available starting tomorrow. i think the amount on chief financial officers is come committed for tomorrow. of the next 30 days we will perform a more detailed review. i don't know what the review will return but if it identifies we require additional resources will come back to notify this committee. >> moving that 300 million from somewhere else within the va the department so where you are moving it from isn't going to hurt those particular areas? >> i think in one potential case it might be carryover is a target those funds. >> you heard mr. johnson talk about the i.t. architecture. if you look at the bill that we passed in committee dealing with advanced appropriation is also cause for planning. the quadrennial report as well as a five-year planning process

within the va so you can focus on where you should be. at that point in time i believe the va i don't believe has taken the position and you opposed the advanced appropriation. have you reconsider that articulate a planning process? >> we have introduced new planning processes or are budgeting so one of the challenges we have is when the realities on the ground are different from some of our planning and a private sector but we are using some of those principles today. i think the ppe planning programming budgeting and ajit ajit -- executions of some of those are coming in already. >> thank you. thank you mr. chairman. >> thank you very much mr. lamborn. >> mr. matkovsky i'm glad to hear that the va is going to use i think the $450 million of carryover for fee basis. i know i was calling for that two weeks ago so you are going

to use 300 so that takes care the money side of it. on the upside what problems do we have to look for? for instance if someone goes in and out of private care from the va system like the potential of news and records what are the medical issues that we have to be cognizant of when they go back and forth using fee basis? i think we have to use fee basis. don't get me wrong. >> i think we have to watch that carefully. one of the things we have learned in our audit is we need to ensure there is sufficient nonva corp. karen cordish and staff and facilities. you can't -- we have to coordinate that care. part of that coordination is the transfer of medical records out. the other part of it is the transfer of medical records in. with pc3 where we have a contractor or contractor arrangements we can stipulate terms of the contract.

a lot of are nonva cares and individual authorizaauthoriza tions harder to specify that we have to be careful about that. in pc3 with a requirement that the data come back upon the delivery and partial terms for payment. in order to go to the processing repayment we require data. it's not an computable form. it comes in a pdf form. we are researching other ways called the nationwide health information network to transfer data. we will see if we can build that into some of our contracts as well. >> we really need to use more fee basis. i believe that the chairman's legislation at that the house is going to consider takes a big step in that. at least for the backlog and i think we are going to to need beyond that. for dr. draper i have a question on fee basis. what obstacles to veterans face right now under va policies for

using fee basis? i have talked to victims who didn't even know was available. that's one obstacle. they do need to know is out there. >> i think it's a case that i describe in my oral comments. i think it's been talked about here. that coordination is critical to make sure that the veteran and the va medical center and the nonva provider are coordinating and the patient records are being transferred appropriately and informatiinformati on is being transferred back and forth. it's difficult for a patient or a veteran to navigate any health system so they are dealing with two separate systems. i think that as an added complication for anyone using a separate system. >> mr. griffin do you see other problems that need to be overcome as veterans have more awareness and ability and pending legislation to use fee basis where there is a backlog?

>> as it's been stated it has to be managed very carefully. we have done audit work in the past of both inpatient fee basis care and outpatient fee basis care. the financial management processes were not there sufficiently to preclude duplicate payments for that care. payments to a medical center that bills for the doctor's care as well as care for the hospital facilities separate bill came in from the provider. we have been working with vha and mr. matkovsky is one of the leads in trying to make sure with the internal controls for the $4.8 billion is in place and we are getting what we paid for. i still think the bigger question is we have to figure out what the balance is between full-time va staff. we always need fee basis no

question especially rural areas that are removed from the metropolitan areas where medical centers are located. it's a good business decision to go that route the staff committed to work with veterans. >> thank you. mr. matkovsky do you have any final comments to my question on fee basis? >> one of the items we are working on right now is to structure regulation -- legislation. not all of the authorities in statute cover all of that within terms of the fees and we are making efforts to allow us to use other forms of agreements in the same way. i think that's important as well. the ig has noted that we have had historic week certain deficiencies in the use of our authorities. we have tried to correct those and we are trying to regulate them. >> thank you very much. >> mr. brown's -- ms. brown you are recognized for five minutes. >> thank you very much an first of all i don't mind being the minority on this committee and i

think my voice is the minority on this committee. for example dod is seamless transfer is not happening so that's part of the problem. it's just the news. we have how many investigations and criminal investigations going on. because we have a reservoir to doesn't mean the bank is going to check out. is that correct? >> that is correct. i think they said we were investigating allegations. >> absolutely and allegations does not mean criminal. >> that is picked to be determined and that is why we are doing the investigation. >> fine.

i don't want my veterans to feel like they are not getting the proper care and i really have not heard that they care is not quality. it's the timeliness of getting the service. can you correct me on that? >> i think there are private-sector surveys that show veterans are satisfied more so than some private-sector facilities. they are satisfied with the care that they get at the va. part of quality is timeliness also. >> i understand that. when i don't show up or an appointment they charge my. like if i have an appointment at mayo and if i don't show up they still give me a bill. now we don't penalize our veterans in that manner and this fee-based for service we need to be careful because it could be a slippery slope. veterans like the care that they get in the va facility. i don't have any problems in

making sure that in some cases that we use private providers that we have got to make sure it's the same quality and we have got to make sure that we still have -- we are making sure as ms. drake said that we have the same kind of coordination. does somebody want to respond? i don't have but a couple of minutes. >> i agree. it has to be quality but as i mentioned earlier i think the best quality is an integrated system and the more of the care that gets farmed out the more you lose on the integrations aspect and keeping track of the care that was provided in the medical record for the veterans. >> i at this report from the washington examiner and it talks about the clinic's, the outpatient clinics and it cites jacksonville as having the

largest delay, 13 years. i want to turn this in and i want to be clear that this is not correct. i don't know who did this survey that i met with the mayor. i met with shands. i met with the va and it didn't take his 132 years to get our clinic done that we have one of the best clinics in the country and i'm very pleased with it. when you are dealing with developing clinics you have a lot of stakeholders including the property, working with the city working with the permitting so i want to turn the sand. it did not take 13 years for my clinic to be built. so i don't know who is doing this research but it's not correct. secondly i want to give to the chairman and article that i read today on the way to washington from the times union, the paper in jacksonville where the state

of florida is suing the va because the state wants to come in and investigate the va. at some point mr. chairman you need to deal with your governor. pass this over to him. [laughter] speediness brown i will deal with my governor when you deal with your president. >> i have 32 seconds. mr. chairman you know that is not a good comment and i think you only an apology for that. the fact is that the state of florida is sending people into the va. that's like sending them into the military. that is not acceptable and it's not a joke. now this president. >> your time has expired.

mr. bilirakis you are recognized. >> thank you mr. chairman. i appreciate it very much. to follow up on mr. lamborn's question and mr. matkovsky what percentage of the health care is outsourced or farmed out? >> roughly about 4.8 million which is -- it's about seven to 8% sir. somewhere around there and they also have state veterans homes that provide long-term care slightly larger number pretty think the total expense would be around 5.5 billion which is closer to 10%. >> all right, thank you. i will move on to mr. griffin. sir in your testimony you stated oig has issued 18 reports that identify deficiencies in scheduling within the va since 2005. can you elaborate on some of the recommendations identified within your reports? >> i would like to give our

system ig for audit to directed most of those reports an opportunity to answer that question. >> absolutely. >> please ms. halliday. we are glad you could join the conversation. >> thank you. in the audit to vha scheduling procedures when we started working in 2005 we identified the national electronic wait lists could be understated by as much as 10,000 veterans. about point early in our careers we made recommendations to improve the oversight over scheduling procedures and to come up with standardized training programs for scheduling at that point. we had found a lot of inconsistencies at the sites we went to. then in 2007 we had another major audit, our audit of vha

outpatient wait times were we looked at consults similar to what dr. draper had looked that. we started working there to look at the issues that are actually going behind the waiting times. there was debate on whether the numbers are more correct only overshadowing the primary points in our early audits. we came to the conclusion that vha's scheduling system is incomplete. it was not providing reliable information. we may begin recommendations for addressing the delays in obtaining subspecialty procedures. we continue to look at the quality of care and then we moved on and we took on looking at wait times in a visn network

and visn three. we found the procedures were not followed. there were systemic albums throughouthroughou t visn three. i would point out on that particular audit we had nonconcurrency's with the recommendations. we wanted vha to establish a formal casual or national training program something with more rigor to it so we would eliminate some of the inconsistencies with the scheduling. we wanted required audits of the schedule was performance. we definitely wanted to make sure that the national reporting software linked to consult create date with appointment creation dates. ..

you did integrity over your information. that is key. we have stayed in that area. >> to they have the necessary funding to employment these recommendations in your opinion? >> funding was never given as a reason why not to implement these recommendations in these. i believe, as we started the teller that, yes, and they had money for the replacement of a scheduling baggage. >> thank you so much. appreciate it. >> thank you, mr. chairman.

mr. griffin, i just want to examine more this statement you made earlier about the proper balance between fee basis and a full-time veterans' health care employees. so your sense is that we really should look at the fee basis as a way to deal with access to health care, rural areas and greater efficiencies overtime are going to be with an integrated approach to health care. >> i think you will always need fee basis as a safety valve. >> you consider it a safety valve. >> right. since you need to make a business determination based upon the number of veterans coming in the your facilities you need to determine based on staffing and performance

standards how many full-time doctors you need to take care of that load of patients. >> we like to know whether we are adequately staffed full-time doctors. the date has been -- it as kind of muddy the waters. without data integrity. a basis for making their decision. >> we can't tell whether it's the shortage of striving. >> that's correct. is it possible, i said that right, but not only do we need to look at fee basis but arrangements.

help us with this shortage. >> i think that we could. one point we want to make is we are looking at productivity staffing inefficiency now as we determine our resource level we have productivity and efficiency data that can be skewed by the time in a state. that is important to note. we have academic affiliate's agreements are we use medical sharing authority and other sharing authority that we use with other federal government partners to include the apartment of defense. >> and dr. draper, if i understand you correctly, one of your concerns about fee basis care is the interchange ability, this aimlessness of the electronic health records that we have at that va and lever system they're using. the private care. >> the coordination of care which includes the transfer back and forth the records. >> and it seems like only one of the ways that i t has been used

-- mentioned maybe seven or eight of the ways in which we use our business system, but that did set the standard for the actual health record part. >> i would say that prior to this there was a general market failure in the world of health i t that set the standard and created a standard that the industry grew up around. >> dr. draper, is there a standard in the private sector health care? is it a multiplicity of the different kinds of health records? >> i think the latter. you know, systems use different things. practices from the private sector that could be like that. >> we have had trouble trying to connect the department of defense and health records and this step. you are saying, with regard to private sector systems there is even a greater challenge posed by the fact that we have a

multiplicity of health systems out there. >> what about our fqac? to the use the standard at all? we have problems integrating with those? >> you know, i think that there is an initiative that is still in its early stages of deployment, maybe folks here have heard about it. the nationwide health affirmation network. we have pilot deployments. industry both with the department of defense and private sector. and now we have been working with kaiser establishing interoperable transfer records. it is a long way away from being completely ready. >> have we given much of about what it would take for proper oversight would expand its fee basis relationship? >> we need to make sure that when we are using care -- i

don't know that we have the specific answer today, to be candid and direct. we need to know what is going to take it to coordinate a correctly. >> thank you. >> thank you. you're recognized for five minutes. >> thank you, mr. chairman. i will give you a sense of to the simple principle the will make the va better tomorrow. if you walk on at va campus and ask to their work for they will say the va. the answer should be the veteran. that i have used, philosophy in my practice, we don't work for the insurance companies, hospital, we work for the patient. if you will do just that and put that culture in, that va will be better tomorrow night. bring that culture from the top to the purse is reaping the floors. i promise you there will be a better organization. i have a couple of things that i want to ask about. and along the fee-based, if a veteran is in a situation where they cannot be seen, ala

waitlist or whenever, i qualified veteran, and they want the -- look, here is the care. that is your insurance policy now was a veteran. you can go utilize that. >> in some cases we have department of defense sharing agreements were recognize a beneficiary and establishes sharing agreement and deal reimbursement. we have done that. >> that could be a possibility. >> potentially. >> another question, you mentioned that in ohio, i think it was among veterans in a weaker to you cleared out that backlog. my question, why does it ever occur? >> i wish we had done now we have done ten years ago to return this focus on speed of care, ensuring we get to good data and returning our management practices of veterans that is all i can tell you.

>> okay. let me go with a couple of other things. i was on the private side is a veteran to work in a community with ed va hospital. the problem is getting information to tell me why the patient was in there to see me. that is an issue also. the va does not share information about drugs that are prescribed. we have huge prescription drug problems in tennessee. we cannot get that information. that va needs to be more forthcoming in their sharing of data with the private sector. that is just a comment. i want to very quickly because our time is limited, the audit findings in the intermediate options, the bullet points the we have, one is to suspend all va senior executive performance awards for facebook.com/booktv. i have not yet had anyone explain to me that metrics. you don't have time tonight, but what do i do to get a bonus? but there is not anyone on this committee that can tell you. i cannot. i want to get that written.

remove the 14th performance goal. in the -- revised and enhance, and implement. as side inspection process. when will that occur? will that occur in a week, month to my year? >> some of those have actually already occurred. reported destruction this morning to remove the 14-day performance measure from all staff. we came up with a mechanism that allows us to of the medical center management kaj each one of them report in the court. amended the performance plan. >> we come back in 90 days or in the fall we can assume that all of these things will be implemented on the intermediate? >> intermediate, sir. >> number two, audit findings long term and other actions, and i don't know what long term is. there are five bullet points the you have here. what is the timeline? >> some of those extended about

six months and others 12 to 18 months. none of them are stretching out much more than 12 or 18 months, sir. >> we will have a 90 days or so on the first. i won't hold you exactly, but approximately three months on the intermediate. the long term will be 18 months on the outside. >> eighteen month on the outside. correct. >> that is something i wanted to get on the record because these are all good things. mr. chairman, i yield back the balance of my time. >> thank you. >> thank you, mr. chair. i wanted to ask you. we talked a lot about training or the lack of training for schedulers across the country. were these schedulers trained to raise the issue of fee based services -- i'm sorry. i am not able to set an appointment for you on a timely

basis but you have this option to go to a private practitioner? >> we use that in the accelerating care. roughly 1800 or so employees were trained for that. part of it, we developed the script on how to offer care for veterans. that is now part of our standard training. >> it is now but has not been. >> it has not been before. >> well, i want to thank both that gao and the inspector general for being here. certainly i think you for your assistance in trying to make the american people and all of us aware of the magnitude of the problem. i think -- i don't think we still fall to properly understand the magnitude. i don't think we well until we get all the data and. but we will get our arms wrapped around the problem and

appreciate your persistence with that. we understand the depth of this problem. of hunted to know what you see as zero as we move forward? as the va tells us, we are going to employ men this, this, and this. we have discovered that we need to do this. and we are going to need some timely feedback as we proceed in that direction. and some help and guidance in your assessments of is this the right direction and is the va doing what they said they're going to do? if you could comment on that. >> i would say that i am pleased that it appears we are at tipping point and we are going to see actions taken in order to address this problem that has

been identified for many, many years. i have committed to our trust but verify. our auditors and health care and specters our final report that will deal with accountability issues there have been occasions over time where after the memo from 2010 was put out addressing all the various schemes as it was referred to in the memo to manipulate data, for a short while after that there was a requirement that directors certify that their facility was in compliance with the the ag regulations for scheduling.

then that disappeared. i think that when we identify a problem and to make the head person accountable to certify that the problem does not exist there, there is no reason to take that certification requirement away. let's keep it there and make them certify annually. then we will go check. if they -- if they lied about the activities at their facility then somebody should hold them accountable for that. >> thank you. dr. draper. >> yes. we work at the request of congress. i think much of our work in the past is ben related to concerns particularly around the scheduling and oversight of the scheduling and wait time process . i think this will be at the request of congress. to continue where we have been in the past and making sure that the strength of the policies and procedures that apply at the wish of the local level and to make sure it's the look at how

va is conducting oversight which we have found to be problematic and to make sure the things are being carried out the way they're supposed to be. so we are an independent voice. we are not partisan. we do provide an independent evaluation of many of the programs. >> i only have a few more seconds. what either one of you comment on how you feel about the accuracy of the data was collected and this nation one out? >> i would say that it was saying pro-active attempts to determine if they had a systemic problem and. i think the process had its limitations in the manner in which the questioning was

conducted, and there was no attempt by design to have accountability as part of the process. this initial phase was just to determine to what extent we have a problem. to that extent it was successful, but it was with its own limitations. >> thank you. i yield back. >> thank you. for five minutes. >> thank you, mr. chairman. mr. griffin and dr. draper, this question is for you. the testimony tonight and earlier reports have begun. it says clearly that we have a reporting problem related to the appointment system and waiting time calculations and the way those have been reported. did your studies of the vha find any other reporting issues that we have to be worried about? one of the things to five always on the roof whims of reports.

we have to -- we can't trust these reports related to winning times and patients seeking care it calls into question of the reports. did either of you find any state that in the case we have of the reporting issues to be concerned by? >> we have found their reliability issues with both the wait times in the consol data, the work that we are currently doing. i think that is another issue, not just about the data. we found and reported in 2012 that another issue with some of the support systems that go to support the work to schedule appointments and did veterans and for timely care was telephone access for appointments. the phones were not being answered. complaints from within the

facility that people would try to call. no one would answer the phone. it is a complicated issue. it's not just about the process itself. some of those supporting systems that help support that as well as problematic. they're needs to be a holistic look at how to improve the overall process. >> mr. griffin. >> i think that decentralize nation -- of the age a with 1700 points of care around the country between the medical centers and the outpatient clinics and various other places where care is provided makes a very challenging the try and stay on top of what is happening in all those facilities. as i mentioned earlier when we did an audit of the vision network they are all different.

it seems like you need to have better organizational structures that apply to all the networks. and as was mentioned earlier, people at the networks seem to flow back and forth between medical centers and what have you. maybe we need them on the front lines providing health care since from obama when they were first established and discount did commit insurance the way they handle contracts. >> thank you if i think americans have received another disappointing reason to not trust big bureaucratic governments.

if we have had a va disability claims brought < out there for quite a while. we have this new va issue. this fungus several hundred million dollars and can build a website. tonight you have heard comments. i am assuming some of the va management is listening. you have heard a comment about things like this. question everything. what is the next big idea? former special operations team. digested a culture of putting the veterans first. i would say, you need to do all of those things as you are trying to create the va the 21st century. and it should be one that is focused on a less bureaucracy and more on taking care of the patient. that may be a totally different model than what you have now, which is a have the bureaucratically structured system with a lot of brick and mortar is. i would urge you to think outside of the box.

if we truly put our veterans first we will find that there is a new model needed to do that verses so we are doing today. >> like all members here i am concerned about the facilities in nevada that are owned the list for further review. this area can get that information about the specifics the better because we have one news report that kind of confirms one former supervisor at the hospital have been encouraging these scheduling practices that we have been talking about. i would just like to see the details if you can get them to me. my question is about the goal that you announced today of notifying than 90,000 veterans and trying to help them either get an appointment or get -- see a doctor in the private sector. you have some 57,000 that were

waiting to be scheduled and another 64,000 to have enrolled in the va but had never been to an appointment. i wondered if you could outline for us which populations you have chosen to notify, how you're going to go about notifying them, and if you could get the information to me about how many in nevada will be part of that $90,000 appreciated. >> i will do that. the question right now. >> i know you will have to get back to me. >> just in general. >> in general we did for accelerated care, we did not have new enroll the upon their request data yet. the recommendation coming from the ig, we worked on that over a couple of weeks and festival listed on the published today. we focused on was veterans who did not have a paw may yet. the 57,000, and veterans to we were waiting for care that were new to the clinic and could identify for wait times. that came together for less than

90,000 veterans. that was just a start. we also incurred facilities ability to facilities. established bases that anyone care center. we are starting tomorrow and will be able to make the data available to the facilities. we had to correct a defect. we did. we are asking facilities starting tomorrow to have that engage in a plan for every veteran on that new enrollee upon a request list. that entire contact will be done in 30 days. if they cannot do it we will use the process we used for phoenix as well. in national call center in topeka, kan. witt's job to action right away, a script calls, and contacted veterans in a short amount of time.

>> if you would get that information to me. i appreciate it. i yield back. >> thank you. for yielding your time. you're recognized for five minutes. >> thank you, mr. chairman. >> appreciate the efforts to to ask questions. at the facility was that i have more than five minutes. it worked out much better that way. i would like to follow up on a couple of things. putting together the allies your poor with the numbers today you mentioned 64,000 roughly that are on the near west. 67,000 are on the electronic wedding list. if i understand that and recall the report from oic last week, then near list was considered an authorized wedding list. in addition to that they had identified, allowed 600 veterans , another type of another rise letting must. if the average is withholding the numbers that would identify

30 to 35,000 veterans of other unauthorized and sicker weighing less. do you have any data on that? that was one-third of the total. >> sure. for phoenix i believe there were three. i believe there were three sources of data in it -- in addition. one of them was the new enrollee upon a request. the other was the counsel for the appointment. that process is still down. they managed awol. the council for primary care loaded picked up. >> love of the numbers that? >> i don't have that. >> that includes 64.

>> you have a rough estimate. >> the process, the collection process for processing and upon request if you can us is a -- 200 veterans in the council list out of the 1100. a 400 on screen shot paper printouts. that was about one-third of the total. are you picking up these other unauthorized? any estimate of how many nationwide? that would be beyond the numbers >> if we continue to report this, bimonthly we will report this data out. it will change. it will be more full-time e.w. well. >> i understand. how many are on the console list? >> i'm sorry. the council process is not an unauthorized mechanism. what is not correct is to not

act on that. that is of phoenix did not do. that is what was not correct. it is correct to use the council system from the emergency departments. >> the oic was inaccurate? >> not of all. >> , how many are on this list? >> we can get that data. >> i wish you would. i am saying by my guesstimate we are talking about another 25 or 30,000 saw. in addition going back to the va report from april of 2010, we also identified manual log books is there any evidence on manual log books being handled at any va facility? >> i have no evidence, but we did not do an evidence collection process. those are not to be used. >> consul management. the desired date.

get these all unauthorized. >> there were some handwritten less that have come to our attention in the course of our work, and we are pursuing those has to creating them at his direction and so on. >> we need those. >> i handwritten lists. there were four or 500 desired appointments that were in someone's desk drawer that were not officially accounted for at the time that there were given us. >> okay. and lastly, we have a report of the zero ig investigation at richmond to see where the investigators arrived at 12:10 p.m., surged one room for a document shredder and left the premises to announce later. can you give me the criteria of these types of searches that last ten minutes only and involve one room? >> that is not familiar information to me. i would be happy to take that for the record and determine

whether or not it really was an ig employee your somebody else. >> okay. lastly, also disturbing reports that the va has insisted that been allowed have representatives present during the zero ig interviews? is this the case at all? >> i think that is the va audit. we have had a couple of directors tried a barge and one of our interviews, and we threw them out. >> even though they had an investigation dry out at the same time that was entirely separate. >> medical center director who was trying to impede our interview with the schedulers. >> general counsel. >> we threw them out of the room >> not an hours. >> i yield back. >> thank you. you're recognized for five minutes. >> thank you. mr. murkowski to my am going to join my colleague from nevada who is requesting data relative to arizona. and this is -- i expressed it at our meeting last week. very large, rural district with

12 mid-american tribes and a lot of those folks do not have telephones or check their mail for months. so i just want to make sure that we are contacting them. i visited with some of the vs0 in arizona when i was on last week. they can be helpful if we need that. i just want to express that concern. and my question was a follow-up question on the audit that you put out today. regarding further review. i just want to read these first two sentences. as a result of these audits some locations were flagged for further review and investigation in the instance of suspected willful misconduct is being reported promptly to the va office of inspector general. that is good. here is my concern. you then go on and say, there are three locations that require further review.

one of those is pressed arizona. my concern is, do i read this step think that there could be suspected willful misconduct that the facility? and what was your criteria for singling out these locations for further review? >> to get a sense, we started, i think, it was on tuesday before the week of may 12 to plan this out. i think that might -- that night, may 11th, which was mother's day, most of our staff dropped everything and went to the field. our goal was to complete the entire audit. of all of our major medical centers and cbo with 10,000 or more patients. >> i appreciate that. thank you. >> they allowed us to intervene nine people and one clinic manager. the rules were that the staff

member could have a union representative present if so desired. if they did not they did not and if they did not want to participate that did not have to that did not allow enough quantitative data to say we have a representative sample. this site auditing comprising of forcing people report. question that we asked it, is there something you want to tell management about? if they said yes, we constructed a narrative response and wrote that narrative response and match it up with qualitative responses on those questionnaires and determined there was a practice the weak dollar was inappropriate that involve changing dates, and that was the criteria. it was qualitative. we were using a combination of quantitative data, but frankly these were leaders in our organization and we use their judgment. >> thank you. i am concerned about the press got facility. follow up with you. i will be interested in your

final review on that. thank you very much, and i yield back. >> thank you. you're recognized for five minutes. >> thank you, mr. chairman. recognize that we have a lot of great care givers in the va system. a couple from my own private practice. one or two days and months to operate at that va. my question, how much caregiver physician and put is available? for example, well i asked at the time when he was here, how many administrators have been providing care? and he said, well, academia. i think there is a component missing. valuable input. and i wonder, you know, if providers are ever asked "what is it that keeps you from seeing more patients?

being more efficient? to they have the opportunity to have that input? the size a love of work and taking care of veterans and is taking care of patients in general know what is there incentive to see more patients? and then, do they have the ability to provide input and make change temecula no, we talked your about things on the national level. welcome every place can be a little bit different. do they have the ability to say, if i had one more medical assistant i concede to more patients in the same amount of time or something along those lines. >> they do, and we have collected some of that data. i just wanted to make one statement, if i may. our staff on the ground give great care. they are committed to my good people. they take care of veterans every day. sometimes we do not give them the resources that they need command we need to fix that. the problem is having inaccurate

data that cannot tell us where we need to fix things, and that is a systemic problem that we have to fix. some of the issues that we find a simple things. you know, having enough housekeeping staff to actually help turn them around so that there quick and ready to use for the next patient. having a system that is easier to use interface with so that instead of looking at your screen we're looking after veteran and you're having a conversation, having additional clinic support staff will make it easier to do, having access to modern technology in a timely basis is also a challenge. adequate space for meetings, collaboration, private offices for mental-health, these are all challenges, they tell us, and we need to open that up, listen to the from the wind will find out what they need so that we can provide it to them. >> do you have plans in place? if the doctor is running around getting supplies and things like

that, that is a tremendous waste of time. do we really want to take a look at all of the paperwork that a physician is asked to do and maybe is not necessary. >> absolutely. one of the things we hear from mark clashes on the front line is, you have me doing administrative work where should be seeing veterans. you have been tied up during this and i can't do my fun clinic time. many to look at that. >> i look forward to hearing what you come up with and what the solutions are to allow for that physician or caregiver and put. >> absolutely. >> thank you, and i yield back. >> thank you. >> you're recognized for five minutes. >> thank you, chairman. again, thank you all. i think i encourage you to continue to push for the transparency. continue to push into the soul-searching to get it all out there. we cannot make good decisions unless we understand what the systemic problem is. i pull back of something from my 2006. to help reveal the business specifications the vh a brought

in philip mattel's taken a principal with macro design group in wellington, virginia, a system consulting with plenty of experience. it is not as though this is a new idea. members of this committee, this is our opportunity. no one was under any illusion that this was anything but as zero some proposition. if one provide -- of one veteran is of beyond we have failed. we have an opportunity to do something big, but don't be under any illusion. electronic medical records. 12 percent of private sector. you will not have collaboration. they don't have it. did not have the ability this and that back to you. this leaves the gold standard. it was probably one of the better ones there, and don't be under any illusion. 98,000 people die in this country for medical error every year. i understand it is an art and science, but we have to do something. getting out and getting care, but do not think it is a panacea

and magic bullet. next year you will have the seal for private hospitals sitting here wondering why your veteran died. we can do something. they're is new model. if we fall back into these old traps no one is going to defend any type of bureaucracy public or private if it does not work because dr. rowe had it right. what is best for the veteran. what is that model going to look like? i understand on the fee for service. as long as it is a viejo medical managers enter the veteran is truly not in charge of his own health care. i get that. mike, i guess, pleats all of us in here is, we have to keep pushing for data. we have to have it come clean. we have to put people in jail. we have to let due process do its work, but we have a responsibility for the veterans, and those 98,000 our constituents, to improve the system and have accountability. i would encourage all of you to my colleagues, it is not going

to be enough and you will not be judged by pointing out what the problems are. that needs to be done, but it is a means to an end. the end is improved care for veterans in a timely manner that is cost-effective to the taxpayer. i think, again, mr. rakowski, you said it. this is a starting point. it is not even the starting point for us, i would argue. the date is going to come. i think it needs to fall back on us. if you want to get this right we don't just come in the middle of the night a couple of times to try and do this. this is important work. we have to find this out. the important work in the legacy will, if we make a difference. i don't know if we noticed this. this is a shifting ground they are out there ready again to engage in this. don't bring them and tell them what you are going to do. patient advocates.

patient advocates to help navigate the system. i am all for it. get on the floor and do it. don't give them their weight. if there are things we can reduce can get them out there. they're willing to do it. that is my rant. i am telling you there is not a person in this room that will be judged by the outcome of all we do here, not the pointing. you guys keep doing your job. mr. rakowski, you keep doing your job. you keep doing your job. we have to keep doing our job. again, not that we pointed it out or found it. what we do to fix it. i yield back. >> thank you very much. >> mr. chairman. >> no questions. i think that is appropriate.

>> we appreciate your attendance tonight. to the witnesses, thank you so much for all being here with us. i will tell the committee that we are going to be having to committee hearings per week for the foreseeable future, and we will be talking about manipulated wait times, bloated middle bureaucracies, the itc issue that we have heard tonight , among others. thank you for your attendance, and this hearing is adjourned. [inaudible conversations] [inaudible conversations] [inaudible conversations]

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>> religion is a powerful identity for -- forming mechanism. it's part of human societies society is figuring out who's us and who is them. who is my group and who is the outgroup? religion answers that question pretty easily. if you pray like my, if you eat like me, if you go to the same church as i do then you are us and if you don't then you are them. you can see very easily how that kind of us, them in group groom mind-set could easily lead to extremism to marginalization. after all as i remind people religion may be the most powerful form of identity

formation but just as powerful as violence. how do you know who is us and is us and who is then is us into his them? of your fighting alongside me you are us. if you are fighting against me you are them. so far from religion and violence being these two things that are at odds and should have nothing to do with each other they have as everyone knows throughout history then much more aligned than we would like them to be.

>> host: larry downes big bang destruction is the name of the book. what killed off rand mcnally? >> guest: 's a series of disruptors that entered the market and they're all better

and cheaper than printed maps of the first thing with the internet. we could get a map on line printed out didn't need to lug around the big looks anymore but then of course what came next with a stand-alone gps devices that not only gave the map but the directions and told you how to go and well after that -- disruption. the smartphone you have the device and you have a network in place. you are paying for it and you have the app stores where software can be automatically downloaded to an an google realize they have the mapping data. they had the gps data and they said there's a reason why we can put that altogether and use this existing network and offer our own navigation maps so they did. they create a google maps downloaded it to millions of android devices and a couple of months time and suddenly everybody had a free, better, cheaper and more customized navigation tool right on their phone. they didn't need maps and they didn't cheat need gps navigators

anymore either. >> host: that was held by decision by president clinton correct? >> guest: the decision was to declassify the gps data. it was out there obviously for military and intelligence purposes and clinton realized they could still keep that use for it but make it available to commercial and not-for-profit uses and suddenly we have the ability to find out just how well our tracking was. we knew everything was. we sent a signal to the satellite to come back down and he knew where it was. that's one of the many decisions sometimes unintended consequences if you will that have created whole industries and opened up technologies in ways that have built markets jobs economy completely in predictable ways. that's the really exciting part about a lot of this innovation. you never know where it's going to wind up. >> host: larry downes now that google has been around for 20 years is a stiller disruptor? >> guest: it is. we still think of it as an

incumbent company now. they have a public company and a large company and they have to worry about things that startups don't have to worry about that one of the amazing things about google so far is its history it has never really made a huge blunder. of course little mistakes goggle + not so good and lost up some of their things but what they understand is they are not in the search business and could stop right there. they said no, no we are in the information business. the more information we got and more importantly the more information we get back in different forms sliced and diced the more uses people will happen the more things we can do with it and of course they are and everything. not just the search but yet they have a driverless vehicles and they are investing heavily in smart homes. they have got the google glass and the next generatiogeneratio n of display technology. energy and of course they have a broadband business in kansas city and now another cities.

they really understand the more information there is the bigger the company gets. as long as they continue that philosophy and kind of innovate around it they will survive or other tech companies have had their moment and gone away. >> host: in your new book big dang destruction how do you and your co-author define disruption? >> we talk about it and it's taken off of work that was done 20 years ago by the harvard business who talked about a technology that comes in. it's cheaper than what the incumbents are offering but not as good a personal computer is a good example. when they first showed up no one thought that they would replace mainframe computers. they were cheap but the hobbyist couldn't get them to work if at all but slowly but surely as they got more customers and revenue they were able to move up to the market and take over now that's what has exactly

happened to the mainframes are gone and its banks at arsenal computers. we discovered in our research something fundamental had changed from that disruptive model and that was because of now many decades of computers getting better and faster and cheaper and smaller using less energy over time it was now possible for a disruptor did into the market not only cheaper that also right from the start. the example we started we were talking about google maps navigation is a smartphone at as compared to stand-alone tools for paperbacks that you would buy from map companies like rand mcnally. you were now getting something that was better because it was on your phone and talk to you. it was always being of dated. it had constantly improved graphics and voice interaction. it was cheaper in case of apps are free. and it was more custom because if you are doing a web search and saw place he wanted to go

just clicked on it and it linked to write to the navigation app. better cheaper and more customized. it's very hard to compete with your incumbent especially when it shows up that way right from the beginning. that is what wayne mean by big bang destruction. >> host: why do you site moore's law? >> guest: he made a profound observation in the 1960s. he said the way in which semiconductor's computer chips are made as they have tremendous economies of scale and cost lots of money to build a fabrication plant. once you have it up and going the more you make the cheaper they become. there was all this -- also this miniaturization is they improved and could make chips that were smaller and the smaller they were they also worked better because there was less distance for the signals to have to travel. he predicted in 1960s that given the trance and engineering

and manufacturing that every 12 to 18 months computers were going to get twice as fast at the same price. he said not sure how long it's going to last but it turns out it's still going in moore's law is still in effect. every 12 to 18 months to get better smaller and cheaper processors and memory and storage in and the other things that go with it. that is what is driven the information revolution. >> host: looking ahead is moore's law is going to continue to be effective? >> guest: there is always someone out there that says moore's laws we can't get any smaller and sure enough the engineers come up with a way. i know longer -- my engineeriengineeri ng props are badly out of date. i was an engineer but i have my team of kitchen cabinet engineers and i asked that same question. they assure me that moore's law is in no danger of going out of business. we even have experiments with molecular level computing that

suggest we'll continue to push this barrier certainly into the rest of our working lives. >> host: in "big bang disruption" he write for incumbents and their carefully instructed strategic plans big bang disruption is the innovator's disaster. >> guest: one of the ways you have to respond when you saw these kind of worse the cheaper disruptive show up as that was the time for u.s. the incumbent to experiment. if you are mainframe computer and make her when he saw the personal computer you would say yourself it's no threat to me now but this is a signal of something that's going to happen eventually. now it's time for me to figure out how to make a transition plan. so what christiansen said was you needed to start tanking about it in launcher on replacement from within which is very very hard for large companies to do.

we saw many large computer companies that were not able to make that transition both in this country and abroad. lots of them went out of business. unisys, either disappeared or when into other businesses. we say this is a mitigated disaster because if you wait until a thing shows up the cheaper alternative you have waited too long. when it shows up it's not worse than less expensive, it's better and less expensive. in the case of our navigation example we have companies like tom-tom and garment and magellan and they knew the smartphone was starting to take off. interested it was possible that somebody like google or apple or somebodysomebody else could laun app that they said we don't see any threat yet. it hasn't shown up yet so we will respond when it does show up up. he did respond and took off and within months had millions of people saying this is better and cheaper. which one am i going to choose? by then was too late for them to

respond. we say innovators that is to say incumbent businesses of any kind need to start looking much earlier into the lifecycle of new technologies and recognize even before there is a product there will be a lot of experiments going on some of them very visible things i kickstarter and crowdfunding platforms that allow you to see how people are playing with new technologies. what we say is that's the moment when you should get worried and that's when you need to start planning how you are going to incorporate them. maybe you will acquire them into your own experiments that you need to start sooner in the process then used to. >> host: larry downes does tom-tom and magellan exists anymore? >> guest: drink the there are much smaller. they lost a lot of value their stocks and revenue and products. they go into more specialized markets. for example you have it -- device in the higher-end car. they would be the makers of that but as far as the consumer

business where you bought your own little stand-alone cheap one your business is gone. >> host: walk us through the four steps of the big bang disruption. >> guest: this sort of the new lifecycle we see for how innovation enters saturates and then leaves markets. we picked those names. of course these are names from big bang theory that what we say is the initial period i was discussing discussing where there are all these experiments going on, that's the singularity. it's cheap now to do experimentation. you can find people to fund you. you can work with off-the-shelf component parts and throw them together and see what shows up. what we see now is lots of that kind of experimentation and an incredible range of field. if you go to the broq new york right now it is turned into an incubator and entire borough of

people doing their startup and funding it through these platforms. baby food. maybe fashion. maybe electronics, 3-d printing. whatever it is it's easy now to do these kinds of experiments and find out if there's a market for it and you can find out if there's a market before you invest any money on your own. this is the hotbed which is kind of like when the universe was being formed. it was all compressed energy and matter getting ready to explode but it hadn't exploded yet rated that's the second phase called the big bang when somebody finally figures out the right combination of technologies, the right business model. the good example of this is kindle. there've there have been a whole decade of electronic book readers before that but no one quite got the right technology or price point or the right network or the right business. amazon had it right. they put them together at the right time and when it launched it wasn't the slow uptake. the other ones have all failed miserably and they didn't sell any. when the kindle came and it was

right the market said hey this is what we have been waiting for. we have heard about this for a decade and finally someone has the cracked the code. it's not about customer segments arriving in this nice sequential way we used to think about it. it's complete what we call catastrophic success. it could be days or could be years if it's a piece of hardware but it's compressed period of time straight out. then comes the big crunch. you have all your customers in a short period of time and you don't want to make the assumption that straight line will continue indefinitely because it won't. the markets are very fickle and everything is now more like fashion in the sense that they are seasoned out if you buy a smartphone. you don't expected to keep selling for five years. you know you will have to have a replacement that's better cheaper smaller and more customized in two years time because if you don't somebody else will. that's the kind of model that is now playing out in all sorts of industries far from consumer

electronics and computers. you have to be ready. the big crunch is going to come. the current product is going to dive not as fast as the vertical uptake but it's going to start to drop off very dramatically once the customers have arrived in there waiting for the next thing. in the last stage called entropy this is the home of companies who couldn't get out of the market in time. maybe they weren't allowed to like the post office. they are regulated and forced to stay in the marketing bin when consumers have largely disappeared survey looks at companies in the agencies that were stuck in markets that were essentially down to a fraction or shadow of them former selves and looked at how they were managed in a much smaller world or they found other ways to escape the incredible gravitational push of a dead market. >> host: where would you put twitter in the stages right now? >> guest: twitter is very much in the big bang stage.

it's still going straight up. the pace of sign-ups is not what it was in the first two years but is still growing dramatically. it still refining itself. the company what are the products how will they make money and how will they diversify horizontally and vertically? is still a very young company and definitely still growing the initial product. it's in big bang mode. >> host: where would you put the cable industry? >> guest: one thing i'm not sure there is a thing such as a cable industry right now. the amazing thing about what's happening to the internet and internet protocol products is it has now compressed our world, our world of voice video and data in ways that nobody would have imagined. please do have cables for television and broadcast over the air and phone companies to foist.

the technology and application were sort of thought to be restricted to one combination. the internet has thrown all that out the window. everybody cannot do everything on the same network so cable in some senses and what it used to be. it's not just about television. it's it's also voice and is also video and its data. its isps as well so they are in this mode of rapidly changing technologies. of course broadband wired and wireless are improving dramatically thanks to moore's law in the quarters to go with us on the one hand it's a huge opportunity and on the other hand it's an enormous risk area that is of course is of course the struggle that all industries in that big bang experience have to deal with. >> host: larry downes what about the role of the government and regulation? you mentioned that a couple of times. >> guest: it's interesting. we did a horizontal view in our study of industries varied we didn't want to just talk about

electronics and computing is the best examples because they're the most mature but we wanted to look at everything so we pick 30 different sectors of the economy and said where is this happening and where is this not happening and where is it happening faster and slower and wide. one of the things we discovered is most heavily regulating fisheries think about health care or related industries are the slowest. some of these regulators have created barrier to entry. you might have a better cheaper energy technology bets you have to get permissiopermissio n to start selling it. you might have a better and cheaper way of doing health care more effectively. maybe it's wearable devices and sensors and monitors but you can't -- as lots of companies have confirmed if you can't innovate at companies can't sell it. the barrier slow down the way in which sub two happens at that at the same time when someone?

the code voice-over internet protocol telephone is a good example of this, once they get and it's all over because a lot of times you will find public utilities or other regulated industries because of those barriers don't have a good incentive to innovate. in fact they will have a lot of disincentive. they need to get permission from government utility commissions before they allowed to invest in the next-generation energy production or distribution. so if they haven't done any innovating all of a sudden an innovator rides that can be even more chaotic or catastrophic than the traditional competitive newsrooms. >> host: where you base in what is your day job? >> guest: i'm based in silicon valley and i worked with technology companies. i write for a number of different publications and mostly the last couple of years i've been doing research for this book. >> host: and this is your third book correct? >> guest: that's right. >> host: "big bang disruption"

we talk about technologtechnolog ies what you do you mean? >> guest: we have talked about computer technology and moore's law is exponential doubling the number every 12 to 18 months. you're exponentially improving it. you're getting a very big number and every 12 to 18 months and it's even bigger in a year. that is one of the main technologies we look at but there are exponential technologies and a lot of other fields as well. some of them are not quite as developed and not quite as ready for prime-time but things like the human genome project for example the cost of decoding or sequencing human dna is falling at the same rate as moore's law. if you look at optics for example the well l.e.d. is improving its a moore's law curve as well doubling the capacity and keeping the price constant every 12 to 18 months. energy we are saying good science of sustainable sources of energy but also emit those

properties as well. in the industry we have got exponential technologies either at work or supporting the work in the case of computers and information that is where we see the most obvious examples of the big bang disruption. >> host: much of our world is c-span and a motion 10 involves energy and commerce committee or the federal communications commission. from your seat in silicon valley how much attention do you pay to what they are up to? >> guest: i pay a lot. i think many of my colleagues and certainly many of those in the investment community don't pay enough. these are areas where we have traditionally not experience a lot of regulation and we don't really think of this as what my friend calls permission less innovation where we are out in the valley and start selling it throwing it up in the market and see what happens. we are often surprised when government regulators whether the fda -- fcc or the federal. commission show up and say you

now you can do that without her permission or you can't do that without passing a number of tests or filing all sorts of rifts in tariffs and schedules so increasingly i think those in silicon valley like myself recognize we need a much more clear understanding certainly of what washington does and doesn't do and the closer working relationship to make sure they don't inadvertently get in the way. >> host: larry downes are we in the sense of an age of monopoly or a oligopoly when it comes to that last measure? >> guest: we are increasingly seeing of course most of the fcc most americans have at least two if not more choices for broadband providing and that could be cable or traditiontradition al telephony or fiber. it could be wireless of course and all broadband is improving in the moore's law case and possibly future satellite providers. we have seen ingesting moves there by people like directv and dish.

we have competition. we are getting more competition but more importantly we have to look more broadly at the entire internet ecosystem because it's not just competition directly between the carriers. there's also market discipline provided by the content providers. companies like google facebook and even netflix can say we have the relationship with the customer. that gives us leverage and how you might build out your networks or how you work with us. we have seen lots of examples of that for content providers the operating system and the smartphone workers in the mobile world have leverage too. they are part of the competitive environment and there's more of them all the time. in some sense regardless of where you get your internet connection from the people that run the network a lot of them have the pressure go from competitors to more indirect

ecosystem. >> host: one of the examples you have in your book is the old-school company and its role. >> guest: corning was great. as you say they are very old-school company. there are the physical business of making glass and physical products and they have become partly by design and partly by good r&d and partly by accident they have become a major player in the smartphone displaying covers for funds. back in the 50s they were working with technology to try to find more sturdy unbreakable glass. experiment didn't work and they couldn't get the price right. they put on the shelf until steve jobs showed up one day and said i need for the iphone, i need something to put over the display that will protect it from all kinds of abuses you can imagine is going to happen. you know we did that experiment

and we couldn't figure out an application or price point or then bet the price went down with in less a year they were in production and now it's become major product. >> host: this guerrilla glass the standard for the company? >> guest: it's definitely the dominant product and of course they have invaded up to -- innovated up to guerrilla glass three. the next iteration would have antibacterial properties so they keep competing with themselves by constantly a dating that yes they are as well. >> host: who is the book written for? the primary audience for all the work that i do this area is for the incumbents. traditional businesses and industries and all the industries that we talk about in the book who are faced with the potential big bang disruptor

coming from a startup or something something like google moving into their industry or accidentally is in the case of the navigation products but traditional businesses that need to learn a very different way of responding. you have to understand the four phases we talked about the shark fin. that's the way the markets develop. it's not happening in industry today. it. likely will in the not too distant future. we we are trying to help them prepare for that and learn how they can leverage what they do have their expertise their intellectual capital they're dissing customer relations is that will help them not only survive but come out better when it's on the other side. >> host: what's the benefit to consumers? >> guest: the benefit to consumers i often say we are living in a golden age for consumers when products get better and cheaper every cycle whether a year or two years or more we are getting what we call economics consumer surplus and in fact so much of the consumers expect that's what's going to

happen. if you remember came out with the iphone 5 s. the consumers were expecting the iphone 6 and they said this is a five s., we don't want it. we are going to wait. this happens more and more. consumers are savvy and they use social media to committed with each other and they're essentially now the market function for many companies and they decide what is the best product and that is the product of everybody buys. ..

>> this is a very good strategy by the way for a long time in silicon valley we have had corporate venture capital. they invest along with the venture capitalists in the new starbucks whose products and services may be closely related are integrated or competing with what they do. in the last few years we've seen very dramatic examples of others doing multibillion in the process in case of the one that you mentioned. they haven't created. they are still accelerating in the kit and they've only been in business a little for two years.

the trick is to do the acquisition. you don't want to do is to sue because he might have hundreds of experiments going on. you might ge get the right one t you are more likely to get the wrong one. you can't acquire them all. before they went public in favor of somebody that wanted to acquire them. it was no longer feasible to acquire them and they were going to go to the public markets and monetize that so there is an increasingly short period of time between when it takes off as a big ban big bank if you wao big acquisitions against description you have to be on

target with the market can't know which of the consumers are voting for and acquire them very quickly. >> host: something that's different in today's world we are doing these experiments into development and public. >> guest: one of the side effects in the broadband and thd networks and mobile computing and so on is that it is now much different to experiment in the market come to see i, see if an, launched a campaign, see if anybody donates and then it is in these very closed secretive research development labs and the price of innovation has come down to the point it's better to do it in the open them to do it secretly and that is another challenge. >> host: strategy in the age of devastation.

the senate homeland security committee examines u.s. border security scales for the border agents than the relationship between russia and china and the impact on the u.s.. later the first woman discusses challenging facing the leaders in the military.

this year marks the 50th anniversary of president johnson's declaration of the war on poverty and the signing of the economic opportunity act. tuesday the house budget committee holds a hearing focusing on the impact of the federal aid programs in reducing poverty. coverage starts at 10 a.m. eastern on our companion network, c-span three.

from the perspective of the victims i don't see any distinction. if you try to justify my program on the basis of the victims lost, i cannot convincingly explain why 9/11, yes, 93 world trade center, no. the only way that you justify this as a special carveout is from the perspective of the nation. the recognition that 9/11 was along with the american civil war, pearl harbor, maybe the assassination of president kennedy. its impacit's impact on the amen people was such that this was a response from america to demonstrate their solidarity and cohesiveness of the american people towards these victims.

the senate homeland security governmental affairs committee holding a hearing assessing u.s. border security and to the current pay structure for the border patrol agents. this is one hour and 45 minutes. >> welcome, everyone. i want to turn over to senator tester if you want to make a statement as well. and i understand senator mccain is trying t try to debate couldp in transportation.

is he going to come in at all? thanks to our colleagues and witnesses for working with the staff to enable us to put this hearing together fairly quickly. the purpose as you know is to examine 1691 the border patrol act of 2014 introduced by senator tester and mccain and this bill would make the badly needed reforms to the system of the border patrol for discourtesy too complicated and difficult to manage. i want to talk about what is happening currently along the borders over the past few years have seen a surge in the unauthorized migration from central america which is nearing record highs and an unprecedented number of people operating at the border are unaccompanied children. some are as young as ten years of age.

they appropriately require that the children be treated differently than other migrants. they must be transferred department of health and human services and there are strict rules about their care. he announced he was creating a task force and devoting additional resources to coordinate the care. since i became chairman of the committees on making months ago i visited the southern border of mexico and arizona and texas on a number of occasions that i've seen firsthand the crowded positions in mexico, guatemala el salvador and i hope to spend some time in honduras. i've come to understand what happens along the borders is only a symptom of the problem it's not the underlying cause. today we'll focus on how we can address the symptoms by increasing enforcement. the tester mccain bill we are examining will save taxpayers money and increase the ability

to patrol and secure our borders. one estimate shows the bill would add the equivalent of 1400 agents to the border. given the challenges we face which have only been underscored by recent event the recent eveno say moving this bill would seem on the surface to be a no-brainer and i support moving forward with the bill as soon as possible. we need to do all we can to treat the symptoms. we can't stop there. it's critical that we understand why all these people are willing to risk everything to come here in the first place in the struggle to mexico to get here. based on what i've seen in the matrix it causes a lack of economic opportunity and in the security situationthesecurity sl salvador, guatemala and honduras the bad guys go south and a lot of them end up in those three central american countries creating not just mischief that may have.

one year ago they passed a bipartisan comprehensive immigration reform measure that addresses many of the causes of undocumented immigration. while it is in perfect it is a significant improvement over the status quo and provides the nation with an important opportunity to fix the system and grow the economy by almost $1 trillion but in order for this to become law we need our colleagues in the house to act and we need to do a better job of helping the central american countries improve the prospects for people hoping them provided the jobs and secure safe and secure communities and a future so they stay in their own country instead of trying to get two hours. the roundtable experts from the multilateral banks as well as the private institutions to discuss how we continue to improve the prospects of the young people and not so young people and i would urge and

invite all of our colleagues to join us. thanks to senator tester and senator mccain. they held an important hearing inmates on january and i'm the one that asked for this hearing because there are two points i would make. one my goal isn't to take anything away from the border patrol agents and we have about 900 or so but are no longer authorized for. the goal should be adequate to pay for the risks and the effort that they put in. but i'm really concerned about what we are doing in terms of setting up a system that could become governmentwide coming at

the question i ask as an accountant and a former business manager is if in fact we need to have about $28,000 or $29,000 above the gs 12, why wouldn't we just changed the base pay? why wouldn't we just pay the system rather than have this overtime system? the other questions that i have associated with what we are doing is things change. what we are doing is talking about putting a payment system in the statute that guarantees a certain amount of overtime every paper cup that's not a part of the contractual obligations. this is a statute. so i'm a little concerned about that as well because if in fact

the border becomes more difficult requiring greater risk and expertise we are going to be somewhat limited about how we have done this. so i'm looking forward to asking the questions to get settled in my mind how do we settle at the level of which they have been compensated and make sure they are secure in the future. i don't want to take 25% if anybody's pay a way. there are a lot of patience yes we are including all of those in this that shouldn't have the payment. in other words, the job shouldn't require. the characteristics of the mix

are important as well. i want to get answers to critical questions today. i have a statement that is written for the record. and again, i want to fix this. i'm not trying to stop it from getting fixed. my understanding is a limited number of people no longer have it as a comparison to the total workforce and i want to make sure that we fixed it right and we fixed it in a way that the house is going to solve the problem, so i appreciate senator tester's acquiescence and pledge my support to get the problem solved when i get my questions answered. >> senator tester. >> ranking member coburn, i think that maybe i could answer your questions now but it may be better left to the expert panels to answer the questions about things changing because i think

you're right, things do change and that's why we are here today because things have changed. we introduced this legislation a little over a year ago and we did have a hearing in january we worked with the border patrol union and national security and others to make the bill even stronger. it is cosponsored by heitkamp and the companion bill is in the house by the representative and a host of others, both democrats and republicans. the bill is supported by the cbp into the border patrol union that represents 16,500 agents in the field. it saves money and it creates

more stability for the border agents and their family and increases manpower along the borders of the security is increased and they are better equipped to do the jobs that are so important to all of us. the reform of the border patrol system is long-overdue. the operation is from 40 years ago quite different from the criminal operations that we see on the border today. things have changed. we've waited long enough and we need to move forward on this bill. in the end, i appreciate the opportunity to have a full committee on this bill. as i look at this bill that increases enforcement. it allows the borders to be as secure as they possibly can to

meet the dangers of terrorism, drugs and illegal immigration that is so common on both northern and southern border. i appreciate the opportunity to hear from the witnesses and be able to ask some questions about this important issue. >> let me take another minute to welcome the witnesses with brief introductions. the deputy chief patrol and the capacity responsible for the daily operation of the border patrol that assists in the

planning. it was one of the contributors to the unification customs and border protection and creation of the department of homeland security. is that true? he serves as the president of the council representing more than 17,000 border patrol agents and support staff. he spent much of his career on the southwest border in central california and tucson arizona sectors and in the past he's been stationed as an officer at one of the busiest. into a an t. 02 he was an instructor at the border patrol academy. >> the next witness, the deputy

assistant commissioner of the office of internal affairs for the u.s. customs border protection since 2012. he just became a witness this morning due to some leadership changes announced by the commission are today. thanks for joining us. we very much appreciate the witness has given extensive knowledge of the issue that we are going to discuss today. he joined the customs service in 1986. is that right? he's been with the office of internal affairs since 2007. thank you again for joining us on such short notice. the final witness is the director of policy affair affait the u.s. office of special counsel. prior to joining the office he was on the staff with the house committee on oversight and

government reform and we thank you for your service and all of you for your service and testimony today. if you want to give us your testimony in roughly five minutes that would be fine. and then we will start some questions. thank you all for joining us. why don't you go first. >> thank you for the opportunity to appear before you for the need for reform. this is a matter of concern to the department, dhs to u.s. customs border patrol. we welcome the opportunity to work with you finding solutions at an affordable cost. the dhs and border patrol require paying the person now and properly managing the system. the application of the uncontrollable overtimes

stretches back many years but existing authority no longer meet the needs of the modern border patrol. the senate 1691 k. reform act would replace with a system that controls costs, fairly compensates irregular necessary work and maximizes the agent capability for the law-enforcement border security responsibilities. if enacted it would ensure the workforce is scheduled to continue work and meet the mission requirements beyond his or her shift while providing predictable rotations around the clock. agents would receive compensation for any work over eight hours per day and remain eligible for other scheduled overtime and the emergencies of her were special missions require. in addition to increasing the patrol capacity by over 2.5 million hours the act would reduce overall cost. it would eliminate fair labor standards act a if the compensation for most agent

assignments that total $105 million in 2013. based on the cost estimates briefed, the pra would save 38 to 67 million annually. they have a business practice that requires the agents rotating into and out of the headquarters assignment in the training environment. this maintains up to date field experience in those positions. prepares leaders in the advanced like other federal law-enforcement agencies the bill contemplates pay for employeeemployees to cycle throh those assignments and back to the field area to the cost to train the skills is considerable into scheduling overtime is much more cost effective in getting the equipment number of hours. cdp moves around the country to maximize the impact and is committed to continuing to do so and also provides thresholds and management controls which would ensure cost savings. without relief, legislative effect in this post over and the morale is likely to take a

downward turn. we commend the commitment for the border patrol agents and proposing legislation that would provide the flexibility to administer a credible cost sufficient compensation system that would meet the needs of the border patrol. we look forward to continuing to work with congress on this endeavor. >> i look forward to this opportunity and answering all of your questions. >> you are recognized. please proceed. >> chairman carper, ranking member coburn on behalf of the 16,500 border agents i represent i would like to thank you for having this hearing to discuss s. 1691. i would especially like to thank senator tester and if senator mccain were here i would like to thank him for introducing this important legislation. instead of reading the statement, i've given it to you last thursday.

i would like to speak with you and i'm looking forward to answering your questions and getting prepared statements you already have but there are a couple of things that i would like, key issues i would like to point out. the first issue is we are no longer dealing with mom and pop smuggling organizations. we are dealing with sophisticated criminal cartel that control of the traffic that is happening that comes into the united states and goes into mexico and they also can troll the activity on the northern border into the coastal border. approximately a year ago all of the agents were notified that they are were hours that would be cut from 100 plus down to approximately 95. since that time, we have seen almost an immediate increase across the border. not only are we seeing an

increase in the sector. we knew about that tidal wave that is currently happening, but we've seen an increase in the corridors like el paso texas on the san diego california these were considered operationally controlled areas. when we cut the hours by nearly 15% of the also seen senator tester. we've seen an increase in arrests since the hours were cut by 50%. that is a huge increase and we've also seen an increase on the postal worker in miami florida by almost 30% on the coastal border. they know when we are vulnerable and due to the hours that are cut we are vulnerable 50% in montana.

that's huge. the second point i would like to address is the retention and as senator mccain's neck of the woods the busiest station in the sector is historically one of the busiest in the nation id leave it currently seizes more drugs than any other station in the nation. we have seen a 5% of the workforce leads in the last year due to the number of hours that have been cut and the pay reductions that were experienc experienced. we also have another 15% at this station alone who have pending applications for other agencies. we cannot afford to lose 20% in the station that is so important to the tucson sector. but that is what is happening under the economic climate. the last point i would like to make and i would like to read

this statement. four years ago when i came into the border, i'm sorry, back in 1997 that recruitment that i was offered was 25% administrative overtime for the rest of my career and that is what we were told we were going to get. we no longer have that and there's two reasons, budgetary and legal issues. we approached the congress four years ago and we tried to get the powers to amend the law to allow us to continue to do what we need to do to control the border unfortunately because it is inexpensive system we couldn't get any attraction. because of that we have worked diligently to come up with a plan that will satisfy all participant parties and the taxpayers are huge cost savings

to secure the border into the agents and we would have a constant paycheck that we would know what it is year-to-year. $6,400 per year. we were again unsuccessful. we are sacrificing a lot. but in the end it would prove to be the doom for the border security and the public and the agency whom i represent. it is very rare that the congress has the opportunity to consider a piece of legislation that saves money and enhances the agency's capability and that is exactly what this does. i look forward to answering questions. it is a privilege to appear before you today to discuss the

ongoing review of the customs border patrol agents over time compensation systems specifically those by the border patrol. properly paying the border security personnel and appropriately managing to pay systems are central to the mission. specifically the primary system in the border patrol stretches back many years and establishes more than 40 years ago it is a payment mechanism that allows fothe compensation of certain employees for irregular but necessary over time. approximately 77% of the pay goes to the employees including more than 20,000 border patrol agents. to be eligible and employee must be in the position of which the hours cannot be controlled administratively and which require substantial amounts of irregular or occasional overtime

work. while many front-line officers and agents across the agent are often through the use misuse of the funds are not tolerated. allegations of misconduct that are raised by employees are typically provided to be handled by the component affairs offices and/or the office of inspector general in conjunction with components of the human resource office. they found to have engaged in the misconduct the subject disciplinary action. the office of internal affairs conducted a series of investigative inquiries regarding the improper use by specific entities. internal affairs, field offices in washington, d.c. that houston texas, san diego california and