on adderall and he was 17 on light physical illness, it has a much longer maturation duration until one discovers the effect and the result of which the tree that can possibly cure. in 2012, justin told his mother that he was taking her cassette and oxycontin. she'd come to a primary-care physician without my knowledge per his request. at bat time the prize to the doctor of his addiction and when his mother wasn't present in the room he stated he had been using heroin for a few months prior to that date. justin asked why not be apprised of the substances and didn't want his mother informed that his heroin usage. without disclosure the heroin usage and the doctor expressed by your concern to justin's mother and told her to taken immediately to a recommended crisis center for treatment. ..

for five weeks that summer. once in rehab i contacted the intake director to inquire about the progress. i was informed he could not disclose any information under the hipaa. i could not be known of miss son's condition. during the five week inhabilitate i sent him to see a psychologist weekly. which ensued u until the ultimate demise. i later learned upon justin's passes he will not disclosed the heroin addiction except do say

it he tried it once. the depression and ocd cati were found untouched. he continue to take the anxiety medication to return to school where he a peered -- appeared to be doing well he even pledged with a fraternity. he died of an accidental overdose a few weeks later. nobody was aware of he was using hayne. everybody was in shock in disbelief. it was too late. i confronted numerous parents and nine out of ten people snorting heroin is an way. it's alarming to learn it was cheaper to buy a bag of heroin than purchasing percocet.

my son traveled to dangerous places to buy drugs. he sold his things and medication when i learned by after the fact. i request -- maintain legal less debit sei in the parent's homes living under the parent's care as specified by president obama until the age of 26 access to the minor's medical records for the following reason. prevention of harm to the society. any type of disorder can be life threatening to society as a whole as indicative of the newtown, columbine, or aurora shooting. he was never violent. unintentionty it destroyed other lives including his younger brother not to mention the individuals he sold his

medicines. he was told of the reckless disregard when driving and activities. thank god me never hurt anyway on the road. i have pictures from the apartment including cigarette burns in the bedding from nodding out which scrolled set the apartment complex ablaze in resulting in injury or death. justin's stepfather had taken him assault rifle shoots. he asked my permission to become licensed to buy a again. which i was against despite not allowing. >> i know we are out of time. did you give a final summary and have you come back you can give to the statement there. i have very important points. it will take three or four minutes. ly give you . >> it was the result of the heroin addiction. it requires the snap cyst is

doing more of the drug. it becomes numb to the surroundings. drug-related deaths have risen steadily. in 2010 drug overdoses killed 38,000 people making drugs a more common cause of death than car accidents alcohol. according to it's the exceeding attributable homicide or hiv aids. according to the u.s. department of health and human services with a prefrontal cortex which does not developed until 26 they engage in risky behavior. with the young adults not having it fully those with addictions exacerbate the behavior. in many circumstances parents know what is best for the children especially give the appropriate medical

information. in an effort to help the parents i launched an all ut campaign to media, lawmakers, president obama, an congressional leaders to call attention to the issue and lobby for adding additional language to hipaa they help protect the troubled young adults and communities from harm. parents are unable to work effectively. the absence of rationale may result in life threatening decisions or my son's case premature death. item number five protected health information can be disclosed without an individual's threat serious threat to health or safety. it may -- present or lessen a serious and imminent threat to person or public. it should stand to reason language addressing the safety

hazard is prudent and necessary. i'm request the following language be add toad the hipaa exception to avoid ambiguity. parents with documented drug abuse or mental health history who continue to the minor or emancipated adult or couldn't to support the will have access to the individual's health care records until the age of 26 to prevent him, her, or society from harm. justin's family, friends, or justin himself couldn't save him. it's my hope it would help save millions of young lives in the future. addiction and mental disability wreak havoc on our society. when you look at the famous and intelligent people who have lives tragically taken due to mental and drug abuse. they lost a wealth of talent. >> thank you. be kelley recognized for five minutes. >> mr. kelly. >> thank you. >> can you hear me now?

thank you, mr. chairman. i'm a father of a paranoid schizophrenic son. he was diagnosed at the age 14, for half his life he's had the illness. i'm afraid i have harsh news and points to make that are going to fall in line, and i think congressman cans i did for the -- cans i did to the comments. he gets to the point. my wife and i upon learning of the diagnose is embarked upon educating ourselves. including advocating the system, familiarizes ourself with the things. and we took upon ourself to educate others. we have done that by teaching classes and serving on boards, speaking engagement, raising money, and bringing people to our home and comforting and helping them to hope. what i'm going to tell you, we where ashamed of ourselves as to what we did not know before our son became mentally ill. and i would dare say that if the members of the committee were

spend a couple of days with someone with psychosis. you would change things tomorrow. what needs to has been there's a gapping hole. there's a difference between -- lack of insight, and a psychotic episode. they are two different things. it can last for long, long periods of time. and lack of insight refuse treatment and don't want anybody to help you of any kind. most importantly not your family members. not just parents. what happens is you're setting a stage for tragedy. literally propping it up. there's a gaping hole we try to address the needs of the severely mentally ill the same way we are the mainstream mentally ill population. it doesn't work. my son fought. he's been a u.s. mabl for a gun. he thought aliens were invading him he thinks to the day he served in two iraqi wars.

he lived almost under a bridge. he think my wife is a stripper and prostitute and i'm a sexual predator. for an entire year he didn't believe he we were his parents. you can tell me he can make responsible decisions about the care? when it gets to the hospital, and sometimes we don't have the recent history. he's been in fourteen -- for fourteen years he's been in eight hospitals in four counties, and one city dozen of different times. you have the broken chain of treatment. so imagine a medical system where physicians and treatment providers can't rely on prior history to treat this person. it's beyond comprehension. the other thing that happens it stifles accountability. and when i tell you that people hide behind hipaa. i'm a 14-ier eggedded man that has been in every situation possible. i think there's a plan for us to make a difference we're sitting

here. and that our son hasn't killed himself. he's far more likely to kill himself than live to the rest of the life with the illness. what we find oncely gets in the hospital treatment can be delayed or not done at all. our son escaped from a mental health facility. hipaa was thrown out the win go. the police were calling, they were try to pry to the bank records. they found him four days later, they dragged them to state hospital so we can talk about it later. once he was in there, he verbally assaulted the administrative hearing judge, put on suicide watch, completely out of it. when the time came for the hearing to see if we received treatment we were precluded from participating. and the panel looked me in the eye and said we can't do it. our hands are tied. two dates later a staff member was killed in the wing. we don't want to know what happened. this is what did happened. he was one year, one year in

that facility. the abuse, the things that happen to him in that hospital and they never ever let us in. when he was 18 they couldn't live without us. when he became 18 we were enemy. we might have been strangers on the street. we have doctors who shared things behind the scenes they knew they were going get in trouble with. we are going to lose our jobs. we have to tell you. members of the committee and people know us. they took chances. when we got outside of the community there was no chances. the only thing that happens imagine somebody who is mentally ill being dangered to real society, even under the best plans with families being involved. it's very difficult process. but take a look at someone who is not part of a plan that includes the support networking. our son has been released and sent on buses and we haven't found him for weeks wondering for he's debt. hipaa empowers homelessness.

our son has been gone. no money, no clothes that a adequate. nothing. gone. we look around in shilters. gone inspect why didn't you tell us? we can't hipaa free -- precludes that. the whole idea the anythings they have to threat to us. they decided he's not a threat. they won't locate us do it. we search for him. the shementers can't tell they're there. and the next that happens the person released, you don't want the person released like this. angry. we are the first target. right. we're the first target. people being released everyday without discharge plannings you don't want somebody that has psychosis as a symptom that pops up. the the idea anticipating and predict when imminent danger is coming. i just fought the state of

maryland for four months to get it across. not one person on the planet can predict the tipping point of someone with a severe mental illness. you can't do it. you try to rely on the people closest to the person. who was that? the family. but the family can't do it. we can't give recent history to the next hospital or doctor because we can't get if. what is worse we have less ability to help. the idea we provide him information to the hospital. it doesn't work. and it's scary. so in closing, i would like to say that hipaa has a lot of gaping holes in it. this is the biggest. but if there's ways to get. we seek to find. which is bad. our son and other people's sons and parents spherve the right to be informed so they're safe and their child is safe. thank you. >> thank you mr. kelley. in thomas, you are recognized. >> i would like to thank congressman for asking me to come to washington to tell my story. i would like to thank chairman

murphy and representative degette for holding the hearing today. my name is january thomas. the story i have to tell is a nightmare that could have been prevented. my life hasn't been the same since it occurred and changed the lives of my entire family and community. on june 24, 2009 what started out as a normal spring morning ended up being a nightmare. a 24-year-old former student mark becker walked to our high school weight room and in front of 22 young high school students emptied the gun. ed did not survive the injuries and he died on the way the hospital. he was 58 years old and he coached for 46 years. in one quick moment so many lives were impacted. our family lost a son, husband, father, grandfather, and brother whom we love very much. the students in the weight room that day along with the extended

community lost a mentor, friend, teacher, and coach. they lost their sense of confidence and secure tip. and the horror of that ay will be with them forever. innocent youngsters including our own young grand soon suddenly realized the world has a dark side. they were taught a horrible but truthful lesson. bad things happen to good people for no reason. even when they think they are safe. our grandsons were robbed of the love of their grp. myson lost their father whom they love very much and i lost my husband. and we miss him every day. but the real tragedy of that day is the fact that it could have been prevented. only four days before ed was murdered, the same young man rammed his car to the dpraj of an aquantity ens and tried to break his way to the home with bain bat. when police arrived he fled in the car leading them on a high speed chase.

he was taken to an area hospital for psychologist evaluation. less than twenty hour hours before my husband died mark decided he didn't want stay at the hospital. the he was dismissed. no one knew. law enforcement was not notified even though they had requested that the hospital let them know when he was going to be dismissed. the hospital's justification for not notifying the law enforcement prior to the release was that hipaa prevented it disclosure. even his parents didn't know if until they were called until mark called them. no one knew that mark had been released. but mark's privacy had been protected. during the investigation to the murder, it was revealed that mark had feelings of animosity and resentment toward ed. we didn't know that. it if mark had come to my home and asked where mark was. i had would have innocently sent the killer to him and ed to the

grave. once again, mark's privacy had been protected. adults with severe mental illnesses are not always able to make good choices for themselves concerning treatment and action. they may need help of a family member or be sure they acquire treatment. they may need outsiders and others to keep them out of harm's way. due to happen pa mark's parents were unable to get information. i would ask you the privacy of one individual more sacred than a life? is it more important than the welfare of our general public? is it more important than a allowing our law enforcement to know when a potentially dangerous offender being released to the very community that they risk their lives every day to protect? ed was an inspiration to many so many our community and most importantly he was a loving son, father, grandfather, and

brother. i urge congress to update the law so we can prevent further tragedies like this one. thank you. thank you. recognized for five minutes. >> thank you very much. i'm really appreciate the opportunity and i want to thank the chairman and the subcommittee for focusing on the issues. which are clearly critical. i direct the health privacy project at the organization called center for democracy and technology, which is a non-profit public interest advocated sei organization that works on behalf of consumers. we like to think of privacy as playing an incredibly important role in making sure that people who are suffering from stigmatizing conditions like mental illness will actually get to treatment. many people express one out of six in surveys consistently that that if they didn't have some guarantee confidentiality they

wouldn't seek treatment. that's the reason why we have privacy laws. they're not aied at trying to create obstacles for people, necessarily. but to create the kind of treatment and environment that people with stying matizing conditions want to be in. they are not absolute. they have lots of exceptions and previous panel talked about them. some of the members of this panel talked about them as well. that allow for the notification of persons in the event of a serges -- serious and imminent threat and noserings of family members except in cases where there's an objection by a patient who has the right to object. in the case it would be either an adult or emancipated minor or in some states that allow minors to consent for treatment on their own and be able to control their privacy rights in that case the minor hold the right. if the objection has not occurred or deal with someone who is incapacity. hipaa provides for the ability for providers to share

information with family members, close friends, or people that the patient designates. having said that, i think it's abundantly clear from the testimony we heard today that hipaa is badly mangled. in term of how people interpret it. and using it frequently as a shield not disclose information or because they fear liability, which frankly, is not anywhere in hipaa. it's what is incredibly frustrating to me when i hear the stories, i'm sure it's frustrating for you too. you know, hipaa say you -- didn't say you can't disclose. for people to blame it on hipaa is frustrating. hipaa allows disclosure. where the disscweblght happening is frustrating to me. i'm a privacy advocate. i believe in the reasons for the exception. we try to take a balanced approach to the issues and understand why the reason why the exceptions exist.

yet for whatever reason, the mit that you can't disclose to family members, and again, this is disclosure to family members are not bound by the potential for a serious and imminent threat. it's the case that if an individual objects, again, if they have the competency and power to object it would be the case where you couldn't disclose. i would say more often than not, there's, you know, again, the experience that the folks at the table notwithstanding people want the family involved in the care. i've had people say to me, my mother, my elderly mother, whom i'm caring for. i would like to be able to have her doctor talk to me about the treatment. and the office is telling me hipaa won't allow it to happen. it's untrue. i am incredibly sympathetic to the frustration of people who are told that hipaa requires something that it doesn't. i'm try fog figure out what we

can do better in terms of educating folks about what hipaa does and doesn't do. because it sounds to me like too many people are hiding behind it in circumstances where there are clear exceptions that allow for the information to be shared. some of the testimony of director rodriguez in the first panel, frankly, there was a lot more i a lot greater exception for the family members than before the hearing. it suggests to me the guidance, which i think is good, it's not the lerlt that everyone east been talking about. letter deals with serious imminent threat. this is guidance what can be shared with family members. often patients want the information to be shared with one or more of the family members or a close friend helping to care for them. yet, it doesn't happen. and it could be made more clear, frankly. we could find ways of disseminating the guidance. i know, where it is on the website.

there's probably lots of folks who can't find who right-hand turn aware that it exists. rticularly when faced with a person and health care facility telling them, which is probably something they unfortunately believe. that hipaa won't allow that information to be shared. when in fact it does. i'm happy to answer any questions. and i appreciate the opportunity. >> thank you very much. we thank all the panelists. i want to say here that i think our hearts go out to the families. for the sad tragedy and mr. kelly you are still dealing with here. i want to recognize for five minutes. i want to make it clear, you stated you had opinion in your testimony. you're not a licensed provider, am i correct? >> no. expwhr. >> . >> and you're not a practicing therapist. >> that's important for the record. on page 10 of your testimony, you said that doctors don't want to share information it's a

quote, convenience excuse. you went on to say it's easier avoiding. doctor martini, is that true. they don't want to know the information. they don't want to talk to families it's difficult? >> the vast majority of physicians are interested in sharing the information. and want to involve families if care. we know for -- one of the ways i look tat i see a praisht at the perhaps most an hour a week. and the families are dealing with the individuals on a ongoing basis. i think any recommendation that i make is as a collie anythings much more likely to be successful. you have talked to providers

about the cases do. you think the cases the providers didn't want to talk to you or they did but couldn't because of the interpretation of the law. >> yes, my family physician told me later he wanted to disclose it. he felt he was under the obligation of the hipaa rules. >> mr. kelley. >> in fourteen years i never encountered a situation where a treatment providers didn't want to disclose it. they went on a limb and secretly told us. >> i can only speak for what law enforcement told me and what mark's parents have told me about, they had difficulty getting information. >> thank you. >> mr. wolfe, mr. kelley. you heard from mr. rodriguez. it sounds like he's saying the law is adequate. that providers aren't aware of the law unjustifiably worried about lawsuit or hospital administrators who pressure staff not to disclose information be fired. do you think that's true it's adequate the way the law is worded? and information gets out to

providers? mr. wolfe? >> i don't think it's adequate as far as getting after the providers. because both in my son's case with the rehab situation, as well as my family care physician, both of them after justin's deceased i confronted them and they told me they definitely would have said something with regard to informing me; however, again, justin signing the hipaa disclosure they were not%ed to. i feel they did have an obligation. they knew that his -- it was life threatening the situation with the house of heroin. they were 0 obliged to follow the . >> i fear there's a significant detachment from reality here. not with you, sir. mr. rodriguez. it's underlined. unless the patient objects. someone that is universally mentally want to object.

it gets thrown out the window. we need excption for the severely mentally ill. >> i can speak on the behalf i'm a volunteer emt for our community, and the threat of lawsuit and it prevents us even from feeling like we are able to tell district family members conditions of patients we transport. so either it's misunderstanding that is what is emphasized in the train. >> thank you. in your written statement you said 17% of 38 million said they would withhold information due to worry about how medical information would be disclosed. my understanding it's general health issues. >> that's right. until the time i had to prepare for the testimony, i looked for some more specific statistics on, you know, a person's being held back from seeking treatment for mental health. i didn't have enough time to find something directly on point

point. i found something on the national alliance on mental aisleness website that talked about how two-thirds of people with mental illness do not seek treatment for a number of reasons. lack of knowledge, fear of disclosure. >> i appreciate that. if you find some other studies. >> i would be happy to keep looking. i ran out of time. >> we have folks here also saying that doctors didn't disclose information, and people are overinterpretting the law, not disclosing the law. and perhaps patients are also over interpreting. you gave something important. it's badly mangled. that was your words. what can be done to clarify law. do we need legislative language. clarification from the office of rights? more public education? what do we need here. >> yeah. yeah. the badly mangled part was reference to the fact we had all the testimony about what is really in hipaa. and people are being told, in fact, that hipaa is something

that it's not. and with the significant consequences, you know, more guidance and better ways of disseminating it. it's not you don't have to look really hard for it on a website. absolutely the first step we should be pursuing here. ideally that could be done in con junks with the -- conjunction with the professional societies who have effective mechanism that reach the members. you know, having read the guy guidance, it's clear, but it could be made more clear. more examples. in the circumstance, you can do x, in this circumstance -- . >> thank you we look forward to getting your specific recommendation. >> thank you. i should also note, mr. chairman, that ed thomas' sister, kony -- connie is in the audience. your testimony brought out. there's a misperception the issues we've been talking about

dead are you -- today are unique to the urban areas of high concentration of areas. parkersburg is a town of 2,000 people, five years ago this may was nearly destroyed by an f5 tornado, and your husband ed was one of the people in the town that rallied people to come back, put the community back together. and one of the other things i think is important about your story is that mark becker is someone you and ed knew very well. >> exactly. he was a member of the community. we have known him our i entire lives. i agree with what they're saying. when it comes to severely meantly ill people, you can't classify them with someone who has cancer or hip -- hepatitis. the think is not rash signal .

>> you went to the same church as mark becker's parents. i know, the kerb family expressed some of the same frustrations as parents that we've heard from the other panelists in trying to get mark the help he needed. .. of mental health. i think their needs to be --

this needs to be oxfam gone. i don't think there's enough resources for people. i think the fact that no one knew he was released and a threat was very frustrating to people. there were a lot of victims involved. they witnessed their coach getting shot down at close range in cold blood and it could have been prevented. that is a big frustration for a lot of people. he was not able to get a lot of harm's way and he was loose on the streets just because he wanted to be. >> i think one of the other things this points to is i lived with somebody with a severe mental illness years ago and i remember the stigma attached and i think we would like to think that we have come a long way as a society in dealing with mental illness as something that impacts people's lives as other diseases but i think the reality is there is still a lot of

stigma attached to it. we would like to avoid having these kind of conversations unless it is impacting us personally. so i want to thank all the panelists for having the courage to share your stories. i know it has been an incredible challenge for all of you. one of the things i talked about earlier is this challenge that family members have with adult children of being able to have a role and make decisions about their care when there are sometimes obstacles. and dr. martini, you talked about this and one of the questions i raised earlier is whether this risk to sell for other standard is still a viable way of getting patient is the help they need for a truly effective treatment. you gave examples of both sides of the story. of one where a family's intervention was counterproductive, one where the need for intervention was not provided that could've been in

the best interest of patients so how do we resolve this? >> what i would like to do is think about what you referred to what is going to help the patient most in their recovery? there are issues about the confidentiality and i understand they are sensitive to that. we are talking of a release in the community and we are talking about red to the to particular cases. looking at those cases, more individual basis. what kind of information needs to be shared, should be shared with family members are they an asset and can they help out this individual quirks would be a good idea to share the information in the primary care physician and the community? who would quite often coordinate care in a variety of ways that also an asset that quite often

isn't part of the process in some ways because the patient are reluctant to have any notice of what's going on. >> the notice for sports illustrated what you submit that for the winder so it is in the record as well? to be on the cover of sports illustrated it's got to be the saddest. thank you. i recognize you for five minutes the gentleman to mr. griffin. >> if i could pass at this time i would appreciate that. >> mr. johnson for five minutes. >> thank you mr. chairman. first of all, panel members i would like to say thank you so much for being with us and your testimony. i know these are very tough testimony is to give and our hearts go out to you.

you said just that health care workers sometimes use hipaa as an excuse not to share information and not simply because they are afraid of fines or sensors. why else would someone with all the information to inquiring family members? >> because the role of a family member cares for someone who is -- as i said, most of my experience is with older adults. also i personally was a family caregiver for my late husband who had a traumatic brain injury and was a quadriplegic so i have my own experiences with the system. family members ask hard questions. they want to know a lot of information about why did this happen, what can they expect? why are you giving this medication when it's on the list that says this is counter

indicated? i can't tell you -- this is not to disparage the nursing profession because they are fabulous but i have had so many nurses say to me are you trying to tell me how to do my job? i think i am because my husband shouldn't have this medication and that medication together. so there's a kind of -- i can tell you how many physicians, nurses and family members are nuisances and they are. i'm not denying that because they ask hard questions. when the patient is in pain or sedated isn't great be in trouble. i think it is a truth universally acknowledged that family members are important on the day of discharge to get them home but not necessarily in the course of the hospitalization. but i think that the hipaa

scare, and i am now concerned that there is going to be a high-tech scare because i'm already getting e-mails from vendors say and we are going to protect you from these horrible audits that are going to happen, and as long as you hi your us you will be safe. >> any time there is a new government regulation and industry crops around the services. >> it is not one thing. it is things support each other is my feeling. >> let me quickly good several other questions. one of the recommendations has been for hipaa -- ocr to permit disclosure of information and protected health information family caregivers or others who are going to be responsible for providing, managing or paying for the patient scare. how do you suggest ocr goes about doing that? >> i agree the web site is one way but not the best way.

i think that they can be involving the medical professions and involving the people the risk managers who are doing a lot of the training involving the readers saying this isn't good patient care. we are concerned about hospital readmissions. one of the reasons people come back to the hospital in 40 days is because the family members responsible for that care don't know what to do so they bring them back. >> do you have recommendations for cms as well? >> would definitely encourage as part of the conditions of the participation in medicare and medicaid to make sure the training they are responsible and accountable for training the hospitals and nursing homes to train the staff and a balanced

way. >> quickly, i'm running out of time. >> we have our contact with providers to patients object to having a family member involved. it has nothing to do with privacy. it has to do with i don't want to worry my daughter. i don't want her to have any responsibility it's not to privacy. >> you observed a culture of fear in one of the facilities your son was admitted to how does this impact the decision making by those health care workers and facilities taking care of your son? and it's more than one hospital, sir but we are not in the position to prevent things from happening. and we have had some candid discussions with the staff and doctors and local hospitals with the we acknowledge they use the

word our hands are tied so we try to go further and emphasize the inability of a patient to take care of themselves and make good decisions and it doesn't faze them. what happens is the patient gets mistreated so our son has come home and has been on the wrong medication and so it's pervasive >> thank you mr. chairman. i like the panel to know i've read all of your testimony although i wasn't here to hear you say it. for those of you that have lost loved ones, my deepest condolences to get as i said in my opening statement i know how difficult it is to have a child with severe illness. my child has a full debate of physical illness, not a mental illness and she is now a freshman at college so i know what you have been dealing with in terms of dr. martini i know

what you were talking about in your testimony, too and the college tuition and they obviously love the child and are deeply concerned that the child is over 18 and they are wanting to become independent and they do have privacy issues today it is a hard balance especially when you are dealing with some of the mental illness which as we have learned in our previous briefings in this panel for professionals to see it manifest which is at the root of some of the violence most notably suicide that evidence is itself between the ages of 18 to 25 a and young women had a slightly older age but this is right at the age where they are becoming independent from their families and most of the time they are over 18. so it is a hard balance because on the one hand it's like you

want these young people to not feel the stigma so that they will get medical treatment, and on the other hand as parents if you are at risk to ourselves or others it is a balance you said something that struck me in trying to grapple with this issue you said we need to look at the individual, the doctor. we need to rely on the doctors to look at the individual cases and see if this is a situation where having parental involvements or involvement of another irresponsible that would be appropriate to let them know. and i guess i agree with that but i also -- in listening to the testimony of the last panel that's exactly what they were

saying is in their interpretation of hipaa that is exactly what medical providers are allowed to do. and so i think what we need to do is providers need to understand what their abilities are, don't you agree with that? >> i think that's a very important part. i think educating providers about hipaa also in a way that makes it seem like this is one of a collaboration is information to be gained. for example the state of tennessee has created the review panel of physicians that can look at cases and can override aspect of hipaa if it decides this particular situation is worthy of that and i think that these kind of initiatives are where hipaa is seen as not a government regulation. but as a process.

if we still have our hhs witnesses here, yes we do, some of them. if i think we should also have our federal agencies work with the colleges because a lot of these problems seem to come with the colleges important for the privacy protections for their students and also letting parents know. and again i think they would have some leeway but we would have to work with them to let them know that. >> i think it's a very good point and there also needs to be some help for them because some thousands of miles away it would be a challenge. >> the last thing i want to talk about because it isn't just the hipaa issue is also access to treatment. and i think some of you have probably seen this in your communities. i was actually a the ai doctor and the assistant came in and said she had a son diagnosed with bipolar.

he had become violent, and he actually put himself into a 72 hour hold, and then he was released. he actually involved their parents and they were involved they couldn't find any mental health treatment for this kid in denver colorado, and this was another issue as well. once you are diagnosed you have to get treatment. i think you probably agree with that. >> absolutely work force is a big issue certainly in the pediatric mental herself -- health service. one thing to remember is that a majority of the mental health problems on actually treated by local physicians and the community coming and we need to work with them and help them and educate them so that access begins local depue >> thank you mr. chairman. >> mr. griffin for five minutes. >> thank you. appreciate the patience. but the follow-up, dr. martini

coming you talked about local health professionals being involved and trying to make sure people get treatment. is it your opinion or what are your thoughts can they also stand in a way of proper communications between fr example treating mental health professionals and a patient general care physician? >> i think that there have been cases that i have worked on where the family, the patient doesn't want a local physician to know about the extent of the psychiatric problems in part because the position and become yet he knows a great many people. i think that a good bit of that anxiety is misplaced on the part of the patient but i can understand it also think what we need to do is we need to work with these local clinicians and physicians to involve them more in mental health care to educate them to make them part of the mental health system so that families recognize the help that they provide is going to be in the patient and family's best

interest. >> one of my concerns that we heard is that takes an informal hearing that it took 18 months for the average person with a mental health problem to, you know, get to see mental health professional, and that is the concern and something that we need to address. but it seems to me that your primary care physician might be in the position to shorten the time period by making the referrals and saying this isn't such a big deal and when it is a trusted family physician a lot of times they can be helpful in that regard also and falling edges of professionalism in the immediate community i represent a rural area it may be 30, 40, 60 miles even more and they can communicate with the local health care provider it does create some benefits. from the perspective of the patient, why do you think such communication between health care providers is important?

>> on the part of the patient what it will allow them to do is to receive services more efficiently. i think the local practitioners' understand the community and what is available in the community. what's available not simply from the standpoint of medical services but also in the community schools. they are familiar with that and i think what we need to do as mental health professionals is work with them to teach them what they can do to get them comfortable with what they can do in their practices and also to teach them when they can and when they should refer to us and then as a part of that we need to be available. we need to make a was always available and that is a big question we need to increase the size of the work force but we also need to do this in an efficient and effective way. >> thank you. i noted in your testimony the fear of liability for violating the revision as coupled with a misunderstanding can be a recipe for not sharing.

i'm wondering if you are familiar with -- and i hate to ask are you familiar with the suits that go the other way where permission could have been granted. they say we couldn't tell the police anything. if you have heard of any suits, and ms. thomas, did you even consider suing them for letting the standard as person back on the streets. they do not have any provisions that enable anyone to sue so either enforcement of patient privacy right or someone else in terms of sort of over interpretation. keep in mind also that it's allowance of disclosure for these reasons the we talk about is permissive.

it still relies on the judgment of health care providers to make a judgment call about what is in the best interest of the patient. having said that, we need to keep in mind hipaa as the floor and there are state laws that may provide greater protection and may have medical privacy statutes that can be used to impose liabilities in the circumstances giving it but i certainly had never heard of anybody being sued for not releasing information except in the case of aggression a patient asks for that is about them. because you are required under the disclosure of that information you can be held accountable for not doing so. >> i guess my concern is, and i was a practicing attorney for a lot of years, but my concern is that that's one of the ways people like to hate lawyers and i understand that but that is one of the ways to sometimes get rectification not that the money is important and can bring it back but it may keep somebody from making that mistake again. here we have an individual in your case, ms. thomas who the police bring in and he's run his

car into the back of a garage and he is even a danger to himself or others to did they bring him in and they want psychological evaluation because he is a threat to somebody and the hospital let him walk out even the police ask for notification? i can't think of anything else -- that is the classic definition of negligence. i'm very sorry. if you want to answer, you can. we were unable to get mark's records for hipaa and we just decided it probably wouldn't be with the lawsuit. >> thank you mr. chairman. first of all light just want to say that i hope in future hearings and other events that

we will then put the testimony and purchase of fusion from the patient community, and i know that there are some -- [applause] i know there is some discussion right now i'm putting -- >> we are not permitted to have any outbursts and i would ask that members not say things that might also provokes an outburst -- >> [inaudible] >> no, continue on. >> and i know there's some discussion about including testimony -- written testimony highly foot noted into the record and i would certainly recommend that that be done without much ado. let me thank especially the family members who came here with their stories. i know it's got to be very, very hard to do and it is much appreciated.

a couple of examples that we gave we had a patient from a former patient with a mild form of what some -- autism and eventually his parents went to court against his wishes because they said their son could not care for himself and must remain dependent and you completed the ruling in their favor was counter to the goals of psychiatric treatment and the real his progress and therapy. so are you saying that there was a bad decision that the sun shouldn't have been able to do what he wanted to do? >> what i was saying is that because the sun wouldn't allow his parents to be involved in his affairs, nor would he let them be involved in therapy, so

i could not incorporate them into any of the program that i was trying to organize or any of the treatment i was trying to organize, couldn't involve them in the medications that he was prescribed. and they get serious concerns about how he was going to function because we couldn't negotiate that, because he continued to refuse to allow them to produce pete, this was the only recourse that they had to leave and encounter because the purpose of the devotee to me is to make them more functional. >> at the point they had been and will earlier, then i understand that, but at the point of someone making a decision, an adult making a decision. i could have been done without having to go to court.

>> one of the reasons i put it in their i was searching for another way to have a better outcome without having to go to court. if there was a mechanism, for example, similar to the thing that i mentioned in tennessee where there was an opportunity to repeal or to present the case in front of the review board involved in hipaa to say this is what is going on in this case. i think it is in this and fungibles best interest to have the parents involved, to have been actively participated because everything is more likely that this individual was going to be successful, his treatment is going to be successful, and his wife i think it's great to be less traumatized. if you have an opportunity to do that and there are some means to modify what is happening in the hipaa regulations in these particular cases i think that there would be an advantage not just for the family but also for the patient. >> you asked the question if there is a bias in the situations, should be towards

parental involvement should be parental involvement? what do you close? what do you conclude? if there is a bias in the situations, should it be towards% when all but rather than away from that? >> i think if there is a bias in the saturation, a child psychiatrist my bias has been too involved balance. the end of the families as often as possible in the treatment, and i think that for a variety of reasons if there is going to be a bias in the situation, my recommendation is that it would be towards family involvement. particularly if there are no specific reasons in the family, no indication for the family, nothing would adversely affect the patient. >> i think there are people in the independent living community that with fuel that a young

adult with all to some that there may be some better ways for that individual to live in the community with support, etc. nutter ban as dependent at home. do you see that as part of the negotiation that might involve everyone? >> absolutely to the lighting in this particular case the goal for the patient was greater incentives. what the hope was in the treatment is he would be able to manage his affairs and the level that he felt in the situation would go down, that we would increase the capabilities that we had to manage the medications. the sense was having his parents and all i think what expedite the process. >> thank you. >> you have five minutes. >> thank you mr. chairman. and i would also like to say to the panel thank you so much.

i'm going to get emotional, for sharing your stories because this is the only way we are going to change anything on mental health, and i know how difficult it is for you to come forward, but i can just say how much we appreciate your input so that we can make the right decisions moving forward. ..

i am concerned about the misconception of lawsuits. because as we know, there, you know, there are so many frivolous malpractice lawsuits out there. and that this is one of those gray areas where health care professionals do not feel they are expected and certainly hipaa evaluations can be weight against them. as far as malpractice, that is not necessarily an avenue that would be taken. am i correct with your testimony? >> yeah. certainly there's nothing in hipaa that would enable someone to be sued. again, to the extent that you have seen sort of any lawsuits in this space around privacy violations, they are filed under state law provisions. in terms of -- i don't, you know, i don't do mall malpractice work. if you are facing a malpractice lawsuit, that's a state law

action. >> perfect. thank you. and i would like to ask you a few questions. >> thank you. >> with your situation, especially in a sensitive as it is. again, i thank you for being brave and sharing that with us. i read other your testimony to find you were in a situation where you knew what was happening to your son, you knew there was a drug addiction, and because of that behavior on his part with the, you know, the manipulation that they do so well he was able to manipulate and then kind of get his way. >> yes. >> and then you were able to get him to a treatment facility, but then you were told they could not share information with you because of hipaa; correct? >> exactly. and the manipulation line that go ace long with addiction, i

have learned from my son and others that this happened was just to give you one example, i wanted to see him go an inpatient treatment program immediately. he said, dad, i don't want to go to an inpatient treatment. i don't want to start using heroin or crack cocaine. and i as a parent had to make a decision what to do. and i did my research and did hear that people smuggle in heroin and crack cocaine and a lot of other users and percocet using, which is what he indicated he was doing to the family. not letting us know he was doing heroin. therefore the lies and manipulation, unfortunately, we sent him to an outpatient which he said he would agree to go to. when i tried to confront the outpatient program i was denied any access to records. >> unfortunately, that is a story that we continue to hair,

and i do agree with you. i think there are some changes that need to be made. more clarifications, i think than anything that health care professionals, family members, and patients can understand a little better what can be shared and cannot. i thank you. >> thank you. >> dr. martini. i have thinker -- thirty seconds left. i want to say recently i was at the partnership of children for cummer land county, north carolina. i represent second district of north carolina. we had a lengthy discussion about member tal illness especially in children. i have a good friend who has a son is awe it'sic and starting to show signs of depression and beginning signs of mental illness. they are having a difficult time trying to find the correct physician for him because of his autism that had already been diagnosed.

quickly, would you say a few words about that? >> i think that vainlt of services -- availability of services critical issue. we need expand the work force, not just on psychiatrists but all childhood professionals. i think we also, as i look to perform, need to work with community physicians. we need to work with schools. there are ways to provide services for children locally that can efficient and effective. >> thank you so much. i appreciate the chairman giving me a few more seconds. thank you. >> mr. scalise is going allow dr. cassidy to go first. recognized for five minutes. >> thank you, mr. chairman, thank you, mr. ska let's. we are concerned about priest and you can respect there's a certain ability we must have or that is exhibited by this. thank you all. pl's levine, the way you said

the hipaa law should be written something a patient understands. i put exclamation mark because. it is written to avoid liability not to inform people what their rights all. thank you, all. dr. martini, what a great name for a psychiatrist in this case. >> i like it. [laughter] >> i asked mr. rodriguez a question, you put here if you had a patient who was -- for by polar and if the is compensated, would you feel that current lip pa allows allow you to speak to the parent of someone who is emancipated by age or law that listens. it it goes any lower they'll have a sky psychotic break. it's not an immediate danger. he seemed to indicate it would be per admissible.

would you accept that? >> if the patient explicitly stated he didn't want that information shared, i think most psychiatrists would believe that they did thefacient was not -- partial was not imminent danger to self or others most believe they shouldn't share it. >> if the history of noncompliant and having bipolar episodes and some of the heart wrenching stories occurring, would it change the calculus or, no, we can't do it? >> i think when i talk to colleagues of mine about that situation, if they're dealing with a patient that is dangerous and noncompliant with the medication. they inform families and significant others and take the risk that that may be in violation of hipaa because they believe it's in the best interest of the patient. >> it's interesting because you say that they take the risk and that's a perception. some of what we heard it shouldn't be a risk. it should be like, wow, it's not

a risk. that tells me there's ambiguity even among people who are full professionals. >> i think that's true. the i think the problem is that that idea of waiting until imminent danger. a patient can be noncompliebt on medication and look stable. and you know that eventually -- . >> not to be rude. we know there will be a pattern of episodes. we know he might see the level going down. it's going happen again. he doesn't pull a gun or do anything terrible. he lives under a bridge and leaves hiss family, sells his -- possession and run down the street. whatever. would there be ambiguity among your colleague whether they ared at risk. >> thing if when they are seeing the patient if the patient appears stable understand mood

asked disorders are opened soic. i think there would be concern they understand in many situations they need to do that. because the patient has a history -- . >> there is a perception they are running a risk. >> yeah. >> mrs. mcgraw, mr. kelley used the term, i'm not sure how to pronounce. i think we are familiar with if we have a teen on the other hand his is far more dramatic. a year of no -- [inaudible] the gentleman said that his parents could not know his history. yet he had no insight. you're not sure how to address that. what would you suggest? >> i was struck. as smart as you are, and you are an excerpt in privacy you learn from mr. rodriguez's testimony. not hearing this testimony there's no way that er physician has no way she can actually be

as facile with the information we are demanding her to be. what suggestion would you have for mr. kelley? >> one of the things we had a lot of conversation about. when i said i learned something from director rodriguez this morning, how the concept of incapacity plays in the capability to share information with family members. which is not contingent. but circumstance under which mental health professional can make a judgment about talking to a family member when they a believe it's in the best interest of the patient. in circumstance when the spaishtd not around to object or incapacity and, you know, looking to the guidance that is right in front of me, about the ability to talk to family members, the issue of the incapacity which is in fact our regulatory language is not explored in much detail. it does leave a lot of uncertainty on the part of providers about how how do they comply with that.

what does it mean? it would be helpful to the guidance explore the issue a little bit more detail. >> thank you. i yield back. >> mr. ska scalise you are recognize. >> thank you, mr. chairman, for having the hearing. and thank you for sharing your stories with us. we had a thought a real helpful forum back in march 5th. we had other family members including -- someone from district who had a son matthew that took his life. was being treated for mental illness. they thought they were making progress, they both -- patted and his wife debby were trying to get information from the doctor, the treatment centers and were not able to get the information. and hipaa was being thrown up as the reason that they couldn't get access. it turned out, after the fact.

unfortunately after mathew took i his life, in his time he authorized his parents to have access to information. and so it was just incredibly frustrating angering for us hearing this at the forum we had. ease specially to them as parents trying to get the right kind of help for their kids and son and couldn't get the access. when we hear the stories, and i know there, you taunted it, that -- talked about it that people hiding behind hipaa when it turns out hipaa may not be the impediment, how do we get some clarity in hipaa to remove this gray area. if it's even in fact gray that is stopping vital information being shared with family members, you know, even in cases where these patients want their parents to have that access. yet, it's being denied. anybody from dr. martini or maybe go across.

if we can figure out what is the disdwheact is stopping this information from being shared when the law by many people's own interpretation doesn't preclude the information from being shared. >> i think the thing that is missing in the situations is a discussion of the clinical presentation. looking a the cases at the much more individual basis and providing within the law some flexibility for in other words appeal or involvement by clay in clinics so there's an opportunity for psychiatrists and psychologies to present the case to an on jettive body make a request for modifications in hipaa and those particular situations. again, thinking about what is in the parent's best interest. and have the objective body rule on the process. i think somehow making it feel as though it's not simply the government telling people what to do. but as the government giving

people an opportunity to protect their rights but also to ensure the patients get the best care possible. >> mrs. levine. >> umm, i think we need to start with medical education, nursing education, and all other kinds of education to have objective people presenting the rule of hipaa. what is per admissible, and so forth. not the risk managers. i'm sorry if anybody here is a risk manager. i think people -- i think this perception of the legal liability, if anybody can sue anybody for anything but the real risk is in the security of the electronic data. and that seems to have been ignored in all of this hipaa scare.

"the washington post . >> i apologies. i have a minute left. >> i think you need to do the education in an on subjective, balanced way and think about the patient's best interest. >> thanks. mr. wolfe. >> i want to say feel the parent it's important for parents to be apprised. what is happened with their children. whefn they are legally emancipated. i think that's important to be put in to because of the obamacare said we take care of them until the age of 26 in your own word our insurance, i would not have lost justin. if i was made aware of he was going in for. i think the parents have to be made aware. the best care givers with regard to our children. and there has to be an exception with regard to that. >> thank you, mr. kelley. >> i would like to ask the committee start expanding the definition of a family member beyond a parent. other members of the family in the roles. quite a lot frankly change is hard.

and i want to thank mrs. mcgraw from the bottom of my heart. it's taken so long to hear when she side. we need to change things. sometimes you can't get change unless you change things. there's unless the patient objects laws will rule the world. >> thank you. i would agree with what he said. i think we need to be more aware of what hipaa actually prohibits. and i think there probably should be some special clauses there for the mentally ill. >> mrs. mcgraw. >> yeah. lots more guidance. clear understandable, disseminated to places so people can easily find it. maybe a hotline for questions. >> the chairman's sometime it expired. at this point -- i understand that the ranking member has a anonymous consent request. i want to say this, this committee has a practice of only

accepting sworn testimony. we're going to be asked to accept a letter seened by a number of organizations which states in the first paragraph there are many so statement toss the record in advance to the hearing. i want to say we became aware of thissed at 7:15 this morning and haven't had time to fullly review the statement. in this case, it is not a a letter but as i said before, quote, statement for the record, unquote. that doesn't follow the tradition of the committee for sworn testimony. more over, it's a point of personal privilege for the chairman. one of the groups who signed the letter, for the record, has repeatedly circulated false chairman about the chairman and ranking member and repeatedly and purposely misrepresented a serious and important work we are doing here on behalf of patients, families, health care providers and the public. they have repeatedly and deliberately misrepresented the committee work with false statements. thus, in this case, submitting a

statement for the record without it being sworn testimony. i yield to the ranking member. >> mr. chairman, i would ask anonymous consent to place a letter dated april 25th 2013 about the position of the organizations regarding hipaa and signed by the american civil liberty union, the autistic, south networking. i would ask to put in the record the p.r.n. of the organization. -- opinion of the organizations. as we doesed before. i've been on the subcommittee for sixteen years, mr. chairman. it's been the practice of the committee to take testimony under oath. you are correct that the letter obviously is not under oath. it's also been the practice of the committee, though, to get extensive information from folks who might have expertise or opinions or otherwise. and i've seen it happen numerous

times from both sides of the aisle. simply accepting a document to the record does not necessarily imply agreement with the position stated in that document by either the chair, the ranking member, or any other member. but rather it helps to give a more full picture of what people think. i agree with you. i do not consider this april 25th letter to be testimony or to substitute for testimony. i believe that it is a statement of that group and we have done that. i've got many examples i can give. in the interest of time. i won't. i simply ask for the chair's for putting it in. and look to clarify documents put in the future. i would also note we put an article from "sports illustrated" in the record today. it seems to me the letter would be appropriate. >> i thank the remembering manager. and understanding some of the unique circumstance this this and the case. we will accept this to the record. and the majority will also put a

statement in along with it. i want to thank the panelists today. in our continue our series to deal with this critically important issue for the american people. not since john f. kennedy was president we have had a focus on the issue of mental health and illness in our country. the passion and statement from the sympathy, our sympathies and prayers go with you. the expertise, dr. martini, pl's levine. i ask you stay in contact. we have a great deal of respect for what you have give today. and we look forward to working with you. almost i might -- i would like to add this. i'm proud of the committee members on both sides of the aisle. i think that the members here have shown absolute dedication to work in this. the statement we had earlier 38,000.

all involved. this committee is focused more than 80 -- any other subcommittee is worked on this. i deeply thank the ranking member for her compassion and passion and in this. and i thank you mr. braley for bringing ms. thomas. i remind members they have ten business days to submit question for the record. i ask the witnesses to promptly respond. with that the committee is adjourned. [inaudible conversations] last week house democratic represents edward mark key faced off in a final debate. here is a portion of that debate now. as the two members discussed apportion rights. >> when you a choice ensure that

a woman on the military on a base oversees i had a right to access to that health care procedure inside a him tear hospital. you expwroafer voted to deny her that right inside global military. it's not thirty years ago. it's not twenty years ago. it's in the last few years you have done that, steve. that's why planned parenthood has endorsement. there's a difference between the two of us on the issue. >> response, please. >> the issue on the military base, those woman are in uniform. they're under command. they didn't just all wake up and decide to dress in green. they are on a military base. you don't salute each other. the idea for women to get an apportion on military base is a bad idea. we ought to give them medical leave, let them get off the base, if you really are in favor of free choice, let them get off the base and make the decision out from under the pour and command. >> one minute. you split it.

you have to be gone in a minute. >> look, i just think that if a woman is in the military, she's in some foreign country, and has to go out to that country in order get that procedure rather than have -- rather than having access to the medical care within that hospital? look, as far as i'm concerned, fire that general. fire that cocial. get rid of people who abuse it -- one of the greatest ongoing tragedies we have in our military is the abuse of women in our military. that's what we have to correct. [inaudible conversations] >> my that is a problem. >> if they are being abused. get them off. look. >> it's my last minute. >> we're done. that was a portion of the debate held last week in boston. both congressman are run forking the u.s. senate seat left vacated by john kerry. the democratic primary is tomorrow with the special election taking place on june

25th. if you are trying to generate the government and looking for ways to generate new revenue, silicon valley has the ans. if your trying to explore and ignited better innovation within your companies, silicon valley has the answers. and from an entrepreneur standpoint, how is entrepreneurship different in silicon valley than other places? which it is. so much is often based on failure and learning from one's experiences. but it's also recognizing that you can be part of the process of adopting other people's ideas or you may have the idea for the next big thing. the bottom line is there's an authenticity to the way things are done in silicon valley that is very accepted. no matter who you are. what makes silicon valley tick? tonight on ""the communicators" on c-span2. tonight on c-span2, booktv

in prime time. starting at 8:30 p.m. eastern. former supreme court justice sandra day 0'connor on her book. "out of order." a panel discussion with authors who have written about the high court. and after that, it's "after words" with martin clanty coauthor of "murder "of the supreme court. all these programs tonight on c-span2. she sneaks sub mys to the. the is in poor health and excludes herself to a second floor room in the white house. meet eliza johnson. we continue the series on first lady with the question and comments by phone, facebook, and twitter. tonight live eastern at c-span

and c-span 3. and c-span radio and c-span.org. he spoked at the heritage foundation for forty five minutes. [inaudible] [inaudible conversations] >> oorch, ladies and gentlemen. welcome to the her tiblg foundation. we of course welcome all of those who join us on the occasion on the heritage.org website and joining us visa c-span. we would ask anyone in-house to see that cell phones have been turned out as we prepare to begin. all of us will appreciate that. especially those recording the event. we will post this program on the heritage home page within twenty twenty four hours. and now if you would join know

in welcoming our presenters. say that will take their place on the stage. gentleman? [applause] >> thank you, john. i'm the chief of staff here. it's a joy and honor along with senator demint to introduce chaplain black to the heritage lecture program. having served in the senate as a chief of staff, i can tell you the chap chap as we look at the topic for day, may cause do you think that the intelligence is to eliminate the divide. in the two sides in to one. a perfect able sei it's helpful to consider what it is. it does not exist to close the

divide, fill the divid or eliminate the divide. in fact the bridge acknowledges the divide. description. he's as a scripture said the man standing in the gap. as a pastor of the senate he serves as counselor, comforter, and front end many including myself. rarely a day goes -- someone spent most of his career deployed most of the time as a navy chaplain has plenty of practice cat device. let me tell you. it's my pleasure to introduce

senator tim demint who will introduce chaplai black. [applause] >> thank you. it's wonderful to have you here. out of the darkness in to the light over here at the heritage foundation. [laughter] i know i came from there myself. chaplain black was commissioned in 1976 as a chaplain in the u.s. navy. and he retired as admiral, after nearly thirty year career. he's earned dpoctd rate in philosophy and ministry. his bying -- biography recounts the story ofover coming. the more recent book, the blessing of adverse i are, finding your god-give purpose in life's troubles.

distill the wisdom he gained gained from thirty years for addressing the many trials in life. barry, we have plenty of those. i appreciate you coming and sharing with us today. [applause] [applause] i'm extremely nirve use. member of my staff are here. they are rei teaking me. >> a lady approached me some time ago and said, dr. black, if they permit prayer in the legislative branch of government, why have they removed prayer from our schools? and i must confess that i was rather flippant in my response, and it was a reflects. and i should have thought

through. i said, ma'am, as long as there are final exams, there will always be prayers in our schools. it demonstrates the fact that even in a secular environment, the spiritual is often present. in 1787, at the continental congress, the group had reached an impasse when ben franklin spoke. he said, gentleman, i'm an old man, i have lived long enough to know if a sparrow cannot fall without god knowing it, an empire or public cannot rise without his help. and franklin suggested that the group should pray.

i think it's example of bringing the spiritual in to a secular environment. many of us feel that the work of the spiritual is that of the minister. if only i were an ordained clergy person. i could inject some spiritualty for my workplace. my work environment, or the secular environment. i would challenge that presupposition, i think it is createically important to remember that 90% of the life of jesus was spent in a secular occupation the priest prophet

ministry outreach. 75% of the biblical heroes were involved in secular occupations. and yet issue able to bring the spirit l to the occupations . z we used to say any my church, a bad know negro. [laughter] knee mia, there were so many that brought the dimension of the spiritual in to a secular environment. joseph was prime minister of egypt and what an amazing contribution he made. bridging that divide between the sacred and the secular. as senator demint mentioned, i was in the navy for twenty seven years.

i was delighted to be in that military organization because, as most of you know, jesus was a navy man. [laughter] ships, walking on water. although some say he was a marine. i believe he was a navy guy. [laughter] through he was in the navy. and so twenty seven years of serving. i still remember having a supervisor, he was second in command, who was an individual that i did not enjoy being with. i must confess. confession is good for the soul. he rarely spoke a paragraph without plenty of profanity. that is rather aggravating for the person the clothe. well, he was writing my evaluation. what do you do? i would take him on in the evening prayer on a ship, there is a public address system.

in the even the chaplain, office of prayer, inclusive prayer for all of the sailors and the executive officer and i were going back forth as i would be debating him in the prayer and he would, of course, after the prayer, as leaving the bridge with the chap plin please report to the executive office. and i would come in. what's wrong, sir? he said how dare you talk about me in the prayer? sir, i mentioned no names. i was simply saying that god must be offended by the am of profanity happening in the on the ship. even at the highest levels. [laughter] [laughter] a clever way of bridging the divide between a sacred and secular. then a new commanding office came aboard. he didn't wear his religion on the 0 sleeve. he didn't even attend the

worship services or the bible studies i conducted on the ship. after two days of wandering around the ship, he had a captain's call. when the new commanding office defines reality for the ship. and one of the things he cede, quoting george washington was that there would be no profanity aboard his ship. i was startled. no profanity according to george washington who said something about that needing to use profanity was an indication of a limited inte elect. there it was. i honestly believed there was no way that the executive officer would be able to speak standard english. there was no way. the end of his career. there was absolutely no way he would be able to obey the order. there was an order that was too much for him. i never heard him speak more than a sentence or two without using profanity. but, miracle of miracles, all of

a sudden the language on that ship was clean and it was amazing the difference it made. the individual was able to inject the ethical and the moral in to a spiritual -- in to a secular environment. my challenge to you, if you are a person of faith, is to find a way to bridge that divide, and to recognize that many times to make a dichotomy between the sacred and the secular is incorrect. the lebanese-american poet in the wonderful book "the prophet "is a wonderful book. the recluse of prophet was

leaving town, and they ask him to speak about various things. speak to us of love, he said. i'm not a speaker but then whatever they would ask him to speak about the lyrical so little -- and when the wing of love enfold you. yield to him. the sword hidden among the pinion will move you. the man speak to of us of children, your children are not the children. they are the son and daughter of right-of-way. they though they are with you. they do not belong to you. and finally said, speak us of religion. he said, have i spoken this day of all else? is not religion all deed and reflection and that which is not deed or reflection a wonder and surprise springing in the soul.

i think first crin capture what we should be doing if we are going make sure as who we are as spiritual beings follow us to the workplace. it says, whether you eat or drink or whatever you do, do it all for the glory of god. it is basically challenging us to glorify god in our behavior. whether we are at work, whether we ared at home, whenever we're and whatever we do, we should strive to glorify god. and i want to make a few suggestions on how to do that. the first suggestion is to be salt and light. some of you have heard a great

communicator ronald reagan talk about america as a shining city upon a hill. he was actually paraphrasing that in 5: 16. jesus said, you are the light of the world. a city set upon a hill. cannot be hidden. we ought to be salt and light if we are to glorify god in the workplace. now in salt, makes food palatable. i spent a lot of time in south carolina pastoring the alumni of the university of south carolina . but anyhow, i cannot imagine grit without salt. i shut shudder at the thought of grits without salt. your presence in the workplace bring you are as a spiritual being and glorifying god in all

you do should make the workplace more palatable. people should not be high fiving one another when you have a sick day. okay. you should -- [laughter] instead make the workplace a more pleasant environment. be salt. salt in the days before refrigeration, also preserved food. and your presence in the workplace bringing you are with a spiritual being should make the workplace a more secure environment. you will recall in genesis 18 has abraham interceding -- god if there are at least ten people there, will you spare the city. james chapter 5: 16. the fervent prayer of the righteous unveil much. when you can't coanything else,

you can always pray. and there is power in your prayer. so be salt by making the workplace more secure with your intersession. be salt by making it more palatable place and be liked. illuminate. illuminate. make a difference. by the insight you bring, based upon the knowledge you have of sacred scriptture. and many times, you don't give chapter and verse, of course, but simply paraphrasing a biblical insight will help you to be a force for good, particularly whether in the workplace people are facing right versus right conundrum. very ease to solve righterer us

is wrong. but the right versus right con conundrum are the difficult ones to solve. that's one of the reasons we're challenged in the legislative branch. many of the issue, not all, but many debated in the chamber involve righterer us is right. truth versus loyalty. long-term versus short term. justice versus mercy. right versus right. the individual versus the community. and you, a person of faith with rev will story knowledge, can imliewl illuminate that environment. the same way joseph was able to illumination to pharaoh. a 70-year governmental career was able to give illumination to -- second, witness without

words. that's tough pull off. a lot of us are good talkers. we don't back up our talk with our actions. if you are ethically congruent, your actions should be the key thing you focus on. francis said preach the gospel everywhere you go when necessary. use words. you, a force for good in the workplace, can make a difference without saying anything. paul put it this way inspect second con rein began, you a living letter to be read by all who see you.

the eyings are better pupil and more willing than the ears. fine counsel is confusing but example always learn. and best of all, the teachers are the ones who live their creed to see good put in action is what everybody needs. i soon can learn to let you see it done. i watch your hands in action. but your tongue too fast it may run. and the lecture you deliver may be double wise and true. but i rather get my message by observing what you do. witness without words.

finally, if you are going bridge that divide between the sacred and the secular, live to serve. your focus should be about servant, labor, or servant leadership. max three responsibilities of leadership -- the first is to define reality. the leader projects the vision for those working in particular organization. the last responsibility of the leader is to make sure there's an orderly transition from the organization to retirement or whenever the person is going after he or she leaves. to say goodbye in a dignified way. that's why in the navy we what we call hail and for wail. you have to be at the hail and

farewell to say goodbye. even for those folks who don't particularly care for. in betweened leader is a sur event. how can i serve? it is this proclivity for service that should make all of the difference in the world. paul put it this way in first crin began, think of yourself as a servant and a steward of the mystery of god. am i serving? one of the last speeches made by or actually was a sermon made by martin king, the last sermon he preached, he ended it by talking about what he wanted said at his funeral. he said if any of you are around when it comes my time to meet my day, i don't want a long funeral.

if you get somebody to deliver the yule gi. tell them not to talk too long or won a noble peace prize. that he tried to give his life serving others. he tried to love somebody. i want them to be able to say that i did try to feed the hungry, clothe the naked, visit those in prison. i want them to say i tried to be right on the war question. i want them to be able to say that i try to love and to serve humanity. then he ended, as baptist preacher has to do with a little bit of lyrical intone nation. we call it hooping.

he said, if you must say i was a drum major, say that i was a drum major for justice. say that i was a drum major for truth. say that i was a drum major for rich useness. and all of the other shallow things of life will not matter. i wanted to leave a committed life behind. that's what each of us can do. if we will bridge the divide between the sacred an the secular. if we are salt, and light whenever we're. if we witness without words, if we live to serve, in other words it will become true if i can

help just one somebody as i pass along, then my living shall not be invade. [applause] [applause] [applause] [applause] >> you think we can arrange for this every mondayed at noon? we'll be glad to take questions. we have a microphone. it if you will be kind introdpiews yourself and question in the form of qea. we'll be happy to recognize you. we'll start down here in the front. >> thank you. your word inspire us. i would like to ask in light of

recent events, bright bart published a specie -- [inaudible] i long with that the push to make military chaplain to accept gay marriage and push that in the military environment. how do you see a committed christian being able to stand up against things that might be considered religious persecution in the united states in politics today? >> well, the military has religious accommodation policies you would have to eliminate in order to full off. the religious accommodation directive make it clear that a clergy person cannot be forced to do anything that he or she is not comfortable with doctrinally. military chaplains serve in a

context called institutional duality. they are enforced bay church. if they receive any enclues yays call as well as being commissioned be i the mill tear an swrawl from an endorsement would remove the military -- the chaplain from his position as a chaplain. so there are safe guards right now that would have to be removed. i can see many military chaplain having some problems because to preach the passage of president paul with integrity would mean being accused of engaging in hate speech. so this is a challenge that i think we are going have to deal with.

going forward. [inaudible] i hear of christian being a quite witness. when it appropriate for christian to be a loud witness? and things like protest and boycott like we saw during the civil rights movement or today the protest or boycotting certain companies and things like that. how should christian decide when to be a quite witness versus when it's appropriate to be loud. >> well, are are to persuade you need a tripod of three things. he used greek words. the first is being perceived as ethically congruent. that's what witnessing without

words is all about. the problem is we are often loud before we have the prel ywied and the sensitivity particularly to the margin alize. and so i think, yes, there is a time for a louder witness. but that should be proceeded by a lot of loving, at love serving. the civil rights movement was actually a great example of witnessing without words. because i participated. of us in alabama in the '60s and desegregated as i said in the audience and listen to martin martin luther king, jr. speak. we put our body in the line with making speeches. martin was our spokesperson. when we face the billy club of the police officer and the police dogs, we did not say a

word. morale the conscious of the nation without words. what you -- [inaudible] [inaudible conversations] i'm working my way around. elliot, i'm a intern here. i'm curious as to what you think -- there seems to a -- to go back to aristotle for a second, politics is supposed to be about justice and society's understanding of justice seems to be have been shifting over the last couple of years. maybe longer. away from the idea of justice that is understood by people of faith and particularly christian

faith. sthawch you now see conflict arising or my conscious precludes me from pay forking the procedure or this kind of insurance. the hhs mandate said justice as defined by the politics of the country requires you to pay for the sort of thing. the religious definition of justice such that the people on the religious side start to become excluded from political participation? and how do you prevent that sort of thing from happening? >> i think jesus' at the same time rendered to caesar. i think that's a crit car part when you are wrestling with issues like that. i think also that a person has to have sufficient integrity where there are lines that you

want won't cross. you have to have the courage like -- [inaudible] an unjust law and they basically say our god is able to deliver us. he will deliver us. but even if he doesn't, and they're talking to the king, we would rather bow than burn. they had a commitment. i don't know where daniel was at the time. i hope he was out of the country. they had the willingness to do that. we see an example of daniel going to have lion's den rather than obeying an unjust law. the whole civil rights movement was based on disobey unjust laws. that's what began i did did. we have a history of nonviolate direct action and we certainly

have enough people of faith that there are creating ways question tackle any challenge that we face. i think win. we have to be a lot more creative in that approach. having a team effort. wonderful verse in luke 10. the harvest is a white. the labor of a few. what do do you? pray the lord of harvest more laborist. we need more laborists. to help in the challenging situation. have that line that you won't cross and it doesn't take a lot of folks to make a difference. if my people call by my name or humble themselves and pray. seek my face or hear from heaven, forgive their sins. there was a powerful forth in that little remanent that know how to speed dial heaven.

[inaudible] there was a lesson in your understanding or your -- i was -- [inaudible] any instruction about this when you cited your position for the u.s. government. the origin of prayer in the congress. my understanding that was started by ben franklin. at the time he proposed that, it seems to me he was probably a -- he wasn't someone that believed in -- i i believe in as a christian. how is it proposed to be used in congress. it's one thing prayer for a christian or a believer or

someone agnostic or dìas. >> franklin was in 1787, at the continue continental congress what prayer came to the congress in 1789. interesting enough, it came three days before the establishment law. on the day the establishment clause was there was a prayer and there was for the most part uninterpreted rather. i think franklin's notion leading contact with the transcendent at the foundation of the whole notion of prayer. we should be in an attitude of prayer.

but it failed if there's any place on the planet where prayer is needed it's capitol hill. .. were you have seen the hand of god moving congress.

>> well, when i first arrived, in the senate in 2003, i had a lady who came to me and asked me to pray for her because she had been diagnosed with inoperable cancer. we have the prayer team of several thousand people and we just get the first name in what the problem is. well, i encountered this lady three or four months later and she was doing so good that she had gone back to her physician and said, if this is dying, it's not too bad and he had brought in all kinds of experts in the bottom line is, could find no evidence of cancer at all. ended up eight years later, she was 90, delivering the eulogy at her funeral. she died, but not of cancer,

died of something else. so one example i believe saying if there be any sick among you, pray. i am convinced that prayers, debt ceiling prayers, sequester prayers, we stay on these and time and time again sometimes at the 11th hour we see god step in and make a difference. senators will say to me, chaplain, something you said in the prayer caused me to change my vote and i don't know what it is but i'm sure the holy spirit has a way of touching hearts and it was probably something that i didn't intend to be directed but god has a sense of humor. so that's a good book for me to write i think. time will not permit me to tell you the many many times i have

seen prayer answered in the u.s. senate. >> my question, there are two -- [inaudible] one of them is in the white house and want to have their own guards on capitol hill. how would you react because it's very -- just a file about prayer but muslims might have an imam. how would you reconcile so many kinds of prayers and having at some point have a different kind, more than one presenting the guard on capitol hill.

>> yeah, well a famous roman catholic writer tells the story of the exodus of the children of israel going through the red sea and of course they go across on dry land and when pharaoh tries to follow, the waters calm and the pharaoh is drowned. the angels in heaven are looking at god and tears are coming down the face of god. the angel said, god why are you crying? your children the israelites have just been freed from egyptian slavery, and god responds yes, my children, the egyptians are dying. i think our efforts to put god in a box, too defined the

transcendent, we are like children building sand castles and i think we are going to discover that there is a greater unity of divinity that surrounds this planet than we realize. so, call him by whatever name you want to call him. i believe he has the whole world in his hands. >> shone with in god we trust. congressman walter jones introduced a bill for years to simply let military chaplains in the prayer of broad with in jesus name we pray. can you gauge the morale of military chaplains abroad? >> well, i have spent 27 years in the navy and retired a two-star admiral. i have prayed during that 27 year ministry thousands of times in the name of jesus.

in a worship service, in my bible studies, when i ministering to the six sick so military chaplains on a daily basis pray in the name of jesus, but because we are in a pluralistic environment of ministry, there are times when a more inclusive prayer should be prayed. for instance, three marines have been killed, two of them are muslim and for me to pray a christ-centered prayer would probably be inappropriate. it would probably wouldn't be best. or when i am praying over an emcee. we have hindus and i'm facilitating for them and i pray a prayer clear you were on the ship there is no way you can --

you can jump overboard if you don't want to hear me but you have to give that prayer. there is nowhere to hide. for me to pray father god in the mighty name of jesus, would probably be a little over the top. the times when military chaplains cannot pray in the name of jesus in my opinion and from my experience, those times are few and far between. i have baptized folks the whole nine yards in that i talk about religious accommodation if they chaplain comes from a religious tradition where he or she says you know, if i don't say that name you know, it's not a prayer. fine, okay we will get someone else to say the prayer for this particular venue, no problem at all. even as there are some chaplains who sprinkle and others of course correctly immersed. [laughter]

i knew senator demint was here so i had to throw that in, baptize them by immersing. no problem. we will get someone else to do that and you can stay committed to your conscience and follow it. i don't see it as a serious problem from my perspective of 27 years of late in the military. >> hi. my name is antonio chavez and i'm a science teacher. i read in -- it said religion was essential to the success of american democracy. in democracy there a lot of selfish instincts in people and religions keep the ends things in check and then you look at what happened in the climate with united states. what you think do you think about that? >> there is debate about whether alexis de tocqueville really

said that and there's also debate about the famous alexis de tocqueville quote america is strong because america will cease to be strong. however if he didn't say it he should have said it because it's basically a paraphrase of proverbs 13:34. righteousness exalt the nature of sin is a reproach to any people. sin is an equal opportunity destroyer. sid does not care that your name is america and unique empires that it imploded, alexander the great, rome in decline. sin can destroy so i think that people of faith should recognize the contribution they make to

national security. and i talk about genesis 18, abraham negotiating for the survival of sodom and gomorrah and he started up around 35. he has got doctors, a wife and he is doing any kind of work. they have -- couldn't even find a tent so i believe you know alexis de the alexis de tocqueve is on target that we do needs to appreciate goodness and celebrate goodness and be willing to die for goodness because the national security issue. anyone from my staff? [laughter] thank you. [applause]

>> we do of course have copies of both of his books available if you would like to have them signed by chaplain black. i'm sure he'd be glad to talk to you for there. will i do have the podium i want to thank you chaplain black for your service to the senate where wade no they need as much help as they can get in thank you for your room careful example. you have an open invitation to come and visit us anytime. thank you and thank you all. [applause] [inaudible conversations] >> wonderful. >> thank you, sir. [inaudible conversations] >> if you are trying to generate a government and looking ways to generate new revenue, if you're

trying to explore and ignite better innovation within your company silicon valley has the answers and then from an entrepreneur standpoint, how is entrepreneurship different than others. so much of it is often based on failure and learning from one's experiences, but it's also recognizing that you can be part of the process of adopting other people's ideas or you may have new ideas for the next big bang but the bottom line is there's an authenticity to the way things are done in silicon valley that is very accepted no matter who you are. >> tonight on c-span2 is booktv in prime-time.

next defense secretary chuck hagel told holds a briefing on u.s. plans to send 12 osprey aircraft to okinawa japan despite concerns over the safety of the aircraft which crashed twice last summer. held at the pentagon, this is 45 minutes. >> today i'm honored to welcome mr. onodera to the pentagon.

we just completed a very productive meeting covering the full range of issues facing the us-japan alliance including north korea's destabilizing behavior, threats to maritime security and our shared efforts to enhance our defense posture and capabilities to respond to the 21st century challenges. >> translator: . [speaking in native tongue]

[speaking in native tongue] >> in the course of our discussions, the minister and i reaffirmed that the us-japan alliance is the cornerstone of regional security and prosperity. [speaking in native tongue] >> while our focus here today is on our defense, i should note that as the united states rebalances to asia, our two nations are taking significant steps to deepen economic and diplomatic ties, including recent progress towards japan

joining the transpacific partnershitr negotiations. >> translator: . [speaking in native tongue] [speaking in native tongue] >> strengthening our security alliance is also critical to achieving the goal of the u.s. rebalance, enhancing prosperity and promoting peace and stability in the region.

[speaking in native tongue] >> the most obvious threat to stability in the region is the provocative behavior of north korea. [speaking in native tongue] minister onodera and i agreed that continued close coordination between u.s. and japanese forces will be essential for monitoring and responding to any further provocations particularly cooperation on missile defense. >> translator: . [speaking in native tongue]

[speaking in native tongue] >> today we made progress on plans to deploy a second tp y. two radar to japan that will help protect both of our nations from the threat of north korean ballistic missiles. >> translator: . [speaking in native tongue]

[speaking in native tongue] the united states remain steadfast in our defense commitments to japan, including extended deterrence and a further nuclear umbrella. >> translator: . [speaking in native tongue] >> minister onodera and i also discussed ongoing friction in the east china's see, another key regional security challenge that must be resolved peacefully and cooperatively between the parties involved.

>> translator: . [speaking in native tongue] >> in our discussion today i reiterated the principles that govern long-standing u.s. policy on this sankaku islands. >> translator: . [speaking in native tongue]

>> the united states does not take a position on the ultimate sovereignty of the islands, but we do recognize they are under the administration of japan and fall under our security treaty obligations. >> translator: . [speaking in native tongue] [speaking in native tongue] >> any action that could raise tensions or lead to miscalculations affect the stability of the entire region. >> translator: . [speaking in native tongue]

>> therefore the united states opposes any unilateral or coercive action that seeks to undermine japan's administrative control. a message general dempsey conveyed to his counterparts last week in beijing. >> translator: . [speaking in native tongue] [speaking in native tongue] >> even as we we focus on these near-term security challenges,

minister onodera and i also engaged in strategic discussions about the future of the alliance. >> translator: . [speaking in native tongue] [speaking in native tongue] >> our staffs have been working for some time on a review of roles, missions and capabilities to inform any revisions to the defense guidelines that underpin our alliance cooperation. >> translator: . [speaking in native tongue]

[speaking in native tongue] >> one area that has been identified as a critical priority is intelligence, surveillance and reconnaissance. >> translator: . [speaking in native tongue] >> today, we announced the formation of a defense isr working group to deepen cooperation in this area. >> translator: . [speaking in native tongue] >> minister onodera and i also

reviewed the significant progress that we have made in realigning u.s. forces in japan in order to achieve a more sustainable resilient and effective military presence in the region. >> translator: . [speaking in native tongue] [speaking in native tongue] [speaking in native tongue] >> he earlier this month the united states and japan jointly announced the basic consolidation plan on okinawa.

>> translator: . [speaking in native tongue] >> its implementation in concert with moving ahead on the replacement facility will ensure that we maintain the right mix of capabilities on okinawa and elsewhere in the region as we reduce our footprint on okinawa and strengthen this alliance for the future. [speaking in native tongue] [speaking in native tongue]

[speaking in native tongue] >> in addition, we confirmed the deployment of a second squadron of an maxie-22 ospreys in japan which will take place this summer and increase our capabilities in the region. >> translator: . [speaking in native tongue] [speaking in native tongue]

>> i would like to recognize minister onodera for his leadership and his commitment to this alliance and also as i have expressed to the prime minister to please convey my gratitude to prime minister abbé. >> translator: . [speaking in native tongue] [speaking in native tongue] >> the tangible progress we have made any reorienting this alliance in the 21st century challengechallenge s is the result of hard work and close coordination between our two governments. >> translator: .

[speaking in native tongue] [speaking in native tongue] >> we are strengthening this alliance. minister onodera, thank you. please proceed. thank you. [speaking in native tongue] >> translator: i had a very good discussion with secretary hagel today. [speaking in native tongue]

[speaking in native tongue] >> translator: with the outcome of the meeting of president obama and prime minister abbé in february secretary hagel and i confirmed this significance of leavening up our bilateral cooperative relationship to a next step. considering the situation of north korea, we continued our bilateral close cooperation, as well as trilateral close cooperation of japan, u.s. and south korea. [speaking in native tongue] >> translator: on this sankaku

islands i explain japan's explained japan's basic position that the islands are clearly and inherent part of the territory of japan in light of historical facts and based upon international law, and that japan is determined to protect its land, water and air. [speaking in native tongue] >> translator: secretary hagel and i confirmed that article v of the us-japan security treaty applies to this sankaku islands and that we are opposed to any unilateral action that aims to change the status quo by force. [speaking in native tongue]

>> translator: on bilateral defense cooperation, we confirmed that bilateral discussions on strategic environmental perceptions are underway. [speaking in native tongue] [speaking in native tongue] >> translator: we welcome the establishment of defense isr information, surveillance and reconnaissance working group and progress of the study on bilateral cooperation in peacetime representative by bilateral patrol and surveillance activities in peacetime. [speaking in native tongue]

[speaking in native tongue] >> translator: on the alignment of usfj we confirmed that landfill permit requests for frf and development of consolidation plan for land returns south of cadena are important steps for significantly mitigating impact on okinawa. we agreed to steadily make progress on usf realignment including development of relocation of usmc in okinawa to guam. [speaking in native tongue]

>> translator: on mv-22 osprey secretary hagel and i confirmed that the government plans to land u.s. 12, mv-22's of the second squadron of mv-22 through mcas there will kuni this summer and then move them to mcas. [speaking in native tongue] >> translator: lastly, i invited secretary hagel's visit to japan this year and we agreed to hold two plus two meetings preferably this year at appropriate timing to discuss

efforts of strengthening alliance among ministers and secretaries of defense and foreign affairs. [speaking in native tongue] [speaking in native tongue] >> translator: based on the outcome of today's meeting with secretary hagel i will continue to work on challenges in order to build even stronger bilateral alliance. thank you for warm hospitality and for secretary hagel and his great staff. >> thank you. >> thank you minister. thank you. >> this is regarding syria and chemical weapons have been used it i was wondering first of all, can you elaborate at all when anything more on what has been learned, the scope? or people injured? was there more than one attack?

with the locations were? secondly if you can't answer anymore questions regarding that, what should the american public read into that assessment , considering the consequences could be so important? >> first, we are continuing to assess what happened, when and where in all the questions you asked, working with our allies and our own intelligence agencies. your second question, think we should wait to get the facts before we make any judgments on what action if any should be taken and what kind of action. [speaking in native tongue] >> translator: my question is on the security situation of east asia. i understand the u.s. south korea joint exercise would -- [speaking in native tongue]

[speaking in native tongue] [speaking in native tongue]

[speaking in native tongue] [speaking in native tongue] [speaking in native tongue] >> translator: my question goes to secretary hagel. my question is on the security situation of east asia. i understand that u.s. south korean joint exercise with and on the 30th of this month. how do you see the situation of

north korea and current status of north korea? and the second question is, how do you see the issue of north korea and its missile program of north korea? and how are you planning to respond to that? >> well the united states, like all of our allies in the region as well as over 80 countries in the world are very concerned about the situation on the korean peninsula. we have said we are working with our allies to be prepared for any contingency, but i would again call on the north korean government to take the path of peace. there is an effect if, wise course of action to enhance

their people, their nation and they should take advantage of that. our capabilities with our allies in the region to deal with provocations, as we have said before, is one that gives us a strong set of preparations which as i've are denoted, we are prepared for any contingency. [speaking in native tongue] [speaking in native tongue]

[speaking in native tongue] [speaking in native tongue] [speaking in native tongue] [speaking in native tongue]

[speaking in native tongue] >> a question for each of you. mr. minister, first similar to the previous question now that these military exercises are ending, how do you assess the north korean threat? do you see thing starting to calm down now or do you think we will have a high level of threat, persistent level of threat from now on? and mr. secretarsecretar y, on syria, as you've probably heard over the next -- last several days members of congress have been calling for a no-fly zone, creation of the safe zone and other military action. do you rule out any unilateral

u.s. military action in syria? and you think that any action would require either a coalition of the willing or nato, u.n. support? secondly, now that time has gone on there are greater concerns about the radicalization of the rebels. do you think that time has passed for any thoughts of arming the rebels? are there too many concerns now about how radical they rebels are and have become? >> translator: . [speaking in native tongue] [speaking in native tongue]

[speaking in native tongue] [speaking in native tongue] [speaking in native tongue]

[speaking in native tongue] [speaking in native tongue] [speaking in native tongue] [speaking in native tongue] >> translator: i would like to begin by explaining my view on

the north korean situation. so far we have analyzed the information that we have gathered and we have been sharing the information between our two countries. as far as i know for the time being we have not received any information that would allow us to level down our level of the patrol against north korea, patrol and surveillance against north korea. >> are you finished, minister? thank you. your two questions. my role is to present to the president, in my responsibility, options for any contingency. i won't speculate on those options nor publicly discuss those options.

>> translator: . [speaking in native tongue] [speaking in native tongue] >> i have already answered it. i'm not going to speculate into hypotheticals and getting into these areas, other than to say that i've said we are prepared to give the president options for any contingency. >> translator: . [speaking in native tongue]

[speaking in native tongue] [speaking in native tongue] [speaking in native tongue]

[speaking in native tongue] [speaking in native tongue] >> translator: my question goes to both of you. it's on the question on the guidelines on us-japan defense cooperation. i understand that you are working on the review of the guidelines of the us-japan defense cooperation but what kind of threat are you having in your mind? and understand that work by going through the discussion of this review, the two countries

are discussing only roles, missions and capabilities of two countries. as well off a administration is currently aiming to beefing up the role of the self-defense forces and to utilize their capabilities for this area. and i understand that both of you have mentioned in the read to work on the bilateral patrol and surveillance area in defense areas in particular. secretary hagel, and what specific area does the u.s. government expect to see more of her role from the self-defense forces through the process of reviewing these guidelines? and to defense ministers onodera what kind of area of self-defense forces role should be beefed-up to deepen the cooperation? and the question goes to as to when are you going to be compiling -- compiling up the basic directions of these

guidelines? if you have any schedules or timeframes in your mind, could you share with us? [speaking in native tongue] [speaking in native tongue] [speaking in native tongue] >> translator: the current guidelines were drafted in 1997. therefore a certain amount of time has passed since then and we have seen drastic changes in the security environment. the u.s. and japan have been studying on these roles, missions and capabilities discussions and we have just

started discussion on the strategic environment perception between our two countries, especially. and as for the schedule of this review, i think it's going to take a few years. >> thank you. i would agree with the minister's timeline. the reason i would agree with it is because this region of the world, the asia-pacific, is a vital area for stability, security, trade. the sea lanes in the pacific are particularly vital to the economic interests of all those nations. to keep those sea lanes open and security and stability in that area is the primary focus of this review.

[speaking in native tongue] [speaking in native tongue] [speaking in native tongue] [speaking in native tongue] [speaking in native tongue]

[speaking in native tongue] >> enhancing and strengthening military-to-military security relationships among our allies directly enhances the stability and security, therefore enhancing trade and development and peace in the region. >> translator: . [speaking in native tongue] [speaking in native tongue]

[speaking in native tongue] >> specifically the first part of your question, what are we doing? i noted, as did the minister, some specific examples of enhancement. the addition of the tpy-2 radar missile site, the mv-22 osprey, the cooperation on rebalancing our marines and facilities on okinawa. those are three areas where we are working together specifically.

>> translator: . [speaking in native tongue] [speaking in native tongue] [speaking in native tongue] >> thank you. >> thank you. >> we will wrap it up there. thank you, everyone. >> thank you.

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>> up next, the secrets of silicon valley. >> host: name of the book, "secrets of silicon valley," the author, deborah, you write that silicon valley is its own unique ecosystem, what do you mean by that? >> guest: it's a distinctive culture based on cooperation, collaboration,