The CHIPPS program was established in 1987. It was made possible by a 5-year grant from the Henry J. Kaiser Foundation to the San Francisco Department of Public Health and the San Francisco Commission on Aging (AAA for San Francisco County). CHIPPS provided fall prevention education, home assessment, and home modification services to eligible older adults. As the grant period came to its end, program staff worked to institutionalize the CHIPPS program into the district AAA offices. However, lack of funding resulted in the elimination of the home assessment and home modification component and all but one staff member. In 1997, CHIPPS, in partnership with University of California San Francisco, applied for and was awarded a research grant by the National Institutes on Health. This grant made it possible to hire additional staff and reinstate home modification services. However, the emphasis on research rather than service provision created a difficult partnership, and a sustainable source of funding was needed. As the NIH grant ended, a proposal for permanent funding was submitted to the San Francisco Health Commission by the Executive Committee of the Department of Public Health. The arguments in favor of the proposal highlighted the CHIPPS program’s positive reputation in the community, its status as a scientifically evaluated intervention, and its cost-saving potential. However, because of competing needs for support for direct health services, the proposal did not succeed. The CHIPPS program was again reduced to a predominantly “education-only” endeavor.
The tide turned in 2005, when the Senior Action Network (SAN), a local senior advocacy organization representing over 100 agencies, decided to revive the program that offered tangible benefits for older – especially low income – adults who could not afford articles such as grab bars, night lights, shower mats, or “grabbers” for individuals with difficulties holding on to an item . SAN decided to make a direct appeal to local political leaders requesting $150,000 per year for the CHIPPS program. These funds were to be used for permanent staff and a service contract with a home modifications provider. At an initial budget hearing, SAN made a formal CHIPPS presentation to the Board of Supervisors, providing background information on fall prevention, program statistics, and testimony from seniors who had benefited from program services. SAN members then followed up with individual meetings with the mayor and a number of County Supervisors. As a final action, SAN held a public demonstration with dozens of seniors chanting, “Save our hips, refund CHIPPS!” As the result of these efforts, the mayor and Boards of Supervisors permanently allocated $150,000 for the CHIPPS program in the Department of Public Health’s budget.
Key efforts leading to success include:
- An established advocacy organization relied on policymakers willing to take on fall prevention
- The CHIPPS program had high visibility, had gained an excellent reputation, and enjoyed community support
- Program evaluation results and cost-savings information were made available