made the decision to do things for veterans in the medical sense along with you know, the tools to be able to do that. what happened last year, as sometimes happens, this large i.t. budget gets you no identified and we can now go forward. an assessment is made. they can't possibly spend that before the end of the year, so we lose $300 million in the process at a time when we really need these. he can now and not deliver what we have party approved and we were delaying that. so i think there is a timing issue. i think there is a mechanism on both ideas and we would be happy to work with you. >> thank you and i want to thank everybody for being here today. i will get into the rural cemetery and we will pose those questions.

>> thank you very much. senator moran. >> madam chairman, thank you very much. mr. secretary, in 2008 congress passed the rural veterans access to care act. this is a piece of legislation i was involved with in my days in the house. and it was signed into law that the program is now referred to as project a.r.c.h.. ..

expand this pilot so that you can take more than one community -- what happens in pratt, kansas, which is less than an hour from wichita is significantly different than what happens in atwood kansas than what happens to wichita and the difference between providers is different between those communities. while i'm happy the pilot program is going -- i'm not

certain -- i'm completely uncertain -- let me say that definitely, i'm completely certain the va has not chosen wisely as it has narrowed the project to a very small scope to determine how it works. and in that regard -- along the same topic of the c box, we have an ongoing problem similar to what has been expressed in regard to mental health by senator tester and i understand the doctor's testimony about the inability to attract and retain professionals but it's sure becoming clear to me that we have that same problem outside mental health. our ability to retain physicians in c box across rural across and i assume across the country is a huge problem and more and more we have nurse practitioners, physician assistants -- that the availability of a physician has become very limited and we have many c box now that no physician is generally present and i

understand the secretary's suggestion about i.t. as a potential suggestion. we certainly -- our vision is to make sure that we do everything as a member of the senate now to provide the va with the resources to provide the necessary personnel. and my assumption my answer will be very similar to what you told senator tester and it's the same one that i hear from folks in kansas is, it's not really a resource issue. we can pay sufficient amounts of money to attract medical professionals but we're struggling like everyone else to attract those professionals. i've heard that answer for a long time. you've said it today, doctor, in some fashion that can't be the final answer, just because everybody else is struggling to attract professionals to take care of patients we can't allow the va to have the same -- i understand the problem. i don't mean to be critical in that sense but there has to be something more than, well, everybody is experiencing this problem. there has to be a path to a

solution. >> i'm going to ask the doctor to address your question. >> i would say, senator, we -- the rural areas are particularly a channing because -- the doctor said that and our tools are really reaching out to -- and we want highly qualified -- we want talent. and our tools are what we're able to compensate, what we're able to award, recognize in performance of good people doing outstanding work. and retaining through bonuses the high quality ones. so our tools are limited. and -- but we owe you the best efforts we can to go after that talent and the biggest challenges are in the rural communities and we -- we have to --

>> mr. secretary, i appreciate your sentence that you owe us that. we understand we owe our veterans that. but i would also tell you that congress -- i owe you every tool possible to help you meet that criteria and the concern that i have is that i'm not being asked to do something to solve the problem. and so what i'm asking for is tell us what we can do to provide the assistance so that when we have a hearing six months from now or we're back here next year talking about the budget to answer whether or not there's a doctor is that -- or that we're meeting the mental health needs of veterans particularly in rural areas is not every health care provider, every community, every rural state is having the same struggle we are, help us help you solve this problem. >> okay, fair enough. >> thank you. >> do you want to respond really quickly? >> i'll try to be very quick. and thank you, senator moran.

the m.d. issue first, you're absolutely right that we all have this difficulty in certain rural parts of the country. i would say that if you look at our m.d. situation across the whole system we don't have a recruitment problem. it's very important that we focus on the fact that this is rural america. two things that we would like to do, one is that we need to expand our tuition reimbursement program to be able to provide an incentive for people to go to rural areas by reimbursing them for their tuition from medical school. the second one was an idea that the secretary had but to do something like the military does with their uniform services medical school and that is recruit people, pay for their medical education with an obligation to follow work with us in particular parts of the country. and those are two areas that we are trying to explore. >> thank you, senator. i just put a little finer point

on what the dr. petzel said. i thought that if we went into areas, rural areas, and found a highly talented youngster, great potential, and targeted that individual and got them through the college and the medical process, they'd be going home and so in the long run we would not be facing the retention bonuses and this kind of thing. you'd have provided someone for the long term as a solution to that requirement of that community. that's part of the discussion here. >> i appreciate your thoughts and please consider me an ally. we can follow up with the a.r.c.h. question later on. >> i certainly want to echo the same comments that senator moran -- i like some of these ideas that you just mentioned so i'd be anxious to participate. i know in one of our hospitals in alaska, they actually give a bonus to employees, pretty significant bonus, up to $10,000

to recruit and retain nurses because the high capacity and the need. so thank you for offering those ideas. let me also say thank you, mr. secretary, for the two staff that you sent up to alaska. i think it was last week or the week before. the chairwoman murray for sending committee staff also. it's important, as you know, to come up to alaska to understand what rural is all about. i know that you have been there. thank you for your visit and your team's visit. it makes a difference to the people there, but it also, i think, opens the eyes to a lot of folks about how we have to deliver health care in the most remote rural areas of this country, so thank you for that commitment. let me, if i can, and i know we have had some conversations, mr. secretary, in regards to the idea of the alaska card and the idea of trying to weave through this access issue in parts of the country that have limited access to veterans' care and

alaska, specifically, as you know we talk about the roadless areas. those areas of 80% of the communities of alaska do not have access by roads. so when we read -- and i noted your testimony about internet connect and then get the mobile van out there, there's no mobile van possible. the mobile van is in the air and that's the only way to get at it. so i know we've talked very positively about how to create this access and i just want to check in on an update of that. i know we have talked about the quality of care through our indian health services which is in -- it's superior to so much care that's being given today across the country and it is high quality care. and tell me kind of what -- where you think we're at at this point. i know you've been very responsive. i know we've been badgering you and you are team on a pretty regular basis because as you've seen the veterans -- all they want to do is go across the

street to an indian health clinic as a choice not as a requirement. if they choose to go to a va health clinic, so be it but if it's across the street, let's make that happen because the quality care is equal or in some cases we would argue in certain specialties of the va. what's your latest on that? >> i think, as you and i have discussed, i think you'll recall that we have put in a policy that would allow veterans from alaska to go locally and reduce the amount of veterans having to travel to the lower 48. there's a rather robust program underway there. as i describe working with the indian health service to establish it to open a lot of processes for -- especially for alaskan native veterans, but in the meantime, based on my visit

to alaska, the alaskan native consortium -- medical consortium, we've also established discussions with them. and trying to ensure that however the ihsmou progresses, that we have -- are ready to provide help to veterans who are being seen now and -- >> do you feel that's going in the right direction with the travel consortium? >> let me turn to dr. petzel -- >> are in negotiations and discussions, okay. >> thank you, mr. secretary, senator begich, i really sympathize with the ruralness of alaska and other parts of the country. while we're waiting for the mou to be finished, alaska is one of two places where we are proceeding with tribal interactions and i hesitate to use the word "pilot," to get -- >> right. >> specific agreements within a

tribal unit in alaska. i believe it's the southeast alaskan tribal association, and we are progressing in getting some arrangements made. it would be wonderful from my perspective if a veteran could make a choice and access tribal clinics if indeed that was more convenient and the quality was access and we could work out the reimbursements and that's what we're trying to do in alaska and we have another effort going on in south dakota. >> and you feel, i guess -- the ultimate question, do you feel it's moving in the right direction? >> absolutely. >> excellent. the last -- i got two quick ones, one is, senate bill 914, it authorizes a waiver that i've introduced on collection of copayments for telehealth, telemedicine. i guess the general comment -- i know that we have about 200 veterans or so, i think about 100 or so are in the program in alaska. i know others across the country, the idea with mental health services, telehealth is a

huge winner in many ways and it works very successfully we've asked that to be waived through this legislation, the co-pay so it increases the capacity of telehealth. can either one of you give me a thought, mr. secretary, of supportive -- i know anytime you take dollars away but my view, telehealth is just a money saver and especially the shortage of mental health services, this is a potential way to meld the two problems and create a new solution. >> neither i nor dr. petzel are familiar with this legislation so if i may -- >> absolutely. >> i'll provide that for the record. >> that's for senate bill 914. and we'll get you some information on that. the last question, if i can, madam chair, if i can just add to my concern under secretary shinseki -- our last call was friday from someone who couldn't get on the 800-number. it's not old. it's new. i know when i was chair of the student loan corporation, one of the things we did -- 'cause we

had a call center, as you can imagine, a lot of people upset when their loan rates changed or they didn't get their payment in or whatever it might be, so we had to go through a whole revamping of the system but the metrics we measured by were on a regular basis reported so we could see where the possibilities are. you had mentioned you're going to have -- or you have a system that you can see the metrics of success, wait time, call time, hold time, response, all those. i would want to echo what my colleague on the other side, i would really anxiously want to see that. this is our number 1 caseload work is around va issues. second to that within the va is the 8ing00 number, lack of response or inadequate response i should say. and that's current, not six months ago or a year ago. this is very current. and customer service is the name of the game. how to make sure these veterans have the services they need. is that something you could provide sooner than later so that i could get a better

understanding? >> i'm going to dive into those numbers today. >> okay. very good. >> based on the testimony. >> thank you. and i think the only solution to your issue on the i.t. is your whole department should be a two-year budget process instead of a one-year and two-year. that's my personal opinion. we still have a lot of problems. >> thank you very much. >> thank you, madam chair. i just have a couple of concerns. the budget request includes operational efficiencies that are estimated that could save $1.2 billion. that's being done in the past and -- by, you know, various administrations. last year's budget request also included operational efficiencies of just over a billion. in the past gao has really questioned whether or not those savings have come down. i guess, if they don't come about, how are you planning for the risk? what's your contingency plan if we don't see a billion dollars

in savings? >> i'm going to call on dr. petzel to respond -- since this is -- they looked at his budget for the savings, anticipated savings. but i can tell you that right off the top, $362 million saved because of dialysis using a medicare standard pay rate instead of paying the rates we were being charged previously. $200 million in proper payments because we reduced those, through the program management accountability program office in i.t., about $200 million in savings because we terminated projects that were not going to deliver, and then about another

$100 million first notice of death in which we stopped payment on veterans accounts when they transpired. in the past this has been an issue, sometimes as much as $100 million in overpayments. and for the future, we are agreed to provide as a minimum $173 million in savings, reducing waste in 2012 and 2013 and so that's part of our effort to get at the savings and efficiencies. and let me just ask dr. petzel to provide more detail. >> thank you, mr. secretary. senator boozman, the savings -- let's just go through a little bit of what went on in '11. we saved a large amount of money. the gao reviewed that and we're still actually negotiating with them about what they actually

found. the essence is going to be that we indeed can validate the savings that we claimed from the various operational efficiencies. they do have a legitimate criticism about the way we measured things and the granularity of the measurement in which we're going to be improving. for 2013, as the secretary mentioned we are going to save a large amount of money in dialysis. we've got contracts now or blanket purchase agreements with virtually every dialysis center that we used that are going to save us hundreds of millions of dollars over what would have expended had we not been able to do that. the medicare rate payment change occurred with the regulations allowing us to charge -- to collect -- charge medicare rates for both medical fee and facility fee is going to save us $100 million. that's absolute money we know we would have spent otherwise had we not been able to do that. and in the efficiencies with fee

care, again, something we could measure easily it's going to be $200 million. acquisition fees about $355 million in savings. there's a long list and i'm not going to take the time to go through that but i'm absolutely confident that we will be able to save this money in vha. >> madam chair, if i may, i have just one last comment here. we're going to look at all of this and work it hard. i've cautioned us that, in the end we have to focus on what makes sense for veterans. and i'll use dialysis as an example. we're after the best prices we can get. and, you know, if you just look at that, you may be encouraged to outsource all of it. i've argued that dialysis is something we have to retain a handle on. we should do a certain amount -- a certain portion of it in-house. why do i say that? i'm just concerned that if we provide funds and let somebody

else take care of dialysis, we ignore what a medical profession is supposed to do and that is as long as we're doing dialysis, we'll have to ask ourselves, what causes it? why do we have to do this? what are the things on the front end that allow us to deal with preventing diabetes so that dialysis doesn't become a fact that we have to live with. and i think the medical profession is the best at asking those questions and that's why i think within the va we need to retain a piece of that operation. >> very quickly. the president's posted a billion dollars of funding for the veterans conservation corps. he anticipates that will create 20,000 jobs for veterans. you know, we all agree that there's a lot of backlog in work that needs to be done in the parks and the infrastructure and those kind of things. i had the opportunity to be the chairman and then the ranking member on economic opportunity

on the house side and really worked very closely and have attended the tap program and visited with lots of veterans about their dreams and aspirations, and i have a lot of concerned spending a billion dollars in that direction. that is not, you know, kind of the direction that we were going in the committee, i don't believe. and like i said, i visited with lots of veterans and i really don't know -- a billion dollars is a lot of money. i think that could be, you know, put to good use. but for myself, i really don't believe that's the direction that we need. i've never heard a veteran express to me that's the route that they would like to go. and so, again, i just want to express some real concern in that regard. >> all right. thank you very much, mr. secretary. obviously, we've had a lot of participation by members on this time. we have another panel that needs to present today. we want to give them sufficient time and i've been called to the capitol so i'm going to submit

the rest of my question for the record and senator burgess, do you have any comments for the secretary? >> madam chairman, i'm going to submit a lengthy set of questions i'm going to ask the secretary and his leadership team a quick response to them in lieu of asking a second round of questions and would make four points to you. these are disturbing trends that i see from the information as we analyze the prior year. the va took in 430,000 more claims than were decided. two, appeals that resulted in a decision took 1123 days to come to fruition. that's disturbing. the va central office staffing increased 40% since '08. in that same time frame, human resource administration increased 80%. for visions created in 1985, we envisioned 22 visions, a total

154 to 220 employees and an annual budget of $27 million. today, we have 21 visions, roughly 1340 staff and $165 million annual cost. many of my question will be referenced to these four areas and i look forward, dr. petzel and some of the others on some of the trends that i see that should raise and do raise flags for me and hopefully would raise flags for both of us. again, i thank you. >> may i respond, madam chairman? >> yes >> i'll be happy to provide the details. i like you -- i'm concerned and watch the growth. there's been growth in the veteran population the last two years we've added 800,000 veterans to our enrollment. the va headquarters is 1% of our

budget today as it was in 2008. and it's a reflection of accommodating that growth and i'll be happy to provide the details. >> mr. secretary, thank you very much to you and your team for accommodating our committee today. we appreciate that and ask that you answer the questions that will be submitted to you by myself and the members of this committee in a timely fashion. with that, i would like to invite our second panel to join us today. and as i said, i've been called to the capitol so i will introduce the panel. i'll let our first speaker go and i will be turning the gavel over in a very bipartisan way to my colleague, senator burr. not to give you practice, only for you to do it today. i appreciate you accommodating me with this. [inaudible conversations]

>> if we can keep the room quiet as everybody changes chairs here, i would really appreciate it 'cause i'd like to introduce the panel as they're coming up. we're going to be moving now to our second panel and as they come up and join us and are seated in the appropriate places, i want to especially, again, if we can have it quiet in the room. [gavel banging] >> i want to extend a very, very warm welcome to a friend of mine from washington, bill shrer. he's the american legion's western national vice commander. bill, thank you so much for being here today, from coming all the way across the country for the tremendous work you do

and for the participation on this panel today, to bring a local perspective that i think is important for all of us to hear, so i appreciate that. he's accompanied today by tim, who's the director of the national legislative commission for american legion. we also have the witnesses here who are here on behalf today on the independence budget, carl blake the national legislative director of the paralyzed veterans of america, jeffery hall, the assistant national legislative director for the disabled american veterans, dianna zamotto of national director of amvets and the representative for veterans for foreign wears and i want to welcome to the panel tim tarantino policy director for iraq and afghanistan vets of america. we'll begin with mr. shrer and move down the table in order. the independent budget witnesses will have 15 minutes total and the american legion and iraq and afghanistan veterans of america will be given 5 minutes each. i again apologize to all of you

obviously we've had tremendous participation in this committee hearing's gone longer. i know i and my staff and all the members of the committee will be looking at your testimony. it's extremely important to us and we'll be submitting you questions as well even though we have -- we don't have a lot of members present. and i especially want to thank senator burr for accommodating my schedule as well. and we'll begin with you. >> ceremony murray, ranking member burr ranking member members of the committee i would like to thank you for the invitation for being here today and testifying on behalf of the american legion america's national patriotic veterans association organization and about the president's proposed budget for the department of veterans affairs. the american legion is grateful for the budget to deal with the needs of our nation's veterans. for those who are bourne the weight of war, of this nation we must always remember that a promise made is a promise that must be kept.

we like -- we find like-minded allies who recognize the importance and even duty to ensure that we're keeping the promise to america's veterans. chairman murray you know the importance of holding government to the promise made to our veterans, the american legion in washington state know how tirelessly you have fought for the veterans at the army medical center to ensure that their wounds of war were not being given the short end of the stick in the interest of financial savings. the american legion also knows how hard it is for this committee to have fought the va to ensure hard work on passing caregivers act and not to narrow -- i'm sorry, madam chair. and not loss the narrow implementation. we still with you in those fights and we're here because you've shone the willing miss in to listen to america's veterans and to make sure we keep this to the promise. the department of veterans affairs is dedicated to providing earned benefits to those who have served. the president's budget is ambitious and certainly an

increase of size especially when the government must be seeking ways of saving money. it's a positive step forward for our veterans, the american legion remains concerned, however, that there are areas where a lack of foresight or faulty planning may lead the va to default on the promise to our veterans. we cannot allow this to happen. one of the greatest shortfalls is to proposed budget for a major or minor construction. ..

>> yes these are serious needs and thus requires billions of dollars in funding and these dollars are those we cannot afford not to spend. we cannot do nonveterans to be an agent, to be place in ages facilities and not meet their most basic of needs. if we fail to function construction now or break a promise once again to our veterans. must contend with his budget. we must also look closely to the va. it intends to spend the money and where they spend the money to make sure it's not based on smoke and mirrors but on real money that will be there when veterans need it most. ambitious prospects in the budget for medical care collections fund our unfortunately based on premises. the american legion fears that this would not bear fruit in the

real world of 2013. setting aside even concerns that the oig found in an effective process our cost-cutting for the va over $110 million annually in revenue were unable to be collected. is a great concern that the proposed increases in the billing amounts. ea's new budget proposed to build private insurance that preferred provider me. resident current medicare rate. this change though it reflects 90% of proposed increase in this area of the budget. frankly, this has never been authorized before and even if authorized the va would be hard-pressed to meet these overly optimistic budget targets. when you fail to generate the necessary revenue, va will be forced to find savings elsewhere in the budget and, of course, that means more broken promises to our veterans. finally we concerned about the overall budget prospect as a whole industry the times, the fiscal strife in the governor. sure this committee is aware of

the pessimism of the american people. regarding the ability of cost to come to terms and to capacity complete budget will ignore certainly worked tirelessly to break these budget deadlocks, and surely share the frustration of the people, when we cannot reach these decisions, including resolutions that have measures make for uncertain planning. while a vast appropriations offers relief they're still projects that languish waiting for started. contracts that linger waiting for approval. operating budget of the government moves from month to month. questions remained about the protection of sequestration and whether this too will suffer and across the board cut of 2%. despite the same protection from previous interpretation of budget controls. va planners need a stable environment to ensure seamless benefits for the veterans they serve. more important to american veterans need to see this for themselves. chairman murder, that concludes my report, and since we will be

taking questions right now, again thank you, and you, senator burr, for allowing me to be here. >> madam chair, centerburg on half of the co-authors of the independent budget, please to be here today to offer our views on the administration's budget request for fiscal year 2013, advance appropriation for fiscal year 2014. in interest of time to limit my comments to just a couple of concerned with particular issues there in the budget request. first let me say up front we sort appreciate the increase the administration has provided for in its budget request. that being said, we have real concerns as it is also by the committee members hear about the impact of sequestration may have. simply put, we probably find it absurd with six was after the budget control act was passed they're still the definitive position on whether not via programs in particular health care programs are protected from sequestration. i think to come in and all the

moves of congress who made a clear and i think it's time for a final decision to be made. with regards to some specific issues in the budget request, we act with the concerns that race to dubai mbs of the committee with regards to medical care collections and the roller coaster ride that has existed in recent years into committee estimates for that. we also agree with the concerns that were raised about perceived management and the program improvements in efficiencies and those savings are ever realized. probably the largest or single biggest concern that we have, however, is what the particular disclosure in the president's budget that outlines what they have said is approximate $3 billion access in resources that are provided for fiscal year 2012, and about $2 billion in excess resources for fiscal year 2013. this makes the question, how can the administration to say that they have $3 billion in excess resources for this fiscal year

with fully seven months as a fiscal year left to go? we all hear the stories about shortages in staffing and those questions were raised earlier in all these different things, and it should sort of boggles the mind that we suddenly have this excess resources or not talk about a small pot of money needed. we're talking about 5% of the va budget. particularly troubling in light of the fact that the g20 in chile face a cut of 2% under sequestration, so we would certainly encourage the committee and all the members of congress to really investigate this and get to the bottom of this. this single fact could pose a bigger problem for the d. in his delivery of care than any of issued and the va has faced we believe in the coming years. this year and in the coming years. with regards to fiscal year 2014 advance appropriation i would highlight a couple concerns we have. first with regards to the increase of medical support compliance. i would point of fact that's that's a pretty substantial increase projected for 2014. this is not unlike some of the comment you made about the growth of the administrative

function within dha. at the same time, advance appropriation provides for a very substantial decrease in medical facility. i missed and some of that is based on a sunday that they will transfer a certain amount of money and some fde from medical facilities into medical services, it also is continued on a cut and nonrecurring maintenance of almost having that account. i think in a lot of discussion in recent years about the impact and what effect it's having on the facilities, the committee should certainly be interested in looking into that further and i know my colleague from the dfw will probably touch on this as well. so with that i will leave, i'll conclude my statement and be happy to take any questions you may have. >> thank you. mr. hall? >> on the half of the disabled american veterans and as a co-author of the independent budget i'm pleased to be at the map of our 1.4 million members to offer our views and

recommendations regarding the independent budget for fiscal year 2013 as it relates to veterans benefits programs, judicial review and the veterans benefits administration. as you know we're not in our third year of dbas latest effo effort. over the next year will begin to see whether those strategies to transform the people, processes and technologies will finally result in a cultural shift away from a speed and production into a business culture of quality and accuracy, which to assist to lead the only way to get the backlog of claims under control. although we've been very please with vb is increasing partnership and collaboration with stakeholders, we urge this committee to provide constant and aggressive oversight of the many transformation activities taking place throughout this year. grabs the most important initiative as you know is veterans benefits management system which is scheduled to begin its roll out nationally in

june of this year with final completion of the rollout in late 2013. so as vba works to complete and deploy this vital new i.t. system, it's absolutely crucial that sufficiently forces are provided. we do note, ranking member burr, that it drops down from $148 million in fiscal year 2012 and $128 million in fiscal year 2013. while we don't know the reason for the decrease in the budget, we cannot emphasize enough the vital importance of the vbms and the need for the sufficient funding and/or to complete the development and implementation. we hope this committee will thoroughly examine whether that level of funding is sufficient also. in order to sustain vba's transformation efforts, fiscal year 2013 recommends maintaining current staffing levels in most business lines, given a large increases in case processes over the past few years we believe vba should be focusing its

efforts on properly training new and existing employees with an emphasis on quality and accuracy to ensure that claims are done right the first time. we know that the vocational rehabilitation and employment service budget proposal for fiscal year 2013 does request funding for approximately 150 new counselors, designate for the expansion of the integrated disability evaluation system and the vet success on campus program. we fully support both of these increases and these progress. however, energy reach the target of having won council for everyone hundred 25 veterans served, they will need approximate 195 additional counselors in fy 2013 to accomplish this. additionally the independent budget is also recommending a staffing increase at the board of appeals. although the board is authorized a 544 full-time employees, it's adopted budget for fiscal year 2012 only supports 532. and for fiscal year 2013 the

budget request further would reduce that number to 527. looking at the historical appeals rates and rising number of original compensation claims, they recommend that vba be provide sufficient funding for and authorized workforce of come in fiscal year 2013, of at least 585 full-time employee equipment. finally, be once again call on congress to enact legislation to finally end the in ecuador prohibition on concurrent receipt for all disabled veterans and eliminate the unfair offset between the survivors benefit plan and the dependence and indemnity compensation. ranking member burr, this concludes my statement. i would be happy to answer any questions? >> thank you, mr. hall. >> good afternoon, senator burr. on the. on the half of amvets and the co-author of the id, i think it was opportune to share our recommendations with you today. my main focus will be in ca, or the national cemetery administration.

the single most important obligation of the in ca is to honor the memory achievements and sacrifices of our veterans who don't know who serve in this nation's armed forces. these acts of self-sacrifice by our veterans obligate america do not only preserve but to rehabilitate and expand our national cemetery system as necessary to meet the needs of american veterans. these venerable and commemorative spaces are part of america's historic material culture. they are museums of art and american history. they are fields of honor and hallowed grounds and they deserve and require our most respectful stewardship. the sacred tradition of our national cemeteries began in 1862 when the earliest military graveyards were situated at battle sites at field or general hospital, and a former prisoner of war sites. and since that time more than 3 million burials have taken place within the nca system.

the ncaa currently maintains stewardship of 131 of our nation's 147 national cemeteri cemeteries, as well as 33 soldiers lost which are currently located in 39 states and puerto rico. as of late 2010, there were more than 20,000, 21 acres of historic landscape, funerary monuments and other architectural features, including within established nca sites. the estimates that of the roughly 22.4 million veterans alive today, that approximately 14.4% of them would choose a national or state veterans cemetery as their final resting place. with the transition of an additional 1 million service members in veteran status over the next 12 months, this number is expected to continue rising until approximately 2017. in fy 2011, they nca which is

the nation's largest cemetery system, invested an estimated $31.49 million into the national shrine initiative, and its efforts to improve the appearance of our national cemeteries. in order to adequately meet this demand for internment, great site maintenance and related essential elements of cemetery operations, the ibvsos recommend $280 million for the nca's operations and maintenance budget in fy 2013 with an annual increase of $20 million until the national shrine commitments operational standards and measures goal regarding height and alignment of headstones and markers, as well as the appearance of great sites, our rates. finally, the ibvsos column the administration and congress to provide the resources needed to meet the critical nature of the nca's mission and to fulfill the nation's commitment to all

veterans who have served their country so honorably and faithfully. that concludes my statement and i'll be happy to take any questions. >> thank you. >> ranking member burr, on behalf of the more than two main members of the veterans of foreign wars in our exit was don't think for the opportunity to testify today. in partnership with, that the denizens of the to take care of construction accounts of limit my remarks to that. every effort must be made to ensure that facilities are safe insufficient if i was to deliver care. since 12,000 for the musician and he has grown from 80% to 121%. the facility conditions have dropped from 81% to 71%. this is having an impact on the delivery of health care. to determine and mars the conditional facilities, va conducted a facility condition assessment. these assessments include inspections of building systems such as electrical, mechanical,

structural and architectural safety. efca review team can grant a rating of in a two in f. and a two seat is either a new condition, the facility or an average condition of facility. and f. means the condition of the facility requires immediate attention. to correct the deficiencies of the keys and asks, va will be to invest nearly $10 billion. va is requesting $400 million for four of the 21 partially funded vha major construction projects in fy '13. leaving well over $5 million remaining in partially funded projects dating back to fiscal year 2007. these projects include seismic deficiencies, improving spinal cord injury centers, completing a polytrauma-blind rehab and research facility, as well as expanding mental health facilities. this request is too low to sport the ever growing need of veterans. therefore, the id partners

request congress provide funding of $2.8 billion to cover all major construction accounts. this will allow va to complete all can kashmir mental health center and fund the four be identified projects for fy '13. although the a's funding request for my construction accounts is lower than the ib's request, this level of funding will allow va to fund more than 120 projects. even though nonrecurring maintenance is funded through these medical facilities account and not to the construction account, it is critical to the is capital infrastructure. the is requesting $774 million in nrm for fy '13, but to keep pace with need and reduce the backlog of nrm, $2.1 billion is needed. the ib is not requesting this amount of money for nrm, only point out the actual need to reach das -- that's the amount needed to reach these strategic

goals. enhanced use lease gives the gifford to lease land and buildings as long as the lease is consistent with va's mission. although enhanced use lease can be used for a wide range of achilles, majority of these leases resulting housing for homeless veterans and assisted living facilities. in fy 2013, va has 19 buildings or parcels of land that a plan for enhanced use lease. out of, this authority has expired and we encourage congress to reauthorize enhanced use lease. so va can continue to put underutilized space to work for veterans. ranking member, this concludes my testament and i look forward to questions. >> mr. tarantino? >> senator burr and neighbors of the committee, thank you for my me to testify and represent the 2000 members and supporters on the present fiscal year 2013 budget request.

my name is tom tarantino and and the deputy policy director for iab. i proudly served 10 years in the army begin my great as an illicit reservist and in thing service as an active duty calgary author although might uniform is now a student i am proud to work with us congress to the backs of american service numbers and veterans. while we are pleased with the administration's recommendation that the va needs increase resources to adequate care for veterans of iraq and afghanistan we believe the va health care must be fully funded to the level recommended in the 2013 budget. even though the proposed va budget does show a 4.5% increase over 2012, it is still more than $4 billion less than what the independent budget recommends. i'm also deeply concerned that congress has not passed the regular budget in what actually is used. fortunately, congress has maintained be a funny both current and in advance and the various continues resolutions and ad hoc appropriations bill.

however, we are concerned that if this innovative budgeting process continues, advanced funding is meant to provide for the health care may you really. when political concerns and dangers brinkmanship threaten va, it's the veterans and service members who can least afford to bear the burden that get the impact. we are at a critical juncture for both service members and veterans. as the department of defense budget shrinks, threatens to earn benefits like health and tricare, active duty and reserve component is plenty shed over 90,000 active duty servicemembers over the next two years, the workload on the va system is only going to increase. so failing to fully fund the va or appropriate the budget in fans would inflict plane -- pain and hardship on thousands of veterans. among the most useful program administered by the va are its educational programs. more than 70,00 70,000 veteransa feminine touches the post-9/11 g.i. bill to further their education, increase the job skills, and secure

employability. one of the single greatest threats the success of the future the g.i. bill is the lack of useful metrics and subsequent inability of the va and state approving agencies to prevent fraud, particularly in the realm of for-profit schools. iava recognizes the -- providing in vital resource for many military members and veterans who do not need or wish to pursue a traditional education. as pointed out in the independent budget, many for-profit schools are simply not holding up their end. for-profit schools receive more than a third of g.i. bill funds while accounting for less than a third of g.i. bill graduates. it does not appear we're getting veterans the tools they need to make sound educational choices. iava recommends a three-pronged approach that is necessary to solve this problem. first we must collect useful data on both student and institutional success. without mandatory uniform data collection across the board, private public profit,

not-for-profit, we will never be able to give students the tools to make the education choices that meet their needs. we also need a clear comprehensible and easily accessible consumer education prevention. having data on schools is useless unless we can present to students in a manner that they can digest. they should include both online methods of comparing schools as was a commitment to increase educational counseling for veterans. and, finally, we have to ensure that the free and open market can weed out poorly performing schools by changing the 90/10 rule to include in classified dod and bea benefits as government funds because they are. all of this must be as he with one goal in mind and as to preserve that g.i. bill. preserving the integrity should be top priority for every lawmaker on capitol hill. the benefit that it provides upward economic mobility for individuals who participate but it benefits their entirety many as a nation and the nation as a

whole in the long run. i would like -- like the post-9/11 g.i. bill -- i'm sorry. the original world war ii returned $7 in taxes and economic output for every dollar that was spent on the program. like then, the post-9/11 g.i. bill is currently threatened by schools that their whole existence is separating veterans from their hard earned benefits. america's new veterans also face serious employment challenges. congress took bold action last year to in passing that out to hire here's act and we think this body for the record this year train forced entry to help intimate this law so that

veterans can get back to work but we also hope that congress will continue to focus on the veterans who do not choose to go in the workforce but you to go to record to school so that they can get the job training that they need. i thank you for your time and attention. >> mr. duncan, think of it have all the names of the going out like to thank the entire panel for your willingness to be here. let me make every assurance to all of your test was are in their hands. i would also ask you to make yourself available to all members and the committee for questions that will follow up this. i like to make a couple of comments, and then ask one question at the end. mischer tarantino, i agree with what you just said, the data is absolutely essential to our ability to evaluate what we are doing, but more important effectiveness of what we're doing. i might throw a cautionary note out. not all individuals who leave active duty are after a degree, but most are after a career. and when you start looking at

placement, you may find out that the assessment that we make about one institution versus another institution is actually reversed. and that those that maybe don't do a good job of providing a degree do a great job of providing the tools for a career. and i think that's what we've got to stay focused. many of you have heard me with our colleagues at the va, as i've question the need for our focus is done delivering a product to veterans. and i will work with the secretary and his leadership team, if they need close-ups in central office or they need plus ups in public relations or whatever it is. but the only way that i will sit still is if i know that the core mission of the va which is to deliver that benefit to the individual servicemembers is being fulfilled. so, ms. zumatto, you talk about a national cemeteries.

secretary tomorrow was here. you know she didn't get any questions. i will speculate. he is doing a damn good job. because he understands what the mission is, and we've got work to do. i think he would be the first to admit it, but he's not losing focus of exactly what that threshold of accountability is going to be for him. and i appreciate you pointing that out. i think all of you have questions of sequestration. i have them. one, i don't think they should have ever been something that we entered into. i think that congress is here to do our job. it's not to leave it up to a server commit or a group of individuals that then decide that we would rather punch the ball then throw it. i think it's time for us to do our job, it starts with doing a budget, required by law to do when annually. without a budget it's hard to do appropriations bill. it's a very simple process.

karl, you pointed out dollars that had been designated as not needed. 3,000,000,002,000,000,000 respectively. i have the same concern, how in advance, so far in advance we can identify that. and i think if you go back, all of you, when we started working on defense appropriations, just one of the concerns that skeptics had that you have a plus-up on to find out it was initially can be shipped somewhere else or to grow something. so i think the chairman is committed, as i might, to get to the bottom, work with va, try to understand how this happened, and quite possibly talk about different ways to reprogram money. i know from a standpoint of the intelligence community, when an agency that is under our jurisdiction wants to reprogram money, they've got to get approval from us to reprogram that money. i think that's probably a wise thing, and we will look at any

potential changes that need to be made. some of you mentioned, and i'm sure all of you who are concerned about construction and maintenance. i'll just make it personal observation. facilities are crucial to the axis and the quality of care that our veterans have received, and the future. we are in the 21st century, and medicine is changing. i won't comment on other states, but in north july, dr. petzel knows this, i've got to facilities that were bill in the 1950s. they are not constructed in a way to put in an mri machine, much less some of the new technology that is going in. even to run a computer that's networked means drilling through walls that were never intended to have holes. .. that super

outpatient facility that can handle 95% of the veterans' needs. it will take us whole to do it but we will never get there if we don't build that in to our long-term and short-term maintenance requests, construction requests. i think that i could question whether the total that's in the budget this year even comes close to handling just the maintenance needs that we have

in existing facilities and i think you probably agree with me on that. those are some of my thoughts having heard your testimony and try to put it in perspective with what we've heard from the va and what the administration's budget proposal is. i would pose one question to each of you, if you want to respond, you can. what trends do you see, that you haven't highlighted in your testimony, that you think should be alarming to our nation's veterans and to policymakers in washington? and i'll just start down here and go down the line. >> ranking member burr, the wounds were about ptsd and agent orange. the signature wars today are about ptsd and tbi. the stigma has never been taken off ptsd. and the young warrior is suffering symptoms. we need to remove that and tbi,

a good analogy. former players in the nfl are currently suing the nfl because they're suing from concussion that goes back 30 and 40 years and these symptoms are now manifesting themselves. what will our warriors suffering from tbi today be facing in 20, 30 years? and what are we going to do about it today to ensure there's something there tomorrow to take care of them? thank you. >> fascinating thing in high school football today many schools today are getting a baseline that they can establish for players so that as you have individuals who have concussions, you can compare after to the baseline to figure out whether there was a brain change. novel approach but we're beginning to recognize the importance of that maybe we will from the standpoint of military personnel as well.

carl? >> i would frame my a broad base about the health care brand of services. while the va sort of shows this trend in its budget this year but when they return the next year the demand trends spiked higher than what they originally projected which how you end up with excess resources when you have a demand curve that's much steeper. as far as something to think about in the near short term, long term with regards to demand, we have to keep in mind that we're basically drawn down in iraq now and at some point in the near future we're probably going to draw down in afghanistan and while there's a commonly held belief the demand will have a plateau because of the aging belief of renz we don't believe we have gotten to that point and we believe you can see a higher spike for demand of services as you have these individuals who are now out of iraq and who may be leaving the service and who will eventually be returning from afghanistan and presumably leave the service as well so we have to make sure we are in a

situation where we are able to meet their unique health care demands while continuing to meet the demand of the population of veterans that the va serves today. >> when i made the comment earlier to the secretary, which will be in the form of a question that the va took in 430,000 more claims than were decided, it's not to give the va a black eye. it's to say, let's make sure that our expectations on what we can accomplish are rational. it's hard for me to believe that you can have 430,000 more claims this year and within a three-year period we can eliminate the backlog. under my calculation, you're going to have to process 150,000 more claims than you take in every year to eliminate the backlog. if you just look at what's in front of us in additional claims to come in, i'm not sure you could make a rational statement like that. i hope through our dialog we're able to get not just on the

disability side but throughout the va, a rational discussion about what expectations got to be -- there's got to be accountability. >> i would just like to follow up with that exact point regarding the disability claims process as you're well aware. v absence has a lot of parts in motion and with a complete transformation process that we're looking at over the course of the year. i'd like to commend va on one aspect, and that is, it's very, very difficult and challenging to not only transform an antiquated system into a modern paperless system, same time reducing the backlog. so while they're working towards reducing the backlog, that's why we want to ensure on maintaining quality and accuracy. as far as a specific trend, veterans as you know communicate

electronically, va is trying to get there with their i.t. system and as my comments had mentioned earlier about the vbms system, we hope it gets there as well. but we just don't know what the outcome is going to be. we know that there's positive results coming out of it from the test stations and we'll to have wait and see what happens when it goes out nationally. but i guess the best would be that we're cautiously optimistic about that, but veterans demand that modernized system and va is trying to get there and hopefully we can get them together. >> i agree with you. va deserves credit for trying something different. none of us know what will work. i would only say in the time that we've designed this and begun to implement it, the trend that i can't ignore is that in 2008, our productivity per fte

and the claims processed were 85 claims per year. today, 2011, 73.3 claims per year. alarming to me -- i'm hopeful the i.t. thing will be the solution but we've taken our eye off of what we're producing out of the current workforce and roughly getting 14 less claims that processes claims and when you look at that trend, that's -- that's very troubling from a standpoint of if this doesn't work we start at a new lower baseline of productivity and the ability to have the backlog is not as long >> thank you, senator burr i appreciate your comments and i agree with all the comments made with my ib partners as far as

nca having any alarming issues, i don't think i have the expertise right now to speak to that, but i will be meeting with the folks at the nca and if i come up with something i'll let you -- >> share it with us. >> thanks. >> i think my testimony pointed out my concerns with construction, but i want to touch on another issue that we've ignored in the past, that has led to lack of research in other areas. i'll use agent orange as an example. it's taken us 40 years to where we are really taking care of the folks that are affected by agent orange. we can't let that happen to folks who have been exposed to burn pits. we lack the science to identify it, to diagnose it, and to treat it. we need -- we need research dollars and we need research dollars specifically for burn exposure. >> i hear you loud and clear and

as the guy that's trying to get the same thing done for camp lejeune victims i hear your warning and frustration. >> senator, we're alarmed about the lack of clarity with the high suicide rate among veterans. we do a pretty good job of tracking after active duty but we don't have any clear idea of the suicide epidemic in the veterans population. the va does a good job -- or a decent job of tracking veterans within the system but in terms of oefoef veterans that's just as half which means half of iraq and afghanistan veterans never step foot in the hospital and we have no idea what's happening out in that population. and so when we're looking at the budget and increases to mental health and sort of this shotgun approach to mental health where we're trying to develop programs of awareness but we're not doing it in a targeted fashion. it's one thing to increase

awareness about stigma and have suicide campaigns but if you don't know what are the problem areas, what are the methodologies and, you know -- what type of issues are those service members facing, then you're basically crawling around in the dark. and so what we're proposing that we need to have a national effort to track veteran suicide in all 50 states. there's a couple ways to do it. i'm happy to talk about it with you offline but until we do that, we're never going to get our hand around this issue and we're never going to solve this problem. >> i think i can speak for the chairman in saying that the committee is committed to do a much better job at understanding the problem and the trend that we have had it more alarming and to speak for the va, i think they take this very seriously. in our last hearing relative to progress we were making, one individual, and i put this caveat in, their responsibility

was the hotline. said well, the progress is evident by the fact that we're getting more calls to the hotline. now, when you look at things franchise overall architecture, when you get a call to the hotline you got a much greater problem out there than what you've might have thought. so i think we've got to connect these things within the administration to understand how to interpret like an increase in calls but i think we're all committed not just in the veterans population but in the active duty force to make sure wherever these pressure points are that we find a way to relieve them long before we reach a suicidal end. let me take this opportunity -- you have been patient with us and we did have great participation from members today. i want thank you on behalf of the chairman and you for your willingness for the insight you give us and for the time that you put in to not only your testimony but your proposals.

this hearing is adjourned. [inaudible conversations] [inaudible conversations] >> nearly half a million people started looking for work last month. and according to the latest unemployment report, most of them found jobs. the large number of people streaming into the workforce kept the unemployment rate unchanged at 8.3%.

even though employers added 227,000 jobs for the month.

>> ernest hemingway's work still influence readers today but not many people know about his work as a spy during world war ii. >> there were a couple of instances that he was aware of, a german submarines approaching fishing boats saying we'll take your catch and your fresh food. so ernest says well, i'm waiting for them to come alongside and then my players are going to lob hand grenades down the open hatches and the other members of the crew are going to machine gun the germans on deck. >> military and intelligence historian nicholas reynolds on hemingway, the spy. sunday night at 8:30, passionate of american history tv this weekend on c-span3. >> the national association of attorneys general recently held their annual summit here in washington, dc. they're the top elected legal officials in their states. in this nearly two-hour session attorneys general discuss some of the challenges they're facing

and they share solutions. [inaudible conversations.)l>> we have a color guard standing patiently so i think we ought to go ahead and get going. good afternoon, and welcome to the spring meeting of the national association of attorneys general. i'm rob mckenna this year's president of the national association. it's my pressure to welcome all of my fellow ag's, our guests and members of the media to our spring meeting. first i'd like to introduce the color guard from the spin garn junior high school junior rotc who will conduct the ceremony. so please stand. ♪

[color guard] [color guard] >> please join me in the pledge of allegiance. >> i pledge allegiance to the flag of the united states of america. and to the republic for which it stands, one nation, under god, indivisible, with liberty and

justice for all. [color guard] [color guard] [applause] [applause] >> so please be seated. again, thanks to the spin garn senior high school jotc for the

color guard presentation. well done. we have 49 attorneys general attending this meeting seated alphabetically by state and territory around the table. and i'd like to take this opportunity to introduce two new attorneys general who were appointed to office early this year. please join me first in welcoming alaska's new attorney general, michael geraghty, right here. michael, welcome. [applause] >> and new jersey's new attorney general, jeffery keasay who's not introduced. his loss. we'll introduce him later. it's now my pleasure to introduce our host attorney general urban nathan from the district of columbia. [applause] >> good afternoon, thank you very much, attorney general mckenna. it's my pleasure to address my necessarily n.a.g. members for the second time as the host of

the district of columbia. i'm sorry for the weather today, but i am assured that it's going to get warmer and sunnier in the next few days and that's not just because of the hot air of the introductions that i'm about to make. in my first year as attorney general we've been fortunate to have a very productive collaboration with many of you at n.a.g. we have appreciated the perspective and time given by n.a.g. and it's executive director and several attorneys general to inform our thinking on challenges and opportunities that we face now because our office is transitioning from an appointed attorney general to an elected attorney general which begins in 2014. in addition, we recognize and value the fine work by many of your offices on amicus briefs and letters to others that we're glad to join and have helped the district have an ability to have

its voice heard on national matters, an issue of particular importance to us in light of the lamentable and unjust situation that we have no voting representation in congress. we've also been fortunate on behalf of our 600,000 citizens to have the opportunity to work on and join in some of the important multistate settlements that our collective resources have made possible. most of you have been in washington before and i want to welcome you back. for those who appear for the first time, i encourage you to take advantage of the wonderful things in our city, the wonderful things it has to offer including historical and scenic sites, good food and other taxable events. we've had an exciting year here in the district of columbia in our office. i'll mention just two items that i think are related to the overall topic of this meeting that is opportunities and challenges in state-federal

relationships. first, we investigated and filed suit and obtained a settlement and a consent judgment against a sitting member of our local legislature for diversion of funds from the district. it took $400,000 that was intended for little league baseball and put it in his own pocket. this is the first time in history that our office ever sued a sitting council member. we referred to criminal matters to the u.s. attorney's office which secured a guilty plea and the individual's awaiting sentencing. i point this out because we worked closely with the u.s. attorney's office in dc which understand congressional legislation has jurisdiction to prosecute major felonies in the district. and while we take no pleasure in this result, we think it sends an important message about the role of our office is prepared to play in cooperation with the u.s. attorney's office in government ethics in the district. the second major thing was we

settled as the presiding judge of the u.s. district court here put it, a major and historic achievement in the so-called dixon case which ended federal oversight of our department of mental health in a 37-year-old class action lawsuit. the judge mentioned that two judges have died while presiding over the case and he was very glad that we did this before we met his maker. it's interesting in this matter to see how the insights of the supreme court's 2009 decision in horn are playing out in various jurisdictions around the countries -- around the country as states and localities evaluate what to do about long-standing federal consent decrees. we believe this case is a harbinger for more success in the district towards our goal of ending the intrusive and expensive federal judicial oversight of local government agencies. and finally, the issue of federal control over the district brings me to the main point i wanted to make today and

that is the ongoing and shameful denial of the basic right for voting representation in u.s. congress for as i said, the 600,000-plus residents of our nation's capital. one of our government's major challenges in the district is that our fate is linked to what is happening or sometimes not happening on capitol hill. a federal shutdown, because of a budget impasse which thankfully is not being bruted about at the moment has created real possibility of closing down our local government as well and including with that is our local school system and other basic local functions and making things worse under current federal law the district without congressional authorization can't spent any of the $1 billion in local taxes that we generate and collect annually. and, of course, compounding this problem is that we have no representation to vote in the

body making these decisions. as you know, this is not simply a matter of local concern but one of national, international and certainly regional consequence. it is or at least ought to be a national shame that as a people throughout the world strive for self-determination, with the support of our federal government, in our nation's capital, residents lack this basic fundamental democratic right. our license plates accurately proclaim taxation without representation. our mayor vincent gray has made this a major priority issue to raise the profile of this issue. and as utah's attorney general rightfully noted several years ago in his testimony to congress, this is a matter of fundamental equal and civil rights. i'm heartened to see that leaders across the partisan spectrum like general shirtif take a stand on this issue and more recently governor mcdonald

from virginia came out publicly in support of budget autonomy for the district recognizing that what happens here can have a ripple effect on a regional economy and the citizens of virginia and maryland who work and obtain services in dc. i'm very grateful that gatherings like this can bring before a bipartisan group, this vital matter. as the chief law enforcement officers and your states committed to justice and democracy, i hope you will join me in raising your voices on this critical civil rights issue. for now, though, i just want to extend a welcome to you, wish you well at this conference, enjoy your time here in the district and let me or my staff know if we can be of any assistance to you, thank you. [applause] >> i'd like to take this opportunity to remind all of you

in attendance that you're cordially invited to the summit in seattle. as you know, this year's focus is pillars of hope, attorneys general united against human trafficking and we're just putting the finish touches on what is a very powerful agenda. we've invited experts from across the country, from government, from nonprofit organizations, from the business world who will be joining us to offer their solutions on how to tackle this growing national and international problem. registration forms are available at the n.a.g. desk out on the foyer and you can also register online on the n.a.g. website. we hope you can attend and i think you'll find it to be a most worthwhile and powerful presentation. i want to thank the members of the leadership cabinet that we formed around the initiative, those ag's who have been working on this program and all their staffs. they have been absolutely phenomenal. now, for the spring meeting agenda, the theme for today's -- or this week's meeting is

opportunities and challenges in the state-federal relationship. it's a theme that captures both the possibilities and the complexities of joint, state, federal partnerships. we're going to be hearing from a number of top federal officials who will discuss how we can foster more effective state-federal partnerships together and those speakers, as you know include united states attorney general eric holder, the director of the consumer financial protection bureau, richard cordray, our former colleague from ohio. and ftc commissioner julie brill. wealso pleased in addition to our speaker lineup we'll have secretary of housing and urban development shaun donovan joining us at 10:00 am on wednesday, which will result in the operation in our sights program lannie brui and director of i.c.e. john morton moving to 11:00 am but we're very pleased that secretary donovan can join us, as you know he was a crucial

partner in the multistate over loan servicing and foreclosures. of course, it wouldn't be a n.a.g. spring meeting without the traditional sage reception tonight hosted by former state attorneys general which will be at 5:30 pm and then tomorrow we have our traditional supreme court reception where a couple of the justices will be joining us. i'd like to thank members of the planning committee for this meeting. attorneys general roy cooper, martha coakley, doug gansler, doug luy, john southers, and, of course, the fantastic n.a.g. staff for their considerable time and effort in organizing our meeting. if you could join me in thanking them for their hard work, we'd appreciate it. mra[applause] >> as we move into our first session i'd just remind you that there are written speaker biographies in your materials so is our couple rather than actually providing those introductions, we'll refer you to those biographies to save

time it, allows us to keep our introductions short and get to the heart of the matter. and we're going to start with our hot topics and best practices round table. an opportunity for all of us to discuss what we're working on, what we think is working best, what we're interested in and concerned about. we're going to follow the pattern or the model that we established at our winter meeting in san antonio where instead of going around the table alphabetically, the planning committee has identified several topics we'll be addressing together. so i'd like to invite hawaii's attorney general dave louis and martha coakley to come up to the front and lead this part of the program and i would like to thank martha and david they did a terrific job once again putting this hot topics panel together. please join me in thanking them. [applause] >> yeah.

>> hello. >> see, mine isn't working. >> aloha, there. >> hello. that's better. all right. okay. so in the tradition of two meetings, i just wanted to start with a quick comment on what i hope will come out of this and this is a session that we hope will be useful for you and for us. one of the things i just wanted to note was that starting my second term as ag, i'm really excited by a lot of the challenges it faces but i know for my first two, three, even four years as many of you are finding there's a huge learning curve what you can do in your office -- [inaudible] >> one of the most valuable --

[laughter] >> we got mics in the background. in the organization and i hope particularly for those of you who are newly elected or starting your second or third years you will see n.a.g. is the same kind of opportunity. past we've gone around the room to talk about what's interesting. the last few meetings we focused a little more on what we call hot topics, things that i hope will be of interest to you or that you can join in with your expertise because you've done it or you have questions about it because you haven't done it yet.

i think we should look at this next hour and a half or so as a little bit of this is your opportunity during this meeting to be in a chat room with your colleagues, some of whom have tons of experience and some of whom are new at it and enthusiastic about it. and so i just wanted to -- as we talk through these topics particularly in light of the theme of this, on federal-relationships, opportunities and challenges, most of the topics that we're talking about can and should probably involve our work with our federal partners so we wanted to do that too. but as we talk about these topics today, i think it's important to think about a couple things. first of all, is this topic something that i am or should be interested in? secondly, what are my options around a topic like this or anything else that i want to do as attorney general. is it statutory? is it regulatory? do we need changes around our states around statutory, regulatory authority? is it involved enforcement issues and if so do i have the people and the resources to do it? is it a legal, civil or criminal

enforcement issue and what do i need to be able to do that? and finally, i think one of the things that maybe we don't talk about as much but is as much your authority and one of the great things about being attorney general is what we talk about is the convening authority. what do you do and can you do to bring people together to discuss these topics, to connect the dots and to provide resources with your federal partners, with your partners at the state or local level around these issues. and how do you use that bully pulpit in a good way to try and get results around some of these issues? and i say this as someone who for the last four years, i think, in seeing what an attorney general's office can do -- we can't do everything in how we focus our efforts. this session i hope today will be helpful to you in not only the topics that we're thinking about here but what are the other things that we can do in our states going forward and together through n.a.g. or subcommittees of n.a.g. to do our jobs better? so with that i'm going to turn

it over to david. >> and let me just echo the comments of general coakley, that the object of what we're going to do now is to try and promote discussion among the ag's in the past we would go around the room and pick random topics. we're going to shake it up and we'll pick the random topics and then we'll go around the room. but we're going to start off with synthetic drugs. and the idea here is that -- what i'm going to try and do is tee up the topic and give you a little bit of the experience in hawaii and then some of my colleagues i'm going to call on to talk about their experiences and, quite frankly, i'm looking forward to everybody -- those of you who have had experience and those of you who have perhaps not had experience joining in the conversation which is to talk about what your experience has been in your state? what are the problems and pitfalls around this particular

issue that you've experienced? what is perhaps some of the legislation that you have gotten involved in? and what, if any, are the best practices that you and your state have come up with? let's jump right into synthetic drugs, starting off. one of the latest fronts that we are confronting, i think, in our state, in many other states is the attempt by a number of people to get around drug prohibitions. and they are doing so by marketing, selling, and distributing synthetic drugs in two main categories, synthetic cannoids which are k2 or spice which are tweaked designer drugs that follow the thc that's in marijuana, and these are being sold as a mixture of herbs or other substances that many times are sprayed with these artificial thc additives that can be 200 to 500 times stronger

than normal marijuana. another synthetic drug is the synthetic catnons which mimics cocaine and methamphetamine and these are sold as bath salts which then are ground up into powder and smoked many times. and these also can create many problems. so these things -- they're trying to get around the laws and the bans on these things. we've had some interesting situations. in hawaii we had attacks by people who have been smoking synthetic pot. in new orleans recently, some guy committed suicide after smoking bath salts. demi moore was rushed to the hospital after smoking k2. and my favorite, of course, was in charleston, west virginia, where man high on bath salts dressed in women's lingerie was killing the neighbor's goat. and it was very strange.

but many of these drugs create hallucinogenic problems and psychotic episodes. the dea has placed a number of these substances temporarily on the banned substances list. there's a bill that passed the house to ban these things in the senate, senator rand paul has held up passage of the bill, unfortunately, but they're still working on it. this has been just a growing, growing problem. one of the problems has been that states that have regulation regulate the drug specifically. the chemical formulation and these guys say, well, what i'm doing is not illegal. you're not banning this substance. 39 states have introduced legislation on this. in hawaii we have introduced legislation to ban families of synthetic drugs.

it is unclear whether or not that will be a sufficient definition to ban things. i had a discussion with lisa madigan from illinois who cannot be here to join us, but she has been doing an awful lot on synthetic drugs, convening informal summits to educate the public about this, doing informal sweeps where they go and they talk to merchants and they tell them what they're doing is illegal and get them to turn in their substances and to stop selling these things. and they've been holding a lot of press conferences and, in fact, doing sweeps, enforcement sweeps, to bust people who are selling these things. general shirtlif, utah has been on the forefront of this as well. can you share some of your experiences with us? >> what we've done -- we've

created what's called a criminal alien strike force two years ago. this has been great because every state -- if your citizens are saying do something more about illegal immigration. and some states have taken more aggressive approaches with regard to enforcement type bills but everything we can do look, my job is to enforce state laws. there are clearly criminal aliens within the state. the criminal aliens are committing crimes and violating state laws. and we have found in two years not only are they manufacturing false ids but they're very involved in synthetic drugs, human trafficking across-the-board. and the next two have netted a substantial amount of spice and synthetic drugs including one that was headquartered in southern part salt lake county has connections to nevada as well as california and they were getting the ingredients from

china. so but the multiagency strike force which includes our office, local law enforcement and federal government we've been very, very successful in going after the spice operations. they end up becoming something more that is multistate including even international with the china connection. so i would just suggest that maybe look into -- you know, into a criminal alien type strike force. initially people would say oh, you know, you're just going after people of color. no, we -- 90%, 95% of all our confidential informants are otherwise undocumented aliens who are the first ones being victimized by the criminals. 90% of our 200 convictions so far are criminal reentrants so they go straight into the federal system hopefully for mandatory sentences but they are very involved in the gang units. the gang units, spice and other illegal narcotics so you can actually get two or three bangs for the buck by doing something like that. >> have you introduced legislation in utah? >> yes. >> and has it been successfully upheld? >> absolutely, yes it has. and we just -- we've had as i

say just recently in february, we had a major spice bust. we're charging under our new statute and it hasn't been challenged on that one but that's the first one we've charged it under but i think we're going to be fine. >> great. one thing that i would note, you know, sometimes we don't hear about things but the latest the american poison control center came out with a survey that they published last year. 1 out of every 9 -- 1 in 9 high school students reported that they have used spice or k2 and tried it. and there's a huge danger to the children. i understand florida has been on the forefront of this, too. could you tell bus your experiences as well? >> yes, thank you. and before i get started, too, on this, it's killing our kids. and another very important issue -- i know it's off

synthetics but it's the oxycodone problem but i testified before congress last week to stress the importance of our war on the real drugs, the prescription drugs throughout our country. but as to the synthetics, general louie, last session we banned the use of bath salts. it's mdpv. what we did is we found that it was all over the panhandle of our state. this stuff is being manufactured in asia. this junk is being sold in our country to our kids legally. they could walk inconvenience -- in convenience store. it's leg. 15, $20 a packet. these kids are sprinkling if potato chips at school, they're snorting it, drinking it, everything you can imagine. and we were having overdoses left and right. so i was in the office not even two months and i found out this

was going on. well, before we could reach session we had spring break. one of the side effects it's a hallucinogenics. we have kids on balconies so that was our biggest fear so in florida, i have the authority to sign an executive order and make the drug illegal for a limited amount of time until we could get it passed at that session. it unanimously passed and so we banned the bath salts and the k2 spice. i can tell you the same horror stories of with videos, law enforcement videos of what this stuff is doing. if somebody tries to say it's simple marijuana it's not even close. it is a hallucinogenic. it's closer to pcp or acid and kids were dying. calls to poison control plummeted after we outlawed this junk. now this session we're back again because we have created creative chemists. they are all over the world just changing the compounds around to

make it legal. so it's back on the shelves under different names. they've even gone so far as to stamp on the back of it, this is legal. being sold in convenience stores. we have additional compounds that's in house and senate in session this week so hopefully that will be signed into law soon. but you've got to keep up with these guys because they're changing the compounds on us every year and our children are overdosing just within the last three weeks we had two overdoses in florida because of the stuff that is now legally just by the -- legal just by the mixing up the compounds. on an education front, we've been all over the state talking about it. you know, when i talked -- i personally go talk to kids whenever i can. our gubernatorial fellows i asked them, have you heard this stuff, they all raise their hands. are your friends taking it? they raised their hands. just this last week, i heard a

story of a 14-year-old girl -- the students i spoke to witnessed this happen. some of the stuff that's still legal she took it and sprinkled it in advanced -- sprinkled it in her potato chips at lunch and overdosed in front of her class. that's what we're seeing. we have to keep up with these chemists and keep fighting the fight. and if any -- we didn't invent the wheel. we went to louisiana because they had already outlawed it originally to get the compounds from them. but if any of you are interested in us, we can tell you the compounds we feel are the most deadly and should be outlawed. >> these packages she's talking about -- this operation we took this out this is utah, you know, 2.5 million people. we seized 150,000 of those 1 gram sugar packets, 150,000. they're selling for 13 bucks a packet, which is nearly almost $900,000 worth of drugs and 150

pounds of herbs and the manufacturing machines where they were manufacturing them right there. so it's one operation so consider how much is out there in all of your states. >> uh-huh. >> general southers, any comments on this as a prosecutor? you guys seeing this in colorado? >> absolutely. you remember last meeting i told you how much colorado loves its cannaanoids but they don't like synthetic. it's all natural in colorado. [laughter] >> our efforts to deal with this have really not been that controversial. we got -- we got off to a good start because of the very high profile situation in september of 2011 when a 15-year-old high school student in thornton, colorado, during her noon hour purchased k2 from a corner store

near her high school, smoked the product over lunch break, passed out in class; woke up, was hallucinating was taken to the hospital. had a long recovery period and it just dramatized for the public how serious this problem was. so we had absolutely no problem in the next session outlawing it. we are now dealing in this legislative session with catanones but the only issues have been -- it's unanimous everybody wants to outlaw it. it is issues of what people have said here, do we just individually list these things and then have to come back every year or can we come up with compound descriptions that we don't have to amend the statutes every year? but in a state that's on the verge of legalizing marijuana next november, we've had no trouble turning the public

against these particular products. >> okay. thank you. and let me just note for all of the ag's, we sent out an email to you with a handout and a memorandum documenting some of these things and also providing some of the press releases that general madigan has issued and also some of the press releases that general shurtlif has issued so you can take a look at that and decide if you want to do something similar. we've also provided you with draft legislation that you might want to consider if you haven't done that in terms of identifying the families of these drugs. general biden? >> i just want to add with what general bondi have, not only are our kids dying and we all know at a too rapid of a rate because of this stuff but law enforcement is dying too. we had a police officer responded to a routine breaking and entering who ran up against one of these folks and found

themselves on the other end of the knife and is now -- now no longer with us, he was killed and so this rapidly moved into our state and our legislature banning it. but if you talk as we all do to law enforcement they're very, very concerned about this not the least of which is an officer safety issue. >> thank you. anybody else have any experiences or court challenges that have been brought up in successes in doing any of this. >> this is jeff from footage. excuse me, last week, last thursday i through my department of consumer affairs as part of the attorney general's office issued an emergency order banning classes and including in that known and unknown variants of things used to make synthetic marijuana so that we can try to get around what we were talking about early which is the backyard chemists that tweak these chemicals a little bit and

technically it's legal and it goes back on the shelves. so it's a very broad-based ban and i know the retailers that sell this stuff and put it out there for kids making it seem like it's okay to use are not going to have it on their shelves anymore so that's what we did in new jersey. >> i have a question for those who are seeing it what is the age group that is targeted it and secondly, do you see that the spread of this is through social media? is it because of the kids' ability on facebook or anything that you've seen? and i guess my last question, urban, rural or across-the-board in your states, for those of you who have seen it? >> yes, they're definitely -- primarily urban right now. >> urban? >> for the spice, as for the manufacturing, that's where it's most popular and where the word is spreading. they are using social media. it directly targets kids. >> what age group, like middle schoolers, high school? >> middle through college.

and it's -- they have names like, little spice packets, brain ticket, three wise men, mary j and some names are named like fruit flavors so they are -- we clearly believe they're being marketed to the youth. we did ban 17 -- our law bans -- i think you have a copy of that 17 specific synthetic drugs. >> right. well, i think this is an area where we can all collaborate and learn from each other and if there are court challenges, i think we can band together to try and work on identifying these generic families and getting them banned so we can address this problem. and i would just note that, you know, there is no quality control in this. these guys get these chemical substances and they spray them onto herbal packages and then it's like spray painting or anything like that. you can -- you can lace something with 100 times what a dose would be or 10 times and

there's just absolutely no guarantee as to how hallucinogenic this stuff may be. okay. general mcgraw? >> we're looking at this issue through the -- the approach in consumer protection. their deceptive practices. and we believe we're on a road to a -- an intermediate solution. >> that's a terrific solution have you brought prosecutions against some of these merchants yet? >> not yet. >> but that's certainly an avenue. okay. let me now jump to our next topic. we're going to take one topic out of order, is that right, general coakley? >> yes, we're going to switch around and gang units will be last. so it's switching places in your brochure with handling scandals. >> okay. we're now going to talk about

constantly reporting and so that's the second topic that we wanted to cover. let me just tee it up for discussion. the issue many times comes up as to when there's sexual abuse allegations in schools or in state agencies or things like that. and the issue comes up as to when you're supposed to do something, what you're supposed to do, whether you report it, whether you call the police, what do you do? in hawaii we've actually had two recent cases. the first case involved allegations that surfaced about a high school track coach who allegedly had touched inappropriately a 13-year-old girl. and what had happened in hawaii was that the coach -- that complaint was made and it was made to the principal and the principal decided that she would make an investigation as an administrative investigation. she interviewed a number of people, decided that the girl

was not credible and that the coach was credible and let it go. six months later, it erupted as a scandal because of a lawsuit was brought and then criminal charges were brought. the charges had now escalated into a much higher degree of alleged touching and there's -- so there is a lawsuit about that and the question is, what was the principal supposed to do? what are the policies and procedures of the schools? when do you -- when do you report this stuff? and who do you report it to? another recent problem that we've had in hawaii was we had allegations surface at a deaf and blind school where there were allegations that the students themselves were coercing sexual activity on behalf of other students and that it had been reported up to the principal. and the principal had done nothing. now have a lawsuit there involving 30 plaintiffs, some of

whom are victims, some of whom are perpetrators and some of whom were both. they were victims and they thought, well, everybody else is doing this, i can be a perpetrator, too. and so now we have that. and the issue, many times, is what are you supposed to do? what are the different perspectives? obviously, law enforcement's perspective is always report. and always report to the authorities and the police as soon as possible. from the school's point of view, they have to decide whether or not they have any expertise in this at all, whether or not they know what they're doing in terms of making an investigation into what are very serious allegations. and whether or not they should be conducting an administrative investigation or sitting back and letting a criminal investigation go forward. many times the school, as well as the state agency has to balance the rights of the accused as well as the rights of the accuser to privacy.

many times these are minors who are making these allegations they are very sensitive and their parents are sensitive about any kind of publicity about this thing. and then you have the problem of, well, is it just a dis-gruntaled student who wants to make trouble because we have seen those things in the past. so we've had these problems, not just in hawaii, obviously, in california, they recently had a situation where they shut down an entire school in florence, california, where they had two allegations of inappropriate sexual contact by teachers and they shut the entire school down and replaced the entire faculty and it is still going on right now. that was over the objections of the students and the parents there who were very concerned that everybody was being tarred with the same brush. and we also know that in

pennsylvania, there have been some allegations that have been raised about a certain coach there, mr. sandusky, mr. invite general kelley to tell us some of the -- perhaps, if you can, and we all realize that there is litigation so none of this is intended to go into litigation details or to force you or anybody else to take a position that could be used in litigation. but perhaps you could talk to us a little bit about some of the issues that you are seeing in your state that have been teed up by the situation with mr. sandusky. >> sure. i wanted to comment just briefly on the policies and procedures and really the lack thereof policies, procedures and law and some of the these instances involving the reporting of child sexual abuse cases. and as david said, we've had

this issue come up in a very good way in pennsylvania as a result of the jerry sandusky case as well as the parallel case where the attorney general's office has charged two high ranking administrators at penn state university for failing to report child sexual abuse that occurred in the football locker room at penn state at lash hall. i don't want to talk as david said too much about the facts of the case but, quite frankly, i've never been involved in a case quite like this, that has -- where there was so much in the public domain and so much already of public record so i think that it will be all right to talk about some of the points that really illustrate the different ways that different people responded to their obligation to report in the sandusky case and in the case where the penn state administrators were charged. i think that it is probably fair

to say that the office of attorney general in pennsylvania became involved in the jerry sandusky investigation primarily because someone actually chose to report an instance of child sexual abuse. and that occurred back in 2008 when a mother of a young boy who attended a high school in clinton county, pennsylvania, which is very near penn state -- where penn state is located notified the authorities at the high school that her son attended, that he had been sexually assaulted by jerry sandusky who was a volunteer coach at that school. the school -- the clinton county school then in turn notified children and youth services, which is what we call that agency in pennsylvania and then the police became involved and eventually shortly after that, the attorney general's office began its investigation, which

resulted in the charges against jerry sandusky over 50 counts of related to sexual assault of over 10 victims. and then from there, the investigation worked backward. and from the report that was made by the mother in clinton county. and we then learned after that initial reporting of that sexual abuse at clinton county that back in 2002, an assistant coach by the name of michael mcqueary had gone to the penn state facilities at lash hall in march of 2002 and saw what he believed to be a young boy in a shower being assaulted by jerry sandusky. and i'm sure you've all read the accounts of what occurred after that. mike immediately called his