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Remarks by 

The Honorable Kathy Greenlee 

Administrator, Administration for Community Living 

and 

Assistant Secretary for Aging 

U.S. Department of Health and Human Services

Ministerial Panel

Promoting Quality of Life and Active Ageing

September 20

Madame Chair, fellow delegates, ladies and gentlemen, I am delighted to be here with 

you today, and honored to represent the United States of America. 

I extend my great appreciation to the United Nations Economic Commission for Europe 

and to the government of Austria for convening this ministerial conference. It is a 

massive undertaking to organize and I want to acknowledge your hard work to make 

sure this conference is a success. 

I want to especially thank the government of Austria, in particular the Federal Ministry 

of Labour, Social Affairs and Consumer Protection, for its generosity in hosting so many 

of our aging conferences, starting with the World Assembly on Ageing in 1982 and most 

recently, today’s conference. This is a momentous occasion, and one of which you 

should be proud. 

The United States of America, under the leadership of President Barack Obama, 

continues to affirm its commitment to the themes of the Madrid International Plan of 

Action on Ageing (MIPAA), and we attach great importance to the five and ten year 

reviews. 

Last year, President Obama stated that “My Administration is committed to meeting the 

needs and aspirations of American seniors, both now and in the future. We are working 

to improve the health and well being of older men and women with a focus on 

preventive care and community living.” 

In his recent Proclamation for World Elder Abuse Awareness Day, President Obama also 

stated that “Every American deserves the chance to live out the full measure of their 

days in health and security.”

U.S. Delegation to the

United Nations Economic Commission For Europe

2012 UNECE Ministerial Conference on Ageing

September 19-20, 2012

Vienna, Austria
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In 2007 in Leon, Spain, the U.S. reported on the progress made in meeting the MIPAA 

objectives in the first five-year review. Today I am pleased to report on our continuous 

progress and some of our challenges. I will focus my remarks on a few key areas.

The U.S. government continues to work to address the health and long-term care 

challenges of a rapidly aging population and to help individuals “age in place” and 

remain in their own homes and communities.

In 2007 we described how we empower our citizens by giving them more choices and 

greater control over their own health care. This philosophy has been expanded to 

include other types of services and benefits that lead to independence. One of the most 

significant achievements since 2007 has been the passage of the Affordable Care Act, 

passed by Congress and signed into law by President Obama in March 2010. This 

landmark legislation calls for comprehensive health reform to make health care more 

affordable, to guarantee more choice and enhance quality, to expand health coverage –

especially to key preventive services, to make health insurers more accountable and to 

make the health system more sustainable.

We know that health promotion and preventive services, starting at an early age, are 

critical to ensuring that people enter their later years at a higher standard of health and 

well-being. The Affordable Care Act provides access to preventive services and 

prescription drug discounts for seniors and also strengthens Medicare. For those of you 

who are not familiar with Medicare, it is our national social insurance program that 

guarantees access to health insurance for Americans ages 65 and older and for younger 

people with disabilities.

Since the law was enacted, nearly 5.4 million seniors and people with disabilities have 

saved over $4.1 billion on prescription drugs. In addition, during the first seven months 

of 2012, the new health care law has helped nearly 18 million people obtain preventive 

services at no cost to them. And new efforts to fight fraud and abuse have returned a 

record $5.4 billion in the last two years alone, helping to ensure the ongoing solvency of 

Medicare. 

In the U.S., we continue to move towards a more balanced system of long-term care 

which respects the wishes of the individual and shifts the focus from institutional care in 

favor of home and community-based services.

In furtherance of this goal, President Obama implemented the Community Living 

Initiative that charged Federal agencies to review programs and policies to enhance 

community living. We believe that all Americans - including people with disabilities and 

seniors - should be able to live at home with the supports they need, participating in 

communities that value their contributions. 
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To help meet these needs, the Secretary of Health and Human Services just created a 

new organization, the Administration for Community Living – which I head. The 

Administration for Community Living brings together the Administration on Aging, the 

Office on Disability and the Administration on Developmental Disabilities in a single 

agency. Our goal is to increase access to community supports and full participation, 

while focusing attention and resources on the unique needs of older Americans and 

people with disabilities.

We are encouraging broader partnerships and alliances that result in comprehensive, 

person-centered care, while continuing to support the needs of caregivers who shoulder 

the responsibility for providing the great majority of all long-term care services for their 

loved ones.

We continue to call attention to not just the needs of older people and promote 

effective community responses to those needs, but to the tremendous resources that 

older individuals bring to our communities. They represent a wealth of knowledge and 

experience and contribute to the continued vitality of every sector of our local, state 

and national communities and economies. In 2010, 23.6% of adults 65 and older 

dedicated 1.7 billion hours of volunteer service in the U.S. In building our resources for 

the future, we continue to look at older persons as an under-utilized resource, and we 

are particularly looking at the skills, education and experience that the Baby Boomers 

can bring.

Protecting the rights of older persons is a central theme running through the MIPAA 

and many global conferences. The U.S. has been actively involved in the UN Open 

Ended Working Group on Ageing which is examining how to best address this issue. We 

look forward to the February 2013 report to the Commission on Social Development on 

the progress in implementing the MIPAA, to provide us a better idea of what is needed 

to best protect the rights of older persons. In the meantime, the U.S. government 

continues to favor exploring all possible options under current human rights law to 

protect the rights of older persons.

The U.S. record on putting programs and policies in place to safeguard the dignity and 

well-being of older persons is well-established and strong. For decades we have had 

robust legislative protections and enforcement mechanisms in place, and our civil 

society organizations continue to be actively involved in these issues.

The framework for our protections is comprised of four cornerstones – the Society 

Security Act passed in 1935; and Medicare, Medicaid and the Older Americans Act, 

which were passed in 1965. These have served as the foundation for economic, health 

and social supports for millions of seniors, individuals with disabilities and their families. 

Additional protections are offered by the Age Discrimination Act, the Age Discrimination 

in Employment Act, the Americans with Disabilities Act, and most recently, the Elder 
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Justice Act, contained within the Affordable Care Act, which President Obama signed 

into law in 2010. 

The Elder Justice Act calls for the development of a comprehensive network of national, 

state and local protections; background checks of direct care workers; additional 

training of long-term care facility surveyors; enhancements for the long-term care 

ombudsman program and elder abuse programs; the development of best practices for 

member states on adult protective services and coordination with law enforcement; and 

the reporting of suspected crimes in long-term care facilities. 

All together, our laws provide protection against discrimination based on age and 

disabilities in Federal programs and employment, and provide protections against 

abuse, neglect and exploitation. They focus on affording Americans equal access to 

participate fully in society free from discrimination, and removing barriers to remaining 

productive members of mainstream society. 

Another issue that all the countries here are now or soon will be facing is the challenge 

of the growing numbers of persons with Alzheimer’s disease or related dementias. Last 

year, President Obama signed into law the National Alzheimer’s Project Act. He stressed 

that “Alzheimer’s disease burdens an increasing number of our nation’s elders and their 

families, and it is essential that we confront the challenge it poses to our public health.” 

This National Plan combines research, medical, and social services to combat the 

disease and its effects. It presents a holistic approach focused on caring for the 5.1 

million Americans with the disease, and providing services, support, and information for 

family members and caregivers. It creates a roadmap to coordinate efforts among 

multiple government agencies and the private sector to promote research, accelerate 

the development of treatment options, improve early diagnosis and coordination of 

care, and strengthen service delivery to affected families—especially among ethnic and 

racial minority populations and other special populations such as people with Down 

syndrome - who are at higher risk for Alzheimer’s. We know that France was the first 

European country to launch a national plan, and we look forward to working with them 

and other countries in finding solutions that will guide us in addressing these diseases. 

A third challenge we continue to confront across the globe is the negative impact of 

mental health issues on the well-being of older adults. Mental health issues, like 

depression, are not a normal part of aging, yet these conditions greatly impact the lives 

of many older adults. Distinctive barriers to the treatment of these conditions among 

the older adult population exist, such as their under-diagnosis and the presence of other 

health conditions. A recent Institute of Medicine report concluded that mental health 

conditions among older adults are common, costly, and often detrimental to their 

health. The report provided clear strategies for addressing the increasing need for 

health care professionals trained in geriatric mental health. 
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Recognizing these challenges and needs, AoA is currently partnering with the Substance 

Abuse and Mental Health Administration to host a series of regional policies academies 

across the U.S. to bring together state aging, behavioral health, and other relevant 

leadership to develop plans to address the mental health needs of older adults. 

In the U.S. we have accomplished a lot in the last five years but we have much more to 

do. Changing demographics, economic challenges and new technologies will shape our 

policies and programs. We like to view these challenges as opportunities. One 

opportunity which I think we would all agree to is the need for prevention across the 

lifespan. If we continue to research, encourage, support and implement evidence-based 

prevention strategies tailored for older adults and for persons with disabilities, we will 

help reduce the epidemic of preventable chronic diseases, lower their associated health 

care costs, and improve quality of life. We also need to work together to mitigate the 

social and environmental conditions that influence people's health risks ---the so-called 

“social determinants of health.”

Another important opportunity is to continue a holistic approach to health care through 

the integration of acute care, long-term care and community-based services. As an 

example, our human services agencies work with medical partners to better manage the 

transition of people from hospital to home or to other care settings. They ensure that 

people have the information, discharge plan, and individualized community services 

necessary to support them at home or in their new setting. By investing in this strategy 

we are reducing hospital re-admissions and health care expenditures, better addressing 

chronic diseases, improving medication management, and enhancing the quality of life 

for millions of Americans. 

A third opportunity is to continue investing in community and person-centered services 

that can meet the needs of an increasingly diverse population. The concept of aging in 

place is at the heart of this strategy, enabling older persons and persons with disabilities 

of all ages to remain at home and engaged in their community with the appropriate 

supports and services for as long as possible. Coordinating with family caregivers and 

others, assistance that is tailored to individual needs, such as transportation, affordable 

housing, and a range of other supportive services are central to the success of aging in 

place. 

In conclusion, we are proud of what we have achieved in implementing the Madrid 

goals but we are mindful of the challenges ahead of us as a country and globally. 

Working together, and continuing to share information about our challenges and our 

successes in meeting them, we can better prepare for our changing world. 

Thank you Madame Chair. 
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