy for details.

Learn More

We have a variety of resources to provide more information on this issue, enlist allies, and educate Congress.

National Resources

State Resources

  • State-specific CDSME Infographics (upon request)
  • State-specific Falls Prevention Infographics (upon request)
  • CDSME Grantee Profiles: Use these documents to learn more about how ACL/AoA’s 2012, 2015, and 2016 state and tribal grantees are implementing, expanding, and sustaining CDSME.
  • Falls Prevention Grantee Profiles: Use these documents to learn more about how ACL/AoA’s 2014, 2015, and 2016 state and tribal grantees are utilizing evidence-based programs to reduce falls and fall-related injuries.
  • Falls Prevention Coalition Descriptions (click Falls Prevention Coalitions and navigate to your state): Use these documents to learn more about how each state’s falls prevention partners are working together to reduce falls and fall related injuries.
  • State Falls Prevention Data Profiles (click Falls Prevention Coalitions and navigate to your state): Use these documents to learn more about the impact of falls prevention efforts in each state.

Contact Us

Contact us if you have questions or need additional support reaching out to your members of Congress.