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 . From 2007-2016, fall death rates in the U.S. increased by 30% . In 2015, the total medical costs for falls totaled more than $50 billion .
Fortunately, research has shown that falls and fall risks can be addressed through systematic risk identification and targeted intervention, including a combination of clinical intervention and community-based programs . When implemented as a part of a results-based, comprehensive strategy, community-based programs have a critical role to play in reducing falls and falls risk among older adults and adults with disabilities across the nation. These program have been shown, though rigorous research, to reduce falls and/or falls risk factors , as well as provide a positive return on investment .
Over nearly two decades. ACL’s Administration on Aging has built an infrastructure to increase access to, and the sustainability of, evidence-based disease prevention and health promotion programs, including falls prevention programs. Between FY2014 and FY2019, ACL/AoA awarded 59 discretionary grants to states, community-based organizations, and tribal organizations to implement evidence-based falls prevention programs. Since September 1, 2014, over 100,000 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 has two goals:
Goal 1: Through robust partnerships, develop a result-based, comprehensive strategy for reducing falls and falls risk among older adults and adults with disabilities living in your community.
Goal 2: Significantly increase the number of older adults and adults with disabilities who participate in evidence-based falls prevention programs, while concurrently pursuing the sustainability of these programs beyond the end of the grant period.
Applicants for this funding opportunity must propose to deliver one or more evidence-based falls prevention programs. These programs must be on the list of pre-approved interventions found in Appendix A. Applications proposing to implement programs not included on the pre-approved list will be administratively eliminated.
Related Federal Activities
This opportunity does not duplicate nor overlap with 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 include:
The Centers for Disease Control and Prevention’s (CDC) National Center for Injury Prevention and Control provides data to use to understand the burden and implications to the U.S. health care 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 health care, and those who pay for health care 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 health care 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 supports opportunities to broaden and improve the linkage between primary care providers 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/.
 U.S. Center for Disease Control and Prevention. National Center for Injury Prevention and Control. Important Facts about Falls. Accessed September 20, 2019 from https://www.cdc.gov
 Florence CS, Bergen G, Atherly A, Burns ER, Stevens JA, Drake C. Medical Costs of Fatal and Nonfatal Falls in Older Adults. Journal of the American Geriatrics Society, 2018 March,
 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.