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HHS FY2016 Budget in Brief

Administration for Community Living HHS FY2016 Budget in Brief: Administration for Community Living (ACL)

The Administration for Community Living works to maximize the independence, well-being, and health of older adults, people with disabilities across their lifespan, and their families and caregivers.

The Administration for Community Living works to maximize the independence, well-being, and health of older adults, people with disabilities across their lifespan, and their families and caregivers.

ACL Budget Overview

(Dollars in millions)

Health and Independence Services 2014 2015 2016 2016
Home & Community-Based Supportive Services 348 348 386 +38
Nutrition Services 811 815 875 +60
Native American Nutrition & Supportive Services 26 26 29 +3
Preventive Health Services 20 20 20 --
Chronic Disease Self-Management 8 8 8 --
Falls Prevention 5 5 5 --
Aging Network Support Activities 7 10 10 --
Subtotal, Health and Independence 1,225 1,231 1,333 +101

Caregiver Services 2014 2015 2016 2016
Family Caregiver Support Services 146 146 151 +5
Family Support Initiative -- -- 15 +15
Native American Caregiver Support Services 6 6 7 +1
Alzheimer's Disease Demonstration Grants 4 4 4 --
Alzheimer's Disease Initiative – Services 11 11 11 --
Lifespan Respite Care 2 2 5 +3
Subtotal, Caregiver Services 168 168 192 +23

Protection of Vulnerable Older Adults 2014 2015 2016 2016
Long Term Care Ombudsman Program 16 16 16 --
Prevention of Elder Abuse & Neglect 5 5 5 --
Senior Medicare Patrol Program 9 9 9 --
Elder Rights Support Activities 4 8 29 +21
Subtotal, Protection of Vulnerable Older Adults 33 37 58 +21

Developmental Disabilities Programs 2014 2015 2016 2016
State Councils on Developmental Disabilities 71 72 72 --
Developmental Disabilities Protection and Advocacy 39 39 39 --
Projects of National Significance 9 9 15 +6
University Centers for Excellence in Developmental Disabilities 37 38 39 +1
National Institute on Disability, Indep. Living, & Rehab. Research /1 104 104 108 +4
Independent Living /1 101 101 106 +5
Subtotal, Developmental Disabilities 360 362 378 +16

Consumer Information, Access and Outreach 2014 2015 2016 2016
Voting Access for People With Disabilities (HAVA) 5 5 5 --
Aging and Disability Resource Centers 15 6 20 +14
National Clearinghouse for Long-Term Care Information -- -- 1 +1
State Health Insurance and Assistance Programs 52 52 52 --
Alzheimer’s Disease Initiative – Outreach 4 4 4 --
Paralysis Resource Center 7 7 7 --
Limb Loss /2 3 3 3 --
Assistive Technology /1 33 33 31 -2
MIPPA Extensions 18 9 -- -9
Subtotal, Consumer Information, Access and Outreach  137 119 123 +4

Other Programs, Total, and Less Funds From Other Sources 2014 2015 2016 2016
Program Administration 37 38 40 +2
Total, Program Level  1,961 1,956 2,123 +168
Less Funds from Other Sources -54 -36 -28 --
Total, Budget Authority  1,907 1,919 2,096 +177

Table Footnotes

1/  These programs were transferred to ACL from the Department of Education by the Workforce Innovation and Opportunity Act. FY 2014 and FY 2015 program funding, administrative funding, and FTE for these programs are displayed comparably.
2/  The Limb Loss program transferred to ACL from CDC in FY 2015. FY 2014 funding for this program is displayed comparably.

Full Time Equivalents

2014: 195
2015: 212
2016: 221
2016 +/- 2015: +9

ACL Programs and Services

The FY 2016 Budget requests $2.1 billion for the Administration for Community Living (ACL), an increase of $177 million over FY 2015. ACL focuses on ensuring that older adults and people with disabilities are able to live independently with the support they need while participating in communities that value their contributions. In FY 2016, the Budget prioritizes efforts to bolster nutrition assistance and other key services that help seniors remain independent, assist and support family caregivers, and increase ACL’s capacity to empower and support individuals with disabilities to live independent lives, fully integrated into all aspects of society.

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Helping Seniors Stay Healthy and Independent

The Budget requests a total of $1.3 billion for services that help older adults remain independent and in the community, including $36 million to support these services in Tribal communities. These efforts will build upon the momentum created by the decennial 2015 White House Conference on Aging, which seeks to recognize the importance of these key programs while also looking ahead to the issues that will help shape the landscape for older Americans for the next decade.

Within this total, the Budget requests $875 million for nutrition services, an increase of $60 million over FY 2015, to ensure that millions of older Americans remain healthy and independent by providing reliable access to nutritious meals and supporting evidence based innovation that will help improve service quality and efficiency.

The Budget also includes $386 million, $38 million more than in FY 2015, to fund in home and community based services to help older Americans live independently and with dignity. These services include transportation; case management; information and referral; help with personal care, including eating, dressing, and bathing; and adult day care and physical fitness programs. In combination with state and local funding, the Budget will support over 28 million hours of assistance to seniors unable to perform daily activities; more than 23 million rides for critical activities such as visiting the doctor, pharmacy, or grocery stores; and nearly 8 million hours of adult day care. These direct services assist older individuals as well as the caregiving friends and family members of these seniors by providing caregivers with relief and flexibility to attend to other demands in their lives, while also continuing to support their friends or loved ones. The Budget also includes $10 million for

Nutrition Services

The Budget includes $875 million for Nutrition Services, $60 million more than FY 2015. Of this increase, $40 million will allow ACL, in combination with state and local funding, to continue to serve 208 million meals to over 2 million older individuals nation-wide, halting the decline in service levels for the first time since 2010, when these programs received a one-time funding increase due to the American Recovery and Reinvestment Act. The number of meals served by Nutrition Services has declined in recent years due to a combination of factors, including flat federal funding that has not kept pace with the rising costs of inputs such as food and fuel, as well as tightened state and local funding that has made leveraging additional non-federal dollars more difficult.

In addition to the $40 million invested in core Nutrition Services, the Budget also invests $20 million in an initiative to support evidence based innovations that will help make future funding for Nutrition Services more impactful through improved quality and efficiency. This funding will be awarded as competitive grants to increase the knowledge of states and nutrition providers, drive improved health outcomes for program recipients by promoting higher service quality, and increase program efficiency through innovative service delivery models.

Aging Network Support Activities that assist seniors to access the resources and services they need to remain in the community, including $2.5 million that is specifically targeted to assist nonprofit service providers that work with the Holocaust survivor community.

The Budget includes $20 million for Preventive Health Services, a program that provides grants to states and territories that help educate older adults about the importance of healthy lifestyles and promote healthy behaviors, which can help to prevent or delay chronic disease and disability, thereby reducing the need for more costly medical interventions. The Budget also includes $8 million for Chronic Disease Self-Management Education and $5 million for Falls Prevention, which both support programs designed to help seniors improve their health status, with the ultimate goal of reducing hospital stays and emergency room visits.

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Protecting Older Americans from Abuse

Fighting the rising scourge of adult abuse, neglect, and exploitation in America remains one of ACL’s top priorities. The Budget, as part of the $29 million request for Elder Rights Support Activities, continues to request $25 million—an increase of $21 million—for ACL’s Elder Justice initiative to address the damaging impact of abuse, neglect, and exploitation on the health and independence of seniors by making strategic investments in Adult Protective Services, research, and evaluation activities.

With this funding, ACL will continue to develop of a national Adult Protective Services data system, including grants to states to test and develop infrastructure, while also providing funding for key research. Research in the area of Adult Protective Services is essential to the future development of evidence based interventions that will effectively prevent, identify, report, and respond to abuse of adults of all ages. ACL will become the federal home for Adult Protective Services and will develop national standards to assist all states in improving the quality and consistency of their Adult Protective Services programs.

This investment in addressing elder abuse builds on ACL’s existing consumer rights programs, which are already helping to protect seniors and people with disabilities in a number of ways. The Budget requests $16 million for the Long-Term Care Ombudsman Program, which provides support for ombudsmen who advocate on behalf of residents of long term care facilities to ensure the protection of their rights and welfare. The Budget also includes $5 million for the Prevention of Elder Abuse and Neglect program and $9 million for the Senior Medicare Patrol Program. These programs seek to protect seniors from abuse and equip them with knowledge to prevent fraud and abuse.

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Supporting Family Caregivers

The Family Support Initiative aims to identify and expand innovative state and local strategies to assist the many millions of family caregivers who support older adults and people with disabilities in their efforts to live independently.

Research published by RAND in October 2014 estimated the value of informal family care for just the elderly population to be $522 billion per year, which is more than all Medicaid expenditures in 2013. Less than nine percent of in-home supports for older adults are provided exclusively through paid services. Additionally, among the estimated five million Americans with developmental disabilities, over 75 percent live with family members, with the vast majority requiring decades of care and less than 25 percent receiving funded services. For all populations, waitlists for services continue to grow, and the number of Americans needing these services is expected to double by 2050. Families are in dire need of assistance, as “caregiver burnout” is a major contributor to placement in institutional care.

The $15 million request for this initiative will provide funds for the development and expansion of promising and evidence-based state and local approaches to supporting the largest provider of our nation’s long-term care: families. This initiative complements the FY 2016 request for $151 million for ACL’s Family Caregiver Support Services, $5 million for Lifespan Respite, $19 million to support the needs of families caring for people with Alzheimer’s disease and dementia, and investments in family support made under the DD Act. These investments will help to build the rigorous research and evidence base needed to build comprehensive, sustainable systems of family support across the lifespan.

Providing Assistance to Individuals with Disabilities while Conducting Innovative Research

ACL is dedicated to ensuring that individuals with disabilities, as well as their families, have the supports they need to live, work, learn, and play as contributing members of their local communities. ACL works toward accomplishing this goal in FY 2016 through a variety of programs, services, and research efforts.

Ongoing partnerships with states and territories include $72 million for State Councils on Developmental Disabilities, $39 million for Developmental Disabilities Protection and Advocacy programs, and $39 million for University Centers for Excellence in Developmental Disabilities.

The Budget also includes, for the first time, three programs transferred to ACL from the Department of Education by the Workforce Innovation and Opportunity Act of 2014, including the National Institute on Disability, Independent Living, and Rehabilitation Research; the Independent Living programs; and the Assistive Technology programs. The addition of these programs to ACL bolsters its capacity to help Americans with disabilities live independently and participate fully in their communities.

The National Institute on Disability, Independent Living, and Rehabilitation Research—which the Budget funds at $108 million, $4 million over FY 2015—generates knowledge and promotes its use to assist people with disabilities in performing activities of their choice in the community, while also seeking to expand society’s capacity to provide full opportunities and accommodations for its citizens with disabilities. This program focuses on research in areas such as employment, health and function, technology for access and function, independent living and community integration, and other associated disability research areas for individuals with disabilities of all ages.

The Budget provides $106 million for the Independent Living program, an increase of $5 million over FY 2015, which supports states and consumer-controlled nonprofit

organizations to assist individuals with significant disabilities in their achievement of self-determined independent living goals, as well as fostering working relationships between various entities to maximize the leadership, empowerment, independence, and productivity of individuals with disabilities. The programs transferred by the Workforce Innovation and Opportunity Act share ACL’s vision that all people, regardless of age and disability, live with dignity, make their own choices, and participate fully in society.

The Budget also provides $15 million for Projects of National Significance, including an additional $5 million in FY 2016 for a Youth Transitions initiative as part of a broader HHS effort to help young Americans with disabilities in the midst of difficult transitions and provide them with the tools and supports they need to enter adulthood. This initiative will help youth with intellectual or developmental disabilities transition successfully from adolescence and the supportive environment of school into an adulthood that offers them post secondary education and work opportunities, ultimately reducing the likelihood that they become solely dependent on Social Security, Medicaid, or other similar benefits.

The Budget also includes $7 million for the Paralysis Resource Center and $3 million for the Limb Loss program, the latter program having transferred to ACL in FY 2015 from the Centers for Disease Control and Prevention.

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Assisting Americans and Promoting Efficiency in Community Based Service Delivery

The Budget requests $20 million in new discretionary funding for the Aging and Disability Resource Centers program, which has a proven track record of success in supporting state efforts to develop more efficient, cost-effective, and consumer-responsive systems of information and integrated access by creating consumer-friendly entry points into long-term care at the community level. Aging and Disability Resource Centers make it easier for Americans nation-wide to learn about and access their health and long-term services and support options.

The Budget also requests $52 million to fund the State Health Insurance Assistance Program, which supports 12,000 counselors in more than 1,300 community based organizations across the country. These individuals and organizations provide Medicare beneficiaries who have a disability and/or are elderly, as well as those nearing Medicare eligibility, with one on one outreach and counseling on the health insurance options available to them.

The FY 2016 request also includes $31 million for the Assistive Technology programs, which were transferred to ACL under the Workforce Innovation and Opportunity Act. Assistive Technology programs support state efforts to improve opportunities for individuals with disabilities of all ages to obtain assistive technology that fosters greater independence, productivity, as well as integration and inclusion within the community and workforce.

Federal Administration

The Budget includes $40 million in funding for program management and support activities. This funding supports rent, staff, and other administrative costs, and is also used to support staff in ACL’s regional offices.

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Content created by Office of Budget (OB)
Content last reviewed on February 2, 2015