What’s at Stake
The Affordable Care Act (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 $900 million, and $5 million was allocated to Falls Prevention and $8 million was allocated to Chronic Disease Self-Management Education (CDSME) for 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.
In addition to the PPHF threat, Administration budget requests and Congressional appropriations bills have also proposed cuts specifically in annual funding for CDSME and Falls Prevention.
Check this page frequently for the latest legislative updates and how that influences advocacy strategies.
The CHAMPION Act (H.R. 3922) is scheduled to be voted on by the House during the week of October 29. The legislation extends funding for important programs, including the Children’s Health Insurance Program (CHIP) and Community Health Centers. However, it offsets that new funding with a $10.5 billion (75%) cut from the PPHF, zeroing out all funding each year over the FY20-26 period.
As Congress debates legislation to repeal the Affordable Care Act, and with it, the PPHF, funding for Falls Prevention and CDSME is threatened.
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 legislation in the Senate, the Better Care Reconciliation Act (BCRA) and the Cassidy-Graham proposal, were unsuccessful. Similar to other proposals, the PPHF is repealed in this latest legislation.
While ACA repeal proposals have stalled, the Fund was cut in order to provide an offset for extending other health programs. The Trust for America’s Health has prepared a table to outline the current funding totals.
FY18 Budget and Appropriations
The Administration’s FY18 budget request 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.
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 Senate Labor-HHS bill 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. Appropriators are working on a final FY18 omnibus appropriations package with the goal of passing it by March 23.
While work continues on FY18 funding, the Administration released its FY19 budget request. Details have yet to emerge about Falls Prevention funding at CDC, but we do know that both ACL CDSME and Falls Prevention funding are proposed for elimination. Similar to last year, Congress will have the final say on how these programs are funding, and appropriators’ work will begin in earnest soon after they finalize FY18 funding.
There are a number of ways you can help defend the PPHF and funding for Falls Prevention and CDSME.
- Educate your members of Congress or their staff with local meetings and events, using our federal budget advocacy information. Make sure you your voice is heard on FY18 CDSME funding by emailing your delegation.
- Organize statewide advocacy with group letters to Congress, such as the template for statewide falls prevention advocacy
- Engage social media and traditional media
- Mobilize advocacy by others by promoting NCOA’s advocacy news sign-up, Straight Talk for Seniors® blog posts, and federal budget policy information.
- Email NCOA Advocacy if you know of Republican members who support Falls Prevention or 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 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.
We have a variety of resources to provide more information on this issue, enlist allies, and educate Congress.
- Issue Brief: Chronic Disease Self-Management Education (CDSME) Funding. Issue brief outlining NCOA’s rationale for $16 million in funding for CDSME in FY18.
- Issue Brief: Falls Prevention Funding. Issue brief outlining the rationale of the Falls Free® Coalition for at least $7.1 million in funding for falls prevention in FY18.
- Group letter organized by National Safety Council in support of $2 million for CDC Falls Prevention.
- Trust for America’s Health Prevention and Public Health Fund Detailed Information
- TFAH op-ed for The Hill: “Missing in the ACA debate: Funding to prevent disease in the first place”
- Straight Talk for Seniors® blog post on the PPHF
- Advocacy One-Pager: PPHF, CDSME, and Falls Prevention
- Recording and slides from Heathy Aging and the ACA webinars (Jan. 5 & 6)
- National CDSME Infographic
- CDSME Success Stories
- Falls Prevention Success Stories
- Falls Prevention Saving Lives, Saving Money Infographic
- 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 if you have questions or need additional support reaching out to your members of Congress.