Congress must save the Administration for Community Living

Even before the Department of Health and Human Services announced its recent major reorganization, the media had been reporting on anticipated changes to the Centers for Disease Control and Prevention, the Food and Drug Administration, and the National Institutes of Health.

But the very last bullet on the HHS fact sheet was a complete surprise to most people: the elimination of the Administration for Community Living (ACL). Furthering this goal, on April 1, HHS fired nearly half of the ACL staff as part of the expansive HHS reductions in force.

ACL was created in 2012 to focus on the needs of both older and disabled Americans, as well as their families and caregivers. With over 11,000 people turning 65 each day, more than one in every four adults experiencing disability (including most adults over age 75), and the number of older adults predicted to outnumber children by 2034, now is not the time to dismantle ACL.

If you are an older adult, person with a disability, or a family caregiver, you’ve likely participated in one of ACL’s critical programs. Annually, ACL’s nutrition programs provide more than 261 million meals through programs like Meals on Wheels. ACL’s family caregiver supports help over 1.5 million families each year, allowing their loved ones to remain at home. Nationwide, millions of Americans participate in programs at over 11,000 senior centers funded by ACL. Independent living services assist over 250,000 disabled people of all ages, from helping people transition home after a hospitalization or nursing home stay to help getting a job. ACL’s State Health Insurance Program provides counseling to 1.8 million low-income Medicare and Medicaid beneficiaries to help them understand their options. ACL programs also include in-home supports, legal assistance, research initiatives, and support for families of children with disabilities, among many others.   

In bringing together disparate programs previously housed across the federal government, ACL strives to improve coordination of limited resources, increase efficiency, and reduce duplication and fragmentation. The aging and disability networks — made up of 2,500 state and local organizations across the country — are now working together, reaching more people. ACL has become a hub for cooperation across HHS and other departments, leading interagency initiatives around caregiving, housing, workforce, prevention of abuse and neglect, healthy aging, and other efforts to ensure both positive outcomes and alignment of federal programs. States have followed ACL’s lead, better aligning and coordinating their own aging and disability programs.

ACL is a lean agency that achieves its important mission through coordination and collaboration. It is the definition of efficiency.

That’s why we — as the individuals who founded ACL and most recently led it — are so dismayed by HHS’ intent to dissolve ACL, reassigning its programs across multiple agencies, stepping backwards towards siloed, uncoordinated programs.

Splitting up the agency is antithetical to the synergies and efficiencies that led to its creation. Aging and disability organizations have similarly reacted strongly to the news.  Since the announcement, over 50 statements and letters, representing more than 1,000 groups, have raised significant concerns. This includes the Disability and Aging Collaborative (over 40 national aging and disability organizations); the Leadership Council of Aging Organizations (nearly 70 national aging groups); and the American Association of People with Disabilities joined by over 450 organizations.

At this point, there are far more questions than answers. HHS has not identified which ACL programs will continue, where they will go, and how they will operate with drastically reduced staff. It has not disclosed what programs might be cut or even eliminated. Nor has it described how coordination will continue if aging and disability programs are spread across several agencies. Decisions are being made without any input from the aging and disability communities.

We strongly encourage HHS Secretary Robert Kennedy to rethink his plans. He should engage with the aging and disability communities, as well as states and local governments, to hear concerns and answer questions. We are confident he will hear of the value and efficiencies in keeping all of the ACL programs together. Moreover, working with stakeholders will be critical to the ongoing success of ACL’s programs.

We also encourage members of Congress to seek answers from HHS. In 2012, there was bipartisan support for the creation of ACL. Congress created specific statutory roles and responsibilities for ACL, its offices and its programs in the Older Americans Act, the Developmental Disabilities Act, and the Workforce Innovation and Opportunities Act. Congress must ensure those roles and responsibilities are respected moving forward, and provide oversight to ensure ACL’s programs will continue to serve these growing populations well.

The issue of community living for older adults and people with disabilities has never been more important. We encourage HHS to pause, think hard about demographics, and ensure that ACL and its programs can successfully meet the extensive needs of millions of Americans, both today and in the future.

Alison Barkoff served as ACL’s acting administrator and assistant secretary for aging from January 2021 to October 2024 and is now the Hirsh health law and policy associate professor at George Washington University Milken Institute School of Public Health. Kathy Greenlee served as U.S. assistant secretary for aging from 2009 to 2016 and was instrumental in creating ACL, serving as its first administrator from 2012 to 2016. Sharon Lewis was one of the founders of ACL, serving in multiple leadership roles from March 2010 to January 2016, including as ACL’s principal deputy administrator; she currently works as a health and disability consultant. Henry Claypool served as director of the Office on Disability in HHS from 2009 to 2012, when he helped found and serves as the first principal deputy administrator of ACL from 2012 to 2013; he currently works as a health technology disability consultant.