>> if i could just talk about how you are a business leader yourself, and you mention your current business and you know the importance of this issue. one of the issues that we grapple with in congress is what is the best way to move forward constructively, particularly around the issue of information of the private and public sector. it seems to be a particular sticking point. what is your viewpoint on that particular issue as a business owner and as someone who is going to be charged with leading the commerce department. >> senator, i believe it is important for you to begin a dialogue with the business community and explain what is at stake. each business understands what is at stake for them individually. especially in terms of our critical infrastructure, things that businesses may take for

granted. to talk about how we need to come together it's important that they have a seat at the table. including the dialogue of creating this and we invite the public sector to be involved, and that is something that i will promote and advocacy for. ..

i'm ready to go. i'm not sure they want us up there. i'm ready to go. [laughter] welcome, welcome to your family. having been in business myself i can tell you there's many pluses that comes to bringing private sector experience to the public sector realm. but also you have to face the challenges of being accountable for some of the thicks that happened in the private sector and people bring up all sorts of things. my first question is our state aflcio and many have a boycott. and one of the issues they are concerned about minimum wage jobs who are the sub contracting of minimum wage jobs in a way to keep the work force at the lower rate. and some concerns about safety and workload issues.

one of the things you'll face as secretary is how to maintain and get a high wage job to our economy. do you want to extent on the former or how we knew the latter? and look forward to . >> senator. i have been in business for twenty seven year and, you know, the corner stone of success in business, you have have to have a good relationship and a good balance between management and labor. there's no success in business without a good relationship between management and labor. and i support the right of workers to organize it. that's what they want to do. and i think that it's extremely important that, as i said management and labor work closely together on issues of good jobs, creating sustainable jobs. >> this isn't a notion of sub contracting out to keep minimum

wage jobs is not something you support? >> no, senator. >> as far as high safety and workload issues? >> the high standards for safety -- absolutely. the work force is part of one's business family, if you will. you have to have a business that operates in a way that works for everyone. management, labor, all the stakeholders. to me safety and security of one's labor force and management is number one priority. >> one issue i would love to see you take a leadership role on within the cannot and one we have talked about and i think you can bring a private sector focus to that would be help sfl the thash the chairman brought up in his opening statement

about a weather-ready nation. to think that literally noah was getting weather service information from europe because they were further ahead, i think it was four dais ahead of predicting what sandy was going to be that noah was capable of. they instituted new technology which basically analyzes the storm and information data in a new way. substitute new ?j i know yes passed the sanity bill and there will be more supercommuting time. that's is an issue we have to keep -- competitive in the last couple of days show u. the difference of knowing fifteen minutes ahead of time and hours ahead of time. >> we are reminded over the last

several months, the importance of having a top quality and best in quality weather service between hurricane sandy, between the hurricanes in oklahoma, the flooding in the midwest. we have all seen that how our weather can threaten lives. as well as property but lived. if i'm confirmed as sex tear of commerce and making sure that our weather service is best in class is something that i would find high priority. >> and so to you think that could include working with the dp of defense? part of the issue they have great satellite technology information. it's often secure. what i guess i'm longing for is your leadership ability coming in and bringing agencies together as well. and figures out how to get the

best information to public officials hands to do a better job of helping people prepare. the technology is there to know the power of the storms. senator one of the things i prided myself is business career is working in partnership with others. in terms if it's the weather or many other aspects in what the commerce department is engaged in. if i'm confirmed it's something i would take seriously and work hard to achieve is good partnership with other agencies and particularly on the area of the weather service. >> thank you. like senator, i can guarantee that fish are important and the late ron browne said if a member of congress is calling him. he guaranteed it was about fish. and i have the same concern and want to know what your thoughts are on the bristol bay mine which is a mine in alaska which is basically at the head of one

of the largest fishery. we want to make sure that you are going to bed a mantd about good science leading the way to protecting against undue development that might impact the fisheries. >> senator, i know the importance of sam mono. we talked about that earlier. to your state and frankly our country, and to my dinner plate at times. [laughter] but and finding a balance to make sure we protect the salmon is very important. to me i don't know the specific of the mine situation. if i'm confirmed it's something i will look in to. >> what i'm interested in is whether you will have good science help engaged in the process? >> absolutely, senator. the importance of science and

technology used throughout the agency is important particularly in that area. >> thank you, mr. chairman. >> thank you, senator. senator. >> thank you very much. for being here. thank you for taking the time to meet with me a few dais ago. again, i appreciate your willingness to be subjected to all of these processes to be a publicker is vent. i know it takes times. we talked about several issues. i want to followup on fish because as you know alaska produces a wild cod american fish product about 57% of the fish. we have a huge interest, obviously economically and otherwise. and i agree with my colleague that the calls you'll get will be about fish. you will think they are about trade and about agreements and

tourism. it's about fish. and i want to make that clear as chair of the committee that deals with it here, we're going through the rights. obviously somebody will be engaged with you on. let me ask you, we are going lose -- you are going to lose someone if you appointed eric is now stepping down. and lot of issues to make sure we have strong leadership there also in noah. apt commitment that you'll make it a priority as quickly as possible because of the work we have to do on the stevens reauthorization bill and the fisheries issues that are in front of us right now. >> senator, one thing i know from my twenty seven years of business. it's important to have good expertise around me, and so if i'm confirmed i'll want to make

sure that the agency has the best in class folks in the positions. i know, how important the fishing industry is, and to you and to many of your colleagues here and something i'll commit to make sure we have the right people in place to work with you. and the key to me, as quickly as possible. >> absolutely. and obviously getting us nervous as we move forward to reauthorization. let me also we talk about satellite and one you're learning about your role to manage satellite and there's a group of independent resphriew aerospace executive that call the program somewhat dysfunctional. it's the phrase they use. i want to make sure that you are committed to looking at the program. it's a multibillion dollar program, as you know. timing is critical. it makes a different on the weather service.

when we do them, we don't have to depend on other people. will you mitt to make chiewr you'll spend the appropriate time to dive in to how to make a system better than it is today around allocations or getting the resources for them and helping us understand what we should be doing help make it better. >> senator, i thoroughly appreciate the critical mission of our satellite. we have seen how important they are to protecting life and as well as as property. over just the last week, let alone with the horrible tragedy in oklahoma let alone with hurricane sandy. and with the flood in the mid west. it's making sure we have best in class technology and we can understand what is going on with the weather, and be to be get the voice out and get the information out as quickly as

possible as well as the accurately as possible is a very important priority. if i'm confirmed as secretary of commerce, something that we will make sure to focus on. >> one area also on satellite obviously the weather and since 2010, the national weather service lost about 300 positions, about 6%. actually in the president's fiscal year '14 budget he eliminates another 103 positions in the forecast officers. there's a hiring freeze in place. i can tell you in alaska there is now created problems. we are in flood season. we severe issues occurring already. we are about to hit fire season in many part of the country. there we have alaska missing entire shifts worth of people bringing people in overtime. you know running a business when you do overtime. there are a lot of costs costs hard to measure until something bad happens. then you realize they were

working too many hours or if fatigue occurred. can i get a commitment from you you will re-examine the decision of the hiring freeze and how they're handling furloughs in the weather service? to me the way that -- you know, i have run businesses. i have ran a city. it's not the best way to do it. it's going have negative impact on the issue. the product we need for situations like in oklahoma or sandy and otherwise. >> senator, i share with you the your concern to make sure we have the appropriate staffing. and i'm aware that noah is working to mitigate the impact of staffing challenges and budget issues on the critical mission. if i'm confirmed as secretary of commerce making sure that our weather service is appropriately set up and operational as a high priority. >> great. let me go to another issue a

shrek here. it's one we talk about this on the arctic oil and gas issues and the eis the environmental impact statement that noah has the supplemental draft out right now. it is -- it was issued a few weeks ago. the definition, when you look at it. as if the drilling program is to limit each company to only one drill well at the time in the theater. meaning two areas of the theater, one rig one well total. that's not going to work based on the 600 leases we have up there. basically by that action you can economically determine the outcome which is nothing will happen. so will you and i know we talked about this. asking for your position. you need confirmed first. will you give some assurances at least here that you'll work to ensure that the people who have let'ses up there can fully

utilize the leases under the conditions we say obviously under the environmental conditions and everything else. not be -- not i think what noaa was doing. but back dooring it by collapsing their ability to move forward by saying, sorry you can only do one. that's it. well, we need them to look at the whole air shed at one time. not just single applications that are coming in. would you commit to look at the broader picture and making sure we don't do something that impacts their ability to move forward? >> senator, i know how important oil and gas exploration is. as well as to the country and your state. it's something i would need to look in to. i'm not familiar yet. but i will look in to it and look forward to working with you on that. >> as we leave, and known say that when you start to talk about a mine in alaska, we

encourage you to talk to us also. i appreciate my colleagues' interest in this issue. there's only one state that has the strongest issue. that's us. [laughter] >> senator,ly try to make sure that all stakeholders have a voice. >> very good. and the chairman knows we invite you to alaska. [laughter] >> appreciate that. >> thank you, senator. senator mccaskill. >> thank you for being here today. i'm aware that for a lot of good reasons, a lot of americans have a cynical view of the federal work force and us. they look at people who work for the federal government at large and make assumptions that many times are unfair. and there are federal employees that are bureaucratic bo do and not working very hard, and making way too much money and

soaking off the taxpayers. ii have to tell you i find it very refreshing to find someone who is stepping up like you are in this position. i think it's pretty obvious that you're not coming to the job for a paycheck. i think it's pretty obvious you're not coming to relax and soak off the taxpayers. you are not coming because you see this as an easy challenge. i think you are really coming because you have a desire to serve this country. and your business background is one that i can think can serve this country very well. the president has proposed to do away with commerce department. and combine the commerce department with small business administration, ustr and other agencies that have various intersections with business in this country. proposing to do away with part

of the federal government is difficult. and i would ask you do you have some idea how your service in this job could help move that goal forward in terms of identifying some strong bipartisan arguments that can be made and one of the problems is we have a lot of committees that deal with the various agencies. if you have given that any thought. if you see based on your business background when sometimes stream lineing, and selling, and merging are essential because so you a discipline 77 a bottom line. unfortunately we don't have a buttonline displin in washington. i wonder if you have any ideas about that. >> senator, i appreciate your inquiring. i support the president's desire

for reorganization authority. i know, his objective is try and make the government more streamline and more effective than efficient. i'm not exactly sure how i personally -- if i was confirmed as secretary of commerce could assist in that effort. if congress were to give the president that authority, i would work to support and try and give him my best advice, which is what he asked me to do in this job. in terms of -- in the meantime, as the commerce department is as set up -- if i was confirmed i would look to try to figure out how we can streamline and be more effective and efficient with the current set upwe've got. >> well, i would look forward to working with you on ongoing basis. particularly when you find

issues of duplication and overlap. my colleagues, senator coburn, worked hard on the duplication issue. it's real. yms, you know, some people on my side of the aisle don't want to confront it. there's dop indication. look at the broadband issue. we have it inning a agriculture. we have it two programs with different goals but different sets of personnel and rules and procedures dealing with the money in both places. i would love to work with you as you identify as an eye -- toward a business mind set how we can wack away a little bit. >> senator, i look forward to working with you on that. >> the other thing i want to mention to you i discovered there was an idea a while ago about creating a federal work force called service executive service. and senior executive service was

created os stens -- to compete with the private sector. and idea would be highly qualified employees with a broad background and knowledge and they move around the government basically with a lot of excellence helping us do a better job performing the service we must as the government. i don't think that is actually come to pass. i think most of the service executive service and the federal government is moving much. i think many are burrowed in in agencies. and it's come my attention they continue to get very, very large bonuses even in the economic climate. i have put in a piece of legislation to stop the bonuses to senior executive services employees. by the way, the average bonus is somewhere it's five figures. they are healthy bo pluses for the government. i think the arch bonus is around $16,000. and the salary for the people range between $119,000 and

$180,000 a year. these are the best of the best even though they make up 1% of the work force. i think they were getting certainly more than that in terms of bonussing they are receiving. what i found troubling about is that in some agencies everyone got the bonus. there's no performance evaluation going on. it was a rite of passage. it was pro forma. you got your bonus. i would like you to take a look in the commerce department, and particularly the legislation i've introduced would prohibit the bonuses from being given in the environment of sequestration. because most -- we have line employees that are having to take days off without pay. and we have this little upper crust of the federal employees that are still getting five figure bonuses. i don't think it makes sense from a business perspective. i would love you to take a look at the commerce department and look at the bonus proposal and

procedures and get back to my office as to what you think. i think gsa reformed it on their own. i think they quit doing it. we discovered this, and i would love to see the commerce department follow suit. >> thank you, senator. i'm not familiar with it. but i look forward to learning about it and certainly i know from my private sector days that bonuses should be earned if one has performed and not if otherwise certainly in a time of tight government budget. we need tow watch every penny and make sure it's appropriately spent. so i will look in to it and learn more. >> welcome to the pit. >> thank you. >> thank you, senator mccaskill. >> thank you, thank you for joining us today, for answering these questions. thank you for coming by my office this week and visiting. i enjoyed the chance to visit. me.

>> me too, thank you. >> let me say at the outset that in a bipartisan note i want to echo the comments that senator mccaskill raced about looking at the bonuses. i think it's an area that addition close scrutiny is warranted. i would like to begin by talking about a topic we talked about in my office. which was free trade and in the course of the conversation, as i understood, what you said, you said you were enthusiastic, unapp poll jettic of free trade. is that a fair characterization, if so would you elaborate? >> senator, i'm a believer that trade agreements can bed a venn teenage use for american business, and so i am -- if i'm

confirmed, would look forward to working with our u.s. trade rep to expand our trade agreement. so that our businesses and our -- can grow and grow their employment population. i think that and create jobs for people in this country. good jobs. and so i'm hopeful that the european trade negotiation and that with asia can be something that if we could gate good agreement can be good for american business and good for american job creation. >> well, thank you. as i shared with you, i have been disappointed that my judgment, the current administration, has been less than vigorous in pursuing free trade. if you are confirmed, i hope you will be ab an effective voice in

making the administration more vigorous in going forward. the second area we talked about that i would like to discuss is the area of regulation, and as you know, my top priority in office is restoring economic growth in this country. yes. >> i think that's the most critical element to ensuring our long-term strength and also expanding the opportunity in this country for the least well off among us to climb the economic ladder and achieve the american dream. and we talked quite a bit about the impact of overly burdensome regulation and how it can harm businesses spes literal small businesses that just starting and struggling. as you know generate two-thirds of all new jobs. yesterday in conformation hearings and this room, nominee to be secretary of transportation, i had a similar

conversation with him and asked him at the time if he would commit in his first hundred days to working to identify at least three regulations that are overly burdensome, and to working with me and with this committee to either modify or repeal them. indeed, i'll confess i liked his response. he suggested three might not be enough and suggested instead ten. which i accepted that as a friendly amendment. and so i would ask you the same question. it you would make the same commitment. >> senator, you know, you and i have the conversation and i think agree, you know, as does the president that the -- it's extremely important we look at our regulation story environment which has become where we put regulation on top of regulation and see how we can streamline regulation to see how it's effective.

so businesses can grow and be innovative and can create jobs. and economic growth, as you have said. so i'm enthews yaysicly will would look at the commerce department. i'm not sure the regulation and the commerce department are as vast regulation the transportation department. but enthusiastically work with the organization to find opportunity to streamline regulation. >> terrific. i appreciate that. you also suggested in our conversation that the concept of zero-based regulation that rather than piling one regulation on other on other and continuing to grow vast and unwieldily. we start from a zero-base and ask what regulation is needed. and senble. -- sensible. i agree with that notion. and so i would welcome, if you would perhaps elaborate on the

concept as you share when we visited. >> well, in business one often is required to start again, if you will, or look at the situation and, if you will, take the concept of zero-based budgeting and look at at it. i think that's what the president was getting at with the executive order was to try and say, let's look at the cost benefit of what we've got. ..

as you know, right now the vast majority of usable spectrum is either owned or shared at the government 60% to 70%. flashier spec dramatics statutorily requires d. ntia to the most efficient use of elect or magnetic sector resources across the federal government. federal government ownership of assets be they spectrum, land or anything should be the minimum necessary to protect our national interest and spectrum i would like to see as much as

possible face in the private sector to allow entrepreneurs to allow businesses to put into productive use to generate economic growth and jobs. do you agree with that approach and would you agree to work together to try to assess how much spectrum the federal government needs and how much can be sold as significant progress to the government, private sector to be put to use her primaries. >> senator, i support the president's goal any staff the agencies to look for 500 megahertz of spectrum. the ntia today has had 100 megahertz to make available for commercial use. i support the effort of finding as much as possible to be used for commercial use and alan seen

our national security and other needs and that is found to have been confirmed however closely with the head ntia to find that spectrum. >> to deny. i look forward to working together on these issues. >> thank you very, very much. ms. pritzker i have one question. actually two questions to ask. about eight months to a year ago , oliver washington by which admit the white house, here and other places we were celebrating something called first nat. there were virtual cheering sessions at the white house everybody was so pleased and they loved the idea because it involved a voluntary action that

would cost the taxpayers a dime. they finally got the house to agree to push them up to 7 billion. it really is about 11 billion that it would cost. but then it comes to layout the whole network. none of it comes to the taxpayers. one problem. the reason for this is you know firefighters goes back to the kuwait and the army would communicate with each other and a save situation. i just live in that situation and stovepipes, where people will not share. the first is way past, the first law was embarrassing. the law allows the fbi and cia to talk to each other.

not that they would do anything, but they have to talk about to each other. rapid response, real-time, all the rest of it. we came up with the idea of first night as a public safety spectrum. firefighters, police, fbi, emt. the technology would be handheld devices all over the country. the same handheld device. not yet completely done. they can see how many bodies were in the burning building. serious injuries so they can then send photographs on to the hospital where the person was taken so they would be prepared. it is such a commonsense idea. episode desperate.

when we had the hearing on it was nothing for first responders. they are just totally wanted. and i do too. and we're not getting that and again, no tax money is required, but obviously it has some problems and we created this first night and a guy named sam gannon. he's very, very good. he runs 15 people on the board, but we just haven't been able to see enough movement. maybe that's the nature of things. the engineers and architecture. i don't know, but i don't want to accept that. i want to your feelings of improvement, moving forward.

at best to spread this across the nation would take maybe a decade. all the towers come you start thinking about an enormous project. but it's what our country needs because as i believe, the climate is changing and one of the problems i think it has to rule on. the legislature you couldn't or didn't have to build a basement. that's not. you understand the concept. the urgency of public safety was so much tragedy and disruption as well as the possibility or probability of attacks by americans and deal with computers at the chinese can do with computers and not everybody

is affable that way. all i want to know is if you're confirmed that you will set mind, body and soul to working with them to understanding the problem to understanding by morrissette happening and there may be a good reason. maybe i'm just impatient because i'm not an engineer, structural or otherwise. a fine meal the secretary of commerce are watching this closely, i would feel quite good we did a quick >> senator, i share your commitment to firstnet. it's a great idea that will benefit for first responders as well as people in distress. in charge of the implementation

that we work with them to feel the urgency and need to implement this as effectively and efficiently and quickly as possible. >> good. thank you very much. >> it's just you and me about to wrap this up i wanted to ask one other question in for a minute all channels that are crafty. the fact to wire tax avoidance schemes and it's hypocritical for the president to nominate cabinet members who benefited from offshore tax havens was criticized by his brothers. how do you respond to that criticism? hispanic center, and the beneficiary of offshore trusts set up when i was little girl. i didn't create them. i don't direct them. i don't control them. divestiture of state to appoint

and remove themselves and appoint a u.s. trustee, but i was required and in this process. >> one other quick question if a man. one of the areas under your purview is the administration enforcement of antidumping laws and the laws intended to prevent industries by imports sold. the price of dumped imports to a noninjurious level. an estimated four to $500 million on four different types of agricultural imports from china have remained and collect data and even though their payment is secured a single entry customs bonds,

which you refer to his leadership or bonds were issued by well-known u.s. insurance companies. you played full accounting to secure antidumping duties on agricultural imports of china and a plan for collecting the duties secured by these bonds. >> senator, i'm not familiar with exactly what you're discussing. i know what antidumping is, but i will look into it and commit to work with you on this issue. >> there's a number of honey producers would be happy to hear that answer. a lot of transshipped honey from china and enforcement mechanisms available to prevent that don't could effectively utilize, so we would welcome your help with that particular issue. >> making sure not just honey producers but american companies are on a level playing field and laws are not being skirted is an

important check even if i'm confirmed i'll work on that. >> thank you, mr. chairman. >> i want to thank you, ms. pritzker for the sharing. i think you have one of the three toughest jobs in washington. i know you do. i put the president and dod at head, but i can't give anyone else. i want to thank you, your family members for being here, want to thank your husband for helping make you stand up in the other room while we were waiting. big strong guy, wasn't very hard for him. i also want to thank our audience that is here. we did something we've never done before and that was because of the importance of this nomination. we open up a whole another round

defense armed services and they sit there watching television as this. i think that's very, very important. i very much appreciate her audience. i very much appreciate colleagues and i very much appreciate you. i really wish you well on this. you assert they have my vote. so that is that. >> thank you, senator. [inaudible conversations]

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[inaudible conversations] [inaudible conversations] >> well, will focus pretty well already. she submitted a number of answers. i don't own that there's anything there that has been pretty effectively, but will just clean up if you can get people's questions on the record.

it's going to get a response in a way that hopefully will satisfy their curiosity. >> i don't want to make any predictions at this point. i thought she did well here today. she brings a great business background which is essential and very needed in the current frustration and an expertise that would be very helpful and we haven't seen anything in there that would be disqualifying at her record or background. i will leave it at that for now. [inaudible conversations]

>> female representatives iran moore, oklahoma to assist tornadoes. homeland secretary jim napolitano and great few days have toured the damage and then start it a president obama should give the people a moore assistance they need. his look at the damage president obama will visit the residence on sunday.

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[background noise] freshman republican senator, might be the the attack on the mark and tankers of texas have blocked the agreement to start the negotiations. they want the senate to agree to it will not be included in any final budget agreement. this debate starting with senator claire mccaskill is just over an hour. >> mr. president, i raced to make unanimous consent motion.

i want to make a few remarks first-period at the risk of being patronizing to my colleagues about the constitution, i would like to give a basic lesson in the constitution this morning. my understanding is founding fathers devised a system for the house of representatives house of representatives and the senate. they have to agree before something becomes law. this is an amazing decision that our founding fathers make. it requires that the senate for all the circus and presented whole state has to reach an agreement with our colleagues in the house who have much smaller constituents these therefore targeted more towards one specific area than some of us are. i listened to lecture after

lecture from my colleagues across the aisle. it's almost as if some of you think you're the only one that's rad are the only one that understands that. well, you're not. here's how the constitution works. when we pass a bill, we go to conference and why did the founding fathers thought that? they understood the compromise was the mother's milk of a democracy. here's the bizarre thing about this. i bet i heard last year 10,000 times, why don't you pass the budget? i listen to the leader of the republican party and put together a montage. we exaggerate. we go too far. but it's not exaggerating.

the rallying cry of the republican party passed a budget, regular order. and what did we do? we passed a budget and regular order. now, here's the really bizarre part. following the constitution to my friends waverunner pretend like they're the only ones who love it. we now have the nerve of some people think regular order doesn't matter and compromise. blowing up the constitutional premise between the two houses, blowing it out. now i don't know what the american people think of this, but she's got to shake your head at the politics of this. you've got to shake your head because here if they keep moving

the goalposts about what he would take to get us to conference. either way, the people on the other side of the republican party. are you so worried they haven't read the constitution and not answerable to their constituent into office as republicans? have another budget bill and we did the debate or it got to make sure they can't compromise than anything we've got to put it into law. there is an opportunity to get your way. it was called amendments. you could have gotten your way to get on the process. we had over 100 of them. we were gaucho 5:30 in the morning. how many amendments do you think the senator from texas offered on the debt ceiling? that is now saying he has to have before. he offers 17 and hence, but he

didn't offer one. there was not one republican amend it on the debt ceiling. not one. that one of the political passing point. the one i look like we didn't care by doing our jobs. you would site tailored to conference. it's been two months. i hope the american people are paying attention. this is not a game and you can't let the constitution when they implode at the next. he can't be a situational constitutional attorney don't get your way. i got elected fair and square and so did you guys. that's why we all have to be one to compromise with one another. we are not serving the american people by playing these games and they are sick and tired of

it and frankly and makes the body look a little silly. so i wait, mr. leader,y. so i wait, mr. leader, mr. president, i ask him consideration of house concurrent resolution 25 at the moment at the desk, the budget resolution passed by the senate be inserted in the pharaohs. the house concurrent resolution 25 is amended be agreed to come in the motion to reconsider be made and laid upon the table in the senate insists on its amendment can request a conference at the house on the disagree and those are the two houses in the chair be authorized to appoint conferees on the part of the senate by following the authorization, two motions to mr. conferees being order from each side. bush into a strength relative to the debt limit, motion to instruct relative to taxes and revenue that there be two hours of debate equally divided

between the two leaders or their designee's prior to relation to the motion and further no amendments being order to either motions prior to the vote. all the above with no intervening action or debate. >> mr. president. >> senator from utah. >> reserving the right to object to ask unanimous consent the senator modified request would not be in order to consider a conference report that includes reconciliation instructions to raise the debt limit. >> with the senator so modify her request? >> could i inquire the senator? i'm asking is that preventing a backroom deal? the conference between the two houses of the founding fathers for conferences that impact is a backroom deal in the constitution and they don't accept the constitution? >> my friend and distinguished colleague from missouri is

absolutely correct in the two houses have to agree before something becomes law. it's also important to point out under article i, section five close to the constitution is constitutionally charged with establishing its own rules for operation. the rules in this body as they apply right here required this request receive unanimous consent. what that means everyone of us have to vote for those. what i and a few of my colleagues have said regardless of what you might decide to do we respect your opinion. if you ask us to vote for this, we need to give our consent, which is a vote. we asked for one site modification. the site modification include something simple, which says we are not going to negotiate the debt limit as part of the budget resolution. they are two separate things. we didn't consider a single amendment that would've addressed the budget resolution

that passed and addressed the debt limit. but that women not having the subject is not appropriate for that to be addressed by the conference committee. >> mr. president. >> will the senator modify her request? >> first of all i think that if we agreed that a smaller or by senators who could change the way the senate does business could have a serious ramifications for the future. he doesn't want to be deprived of the vote. they are ready to vote to my colleague from utah. we are ready to vote on a motion that would send this bill pushes

the subject of an enormous amount of debate and discussion for hours and hours until 7:00 in the morning to a conference with motions to instruct the contrary. i'd be more than happy to vote on instructions to the conferees concerning his previous concern of tax increase or add increasing the debt on it. that's the way the senate should do business. if the senator from utah would allow this to vote on whether we should move to conference with instructions to conferees, that is the regular order. a number of senators come a small number, minority within a minority here we go to

conference because of a particular problem with an issue that is important to the senator from utah. it's important as to whether he raise the debt limit or not. i say to my colleague from mississippi, suppose they passed the act though. suppose the house of representatives want to appoint conferees but there is a burning issue at a number of my colleagues and my block when the conference. this isn't just about the budget conferees. this is about whether there will ever be able to appoint conferees on a bill passed by the house and also by the senate will come together and do what we've been doing since the commerce of the united states started functioning. that is to sit down and iron out our differences. for senator from utah is worried

about the result. i'm worried about a bill right now that is just outrageous in porkbarrel spending and catfish and stuff that i have concerned about subsidies for the tobacco companies. that does not mean i'm going to have jagged remove for conferees on the well of the senate and congress and people is heard in open arms today. where naughtier to block. we are to articulate the issues than the best impossible most eloquent way we can for the good of the country and not let the process move forward. i say you're not going to win every fight here. the experience i've had over here in the united states senate you open in the end if your cause is just, but she can only

win to make your argument here in the congress and the american people. we are about to i hope conclude the immigration reform bill. there'll be portions that i don't like. so are the portions of the bill that many of my colleagues won't like. we are not counting on a hundred votes in the united states senate, but we count on a majority of votes and passing it and we hope the house will do the same and look at a conference. if a group of senators, four, five, 10 object to is going to conference on the immigration bill should stop. i am very worried if this happens about the precedent on how the congress of the united

states does business. after the newton massacre by colic from utah and from florida said we don't want to take up the gun though. we don't want to discuss the gun battle. i happen to have disagreed with many of the proposals. would it have been great to not even debate in the newton massacre. but the senator from utah native is the best not to move forward. thank god there is a group of us does have us move forward. let's do what we can. so here we are again. the budget that for four years i loved reading the bailout from missouri who would not insist on being brought to the florida

senate. now i budget is being passed. that's not nearly as enjoyable as it once was and now after being so proud that we can observe at least evoke him in the senator from utah wants a vote pair but he should appoint conferees are not about those instructions to the contrary should be. that is what we should be doing. i understand how important it is i can tell you there's a majority of us don't want the congress to work the people's will. all i would do and say they will agree with motions to instruct a conferees. if it is the senator from utah concerned the conferees should not address the debt ceiling, let's go to instruct the

conferees to do that. i can also tell my colleague from utah something else. if we continue to block things like this tom block the regular order, then the majority will be tempted to change the rules of the senate. that would be the most disastrous outcome i could ever imagine and i don't begrudge anybody whether they've been here six months or 30 years. they are right for senators. i hope my colleagues would look at the way the senate has functioned in the past. the american people unhappy with us? of course they're unhappy with us. one reason is they don't see us accomplishing anything. what i've done for the serious than the people have respected in this body on both sides of the aisle fight the good fight, and make your case, colleagues and the american people and then

you accept the outcome of a regular order while preserving your rights as an individual senator. we've maintain the balance to a large degree. i would urge my colleagues to do what we've been doing and that his emotions to instruct the conferees as their issue is taxes, three shoes the debt ceiling and instruct those conferees and those conferees carry out the will of the majority of the united states senate. >> mr. president. >> mr. president. >> mr. president. >> senator from missouri. i reserve the right to request to amend my request and i would say that within my request is in fact the opportunity to vote and he had the opportunity to offer

an amendment on the debt ceiling in the budget and he did not. i certainly think by colic from arizona and i reserve my unanimous -- i renew my unanimous can that motion. >> is there objection to the modified request? >> senator from michigan misrecognize. >> for 30 seconds this is an debate, but i do have for purposes of colleagues who want to speak next ask once the debate is done by senator feinstein, senator mccain have 15 minutes discussing farrm bill amendment. >> without objection. >> mr. president. >> is there objection to the original request? the senator from utah. >> or 61 days come several macculloch some have objected to the request for unanimous consent to circumvent regular order, to go to conference on.

they want permission to skip a few steps in the process and jump straight to the closed-door backroom meetings. dare come to senior negotiators in the house and senate will be free to wait until an artificial deadline and ran through him read. but the country backed up against another economics of crisis were concerns that they will exploit the opportunity to sneak a definite increase into the country. we think it's inappropriate and objecting to this dysfunctional and republican and democratic process has invited anger and criticisms from colleagues on both sides of the aisle. we just don't get it. we just don't get it were told. proceeding to a secret closed-door backroom 11th hour deal is the way the process works and the white house works. it's the way washington works. that's why we're object being.

in case nobody has noticed, the way washington works stinks here closed-door backroom are the problem. every argument in favor of congress and the budget without conditions and if it knows what it's doing. it goes into a backroom to trust and transit on the work for the good of the country and trust us to not wait to the 11th hour total fault they can credit of the united states hostage in grand or another thousand page saying trust us for congress. as it happens, the american people don't trust congress or either party may have given them 17 trillion reasons not to do so. i can provide physical evidence to support my claim that the american people had confidence in the senate works.

i know for a fact it would be here. i don't think my colleagues ms. objection to be here either. we were not sent here to affirm the way the senate worked as congress directed trillions in debt and inflated the housing bubble, doled out favors to special interests, squeeze the middle class and track the foreign poverty. we were sent to change that. we are fully aware washington establishments within both parties don't like what were saying that as computer programmers are sometimes inclined to say, that is a feature, not a bug. the tactics of washington served the interests of washington and congress itself. the federal bureaucracy corporate cronies and special-interest and it does so at the expense of the american people, wallets and freedom. the only time i can think of when adalbert out that way was at the recent budget sequestration and that was literally an accident, a

mistake. the sequestration process worked out the opposite of how washington expected and intended. there is a reason that six of the 10 wealthiest counties in the united states are suburbs of washington d.c. come a city that produces almost nothing in real tangible economic value and it's not because the two parties have been so respect to taking on the special interest in doing the people's business. there's a reason the two parties on the right and occupy on the left protest or shared perception that our economy and politics and society seem great. leads on wall street, k street and pennsylvania avenue must play by another. it's because they're mostly right. this is our true quality crisis. not between rich and poor but washington and everyone else in america. the national debt and statutory limit is a hidden part of this inequality crisis.

after all, what is new debt that a tax increase of sorts on future americans? on those who in some cases cannot vote, on those who in some cases have yet to be born in praising the debt limit this results in a pernicious form of taxation without representation. as for the american people resented by washington desperately wants to raise the debt limit with as little public scrutiny and accountability as possible and that's why we are objecting. critics if we should allow the process to move forward. i don't know if they've noticed, but we're having the debate. we've had a several days in a row in more than not they have the debate on the floor open to public scrutiny and not secretly behind closed doors. this right here is how the process is supposed to work. the only way the american people can have any hope in supervising their congress, not ours is for

us to do our work to open according to the rules. i thought were asking for and only on this one issue for all of our concerns we still -- we still said all along we will not block a budget conference. we can go to conference right now on the budget, right this very moment. we are going to give permission to scurry off to closed-door negotiations to cut the backroom deal. only fast is a small and simple request. they've got them another day. do everything else you want. spend the money one can use accounting gimmicks you want. when you go into the backroom, check the debt limit at the door. that we the american people can have a separate debate on its merits here on the floor. they should not be

controversial. house republican budget did not occluded debt limit increase her instructions to include one. house and senate negotiators therefore have no procedural or democratic justification for putting a debt limit hike in their tasks. they have no right to do it. yet they won't promise not to. once again, mr. president, it's a message of trust us, or congress. this is how the senate works. this is our doing things. respectfully, this is how we fail. this is how we earn our 15% approval rate. we know this is business as usual. that's why were objecting. if the majority wants to proceed to regular order we cannot stop them but again that's not the request at the request is to break from regular order and go straight into secret negotiations behind closed doors were in the washington center view of a real governing be

done. the american people do not trust secret backroom deals and neither do i. unless and until the american people are assured will not seek a debt limit increase into the conference report, will happily continue to object and i object to the motion on the floor. >> the objection is heard. >> senator from arizona. >> just briefly, we been through before. for the senator from utah has just that if we pass the legislation or the house passes legislation that we will not put a conference unless certain conditions are improved -- imposed upon those conferees that happen to be important to a small group of united states senators. obviously that will paralyze the process here. obviously you can predict the outcome. the senator from utah keeps talking about backroom

closed-door deals. it is the process of the senate to appoint conferees in the house to appoint conferees and those conferees come to agreement. if the senator from utah wants to get rid of the backroom, all the other adverbs, then what is the process? how do we reconcile our legislation in one body in the other body? that's what we've been doing for a couple hundred years. >> with the senator yield for a question? >> all i can say is the senator from utah got another way of reconciling legislation between the house and senate? of course not. of course he doesn't. of course he doesn't. that's the only way that we can

get legislation that will be passed by both bodies in the united states. that's the only way. if this is imposed, there is no reason why any group of senator should impose conditions on conferees are now on, which will then mean of course do a better conference. so i'd be by to answer your question. >> of may 2 ask the senator question. i understand the budget resolution passed by the house, the budget resolution passed by the senate if conference in agreed-upon passed by the house and senate but never sent to the president. it is a budget resolution that governs the way. the question of the debt ceiling could be done if there could be any action on the debt ceiling in a separate legislative vehicle that ultimately goes to

the president of the united states. even if there were an agreement on debt and it in the budget conference, would have no impact of law. >> perhaps the senator from utah doesn't know about the fact he then asked it didn't raise the debt ceiling it could not go to the president of the united states. maybe the senator from utah ought to learn more how businesses and the congress of the united states. i get budget resolution not science that we then if we go to the death of an as a result which would be a relevant to the work of the conference, then it wouldn't have been a meeting whatsoever. this business is secret.

>> as for conferences are about a conference results are subject to a vote as to the conference resolved. >> i have concurred with our budget chair while you are debating this with the senator of utah. maybe they are not of where the conference committees are open to anyone who wants to observe that. i would like for you to invite the senator from utah to sit in on the conference committee and listen to every word. this notion our democracy is a backroom deal the founding fathers are shaking their head in disgust at this notion. it's an open process and anyone can come and listen. >> since the budget conference is open that will also be on c-span. all the american people can watch with the deliberations

are. why would the senator from utah say it's a backroom closed-door deal. does the senator from utah know this is open and seeing everybody at the conferences? this is a backroom closed-door deal and is misleading and no knowledge of how and which one is worse. all i can say is we now even if we had a restriction on allowing breezing the budget, the debt and that, even if we -- it would not matter because it is not legislation that would be signed by the president of the united states a matter what the budget conferees did and we also the budget conferees unlike many

bullet meant the budget conferees meet in open session with c-span and the american people able to observe it. i at least hope the senator from utah would withdraw his comment that this is a backroom closed-door deal because it isn't. those are fundamental facts. again, it's really disappointing we are spending this time when we should be on the fine though. the senator from california and i have an import amendment to remove a lot of corruption in that bill. i would go ahead and yield the floor. >> senator from utah. >> us to the suggestion this produces a budget resolution that does not go to the president technically on its own faith. we are concerned about the conference report two of the normal rules to be circumvented. that would itself --

>> to be voted on a 51 vote margin. so this is different regardless of how we make that meeting in which every senator, i've representative is able to participate in the same way on the floor. >> does he admit he misspoke? is not behind closed doors. >> compared to do things on the floor this is a closed-door deal. this is not subject to the same screwed me. the fact is we have rules on something like this that allow us to proceed on the threshold. that's the basis of our concern to raise the debt lemon

incurring additional potentially chines of dollars in borrowing authority on the basis of only 51 vote threshold. that's our concern. >> mr. president. i've been listening to this debate not just now but for 61 days as we've been working extremely hard to get the budget passed and got a conference to work with our house colleagues who by the way our majority republicans. we are working to do that because the american people have been very lax about not managing crisis. we all know what will happen if we don't go to conference is exactly what the senator from utah has been saying he doesn't want. if we go to conference we will have an open conference committee to discuss differences between the house and senate budget that will then give

instructions to conference on how to move forward in our appropriations bill that we are now looking at and how we deal with sequestration. it will be an open debate that will come back here. but if we are not allowed to go to conference, what will happen because we do have to pass the appropriations spending bill were moved to a continuing resolution because we can't get a budget deal, we have to have closed-door discussions come secret discussions to figure what we do in the debt ceiling had a macabre down in the middle of the night any one of had an opportunity to be a part of it because of the delay occurring right now. if the senate allows us to go to conference, members of the senate, both democrats and republicans, my counterpart senator sessions than i and his committee hustles congressman ryan from the republican party and his members will sit together in an open process and determine how we move our budget

forward. >> in case of the appointment of conferees, will you have it open to the public and c-span or any other media coverage that would like to come in the room? >> once the conference is that, it is like any other committee hearing for a photo of the public will come in and listen. they will watch on c-span. it will be an open process. i tell the senator from arizona that if we don't get to conference, we have to have discussions about how we manage our finances and our government looking forward and those will be behind closed doors. the senator is objecting because of closed-door secret meetings. so i would really hope that our republican colleagues would allow us to move forward. as the senator from missouri said, we have 50 hours of debate, over 100 amendments concerning. not one amendment was offered are considered on the debt

ceiling, which is now objecting to go to conference two. we had an ability high senator from texas offers 17 amendment and he's been acting because of this. not one of them about the debt ceiling. i know the senator wants to have a bad feeling debate on the floor of the senate. he is welcome to come to the floor any time and talk about the debt ceiling. we welcome a discussion. we split the bill should be paid separate from what we are talking about here. >> how many amendments are considered? >> over 100 amendments considered. 50 hours of debate equally divided. >> how many were voted on? >> over 70 were agreed to. >> not one amendment on the debt ceiling. >> i think the senator. >> i would add that with the senator from missouri has offered after talking with the senator from arizona is the

ability to have a vote on not. if you have to have that now, we want to get to conference. we will allow a vote on that. ..

>> the budget resolution will come back to the senate. everyone will have a chance to say it. i will tell you that this will fund the different aspects of government transportation and housing and that is our obligation at united states congress in order for the american public to be able to manage what we need to do to pass the budget. i would really urge our public and colleagues to back off on their interest on this. i'm ready to go to conference. as chair of the budget committee, we were really hard about a pastor in the senate. i know my responsibility as a united states senator. it is work with my house republican colleagues and those on our conference committee to come to the best judgment that we can mutually. to move our country forward and

to get us out of this management by crisis that is forced upon us time and time again over the last several years are the american people deserve certainty. we want to move to an open committee process. >> i think it is critically important. and i wanted to move as well. we have to vote for things that we don't like is a compromise at times. it gives us the things that we need. i certainly have been on the losing end of multiple votes in the time that i have been here.

i voted against the budget. i believe that the institution should move forward in negotiating the differences. so that we can finally have a budget in this country to move forward. the only thing i'm asking for is that as part of that negotiation, as part of that negotiation, the issue of the debt limit not be included. i have heard statements that were made for these that limits. most of us agree that that was an issue that need to needed to be dealt with. this is an extremely consequential issue, one that needs to be debated in another help. the massive debt that our country faces is a function of the structural problem that we have, the massive government programs they're going bankrupt. and if we don't deal with it, it keeps getting worse.

the statements they today, but we can't raise the debt limit even if we wanted to. and that is why we are widening the objection. we can be negotiating with the house this very moment before we do is to, look, go ahead and negotiate the difference in the tax increase we are voting against, and negotiate all the sorts of things. but the debt limit cannot be part of this, it has to be dealt with separately. i just don't understand the objection to that. i would say one more thing in this amendment. a cautionary tale that the next time someone says don't file and the imminent coming maybe you should file them. because you can't hold your peace forever. we need to move to negotiations with the house with a very simple language in it. so i am going to move a unanimous consent of the senate proceed with the senate with a

resolution and the budget resolution be passed by the senate and that this has been agreed to the senate insist upon the amendment on this disagreeing vote of the houses. all with no intervening action. that it not be in order of the senate to increase the debt ceiling. >> we object. >> the objection is heard. >> we are in the same place that you were before.

this is no bipartisan debt. this is a debt. this is a debt that came over the last 20 or 30 years. although we have never seen anything like it the last four years. it is a structural problem with our spending programs. we don't deal with these programs, it will collapse our economy, it is time to deal with it now. that issue should be debated on its own. >> i would like to respond by saying that this was part of the budget resolution and it would have no effect in law.

so what the knowledge of those advocating this is about, if this is a prerequisite, every conference that we have, and senators would be allowed. according to this, mr. president, setting certain parameters of these conferences, which is a procedure that we use now. we are willing that these issues on any issue that any senator feels is necessary for the conferees to do their job. >> the senate is a wondrous creation.

>> the way that i really see what is going on here, we now have a duper minority. if this were allowed to pass, what we would be doing is changing what the founding fathers had in mind in terms of the power of minority and actually say, let's go back in history and say that there are one or two or three senators were for senators that decided, that they want going to do the votes for women were they weren't going to do some of the changes that have occurred what

would happen if a majority would have no choice at that point. >> that is a danger. that is a significant danger. insist that certain conditions be imposed. it is not that we don't want the conferees to do certain things. that is the regular order of how we do business. let's have emotions. it has been my experience and

this is the majority of united states senate. so it is kind of a sad time. to be part of the negotiations that would have no meaning in law whatsoever because it is not signed by the president. we have the conferees, we could be doing so many things. and we are not. we are not doing the things. finally, i would begin to share my experience with my colleagues. i have made the argument on most things i believe that i stand for. i have been passionate on those

issues and sometimes i have irritate my colleagues. but at least i have had my say. then after i've had my say, the votes and the body have decided. i have tried to convince my colleagues of the rightness of a position. that is not how the senate should function. it was supposed to debate ends discussed and are passionate appeals and beliefs. and then put it to the body. that is the protection of the individual senator, not just say that we are going to do anything. that is not what the american people want to do. there's so much with the debt and the deficit.

the point is that whether it's the greatest in the world or not, so we can have a budget and we can have the american people. we have the american people and we engage in honest and open debate.

this is a procedure employed by the budget committee and conference. i yield the floor. >> mr. president, the senator from texas. >> we had been at war for years. over which end of the edge open first. we opened a big egg and then we open the small end of the egg. the big ten and the little end are battling endlessly. i am sorry to say that a satirical depiction often reflecting what occurs in us. we spent a great deal of time arguing about procedural motions to commit or not to commit. things that do not matter to the

american people. and then we are bankrupting our children and our grandchildren. if i put them i would like to cut through all of the arguments back and forth. because in my view, most of the arguments are, by design, they are missing the point of this disagreement. this disagreement is over one issue and one issue only. in the united states senate race are debt limit but only 50 votes. what does it take 60. everything else that is being talked about is a side issue. the central issue is should the senate be able to raise the debt limit was 50 votes or 60 votes. i will note that my friends from arizona questioned the knowledge of those who are objective. he suggested that perhaps our knowledge was lacking because this cannot be done. why no, my friends from arizona, he is longbranch another's

another's body. he knows notes that in 1987 and 1990, this was not a hypothetical. in 1995 to may 2004, it didn't quite get accomplished, but it was attempted in occurs under this budget act is that when a conference reported this, they raised the debt ceiling and that can then be passed by this body with nearly 60 votes. this is all an avenue to allow a debt ceiling increase. for 62 days we have vast majority leaders to simply say that we will not use this as a

procedural trick to raise the debt ceiling. the 50 votes and we can go to conference. for 60 today the majority leader had said no. that means absolutely clear that is what this about. on both sides of the chamber, their art different things at work. he simply wants a brit and translator. he wants an unlimited credit card if he digs in deeper and deeper. he says this publicly. repeatably from the white house. what they are doing is standing shoulder to shoulder with democrat president.

raising the debt limit with just 50 votes, which means that that would then allow the democratic majority to vote without listening to a word from the minority. that's what this fight is about and there is no other issue being contested here. some have suggested that we ought to have a motion to instruct it. the problem with it is it is nonbinding. so it is a purely symbolic gesture. there are 55 democrats and 55 the vote against it. here is some of those on the right side of the aisle. there are some who would very much like cast a vote against

raising the debt ceiling and allow our friends on the left side of the aisle three that dealing here they can go to their constituents and say that we voted now. yet at the same time, and they didn't have to actually stop what was happening. that is an outcome that i believe that there are some on the side of the aisle who desire it. i do feel obliged to rise in defense of my colleagues the republicans. because the senior senator has included the republicans by claiming repeatedly that it is only a minority of republicans who are opposed to raising the debt ceiling on just 50 votes. he has repeatedly suggested that it may be a small minority, the overwhelming majority of

republicans, the senior center said, we stand with terry reed and want to be able to raise the debt ceiling. let me suggest a senator from arizona. in saying that he is included with all 45 republicans in the body. it has been said yesterday that those of us who are fighting to defend liberty, fighting to root control the debt, it has been suggested that we are wacko birds. if that is the case, i will suggest to my friends from arizona that there may be more wacko birds in the senate then discussed. i've encouraged my friend, senator from arizona. but if he were to circulate the simple statement that said the

republican senators hereby state that same state that we give terry reed and the democrats the ability to raise the debt ceiling of 50 votes instead of xp. i believe it is only a minority of republicans that opposed that. but it is not accurate. this issue gets obscured by the procedural complexities. it is very simple. majority leader harry reid and the democrats want to raise the debt ceiling. they stated that they wanted to do so. they want to do so consistent with president obama's instructions. to do so without debate because he doesn't want to have debates

or conditions or anything to fix her out-of-control spending worked out. going from $10 trillion to $17 trillion has not been enough area that is the desire of the democrats. we could go to conference right now today if the democrats with them to day that we won't raise the debt ceiling was just using 50 votes. that is not what the majority wants to do. those who argue that republicans should accede to that demand, they argue that all of us love told constituents that we are going to fight to solve this problem, stop this out-of-control spending, stop destructing our kid.

those are just what we tell constituents at home that is not actually what we do when we are on the senate. but a senior senator said it is only a small minority that believes this, if my friend, the senior senator is able to produce a written letter with majority of republicans, i would offer it here and now to go to a home game of my houston astros and i can guarantee you that that will not be well received in houston. but yet i stand in complete comfort that i will not find myself in that situation. because i don't believe it is right that the majority of the republicans in this body have given up the fight on spending and reining in out-of-control bipartisan spending deficits and

debt. i believe we have seen leadership in this body stand together to fix the problem and that is what the american people want. so let me say this in closing. it is easy to get confused by all of the procedural discussions back and forth. this issue is about one issue alone. should majority leader harry reid be able to raise the debt limit an unlimited amount with just 50 votes? worsened over quire 60? there would have to be some positive steps to fix the problem. the majority leader has the votes right now today to write a blank check to the federal government. that is the issue. and i think the american people are not conflicted and the answer to that issue. the american people want to fix

the problem. they want to stop digging the debt hold eager and putting our kids and grandkids on the half to grief. i am proud that so many senators are working very hard to onerous and our constituents. because that is exactly what her job is. i yield the floor. >> the senator from utah. >> i think my friend and my colleagues. the senator from texas for his remarks. i speak briefly to respond to the points that have come up today. first of all, it is important for us to remember that although the rules of our body might allow for a conference committee to meet in public, and although that may have happened in the past from time to time. and after on the senior staff members who have been here longer than me. this typically hasn't happened in recent years. in fact, it has become relatively rare in recent years.

to suggest it is an open process because it has the capacity to be made into an open process. those are not the same things. we can expect for this to be a closed-door process. we of course we'd conference committees and we are not disputing the fact that sometimes it is important for conference committees to meet. one passing and how someone passing in the senate. what we are talking about is a very limited request. limiting the scope of their work. exclude the possibility of a debt limit increase without the 60 vote threshold. it is important to remember that although this is the procedure that the majority has chosen to use in order to try to get to conference the conference committee, it is not the only way. in fact, it is possible to do this without unanimous consent.

without all this being willing to do it. effectively voting to do that. the other body can slap the minutes on top of it and replace the senate background and it is my understanding that we can go to congress without unanimous consent. there are other ways. this is where the majority has chosen to go. we will continue to do this until such time as it becomes necessary or until modifying the request. this will take lace the subsequent 260 vote threshold.

thank you, madam president. i yield the floor. >> coming up on c-span2 tonight, he said senate hearing examining health care. and the senate confirmation hearing for transportation secretary nominee charlotte north carolina mayor anthony foxx. >> on our next "washington journal." human rights watch about president obama's counterterrorism speech in the use of drums. tax policy analysts for the heritage foundation. later, look at some of the demographic trends and rule america, including farming and

agriculture. >> what has happened in the senate has to do with a budget resolution with the budget history since 1974. so statutorily, we want to pass a budget and complete that process by april 15. here we are. it is no wonder that everything is part of sequestration and the

automatic cuts. >> this has to do with congressional red gridlock on "after words." this weekend on booktv. >> veterans affairs and health and human services officials estimate on thursday. because senate homeland security subcommittee examined how federal health health care programs affect those living in native american areas. this is one hour and 40 minutes. >> we call to order this

hearing. including the federal work force this morning. this is entitled improving federal health care and building partnerships. i look forward to hearing from eyewitnesses about efforts made by the federal health care workforce including but veterans and native americans. it includes federal health care workforce and we will have the opportunity for collaboration and cost-sharing and explain strong partnerships between agencies and local providers. to someone who has worked with the veterans and the native american populations. i am aware of the challenges in frontier areas. especially in a timely manner. to address these challenges, it includes a multifaceted approach.

we expand the vet centers and transportation options for folks who have forced two been traveling through distances to the sikh health care. but we also need to address workforce shortages and agencies like the dea and indian health service. far too often we have seen facilities that title because we cannot recruit mental health professionals and sometimes they're under siege shortages. this is a rule problem and a national problem. we need to ensure that their are artworks in collaboration and not in competition. the vibration should only be happening between federal agencies, but between the state level and happening in more rural areas. the federal health care workforce needs to limit the resources it had.

just because a veteran lives in a place like montana doesn't make him or her less deserving with health care. we have some great witnesses with us here today. as we discuss these issues in more detail, i look forward to hearing from each of them. i will now turn it over to the ranking member for his opening statement. >> thank you, mr. chairman. thank you for having hearing today in montana and ohio and around the country. it is an important topic. if the testimony will get today will shed lightpic. if the testimony will get today will shed light on rural health care in particular. i think the witnesses for being here with this panel. one of the most important functions that we must fulfill is the care of our veterans. you know, they are out there defending us as veterans.

their mission continues. we have to make sure that we are there with them. there are many health care problems that face us. they need to travel, as the chairman said, distances to seek care in many cases. we are coping everyday with physical and the invisible wounds of war. unfortunately for them, health care is not as readily available. in the context of traumatic brain injury, it is often referred to as a wound of iraq and afghanistan. over 256,000 service members have suffered tremendous brain injury from 2000 until 2012. at the same time, research service has estimated that over 100,000 service members have suffered from post to manage

stress. what is one thing to be able to get our rural veterans treatment for an orthopedic issue or even help with a diabetes management program. but often it is another thing entirely to present his full scope of treatment or. >> host: stress. the witnesses recognize the scope of the problem. each of the department has a number of initiatives to address this problem. i will point to hearing more about that today. i will day that i am concerned that we are making internal adjustments and small steps forward. i think our veterans are not as effective as they could be.

we are now losing 22 veterans a day. fundamental changes are needed to occur from the way that we react. when i'm back in ohio, i regularly talk to her veterans that their interactions with the ba. some are very positive. we need this treatment and coordinated appointments include customer service. we have to drive a couple of hours and when he shows up a little late, we are not setting up that person for success. the stories we have heard are not isolated. some of the same stories are out

there. so we have to leverage the resources of our nation, including the men and women who have given so much less. we have providers from other countries getting ready to support this population and when given the opportunity to do so and connecting our veterans with the right treatment. that is something that we ought to talk about and be focused on today. i think eyewitnesses and i look forward to the testimony today in discussing these issues. >> i would just like to say thank you. >> i would like to welcome our first panel of witnesses. increasing our access, including recruiting and entertaining, and quality health care workforce. i would like to introduce the

doctor who is the under secretary of health of veterans affairs red since every 1 since, he oversees the health care needs of some 8 million veterans. currently enrolled in veterans administration. the nations largest integrated health care system. they employ over 200,000 staff members and more than 1700 sites across this country. last year, we need these patient admissions. welcome, doctor. we look forward to your testimony. next we have doctor you that libido who is the director of health service at the u.s. department of health. this includes the health delivey

system including 566 recognized tribes and some 35 states. we have tom morris who is the associate resource administration, otherwise known as hersa. tom's officers are a critical bunch of resource people on rural health issues. it enhances our local partners to increase access and those communities.

we just got going before we got to the doctor for his opening statement. you can have an opening statement if you'd like. it is up to you. >> we will start with the doctor. he will have five minutes and the oral testimony is to know that you're full written testimony will be part of the record. >> ranking member portman, thank you for the opportunity to speak with you today about recruits and retaining and deploying the health workforce to ensure that veterans can access assess the health care that they have earned and deserve. we are committed to providing veterans with quality and timely and accessible health care is close to possible as can be.

this includes veterans, service members and military families. it has made significant progress to increase the mental health workforce to meet the needs of veterans. as of may 14, 2013, we have hired 1,100,003 mental health mental-health providers. in addition to that, we have hired 2063 vacancies. this has included mental-health providers. in addition to that, we have begun hiring a new group of people including peer specialists. 261 of them have been hired. we are implementing a number of creative improvement strategies to ensure access to care for all

veterans. this increases the awareness of employment opportunities, national advertisements, television from commercials, we have also begun to hold facility based mental-health summits with the purpose of building and expanding coalition for community providers and organizations in the community and federal and state agencies. this includes improving access and health care by developing innovative practices to suit what unique needs of veterans and geographically remote areas. we have used a number of project arches and patient centered care or pc three in order to provide eligible veterans timely access to care for a network of non-va medical providers who meet d.a. quality standards. this will continue to implement ways to broaden access and care

to veterans. especially in geographically remote areas or it can be difficult to promote health care professionals. and where travel is excessive. we are a national leader in health care. in fiscal year 2012, dj providing care to half a million patients who video this technology. this number is set to rise to 800 30,000 in 2013. including outcomes and is one that ensures the liberty of services to improve access to specialist. it leverages health care specialists from a regional center to offer expert advice

and provide will health care setting. this includes access to the va health care system and is designed to give them greater control over health and wellness. this includes our ability to access electronic medical records. the optimize the delivery of treatments by using technologies and tools, such as mobile applications. these applications can include ms. williams and the award-winning ptsd coach is an opportunity that provides understanding of those symptoms associated with ptsd.

it is a mobile application for patients to use during their treatment. as a treatment companion. fostering with basis and organizations to bring value to veterans and expand access to care that is reserved. these local community partnerships include direct access to the va health care and workload. in response to barack obama and his executive order, the va is working with health and human services and we have initiated projects as to how we can bring mental-health services to people that are experiencing difficulties.

we are committed to an accessible system that is responsible to the needs of americans. we continue to implement our strategy to recruit locally. we want to include technology and partnerships to include these goals. we want to thank the subcommittee who appears before us to discuss this issue and i am prepared to answer questions that you may have. >> thank you, for your testimony. we will move to doctor yvette rubido. >> thank you, mr. chairman. thank you, members and ranking member. my name is yvette rubido and i am the acting director of the indian health service and i'm pleased to provide testimony on our efforts to develop and support the federal health care workforce. it plays a critical role in supporting the overall mission of the rural health care system addressing the population with significant disparities in health and access to care. we share similar challenges

faced by rule communities across the nation. many of our facilities are in remote locations. especially health care providers. health care remains an issue. [inaudible] continued efforts to and proved a federal workforce is critical. many of our reforms are based on input and recommendations. this includes our employees and stakeholders. we also support programs such as the american indians of

psychology and the american indians and nursing programs. develops interest in health professions in returning to our community to work for us in the future. it helps us with programs with the workforce. the isaf program is one of our most respected and recruited for a variety of positions in our workforce. it includes our strategies by gathering input with our stakeholders to better understand the needs of our workforce. another important strategy is to improve the workplace environment at ihs for better support. it is made for improvements. hiring processes, credentialing, to ensure that we have a quality that are workforce. we also worked meager salaries

more competitive with the private sector, which is especially important for health care improvement. we are going to develop and support the federal workforce with other federal agencies including tribal communities. our partnership with the services administration has helped us recruit more health professionals through the national health service scholarship program. our partners have helped us improve coordination of care through implementation of our 2010 memorandum of understanding in our 2012 ihs national reimbursement agreement. those are helping the workforce improve access to quality and health care. our partnerships are extremely important to recruitment because of the winter provides to students. one of our most powerful

recruitment strategies is that a partnership exists with our community. as more of us feel at home and supported by her community, the likelihood that we will become a long-term member of that community, it will increase. the federal workforce is essential to the health service and the delivery of health services. we appreciate the opportunity to testify at the hearing. including opportunities for improvement. i'm happy to answer questions. >> thank you, we appreciate your testimony. we go to mr. morris. >> mr. chairman. ranking member. thank you for the opportunity to testify today on the half of the health and he human services department. including federal policy administration. twenty-five years, we have

served as a focal point for communities within hhs. includes policies, regulations, programs and rule communities. this includes issues raised for health care professions in rural communities. we also administer programs that are grant funded with immunity based pilot programs and state programs focused on quality and performance. we welcome the opportunity to discuss ways to help communities attract and retain health care providers. this includes the department and administration. 15 million people live in the rural areas. including 60% of the population. this includes 80% in the united states. the health care system is focused on primary care and this provides qualified health

centers and rural health clinics. we have several initiatives to focus on with the capacity that we have. we provide grants as well as a look with the flexibility grant program that works to improve quality and finance performance. the communities go far beyond. this includes the national service corps which supports payments and scholarships. including our providers and rural areas. primary care, behavioral health, heavily focused on community-based propositions. including 15 of the 22

communities across the country. studies indicate that 7% of the state and rural practices. in this includes working with their communities. we also benefit from hhs and other programs. >> this includes our communities and needs an emerging technology. technology plays a key role in mental health, particularly in rural areas where things are

often scarce. this includes montana, alaska, including rural veterans and those who need to enhance their care. we are also working to operate and maintain these electronic health records as part of the exchange. these technologies continue to be deployed in health care. we thank you for the opportunity and the workforce is that we have today to work on future countess. >> thank you for your testimony. around 10:30 a.m., there will be a vote. what we are going to do is stagger it out. we are not going to adjourn. we will just stagger it out.

>> we will take it to the senator. okay? thank you. >> seven minutes on the clock, please. >> okay. sir, the va has made a commitment to higher new mental-health professionals. health clinicians. i think about 300 support staff, correct me if my numbers are wrong. where are we at on those hiring for the sports that? >> the numbers are correct. we have two ways that we look at this. one is the actual positions that have been filled. and we have built without their 256 of that 1600 critical mental

health providers. in in other words, we look at this as every quarter, we are able to assess the number of clinical providers providing direct care that we actually have on board. now i have the most recent data from march 2013. that indicates that we have an additional 1556 people on board, providing mental health care than we get back to me. we believe that we are well on our way to meeting the goal. we have hired almost all within the administrative personnel. >> what is the 1556 edition? what are your total numbers on that next total mental-health that we have, let me get this

number correct. i believe the total that we have on board, providing direct patient care is about 18,600. that would include psychiatrists, psychologists, clinical health nurses. psychiatric social workers. those trained for family service >> as you well know, i think that this can be relevant to all america. we have had a shortage of mental health professionals for years. unless you're getting a healthy person who hires them what you indicated that we have, it is unable to make up the ground person who hires them what you indicated that we have, it is unable to make up the ground with the impacts of ptsd and others. you have talked about where we are today.

how in the future there are longtime efforts for assessment. if so, are there long-term assessments as we move forward to help bring more folks into this? >> first of all, mr. chairman, there are ongoing recruitment efforts. it is slightly over 13% amongst clinical mental health providers to a little bit below 11% and that is a significant number when you are talking about almost 20,000 mental-health professionals. we are assessing and we will assess continuously whether or not we are meeting the access needs and standards that we have described. if we discover that we are not

able to do that because we do not have the personnel available, we will continue to add to the mental-health workforce. but i think it would be useful. the other thing that we are doing with relatively new efforts, most important of which is the use which is the use of mental health to deal with these shortages of psychiatry, which we and everyone had difficulty recruiting. i know you're very familiar with that. we have set up regional centers of psychiatry that communicate with her community-based health care clinics and provide consultation and therapy by elemental health from remote areas such as spokane, washington, difficulty recruiting psychiatrists into one of these ventures, in an urban area where we are able to recruit psychiatrists to new

york and minneapolis and houston and san francisco. these are regional centers are proved to be very effective area the mental-health therapy is very well-received. they like the idea that they don't have to travel great. they are not above all, frustrated by warty five-minute drive, even across town. especially in an urban area. that is going to be a major effort in the next two years to help us provide psychiatric services in remote areas. >> i thank you. doctor yvette rubido, i want to talk about the challenges that are unique to indian country as you were retain quality health care folks. time and again we hear about those who must bring in folks from outside the area as primary care doctors. also specialists and nurses.

these are highly skilled and high-paying jobs especially in the indian companies. i had a group of eighth-graders yesterday and one of the questions that they asked me was how do we get more doctors and nurses from crow country in this hospital. these are eighth-graders and kids that understand what's what is going on. can you talk about the challenges of recruiting in indian country. >> our challenges are significant. we certainly would like to recruit more individuals from our tribal communities to work in our facilities and to be health professionals. the challenges are in the communities in schools and things like that. they have to travel far away for their education and sometimes they don't come back. our programs have helped us to recruit and retain what is going on in our system.

.. despite higher in over 1500 new physicians in the last year or so on the outside. beyond capacity issues were some times you do have the use a

private or a few surveys, what's the threshold? how far do you require a veteran to go to seek services? how do you define geographic inaccessibility's is your criteria? >> thank you, senator portman. we have definitions of a plurality for us all distances are fixed amounts to be an example and 60 minutes to services. those are not really used them in a great sense for more evaluating whether somebody should be feet as they call it or cared for in the community. much of it has to do with the convenient to them being able to travel. if you have an 81-year-old gentleman who lives even 60 miles from the medical center, it's a burden to as the

individual to travel for a routine clinic appointment and even for some individuals were much closer but have to travel across an urban area, that can be a daunting task for somebody who is 81 years old. so we tried to do two things. number one, and option is seeing that care, providing the care of the local community and we've got two pilots running right now looking at that option. another one we are using and in creasey numbers is what we call a video camera in the patient's home, instruments to monitor the patient's weight, ekg blood pressure and their primary care provider or their medical center has proven very affect goods and taking care of patients with multiple chronic diseases with

the opportunity to not travel. we reduce. we reduce hospitalizations by almost a third by providing us care with the communication. >> for mental health treatment, is that as effective as it is for other clients we talked about earlier the fact we have so many who are veterans of the work tbi and so maybe for somebody who is again recovering from an orthopedic future or somebody on dialysis, maybe you can work through some of these issues using some of the telemedicine you're talking about. >> tele- mental health is remarkably well except dead. it began in the va on an indian

reservation undergoes that indian reservation in south dakota almost 10 years ago now as a study, treating ptsd by a researcher at the university of colorado proved to be successful unless the entertainers for spreading tele- mental health around the country. the acceptance rate is based in the satisfaction rate that is is over 90% for the patience to d.c. i'll tell you an anecdote very quickly. and then has to travel 45 niles -- 45 minutes to get to a psychiatrist who works in one of the medical center's a game he described on the videocamera dx variants pier 45 minutes of traffic. he's frustrated, angry and not the same kind of person he normally is by the time he shows up for the appointment. when he does the therapy episode

in his own home, he's comfortable, trip and across the urban traffic is relaxed and he has an entirely different person in the therapy session has a better effect. it works very well and we will be exploiting this to the maximum over the next several years. >> do you think using non-va health in tbi is something that you're doing that she provided the committee by 2% for mental health patients are seen by non-va providers every year? dod has a policy which i care that's a little different where they use non-dod mental health providers first at the incinerator basis. what is your policy and it's only align 2% of veterans by

many providers outside the system appropriate? >> that should be asked and that, senator. i have no doubt 2% is not as much as needed and could be and we are in fact doing it. the new non-va care arrangement called pc three is going to have entered a mental health component it will be expanding that. the issues and making sure not va providers are with depression and the things we see as a result of combat, but we are expanding and we intend to expand our use of non-va providers. the pilot we do with the health centers as an example we've committed to piloting in 15 locations of how this works with a contractor to federally qualified health care provider is often run in 15 of them.

five more can be added shortly and i have no doubt that network is going to ask him. >> i noticed the data you provided us cassette 2010 and does show an increase 2,722,009, a decrease in 2010 from 2009. are you suggesting that data for 2011 and 2012 or 13 would show an increase? >> certainly 10 will show an increase. i don't know 11 looks like, but it should show an increase. >> you've given us some important information. i appreciate that. are your own account using over a million until health patient now appear clearly a lot more veterans need this service. if we assume patients are dispersed to the veteran population as a whole, that is

at least 300,000 mental health patients in highly rural areas are seeking truth and an icq net through the use programs that are telemedicine, tele- mental health programs. how many of these are connected? >> that's a very good question. presently it's 83,000 patients we've delivered to let mental health services issues two. >> how many of those have to go to one of your community-based outpatient clinics to get the service? >> almost all of them, senator, would go to some location where we have health services. they been a few, but not many that we have is the gentleman described in new jersey where he set this up in their home. >> that's a pilot program you think should be expanded? >> not a pilot.

it's in its infancy it will be asked and did. i think we've demonstrated -- these patients have demonstrated better therapy sessions when we see them in the context of their home. >> anything we can do to help you expand the capacity? >> i think we have the resources. we have the money to buy the equipment and the price has shrunk dramatically and it's basically just a web cam on a computer. the sigma need help with around the country, all of us do a psychiatrist are not enough psychiatrists is much less than meets being treated by the indian health service. that's probably one of our largest issues. >> thank you, dr. petzel.

i appreciate your testimony. >> thank you very much for your work in your time in alaska that we call the hero scarred and delivering health care is ever says to rural veterans, especially in rural or where it's very difficult to get access. i want to ask you a general question, but first i want to commend you for moving forward. hopefully i've given them the task after a period of time to be working with us on many issues that may come up to make sure we continue the process so veterans from under where they live they don't have to worry about fine-tuning greater seattle. can you give me a quick update

on how that is working and how you feel the success of that is? >> i want to mention i had dinner last night and he said i'm mentioned she sent her regards. >> very good. thank you. >> we've had great success and work in the south-central and the other tribes in alaska. the contract we have for sharing services with south central has been very effective in providing specialty services. we also had some instances where in more remote areas veteran patients are being seen in tribal facilities, obviating the need to travel back to fairbanks or to anchorage. the second issue -- the number of people having to travel out of alaska down to seattle has shrunk dramatically and i would

say with very few exceptions were going to eliminate that need in the not-too-distant future. there's some things for such a bone marrow transplant, which seattle is the obvious place to go. otherwise our goal is to not have veterans in alaska traveling out of alaska in order to receive care. but i think remake in progress, sir. >> let me ask you since i've been here that's been an issue and i appreciate the regulatory change committee to eliminate co-pays for mental health providers are mental health services in the last to and you know this so it's kind of repeating the obvious that we've been on the forefront of tele- health from the mental health to delivery of everything you can imagine for mental health. do you have, let's say i'm an

alaskan who need services to telemedicine and my doctor is in idaho. is that dr. have to be licensed in alaska quiet >> the short answer is no. in the va as in every federal health care entity in a state, but she did not have to have a license in the state in which are practicing. the licensor issue is really not a problem. the problem if it arises is not the credentialing. it's the privileging. you need to have that individual have the right kind of privileges in the right organization. so if a doctor in boise was

doing specialty care for somebody at the anchorage facility, they would have to be privilege to oppose anchorage and boise. we are working to try and smooth out this process. >> thank you for splitting the two issues. i knew there was an issue here and i saw the privileging as the situation. is there anything legislatively we need to do? i know we did some stuff at dod that senator kelley ayotte and i did a couple years ago to fix that problem. to make sure no matter where the active military member would go if you get services delivered from whenever doctor they had at any time. is there anything legislatively we need to do? >> senator begich, i don't know. the privileging issue is something that has to do with regulating bodies and medical

care, the joint commission. the joint commission requires the individual be privilege at the point where they are delivering care. there is no law, not even a federal regulation that has anything to do with privileging. it's basically a requirement. we've been working with and to find ways to make it easier to have people privileged at various places. but right now privileging is the right of the medical center or the clinic delivering the care. >> very good. let me against a thank you for the work you guys have done in regards to getting what i call the hero scarred for health care for veterans to matter where they live, the services they've earned. thank you for that. >> i would like to also comment on the fact that working with the ihs in alaska has just been

wonderful. that has been a very, very good example of federal collaboration. >> they're a great group. let me ask if i can and dr. petzel, thank you for that. as you know, we have a significant problem and i want to echo what dr. said he said. i would argue that we have the best if not the top in the country when it comes to delivery in the most harsh climates, conditions and situations. i agree we have some credible we're making headway in. you've heard me talk about this before and that is the consistent problem of staffing packages. how do you make sure you have a vacancy rate of 30% and senator categories as you describe.

the bigger issue is we have as you know no miss completed, dutiful facility. they don't have a staffing package. they can't deliver services to federal government contracted with them to do. you got about 53 million last year and this year nationwide. just one of fairbanks, tcc, will take 8 million of that. how are we going to solve this? is one thing to have a clinic in an urban area, but to get someone hired in a rural area like alaska, you can't do it today they're open. it doesn't make any sense. how are we going to solve this because this is honestly we have vested lots of money in a

civility cinema adults have been. what's the answer here? these are rural areas. >> the answer is to work together on appropriations that would help us get the staffing packages and i'm pleased with what the president's budget for 2014 in terms of staffing packages including joint venture facilities in alaska and oklahoma helps us catch up to the amounts we need to catch up. it's a difficult climate over the last two years, but partially as we work with the tribes our proposal for a $77 million helps us catch up. >> is that enough? >> that's enough to catch up with facilities to be open in 2014. right now are doing a 2015 formulation to estimate which ones will be open. >> one last question. they have a top lawyer

available. they will fill it up. va has the clinic down the street at that capacity in the full-service clinic. why don't we just take the clinic at the va has come and take the space that is a beautiful space, highly collaborative effort. >> is that a good idea? >> yes, because it allows us to do that through sharing facilities and staff so they started to do that and hope to do more. >> we would be delighted if that arrangement worked for both parties. >> fantastic. i think that's a huge opportunity. >> thank you. i have to go vote. >> thank you, mr. chairman. and thanks to all the members of the panel. we used to think this is not

important issue to north dakota. i want to point out the two senators whose names were booked and testimony were senator conrad and senator byrd egg from north dakota and concerned over a long period of time about moral health delivery whether its veterans, native americans or just mom and dad on the farm. this is a critical infrastructure ratio for the development and continued viability of rural america. scan your capacity by using the technology. are you so convinced the

technology is available in indian country are rural america? the kinds of things you can do in washington d.c., do you believe you can do in north dakota? is there the infrastructure back on, the amount of technology and have you looked at those issues going forward when you promote telemedicine as a solution? >> senator, i'll take a crack at that first. 10 years ago but lg was clunky and it requires special telephone lines were often difficult to get into in terms of remote areas. that whole landscape is changing dramatically. number one we can now use a high-resolution web camera to provide the same fidelity of mh,

et cetera. >> i don't mean to interrupt, but is that true in every remote location united states? >> we can put the technology and he plays and use the internet. >> what happens if the internet is intermittent at dial-up? >> if it's dial-up, it works. would not run into those difficulties really any place. we've been providing services at this nature on hydrated will be providing those services in devils lake in north dakota. every place reviews said it been reliable. more importantly is fairly well accepted by the patients. when they see that as an alternative, driving 100 miles to fargo they get good care with

it. i am convinced this is going to be the wave of the future. >> at i.t. are your response to that because your umbrella is a little broader. >> you know, i think there's challenges in terms of broad and as you can enough capacity to use the full extent of the technology she that i agree with dr. petzel works very well. there's been some analysis of broad band gaps. the fcc has done some revision to its universal service program for rural health care that we think is a key tool in the last mile in these areas and that was announced within the last couple. in addition to that, some of the investments and recovery act of the department of commerce and agriculture help close that gap. there are areas that are

successful. >> i think there's any doubt there's a dive right in this country. we can't offer a solution to the office of rural health care and solve it with telemedicine and not have the highway that's going to take you there. so i am chairing on the committee and this is an area that goes beyond telemedicine but it's obviously not so critical component of rural development in my opinion. i've a question for dr. roubideaux as well. senator begich and the work done in alaska is very intriguing to us in north dakota. we think we have remote locations. we think we have a great deal of difficulty and i would tell you where you hear a lot raised in terms of indian health service is not what i hear in my state.

what i hear is clinic shutting down because they don't have the capacity and don't have the staff to even open up on a friday. that overflow goes to other hospitals. so i'm very concerned about the long-term commitment and appreciation you have about the concerns that native americans in my state have about the quality of their health care. >> i want to reassure you we are absolutely committed to providing health care services to the best of our ability to the alaska master of the country. you're absolutely right there differences among areas. it tends to track run a difference between what the proportion for more direct service programs and there's flexibility straw travel management hoping alaska do some innovative things. we still have the federal trust response ability and commitment

to service programs in north dakota and throughout the regions in the country. we are still working hard to get the same types of improvements in those programs. >> not to prolong it, but i will tell you this that there are concerns about squashing innovation, especially in the mental health area because it doesn't fit with what people may see as traditional models. a page of a longer conversation with you about that going into the future, but we need to be innovative in order to provide the services. we need to continue to develop the work for us and technical expertise of anyone who wants to offer services, but particularly the progress we have at you in the to train indian.recent indian nurses. if i could indulge one additional question on heroes. i am very interested in looking

not modeling a health card program senator begich has been able to get a pilot on. a very interested in modeling that in north dakota and particularly as it relates to native american veterans. anyone who understands indian country does that native americans in terms of the percentage of their population served a double, triple, quadruple numbers in the armed services. when i come home have access to veterans that neither one seems to work. we don't want people of chemotherapy entitled to veterans services to have to get on a bus and drive 10 hours am literally waiting far ago, another eight hours while the other patients on the bus get their services. as somebody who understands chemotherapy, that's not a healthy thing to do to people.

we believe north core would be a great additional site for modeling a hero's health card in the lower 48. >> would be delighted to talk about that. >> terrific. >> in north dakota and south dakota were used to work, 50% of the native american adult males are veterans. that's a huge number. >> thank you, senator. i have a question for tom morris. your administrator of the rural health policy and member of the veterans rural health advisory committee. you have a very unique is on a lot of the issues we talk about today. could you tell me what the biggest challenge is to greater collaboration between agencies like pa and hhs ip? >> we've had a good partnership

and in 2007 they reached out very early on to learn the lessons we learned over the last 25 years about what is like to be a voice for rural innovation that collaboration has continued.