Administrator and Assistant Secretary for Aging
Administration for Community Living (ACL)
U.S. Department of Health and Human Services
(Remarks delivered by Kathleen Otte, ACL Regional Administrator)
U.N. Commission for Social Development
High-Level Panel Discussion on the Family
In Observance of the Twentieth Anniversary
Of the International Year of the Family, 2014
Friday, 14, February 2014
Nature of the Family – Families Come in Various Forms
Thank you Moderator Gonzales, esteemed colleagues, Members of the Commission for Social Development and Civil Society.
On behalf of the Administrator and Assistant Secretary for Aging, Kathy Greenlee and the United States, I am pleased to join today’s event to further discussion at the United Nations about the human rights enjoyed by all individuals within a family, as we mark the twentieth anniversary of the International Year of the Family. The family clearly plays an important role within society, and we have come to observe that the nature, and role of the family, adapt over time while the family retains its fundamental value.
We believe that the family plays an essential role in the raising of children, and in fostering “an atmosphere of happiness, love and understanding,” as the recent UNGA resolution on the family describes.
We believe that social development across the globe requires stable and strong families of all types to address the important issues of poverty, work-life balance, and support amongst and between the generations, which we will be discussing further today.
Any and all UN discussions on the important role of the family must consider all types of loving families that exist today, be those families headed by one mother and father, a single parent, a same-sex couple, grandparents, or the myriad other family structures which provide essential support for raising children. It is essential that UN recognize these various forms of the family as we further address human rights and the family throughout various UN fora. In our work, we do not want to leave anyone behind.
The Department of Health and Human Services is in the forefront of government agencies working to foster strong families and to leave no one behind. Our Administration for Children & Families promotes the economic and social well-being of families, children, individuals and communities.
The Administration for Children and Families provide the following services to support and foster strong families and ensure that we “Leave no one behind.” These services include:
- Provide temporary assistance to needy families so that children can be cared for in their own home;
- Reduce the dependency of needy parents by promoting job preparation, work and marriage;
- Encourage the formation and maintenance of two-parent families;
- Promote school readiness of children ages birth to 5 from low-income families through the Head Start program;
- Prevent child abuse and neglect; support children in foster care; runaway youth and victims of domestic violence;
- Connect noncustodial parents with children;
- Provide for refugee resettlement assistance; and
- Provide social and economic development, native language and environmental initiatives for Native Americans.
Today I will focus my remarks on family members, who are often left behind, remain invisible, and forgotten in discussions of the family - persons with disabilities and older persons.
We believe that all Americans—including people with disabilities and older adults—should be able to live at home with the supports they need, participating in communities that value their contributions. To help meet these needs, the U.S. Department of Health and Human Services created a new organization, the Administration for Community Living.
The Administration for Community Living brings together our department’s programs for persons with disabilities, including intellectual and developmental disabilities, and our programs for older persons. This office serves as the Federal agency responsible for increasing access to community supports, while focusing attention and resources on the unique needs of older Americans and people with disabilities across the lifespan. Our mission is to maximize the independence, well-being, and health of older adults, people with disabilities across the lifespan, and their families and caregivers.
We believe that all people/Americans, including people with disabilities and their families, have the right to fully participate in their communities, and are protected from discrimination on the basis of disability.
Achieving real progress for persons with disabilities and their families at the domestic level has required commitment to robust laws and standards implemented through strong enforcement mechanisms.
This work toward equality and inclusion over the last decades has been based on strong domestic laws and standards (such as the Americans with Disabilities Act, the Rehabilitation Act, the Individuals with Disabilities Education Act, among others) with strong enforcement mechanism.
Effective laws and standards must empower persons with disabilities, their families and their representative organizations to be partners in this work. For example, federally-funded centers for independent living and protection and advocacy agencies are essential partners in our work to promote full access and protect the rights of persons with disabilities in the United States. We must give real meaning to the slogan “Nothing About Us Without Us.”
We have achieved some important progress in integrating people with disabilities into the mainstream of American life, and in shifting the orientation for people with significant needs from institutions to community-based settings.
We know that family members, friends, and members of the community play a key role in enhancing the lives of individuals with disabilities, especially when the family members, friends, and community members are provided with the necessary community services, individualized supports, and other forms of assistance. One important support for people with disabilities and their families may include the opportunity for social engagement, where allies can build relationships and formulate and share ideas.
It’s also important to address the significant barriers people with disabilities may experience in creating and maintaining their own families. The conversation about family-oriented policies should include consideration of the necessary supports to help parents with disabilities deal effectively with the unique challenges they face, as well as those that every family may face.
We know that families often serve as the main care providers for family members with disabilities, and in the U.S. may receive few formal family support services and face long waiting lists for services.
A full conversation about family-oriented policies must include the reality of aging parents and caregivers, and consider the role for siblings in considering strategies to ensure that families who are assisting family members with disabilities have access to person-centered and family-centered resources, supports, services, and other assistance, with an overarching goal that people with disabilities and their families have the opportunity to experience the same quality of life in their communities as their friends and neighbors. These considerations are a necessary element in a development agenda that supports people with disabilities and their family members achieving and maintaining economic independence and success.
We must also recognize that the definition of “family” must be broad enough to include grandparents and elders. And when we work to address family violence, we must not forget that older adults are part of our families. Predictions indicate that by 2025 the global population of those 60+ will double to 1.2 billion. How will we care for all of those older adults? This is a growing concern among all nations. Who will provide this care? Who will pay for it? Where will it be delivered? These are the Aging policy issues of our time. And silently, underneath this data, sits another truth. More older people equal more elder abuse.
Elder abuse is a public health crisis and a crime which impacts people around the world. I believe that the concept of respecting our elders is universal. This is not an American concept, but a human concept and cultural value across this planet.
While elders are still respected in many cultures, elder abuse may still occur. Violence against elders is real, unreported, not prevented and victims lack services.
The World Health Organization has declared that elder abuse is a violation of an older adult’s fundamental rights to be safe and free of violence.
Elder abuse is also a women’s issue. Last year, the UN released a special report on the issue of “Neglect, Abuse and Violence against Older Women.” This report concluded that “Population ageing is a global trend that is changing economies and societies around the world. The feminization of ageing, representing the intersection of age and gender, has important implications for policy as the world continues to age. It is time for neglect, abuse and violence against older women to be made visible, and made to end.”
Recent estimates in the U.S. suggest that 1 in 10 older adults experience physical, psychological, and sexual abuse, neglect, and financial exploitation. And yet only a small fraction of this abuse is reported.
In fact, so much needs to be done to advance this field that it can be overwhelming. That is why everyone needs to help. The good news is that everyone can. Elder abuse is often a subset of other social issues including the following:
- Mental health issues: Older people may struggle with depression, suicide and cognitive impairment. Older adults are targeted by criminals who prey upon their limited cognitive abilities.
- Criminal justice: Help with forensics, law enforcement, prosecution.
- Domestic violence: Late life domestic violence is different. I believe this to be true personally and professionally. I have worked at a battered women’s shelter and I have directed a statewide domestic violence and sexual assault association. Safety planning, services, financial options – they are different for older women and men who are battered by intimate partners.
For nearly 40 years, the U.S. Administration on Aging has provided federal leadership in strengthening elder justice programming designed to prevent and address elder abuse, neglect and exploitation. Some examples include:
- Long Term Care Ombudsman Program established in 1972
- National Center on Elder Abuse established in 1988
- Older Americans Act funding to support state and community-based elder justice training and community collaboration
- Recently we established an Adult Protective Services Resource Center
But we need more. For ten years, advocates worked with members of the U.S. Congress to pass the Elder Justice Act. By the successful end of that work, over 600 organizations had signed on to support the Act, the issue and the goals. The Elder Justice Act is groundbreaking in its comprehensive approach to elder abuse. It establishes a framework for enhancing the data collected by State Adult Protective Service programs, it provides for direct federal funding of state abuse investigators – the first dedicated federal funding. It helps improve the quality of care in nursing homes by enhancing the long term care ombudsman program and establishing a system to report crimes in nursing homes, and it assists States in implementing criminal background checks for employees with direct access to patients. It also provides for greater collaboration among federal agencies. This Administration is committed to helping address this huge social and criminal problem.
I mentioned that families are often the main care providers for family members with disabilities. They are also the main care providers of older family members. In the U.S., 80% of all long term care is provided by family members, often called family caregivers. As of 2009, the value of the care they provide, if purchased on the open market, was estimated at approximately $450 billion.
We have a number of programs -- the National Family Caregiving Support Program, the Alzheimer’s Disease Supportive Services Program and the Lifespan Respite Program -- that formally recognize the important role of family caregivers and the even greater importance of supporting and sustaining them in their work. The combination of respite care, combined with information, access assistance, and counseling enable family caregivers to have that all important break from their daily tasks, to rest, and to reduce stress.
But, as you know, there is much more work to be done. Working together, and continuing to share information about our challenges and our successes in meeting them, we can better prepare for our changing world. We welcome the opportunity to have a dialogue with other countries. We have much to learn from one another and collectively we can strengthen families, which are the foundation of our societies.
In conclusion, we believe that social development across the globe requires stable and strong families, of all types, where no family member will be left behind nor remain invisible. We have much to learn from one another. Collectively, we can strengthen families, which are the foundation of our societies.
On behalf of Administrator Secretary Kathy Greenlee, I express my appreciation for the opportunity to share our challenges and our successes in this changing world.