Current or previous ACL Fall Prevention grantees are not excluded from this funding opportunity, but must note previous funding in their application and provide a strong rationale for the need for additional funding, which must include significant enhancement of the evidence-based prevention program network developed with prior funding, expansion of the program to geographic areas where the particular program(s) are not currently offered, and/or a focus on reaching a different target population.
The mission of ACL is to maximize the independence, well-being, and health of older adults, people with disabilities across the lifespan, and their families and caregivers. Falls can have a widespread and significant impact on health, can be deadly, and often result in high costs. One out of four older adults fall each year. In 2014, 2.8 million older adults were treated in emergency departments for falls injuries and more than 800,000 of these patients were hospitalized. In 2014, adjusted for inflation, the direct medical costs for fall injuries were $31 billion annually. Fortunately, research has shown that falls and fall risks can be reduced through systematic risk identification and targeted intervention, including a combination of clinical and community-based interventions. Multiple evidence-based community programs have been shown to reduce falls and/or falls risk factors, as well as provide a positive return on investment.
The Administration on Aging (AoA) has a long history of supporting health promotion and disease prevention efforts. Since 2006, AoA has provided grants and Older Americans Act funding that have helped build an infrastructure that supports evidence-based health promotion and disease prevention efforts, including those focused on falls prevention, chronic disease self-management, mental health, medication management, and physical fitness. Between FY2014 and FY2018, ACL/AoA funded 47 grants to states, community based organizations, and tribal organizations to implement evidence-based falls prevention programs. Since 2014, more than 55,000 individuals have participated in an AoA-supported evidence-based falls prevention program. For more information about ACL’s Falls Prevention Program – including profiles of current grantees – please visit: https://www.acl.gov/programs/health-wellness/falls-prevention
This funding opportunity is designed for applicants to propose how they will develop capacity for, deliver, and sustain evidence-based falls prevention programs for older adults, in close collaboration with the national aging network.
Each funding option has two primary goals.
Goal 1: Develop capacity in areas with no or limited evidence-based program infrastructure to introduce, deliver, and expand the reach (program participants) of evidence-based falls prevention programs within underserved geographic areas and/or populations.
Program capacity (including program trainers/facilitators, host/implementation sites, partner organizations, etc.) should be developed in a manner that is sustainable beyond the duration of grant funding.
For the purpose of this funding opportunity, underserved areas/populations include older adults that have experienced health disparities, including from minority and rural populations. These populations may have a high risk for multiple health problems (including mental illness), lack access to transportation, face a shortage of readily available health care providers, have mobility impairments, and encounter other significant hardships (financial, educational, and housing).
Applicants for this funding opportunity must propose one or more evidence-based falls prevention programs. These programs must be on the list of pre-approved interventions in Appendix A of this Funding Opportunity Announcement. Applications that include programs not found on the list of pre-approved interventions in Appendix A will be administratively eliminated and will not be reviewed.
Goal 2: Develop a business plan with strategies to support the proposed programs during and beyond the grant period.
For more information on business planning and financial sustainability, please visit https://www.ncoa.org/center-for-healthy-aging/basics-of-evidence-based-….
Sustainable Systems Grants
Goal 1: Significantly increase the number of older adults at risk for falls who participate in evidence-based community programs to reduce falls and falls risks.
Applicants for this funding opportunity must propose one or more evidence-based falls prevention programs. These programs must be on the list of pre-approved interventions in Appendix A. Applications that include programs not found on the list of pre-approved interventions in Appendix A will be administratively eliminated and will not be reviewed.
Goal 2: Implement new and innovative funding arrangements, including contracts and collaborations with multiple sustainability partners, to support evidence-based falls prevention program(s) both during and beyond the grant period. Additionally, embed the program(s) into an integrated, sustainable evidence-based prevention program network via centralized, coordinated processes.
Sustainable Systems Applicants must identify their intended innovative funding arrangements and the mechanism(s) in which they will use to secure these arrangements.
Please see Appendix B for the definition of an integrated, sustainable evidence-based prevention program network.
Related Federal Activities
This opportunity does not duplicate nor overlap existing Federal efforts related to falls prevention; it aligns with current efforts to maximize the impact of this funding. Some examples of existing national, state, and local falls prevention efforts that could be leveraged may include:
The Centers for Disease Control and Prevention’s (CDC) National Center for Injury Prevention and Control puts data to use to understand the burden and implications to the U.S. healthcare system across health issues including falls, the leading cause of both fatal and nonfatal injuries among older adults. Using these data, CDC is building partnerships with health systems, providers of healthcare, and those who pay for healthcare services. These partnerships will improve what is known about the burden of falls and the integration of effective fall prevention strategies and patient care. The CDC’s Stopping Elderly Accidents, Deaths & Injuries (STEADI) initiative provides resources and tools for healthcare providers. These tools include online trainings, screening tools, case studies, videos and information on how to conduct functional assessments, and patient educational materials. CDC is also working with suppliers of electronic health records systems to facilitate the adoption and use of the STEADI tools in the clinic setting. CDC also support opportunities to broaden and improve the linkage between primary care and evidence-based community falls prevention programs supported by ACL.
Related resources include:
CDC STEADI Initiative
CDC Facts on Older Adult Falls
CDC Compendium of Effective Fall Interventions: What Works for Community-Dwelling Older Adults
The ACL-funded National Falls Prevention Resource Center (NFPRC) based at the National Council on Aging, works to increase public awareness about the risks of falls and how to prevent them, support the implementation of evidence-based falls prevention programs, and serve as a national clearinghouse of tools and best practices. The NFPRC also leads the Falls Free Initiative, a national effort to address the growing public health issue of falls, fall-related injuries and deaths. The initiative includes 70 national organizations and a 43-member State Coalition on Falls Prevention Workgroup charged with collaboratively promoting effective strategies to address falls.
Related resources include:
National Falls Prevention Resource Center Webpage
Falls Free; Initiative
Falls Prevention Awareness Day
2015 Falls Free; National Action Plan
Fall Prevention Facts
Resources for Older Adults and Caregivers
Evidence-Based Fall Prevention Programs
State Policy Toolkit for Advancing Falls Prevention
 U.S Centers for Disease Control and Prevention. (2016). Facts About Falls. Accessed November 28, 2016 from http://www.cdc.gov/homeandrecreationalsafety/falls/adultfalls.html.
 U.S. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web–based Injury Statistics Query and Reporting System (WISQARS) [online], accessed August 5, 2016 at http://www.cdc.gov/injury/wisqars/.
 Burns EB, Stevens JA, Lee RL. (2016). The direct costs of fatal and non-fatal falls among older adults—United States. Journal of Safety Research.
 U.S. Centers for Disease Control and Prevention. (2015). Compendium of Effective Fall Interventions: What Works for Community-Dwelling Older Adults, available at: http://www.cdc.gov/HomeandRecreationalSafety/Falls/compendium.html
 Fuzhong L, Harmer P, Fisher JK, Mcauley E. (2004) Tai Chi: Improving Functional Balance and Predicting Subsequent Falls in Older Persons. Med Sci Sports Exerc. 36 (12): 2046-2052.
 Clemson L, Cumming RG, Kendig H, Swann M, Heard R, Taylor K. (2004) The Effectiveness of a Community-Based Program for Reducing the Incidence of Falls in the Elderly: A Randomized Trial. J Am Geriatr Soc., 52 (9): 1487–1494.
 Healy, T.C., Peng, C., Haynes, P., McMahon, E., Botler, J., & Gross, L. (2008). The feasibility and effectiveness of translating A Matter of Balance into a volunteer lay leader model. Journal of Applied Gerontology, 27(1): 34-51.
 Carande-Kulisa, V., et al. (2015), A cost–benefit analysis of three older adult fall prevention interventions, Journal of Safety Research, Accessed January 4th, 2016 from: http://www.sciencedirect.com/science/article/pii/S0022437514001170.