that. i don't know how much is administrative. >> host: a city where all than it was in the washington area, john is calling in from breeze with pennsylvania other democrat's line. everybody who comes outside of washington tries to go west goes through breeze would at some point i think. >> caller: yes video. and once again i'm calling -- chairman congressman shuster. i follow my congressman's bills tentatively and impartially i have been able to read this one. but a previous bill, almost a third of the highway trust fund spending went to mass transit. and then there was another eight or 12% of the previous bill that went into canals, and they went into funding, into dredge for

harbors. so the trouble is that we have, a lot of people want to tax and spend a highway money. those of us who live in the rural areas have more cars can drive more miles, spend a higher percentage of our earned income on the gas tax and those in urban areas. some of our major cities, people don't even own cars. a third of the people who live in manhattan don't own a car, but we pay our tax dollars to fund their buses come their subways and to mass transit. we have a huge amount of trucks that roll through the middle of our country which take federal funding to keep those interstates open. we should increase the tax on the trucking industry. alleviate the stress on individuals, on the canals, on the roads, on the bridges. if you look into the highway

bill you will soon find out that we pay -- automatic the upper end of the mississippi river. there's just a huge amount of things that are, like i say, the funds are being diverted into a pet projects, diverted into individual things. we are paying the amtrak corridor out of the transportation bill, right? that is only used grand from philadelphia to boston, is 30% of the population but is only used by a small amount of people and it is taking gas revenues that should be used for highways and one john, since you seem very knowledgeable about all of this, what did you do you work in the transportation industry? callback actually, i ran against bill once. and i supported the two other candidates and i do opposition

research a little bit. >> host: why do you have to get off the highway -- >> we believe this until after the american enterprise institute for discussion of the criminal justice system and prison reform. this is hosted by the american enterprise institute. >> the last year, discussion on criminal justice reform come on over criminalization, on all sorts of things. went of things. workmen to focus today on on specific aspects of that. my thoughts on part of why i picked this, this is about prison specifically, and i do libertarian leanings. i think and rethink our illegal. on the catholic. big justice and mercy needs to be played at the on the other hand, i don't know and i don't think this is a we will get into today a question of our we may be locking up all the millions of people we lock up makes our country safer? that's a tricky question to

debate. here at aei you have lots of opinions but once with the people in prison, are we doing anything to help them or of which is ruining lives? so when you have prison since his server deterrent effect so there's some good there. it keeps dangerous criminals off the streets, so there's some good there. but we called it correctional facility to are they doing anything to correct or just making things worse? so different bracketing for now the debate to some extent of over criminalization, although that would be relevant, once people are in prison are they being harmed cracks or of retreating to in a way that will benefit society our society? i think we know the answer maybe i think it would change anything going forward? wanwhat i take to discuss this a past two guys i know i don't with in their lives. i write about lobbying and politics. i brought in a former lobbyist and former politician. on my right is kevin ring, a

lawyer and a former republican congressional aide. he was executive director of the republican study committee. he passed through the revolving door, became a lobbyist in 1999. he wrote a book which was big reading in my house with my brother when he was in law school. it was scalia's dissent. acacia compiled a book. it was an excellent book. book. if you're feeling and it wasn't good things to get your bile up and running, read that. he now is at the families against mandatory minimums. and on my left, jeff smith, former missouri state senator, congressional candidate who all lot of us stumbled upon in a documentary called can mr. smith still go to washington cracks and he is now an assistant professor at the new school in new york. the reason i bring them here though is that both have served time in prison. before they get to the substance

of quickly, kevin suggested so that divide of the ball, why don't you guys quickly, however irritatingly or whatever you want, explain why you spent time in prison. >> i'll make it really funny because it's such a laugh. [laughter] know. i was a lobbyist and had the misfortune of working for jack abramoff was the big republican lobbyist at the time, was the leader and editing the eighth of scandal, big scandal in bush administration. i was basically charged with a junior form of bribery and was found guilty and i served 16 months, 20 months since i've answered 15 and a half months in federal prison camp in cumberland, maryland,. >> i forgot to mention that i said the documentary name was can mr. smith to go to washington? what happened when his just brand-new book for sale in the lobby called "mr. smith goes to

prison" which tells his story very well but can you quickly tell us because sure, sure. when i was in the senate in missouri i was on a panel and a moderate asked the question that i found too intrusive that it took kind of the blood and and bludgeoned the moderator. no. [laughter] actually what happened was i was running for congress back in 2004. we ran likably grass-roots campaign to i will try to convince this as much as i can to i was running against a dynasty candidate, and we were trying to run a grassroots campaign and get over the top. about three weeks before election day two of my age were approached by a consultant who billed himself as a so-called practitioner of the political dark arts. he told by aides that he want to put out a postcard detailing my opponent carnahan, a 10 way race

competing and carnahan's dismal attendance record as a state legislator. my age came to me and said he wants to do this, should we give him the information? the voting record. which we tell the box and i replied i don't want to know what you do. they said so does that mean we should do it once i said it means you shouldn't have anything. do you understand the? they said okay. so they gave him that voting information which is publicly available but it violates the mccain-feingold statute because it constituted illegal coordination between my campaign and a third party group. i lost by about one percentage point. about a wee week after the campg my attorney prepared an affidavit for me to sign in to sponsor federal election commission complaint that carnahan had filed. he won but he filed and he pushed his complaint and affidavit 15 statements. 14 were true, one of them was not. it denied he knows about the postcard. even though i knew that might aides had met with the person what they could put it out, i

signed a false affidavit. five years later when i said a state senator, my best friend called me. he told me that the man who had done the postcard five years earlier had just been picked up by the feds for mortgage fraud, bank fraud, wire fraud, illegal weapons possession, spousal abuse -- >> car bomb speak with haywood dissipation it is the chief suspect of a car bombing that nearly killed his ex-wife's divorce lawyer. and i let my aides get mixed up with this monster. my best friend and i see what i'm going to do? what is the feds come and knock on our door because of this guy says five years earlier, you know, i can deliver somebody who's a state senator. my best and i talked about that for a couple of us and little did i know that he was wearing a wire. so then i was basically, my only

chances to present what to do something similar and i didn't do that in a sense to a year and a day and was in federal custody for about 10 and a half months. >> thank you. i think one want to start is with, from your guys experience and from your knowledge professionally working with families, with incarcerated people, does prison do anything to help criminals? can't get or does it just sort of ruined lives and make people worse off? >> that's a broad question and i think for some people, prison serves a purpose. there are dangerous people who should be kept away from civil society. there's no doubt about that. no one would just agree with it. i think to the extent people are physically dangerous or get some compulsion problem with the wiki defending, prison may be the only solution. i think we've come to a solution where there's a large swath of

people that prison is a necessary. for those people present can play different roles. for some there's a lot of people who are uneducated. these are not master criminals. we put a lot of faith in the fact that our criminal laws will deter bad behavior because if we ratchet up penalties people will be more inclined to follow the law. that's just off the population and that we. these are people who just didn't think they're going to get caught. they didn't read the u.s. code to figure what the penalties were. they did new cost-benefit analysis. they just sold drugs because they wanted extra money. that was most people. you should read just excellent book. it captured my experience almost perfectly. there's a myth about why, not only on white but white-collar, but arnaud white-collar prisons anymore. most of the people in my can't were drugs and guns violations. people serving mandatory minimums for drugs. it was a real wide over it people. some people got something out of

the experience. some people need to take out the they were immature. edges limited brain function and they just needed to grow up and mature. there are other people who didn't speak much english, had very limited education and they were able to get their ged, that may have helped. for most of the people the it's just killing time. and people with the that's okay. if you board that doesn't bother me. but it should because while you're sitting there at the camp on a shelf, the job market is a fancy, technology is a fancy come your family is moving onto everything is changing and you have no responsibility when you're in prison. you may have a job but it's a lot of makeshift jobs. and so your skills atrophy, and man is a greater continues to anything. and i think that's what happens to prisoners peculiar to get institutionalized. so you learn what it takes to

become a decent producer. you stay out of fights, stay out of stupid arguments. you don't touch of the people slaughtered. that sort of stuff. you go to the commissary, you have a limited amount of things you can buy. you learn that lifestyle. for some people who came from dangerous areas there's a certain comfort in that. when they get close to leaving they got very nervous because they were afraid of the choices. so fo for a lot of people long sentences without any meaningful programming, and we will address that, because a lesser able to get drug treatment for your addiction or you get your ged, virtually nothing else available that's going to help you react -- we acclimate. that's a real problem. we look at recidivism rates and save these people come out in real thing, i know people are going to try to do the right thing so i served with. some people will be fine. some people will try to do the right thing and after futures that could be able to make ends meet, they had a family to support and they are at risk to

going back to the lifestyle that since in the first place. i do want to talk to give jeff a chance but i want to see there's so much more that can be done on the programming side but it has to be coupled in a way that not only do we do more to treat them well with her because not only is it compassionate but it's our interests, but also w we have to shorten distances because there's no amount of programming is going to sort of status facility for 10 or 20 years living in that kind of confinement. >> did you see anything there were youth thought they were being held for being approved anybody left, sort of with better impulse control or mow prepared for the world when they came in? >> not really. i wish i could tell you differently, but in my experience, prison did a lot to create better criminals at almost nothing to rehabilitate people. so there's three ways i can talk about. if i'm going on too long

stopping. the first weight is present reinforcers people's tendency to operate outside of like the rules and outside of the normal economy. and the way it does it is pretty simple. most people have the misconception when you get locked up you've got me, you've got three hots and a cot and your father most prisoners are destitute. they don't have a penny to the name. they get into prison. they don't have someone on the outside of the many other books. maybe some of them to for the first year and first figures but then people fade out and forget about them. the problem with that is that not everything, you don't have it me. you have to buy your own soul, your own children, your own toothpaste. so the basics of personal hygiene, and if you're living virtually on top of hundreds if not thousands of other people in hygiene is really, really important for a lot of reasons that i could get into later but the point is if you want to have

a normal lifestyle where you just have basic hygiene needs met come little anything else to make your life have a comfortable you have to find a hostile. the hostels range anywhere from things that are totally illegal like guys who develop their artistic talent and to draw portraits of other guys go friends or children that people can send home for birthdays or mother's day, two things that are a little bit less legal like bookies whom make book on the basketball games to guys who run barbershops, which the prisoners labor, to guys who run act ii partners, which the prisoners not find wisdom to guys were smuggling contraband in. there's all types of puzzles, and i would take him and i -- or should you kind words about the book, kevin, and i agree with almost everything you said except i found some very skilled men in there.

i would say that in my experience there's not a single concept you can learn at wharton that you could learn inside federal prison. new product launch, quality control, territorial expansion. barriers to entry, supply chain management. i heard everyone of these concepts elucidated many times. using somewhat different lingo and you would learned at wharton, but they understood everyone of these concepts and, unfortunately, there was no training at all to help people translate their intuitive grasp of the business world that they have learned to success in the drug world, no formal training to turn those into formal enterprises on the street. there was a computer course that was offered, i will tell the story will quick you don't mind, there were three courses while i was there. one ged course that they have a pretty strategic and so the pressure didn't really care that much for most of the time

insisted he wanted to you didn't have to go. then there was -- what a better way to the person for success oriented and learn how to grow tomatoes in water for two weeks? and thirdly there was a computer skills of course that was a course everyone on the way out finally, we've been celebrating the whole time over this and that 12 brand-new computer but no one ever got to go in. it was locked the whole time. a month before release a dozen of us got to go, we sat down at the computer's. i was in southeast kentucky and wco tells us sign in and we signed in the form and he says, we also got and he says or right. see that button on the bottom right? push it in. so we push it into your computer turns on. we sit there for about 90 seconds. been a prisoner system starts playing with a mouse. and he says, you know, c.o. come

if you push -- shut the blank backed up. okay? we sat in silence for another 35 minutes. at the end of about 40 minutes in, the c.o. said, y'all remember the little button on the bottom right? welcome push it again and didn't get the -- back to yourself. but since we all signed in, they could tell that we have successfully completed a computer skills course another person could get a stipend from the federal government for having done that. so that i would say what sort of indicative of the amount of rehabilitation going on. >> that's where want to go now is programming. that it does happen, right? is supposed to be part of the federal system, the state system. i mean, do they try it, what can work his computer? computers and like a good thing

to learn because that's a huge part of what sort of creates a coming apart in society is that some of us have a good ally to do with computers and others don't. are their career based things? could you teach somebody something pulls control or is it too late by the time they are there? what would you want to see? >> i which is a the courses just talked about, these are called ace courses. they are taught by inmates. most of the program is taught by inmates. i didn't take hydroponics but i could take jeopardy. i could take a class on current events or crocheting and get credit. and it was all busy work and it was a just the present administration wanted to show that they're keeping us busy. most of the guys wouldn't even go to the classic they were just like the attendance to form to say they would end and they would get their certificate. when you go to your review you would give them the certificate. i have been so busy working hard

and we are rehabilitating you. everybody felt so good. i joke about but i would think is so corrosive because these are people who need to learn the rules but as jeff was saying, the people who did all those things, they were tired shirt, make food. we ha have betting. i didn't care about any of that. i didn't partake in it but i just thought this is a place with broken the rules, you're at your lowest of lows. this is one place where you really want to get on board and do the right thing. that prison doesn't care. there's nothing there for people so they make, sort of idle minds can idle hands. so the program was really lackluster but in terms of the things i was taught, there are fewer addicts and people would think at least and the federal treatment. only a couple who came in that were really strong out, were in the throes of an addiction the need for. there were people who had dependency that probably needed help but it's not necessary why they committed their crime.

the thing i felt was missing the most with some sort of cognitive pay for therapy, some sort of psychological, some therapy. a lot of these folks come from communities where that is frowned upon, and this people ever for frowns upon this, but the lack of impulse control, just the emotional disconnect. these are, a lot of the behavior is antisocial. that's what got them in this position and other go to the most antisocial place in the world where you're walking around with headphones on screen your music to no one and no intel you to be quiet because no one is going to screw with you. it's just, it just perpetuates the worst behavior. and so i think about a fight you to be overturned the tv channel or somebody calling a foul and a basketball game. those are things that you have

these people can't have them there. they might not seek this helped otherwise but while you have them there, there are certain things you could do to work with them to get them thinking about their thinking patterns can get something about their behavior and the choices they're making and the roots of those choice. people do what they were raised to do and they're not thinking about it otherwise. even those of us who try still struggle and to provide ourselves why do i feel this way. these guys are not thinking of any of that. it's not cool to think that either. at cumberland we have 250 prisoners and when one trained psychologist. she was that of a drug treatment program. she did want to do any more work than that. i was there at a little while and i two young girls to was missing tape and in a summit of the guys were missing their kids, we talk of putting together a group like there was in aa, different support groups and we said is put together a father's group so we can talk about ideas about how to stay in touch with her kids, how do you

are minutes, that he is things like finding out the guy who creates pictures that we can send them anything that you can find to stay close to your children, that's what you want to do. you want to say i am bummed out, i'm done, i has to visit -- had a visit this weekend, i'm sick. you don't go cry on your bunk mates shoulder but it's prison. 12 group like that, this would be a sure winner. the psychologist wanted no part. she would respond to e-mails asking if we could put that group together. there's a lot of lip service about family reunification of the aborted is just a close but not a lot that gets done. as jeff said, that c.o. who said no, you can leave, that's the level of concern. it sort of i checked the box, i give your computer to get it doesn't matter if you learn anything. do are things that can be done for not being done. the federal government is far behind. >> when asked in a second about something you alluded to, how i think you used in your book the phrase convict code about how

you have to behave do not have the pressures make your life horrible good but before you talk about the i want you to just say what you can say about programming. using psychological health is possible, helpful, what are your thoughts? >> i agree with everything kevin said. you guys had crocheting? >> and i am a master now spend i applied to teach current events because i put in to put in five different courses but instead i was put to work, i see couple of you have the book if you turn the book on his back you can see what my job was. i worked in the warehouse on the loading dock and you can see my true that he worked with. you can probably tell which one i was. [laughter] anyway, so no, i mean, i'm not trying to be -- you do the crime, you do the time. you do the time that they want you to do the time. not how you want to do that on.

unlikely to complain about my job but i definitely think, i do decades worth of teaching teachg experience and i've been a state senator and i would've loved to teach a course. apply to teach a black history course in color and most of the prisoners were black and i thought that could've been interesting. i wanted to teach current events course but i applied to teach come to realize like anything that any political or ideological charge was not going to fly so i appointed teach like a job interviewing course and like a resume writing, thank a teacher guys a little more about that. they ignored all five requests. although about three weeks before i got out, they did finally moved me, which is interesting. i had fallen off of, i worked, we moved about 3 35 or 40,000 pounds of food a day into freezers that were bigger than this room. and i fell off the top of the

freezer a few weeks before i left, and then i don't think they're going to get it but the lieutenant governor of missouri happened to visit the next day, and then they figured that he might have come in response to the following even though it was told a coincidence. when they figured he might have some juice behind you, then they did move me. then they send it to the education department and i was, and was going to be long but i would hope i get to teach. the guy in charge of it said, he said, in makeup what your education level? i said ph.d. and he said, all right. we will start you off sweeping the classroom. sideswipe the classroom for my last month. >> not to put too much just on the bureau of prisons because i was going to teach a writing class as well because a lot of guys asked me to edit things they're doing either court filings or coursework, correspondence courses and asked me to write that i think writing

is a lost skill anyways i think this is pretty miserable. and so i said, some guy said would you teach a class in writing? same thing, resume, cover letters, basic letters like the. and i have to say part of the problem was that no one would have come. a couple other guys would seek me out privately but they weren't going to come from five to six at night because the prison wasn't going to make them. there were some guys who are interested, but i don't want to put it all on the prisoner that prison should make them come. spent if anyone can compel someone spirit that was to think ahead of education of education. i said, he said, he said how would 50 people go to this class. it was an electrical class. right, they are not going. if they are not going what am i giving them all certificates? tissue don't know who is there or not. you check attendance. all right, forget it.

>> what you said really spoke volume. the first thing you said, people would come up to me and asked different but they wouldn't go to a class. all the time people want to tell. they wanted to bring on the ged. they wanted to write a resume that they would quietly come to my cell and ask. so this debit interest in it and i would say like a pretty insatiable thirst to look at what they're going to do next and how they're going to acquire a skill. but doing things, prison wasn't always interesting that. there's a lot of research on prison education programming and the rand corporation just did a study, i met a study of dozens of other studies of prison education programs around the country. it shows first of all there's a 43% reduction in recidivism for prisoners to advance educational while they are incarcerated. secondly, for every dollar we spend on prison education

programs and vocational training there isn't almost $6 return in reduced cost related to that recidivism. that make sense if you think of the 43% reduction in you think it's costing on average about $31,000 a year to incarcerate someone you can see a much money we can save. what kind of courses, you talk about therapy. therapy would be so important because people don't have an outlet. prison teaches you so many things that it teaches you a way to behave, like to suppress all emotion all the time. >> this is going to be my next question to you talk about the conflict the code, making eye contact or seeming to friendly. ..

you don't do anything because then they know how to get to you. and there's a lot of people that play of mind games and have time on their hands and they've developed really sort of acute senses for other people's weaknesses and they will prey on that said you were not to express any emotion and you develop a tendency to overreact

because if someone cuts in line ahead of you and you don't step to them than your week and everyone knows your week and then people are going to find another way to try to exploit that so all the tendencies are dysfunctional in society and that is the root of the problem. it doesn't have to be this way. that was the most positive place where the camaraderie and enthusiasm exceeded anything that i've experienced at the new school. they run a-level curriculum where it culminates in prisoners that compete in the shark tank like competition with the help

of executives and students from all over the world who advise them on the creation of the business plans and the sort of positivity and genuine care and concern and love was similar to that of a winning team into the recidivism rate for the graduate program over the last 11 years, 6%. less than one tenth of the national recidivism rate and several have started multimillion dollar businesses as well. so, i think there are ways we see examples of ways to create an atmosphere that's different. >> so there are examples of these things being done right. >> i don't want to disagree and again when i read the book i spared everyone telling my story because you told it perfectly. the one thing that i would say

is my sense is some of the folks there were too many waiting to be there and i born and i think that i am afraid that sometimes we romanticize the the precipitation to think that these are people that he would have to you would have to a dinner party. this is the least valuable players. it's not a great group of people to hang around with. i'm not trying to be above it. people would write back on me that i was with them and i get that it's just that these are both skilled with education all of which i think can be dealt with i don't want to mislead people into thinking that they are all budding entrepreneurs because was worried me the most is when people would come up and say i've got this business plan going to come out an application and they don't know what an iphone is that they but they have an affect going to sell him to be like investors if somebody

heard of this idea and they've been sitting there for six or seven years they don't know market research or anything like that. they didn't know what they didn't know so i felt like with some people you shouldn't worry about being your own boss you should just hope to be a called in a machine somewhere. you don't need to compete with wal-mart can just be a greeter, hold a job, pay the bills and support you and don't crush your dreams but you're going out with a felony conviction or you don't know the job market is like. so i thought the prison could give people a little realism. by giving so much space they let people dream unrealistic dreams and i thought it was counterproductive for the people who really needed a dose of reality as to what they were going to face when they got out. i was the opposite. i was so fortunate and my circumstances were different sound i could exempt myself from that. i knew i was going to do but a

lot of them don't and if they are allowed to dream unrealistic dreams i don't think that's helping them. >> i want questions from all of you in a minute i have one last topic. reentry when they get out of prison are there existing programs? you studied a lot of these that work and also just so that people here are think of anybody close to them come out of prison, what are the challenges besides not having seen an iphone? spinnaker huge challenges family and community support. we talk about how heartbreaking it is to watch men who work -- i don't know what the wage was for your job training $5.25 a week which a lot of people say that's not bad and i tell them that told them that was my monthly. [laughter] you know, for 40 hour week in

the warehouse but of course like you i was lucky. i had money and most of it went to my lawyers and i had to pay big fines for the government and soap of his most by had enough to have someone send me 100 bucks here and there is a vitally sad money on my books if i needed it. most of these guys you're working and thinking somewhere between five to $25 a month and not only do you have to buy the basics of personal hygiene but if you sometimes have child support over the years accumulating while you are incarcerated and then to stay in touch with your family where i was the interstate phone calls were like a dollar and a half a minute for me to call home. others it was even more. there were some it's been as much as $14 a minute. the fcc changed that in enabling that came out last week thanks to the great work of the organization and others as well. but this is a huge part of

reentry is the resentment that a lot of family members have because they didn't stay in touch and they don't fully understand how hard it was to get the resources to stay in touch and you never tell people how bad it was. you don't want people feeling even worse than they already feel and savings finds a family into getting family back together that is the challenge. the fact that 90% of employers perform background checks is a huge obstacle. one of the reasons i'm in entrepreneur is people don't want to hire you speak of we have a friendly disagreement about this stuff. they could run their own landscaping business. they get from their own barbershop. they could run their own janitorial business. they have that entrepreneurial spirit and in many cases that's

what led them to the drug case because they said i don't want to work at mcdonald's making $7 an hour. i want to do better and so the challenge channeling that energy into something that's legitimate enterprise and also literally figuring out a way to get them the basics to get halfway house. mine was worse than my person. i don't know if yours is like my halfway house was crazy. and when you put people right back in that place, 650,000 people every year come back to the doorsteps of the communities have the same communities where they already failed except now they have the stigma of a prison record and they are broke and they have to pay for their halfway house and drug testing and for transportation and clothes to look decent in a job interview can it surprising to me sometimes that one out of, you know, three people don't

reoffend. how they are able to get back on their feet. so we need practical, we need therapeutic resources, not a p. o that's saying the here and here at this time if you are late i would violate company to be here for the test. someone needs to counterbalance that and say how are you feeling about being back here and what do you need that can help you? can we help you with bus passes, can we help you learn to use the internet, do you have someone to list as a reference? we have people you can talk to. a database of employers like second chance employers willing to hire people. it's great to see people like wal-mart be in the box but we need productivity and people to step up and say one of the resources it takes to identify and recruit and hire and can support and retain people incarcerated. >> again i am a conservative libertarian but that sounds like the perfect thing for a

nonprofit local buy locally a state-by-state level to do. do you think i should be part of the criminal justice system to do that or what you see that being done outside? >> there's an amazing company that started a foundation. dave was incarcerated in was the brother of the company owner and he came out and they said we want to help you can you bake some bread. he starts baking the bread -- [inaudible] he made the bread totally different. he experimented with stuff and it went nuts and everyone wanted it and it grew hundreds and now i got fired by a much bigger company because it's been successful and they decided they were going to make it their mission to be a second chance employers.

almost 40% of their employees or people who came out of prison. and dave put on a big summit for employers across the pacific northwest to learn what they are doing. and so i think government could have a role in connecting people into giving more than $20 a bus ticket back to wherever you're from and connecting you to those resources. i'm not optimistic given my prison experience they agreed to take that seriously because one of the ceos when people would leave, his line would be able see you in six months. it's those like you that remind me i'm always going to have a job. >> so i think the reason is because the halfway houses you're still under the department's control. i was still serving a sentence i had to do home confinement for a couple of months and i got to go to rockville and get to home confinement but if i had to to

go to hope village in dc i know a lot of people that have been there it is way worse than the present for most people. i mean, they are stealing things from the inmates. some people would pass up the halfway house time because they didn't want to deal with it so i think there's minimal standards that could be set to control these. rockville even though i didn't have to spend time there, they have a good reputation because they really spend time getting people on the phone. they require them to spend a certain amount of time applying for jobs. that's their focus is you're going to apply to ten jobs jobs for attend jobs the days of his period they make them do that so they are really on them and i think that is a good thing. you mentioned coke and wal-mart and i would say this is one of those cultural changes that needs to happen. >> so coke, wal-mart wal-mart can target from some of them have voluntarily said we are not going to put on our application

whether you have a criminal conviction. we will find that out. but we don't want to knock you out of the consideration based on that one fact alone. so that's a smart move they did on their own. there is no law that requires that. president obama announced he's going to ban the box for federal contractors so that's not asked. i will just see this as a conservative i think an employer can ask whatever they want. so this idea to me is last about what it's actually but it's actually going to do because a lot of those i served with a could and could ask them their application they would submit a resume and there would be a ten year gap. this is not going to take long for someone to figure out where you've been where you stand with the people listed prison jobs because they don't want the gap and they did do some work. so i'm not so optimistic about that. it has to be a cultural change. there is no law that's going to make people people hire vendors and give them a second chance. we have to do that.

i do not -- i have to do community service because after two trials i couldn't afford to pay a fine slave to 200 hours of community service. we are proud of the progressiveness in the county. if bernie sanders were not the answer coming hillary is a fascist affair. and so this is the greatest place you should be able to come home to and did i got turned down by three different faces to do community service because of my felony conviction. the places have blanket policies not to hire felons. i don't seek to be paid. i have a law degree at a just want to stack books in the bookstore but they will not hire me. so forget to ban the box. forget about not asking. how about getting rid of policies that don't allow you to consider me at all? and so again, i think it is cultural. i think it is just us saying and knowing more people have gone to prison saying i'm not going to write you off because you served some time. i'm going to judge you as an

individual and get to know you and i think that's what has to happen. that's not a government solution to. >> that. >> one solution and we might be -- i think even people on the right might find this interesting remember what i said when people got outcome of that really embodied the incentive structure as it operates for prison wardens and prison administrators. they have a job because that there that is that there will always be us. but if we gave stipends or bonuses to those that worked in prisons basically if we tracked everyone that came out of prison and went five years without a reset of precipitating at the last two prisons where they were housed. maybe if we turn the incentive on the head than prison guards would be more focus on boosting you up then tearing you down. >> i agree with that. i would take the sort of

boarding or the head of the facility, i would put it on him to create that coulter and i certainly would want to know -- i think the judge themselves now on nobody's gates today. [laughter] but everybody leaves the prison is reoffending. and we want to know that so the bureau of prisons should at least track that information how are different facilities doing because we also build these prisons in dogpatch usa so a lot of the people that are guards that jeff has imitated a very well with the type of people i had in cumberland, and if they were this close to being inmates themselves and i didn't find them any more moral or educated or anything than the people i was serving with and so what is the training for them? it is their background? why doesn't the head of my prison is something about psychology and motivation instead of insulting people try to build them up to any state or locality or county where they all -- where there are sort of

good incentives or beer given a job to help people? >> i'm going to -- until about five minutes ago you couldn't have told that he was a republican or liberal. [laughter] >> the people who've done this the best over the last few years are like nikki haley in south carolina and rick perry in texas should. it's a little more than one third of the national average. the texas races that 23%. they are doing great. the one i talked about that in texas. the liberals and the cynics i'd say the reason it's so loves because they execute so many people and there's 236 people who couldn't possibly.

but i will say this. conservative republicans and southern especially in the south governors have really led the way over the last five or six years on those on the front end on sentencing reform and then on trying to be more compassionate inside of prisons in a way that will reduce recidivism and it's a credit and maven deals made this a focus, john kasich, not only did he focus on this but then he ran for the reelection on specifically this issue which is encouraging to me. >> audience questions. we have a microphone and it will continue. >> i am a retired journalist and educator i want to begin with an accolade. first, thank you. i'm sure there's times you regret what happened to you but i think that it's been my impression working in urban schools in areas that the one population that's probably his

least represented as prisoners both while they are in prison and even more so when they come out so i think that's good and my question kind of comes along with that. you talked a little bit about this but what's been the reaction of so much to you personally but your message? i think it's such an important message. do you think people are hearing you and if they are hearing you, you know, are they beginning to add -- will extend to be a multitude of things but just the message can have been received as you are an expert tax >> and along political lines as if being received differently? >> is as you could imagine. some people -- i didn't want to be the guy that came out the expert and it's not because i didn't want to relive the experience. i worked before i was invited so i was involved in these issues. i had been on the wrong side of these issues when i was a staffer on capitol hill. i wrote some of the mandatory minimum laws when i was a staffer and i was young and i do

nothing but i thought i knew everything. and so part of this was a little bit of penance and just the idea that it didn't appeal to me as a conservative anymore that we would with politicians wrapped sentences for cases they knew nothing about so i thought i wanted to get that message out and i'm lucky that as jeff said there are so many others that are doing this. at a personal level you know, you think that targeting support because this is the people who are talking to you and it is a sort of self-fulfilling process. i know there are people who -- what i don't like is any other walk in my experience matters. and especially conservatives. if you complain about the epa. they would say you know because you're out there and if you are screwing with your business we want to hear your viewpoint. if i said my experience of course you say that. nobody has done more to fight crime individually. he was the nypd chief during 9/11. but if you're going to dismiss him because he has a conviction and by the way jeff never talks

about reforming the law for his conviction was. i talk about mandatory minimums. i wasn't subject to one. he is talking up the system that we saw and unfortunately we have experience. so i'm a big boy, i can take it. but i don't like when they discount it because people think it is a motive i have. i would just as well not talk about this but i was there and i saw it. i helped create a bad system is part of a staffer from being a staffer. so the reaction is mixed. >> obviously there's that sample bias of the people that come to events where i'm selling my book there will probably be books better be associated to the message for most heartening thing is i try to go to places that are unexpected. i go on conservative talk radio, i go on liberal, go wherever i can when people invite me.

and i've had very commander a few people come back to me and say well what about rapists? and i actually talk about that in my standard talk because i think it's important to talk about because there is no clear example of how we operate our prisons driving recidivism. we tolerate the rape culture inside prison. there are more that have been in prison every here and have found the streets have been outside prison. and how do we handle that? the laugh about it. like the pop culture it's a staple of the detective shows, law and order to say the prosecutor says don't drop the soap to the perpetrator that's going away. how callous do you have to be to think that no matter what happens to you on the inside you deserved it because you broke the law tax that's crazy. and unfortunately, a hugely

disproportionate number of men who are raped on the inside come out and tragically attempt to reclaim their manhood in the way they proceed it was stolen from them on the inside cracks and so i am trying to talk about issues a lot of people don't want to talk about in some ways i'm a good messenger for it because i was a policymaker and i worked on criminal justice reform as a policymaker and i any researcher, too. in other respects i'm not the right messenger. i may light highly educated, not representative of the prison population. but any progress way, i can reach people in a way other people can't reach and so i'm hopeful i can do that and spread the message to people that otherwise may be that it wasn't. >> you may have noticed that we are all white. he was attacked, jeff was attacked in the campaign as a well-known caucasian when he was

running in a district that is largely black. we invite people here can we try to get diversity. some people say yes, some people say no. yes. >> i am sherilyn, a writer. we have 6,000 federal prisoners that are being released jeff talks about in his book the reason why, one of the reasons why he was doing the inventory on the loading dock is because he had -- he could read and he had math skills. so i'm curious, there've been a lot of reports about how there's a limited number of books in prison libraries, they don't allow newspapers. so what are the 6,000 prisoners claim to do if they can't even read and have minimal math

skills? you can't even back at the grocery store without having the diversity skills or math skills. >> any of you experienced this, illiteracy? >> we had newspapers, we had a library i worked in for a little while. i had sent in. part of this is not everybody in there is dying to read. some people can't and wants to come some people really do use that time to self educate because there's not classes. that's not the norm, that's honest. if they were really starving for education, some of them they wouldn't be in the position they were in. but in terms of the 6,000 coming out i want to say because they've been having to respond on this a lot this was not the obama administration decision this was the commission and if we cannot tolerate this 6,000 who are the lowest -- there've

been news reports about 6,000 people being let out early from federal prison for drug offenders and if you listen to bill o'reilly if you think you should read your basement and lock the door because they are all violent folks. they are not. i was in prison i just got up six months ago. i was there when people said it were getting the reduction. so what happened is the sentencing commission over a year ago said the drugs were too high, the guidelines were too high and it is driven a lot by the weight of the drug involved in your offense. they reduced that so for most people they just got a slightly shorter sentence. if you had had have an 11 year sentence you were going to get nine created a a native of change going forward but they said it's not fair to not include for the people who are already serving. let's get rid of some of the overcrowding we have and as an equity matter what stupid this way so people were allowed to go into court, they had to have a good record of the prosecutor was allowed to object to the judge had to agree. so the people that are coming

out, there's been this fear mongering going out 6,000 people. they let out 70,000 a year in state prisons without more creative to be a geezer like a handful in each community and these are people who are serving drug offenses who served substantial amounts of time who were coming out anyway so if you were worried they were not ready for society, they were not going to be in a year and a half either switch the biggest known issue but it's been turned into something big and what scares me about it is if we can program these people back have been those that then those that want to tackle the bigger prison issues are going to have a hard time because these are the lowest hanging fruit that we have in the system. >> what are we doing to help him come and even the ones that have much bigger problems, these are the lowest of the lowest, but our -- do they have literacy skills? >> we are doing with them as we did with everybody and it's not enough.

but the decision was for the past year if these people could transition to halfway houses in home confinement and look for work so it wasn't as if of november 16000 people walked out of the door. but if you're talking about what you're doing to prepare than i think that is the whole point is not enough. >> some of these it's been -- you mentioned are some examples of things that have worked in some cases and a lot of them you talk about the texas case or these other reentry programs having some good programs. a lot of these i'm almost feeling optimistic that we have some solutions that worked on a local level and maybe they can be expanded to other situations become a question of people who are illiterate getting an education and imprisoned is there any example of that been done well being done well do you know of? >> the problem is it's anecdotal and i think that there's a problem in the criminal justice system overall you don't have good data and its crazy if i said what is the recidivism rate you would give a number that you heard that if i said is that the

number of people going back to jail or the number of people just reoffending is that the number of people technical violations store to drop off and not know that a lot of researchers don't know the answer to that either. we don't have good data so even when we talk about programs that work, but they need to do is also a necessity to programs. so i'm all for them investing in programming that we think work that reduces an education as an example of that but i wanted measured and tested and then spread elsewhere in the country. >> that may be the this may be the best answer possibly need more data. >> in the front table here the microphone is coming from right behind you. >> good evening. >> my name is elizabeth elizabeth charity and i'm the ceo. what happened is i was in the corporate world and what than what i did was i lost my job and i started volunteering in the

juvenile justice system in into juvenile detention centers and while i was there out of a volunteer for like 20 years and what i did is i wrote a grant and i gave it to the former governor george allen and i started a 12 week job readiness program. but during that time, i decided to do is come and go back to school to george mason university, and i did a study on transforming the offender to an entrepreneur. i put together the 12 week curriculum and i submitted it to george mason university and what we are planning on doing is getting students to come in and help us teach the 12 week readiness mentoring program but we want it to go into the juvenile detention center. we have been given the

opportunity to be able to go before the department of juvenile justice to introduce this and i would truly love to have some of your statements included in our study. this could be a two to three year study in which we can get this data in all that information. >> my question following up on that incredibly interesting sounding project is on the juvenile level have either of you don't research or looked into dot that seems like that as a whole different set of needs and problems for juveniles vendors. >> it does have a different set of needs and one of the most disturbing things that i uncovered in my research for the book with a number of states that put juveniles in solitary. i mean, they are so ill equipped. no one should really be in solitary except the most extreme circumstances pretty much across the world they've decided this

is basically slow-motion torture to do this to people. but where i was i don't know if you had this experience you would have a guy on your team and he wouldn't show up for the game and they were like he's gone. where is he come he's just gone. you don't know why, they just disappear and they are in solitary and you never see them again. the people that came out, they were broken people. it had broken down and so the number one thing i think that we need to do is to absolutely forbid juvenile solitary because no young person especially should give them their logical developments at that juncture should ever be put in solitary that's the first thing. but i think we need to look further back. everyone is talking about the prison pipeline and it's real. a friend of mine who's a professor at columbia just wrote

a book on this in chicago and she looks at him just the way that like portraits mostly of color in our society from the minute they go to school they are 5-years-old, they are accustomed to like metal detectors and going and the sort of things we know in the state so we need to go even further back than the juvenile justice system and make it so that it's not considered and stopped normalizing the experience. >> we can talk about that after. over there in the salmon colored shirt. they kept the programming we support the college offering liberal arts degrees and talking

to people that are less sympathetic whom i'd only have a ged and no longer gets a subsidy from the department of corrections to finance their college education how is it a bit about offering whether it's college education or other education and spending yet more money on incarcerated people and helping them see if it's really worth it. >> i talked to the skeptics a lot. >> ira member thinking at that point it's still helpful

sometimes to be working on these issues and to talk to somebody on the hill was like why would i ever short in a shorten a sentence for anyone that committed any crime you think wade because there's no evidence it's reducing any crime it's not helping recidivism is causing money but there's still this turn on fox especially among the conservatives it's this deeply ingrained sense that justice needs to be served by his people do not deserve our sympathy or help. >> until they know somebody that runs the following won't and that's happening more and more so some of the people that have come out now and are supportive on the right just look at their family tree for a minute and you will find someone that went to jail and all of a sudden they had an experience in the criminal justice system. some just want to run around during the crime site of the '90s and they don't have those

scars that old stale debate. but how to talk to them i think it really is about appealing to their soap and rest because you can't make somebody feel compassion. sometimes it's not that i don't want us to not be tough on crime i just think what we are doing isn't tough on crime it's tough on criminals. if i want to show how how tough i am innocent and someone 20 years i may feel good about health tough i was on the person that if i just made him a worse offender and i destroyed their family and so now these kids are more likely to go to jail if i'm just driving up costs across the board the cost across-the-board lifetime but that's not being tough on crime and so again i do think this is a cultural issue that isn't so much legislative.

half of them will say for the grace of god. the other half would say even though they knew what they were doing you asked for it. >> there's something weird in our society where if all of a sudden speeding on the beltway got ten years we'll do it but the person that got caught zero sympathy and so there is a quick thing we have that once you break the law, you become the other and we don't want to feel any sympathy or empathy for you and that is just going to take us growing out of that. we are going to get to the point of the law have more first-hand experiences here and that may be what it takes. >> money and public safety is how i talk to conservatives.

do you like spending $80 billion a year of your money on a revolving door? >> they get plasma screen tvs -- >> ipad i bet it went from this fix to that thick. a. of these are americans. we will see them come and maybe they won't live in your suburb but when you go downtown for the opera or for the baseball game you will see them and if they want you to come out and you've got the right recipe.

>> grace talk and very entertaining but speaking of entertainment, before i ask a question i wanted to note are you familiar with the comedian kevin hart? i went to see him recently and i can relate because he's under 5-foot nine so it's even tougher for him but he does this joke about how or a monologue about what it's like to avoid fights and why he avoids fights and it's interesting to see the rationale he uses because he basically says i know what the consequences are going to be if i get into a fight with this person so i think there's a difference between the way people think. if identified i will do this in the visitor will come out okay versus someone who says it's good to come out of bad i need to walk away from that so i've

been able to stay out of prison because i've avoided a lot of situations where i could have made the wrong decision and maybe it was because my mom or dad were going to catholic school, i don't know what it was because a result i know i would be the whitest guy in prison. do you or people that you've spoken to actually delete it .-full-stop and then prison was wrong because i think and this is my theory and i don't do anything about it because i've never been to prison but there's a point where you decide you know what maybe i'm wrong to be a should have been put in prison for some reason. there is no perfect answer but i'm going to start reading the bible and all these other things

about the structure of financial transactions that you would still like to the feds and i would talk about whether i knew the meeting took place. i said i didn't know about that because they didn't have the appropriate pay for by the disclaimer that sounds sort of technical but the underlining primacy campaign-finance violation and the obstruction of justice. i think i did anything wrong backs i think i broke the law, and therefore in this country i done something wrong and i think i did something really stupid

and it was a big mistake and i learned a lot from it. basically what i did it was with a 10,000-dollar postcard and a jeb bush has a super pack that has over $100 million it. he's plotting and running the super pack so they don't really need to coordinate because they spend the first six months of this year figuring out exactly what they were going to do with the $100 million. i made the mistake of doing it in an illegal way.

as we came together at lunch today the fact is i did the crime, so i had to do the crime. one of the biggest misconception is prisoners say i didn't do it. they used to joke one time it's a long story but they were going to plant ronnie in my freezer jackets because they were going to get me in trouble. therefore they thought i was a brat and i was going to snitch on them for stealing. i was good to go to the high-security prison so i don't want to do that.

he's like what are you afraid of? he looks at me and he's like the only thing is i missed. [laughter] he was in the drug trade in china people and shot at people and he freely admitted everything he did and just ambitious enough and hard-working enough. it didn't matter if the the box is the sex perfectly. i didn't care and he was like that's not right. come on, senator. he had pride in his work.

they said we know what you're doing, you know what the penalty was. he had no idea what the penalty was. but what were you thinking? he wasn't thinking. he made a decision of this proved proof the moment without thinking everything through. those are called mistakes and bad judgment and the same thing with me. and ultimately to hope that they would do something with my clients that was called lobbying did i have a criminal intent to trade those things anyone for one basis and i would have done

anything to stay home with my daughter's so i would have put guilty in a second if i could have done that. i was going to have to incriminate others. if i didn't believe they were guilty and i wasn't going to do this or that that so that is my story and i live with it and i didn't seek any sympathy speak any sympathy from people that were serving longer sentences for similar mistakes. i gave them the facts so i was sort of raised that way you asked for it. but the people there didn't think about the conduct. they were not thinking of doing cost-benefit analysis and so there are things you can do to

sort of time people to make better decisions or to at least punish them in ways that respond they are really tried to get off drugs, let them see the repercussions of or drug trafficking data. don't let them sit in a cell for ten years where they have no face-to-face contact with that. i would agree the system is racist. every person i met they would say the system is racist, did you do with? yes i did. [laughter] they all thought i was in india that i had gone to trial. i don't think that it is in a lot of cases and that is what we

need to reevaluate because of the punishments we are doling out. this has been taken up across the theological spectrum of criminal justice reform broadly including prison reform and i would like to go on forever but we are incapable of doing that. what is the book about blacks is about when he went to prison. all of a sudden the kids gathered around and they thought that i was a really interesting story, and it was informative for me to talk to them about it. my oldest asked if she could read it and i said no. [laughter]

suggest don't buy it for your 7-year-old child, but it was -- i thought that was a really interesting thing that exposure to that is something we read about but you're supposed to visit and care about the imprisoned but it's amusing so i see it getting picked up across the spectrum and i i put these little solutions on the local level can double up but i want to -- >> speaking of little kids into my 4-year-old son every time you're out in public he's very gregarious and has the politician in him and he walks around everyone and says have you read dada went to prison? [laughter] >> thank you all for coming. [applause]

[inaudible conversations] [inaudible conversations] on the terminal justice system in prison reform. if you missed any of it will be available shortly to see you anytime online at c-span.org.

discussions on prison reform lead to the impact of the legalization of marijuana in numerous states across the country and just this week they defeated a measure to legalize recreational use of the drug. be sure to be with us tomorrow. think back. at the beginning we heard people say it costs too much. when you think about it now there are these stores. two adults want to go? they want to access it in a way similar that they want to use alcohol. they want to find someone who has it and hope they have what you want and that it is what they is what they say it is and that they are actually going to give it to you and you're going to be safe or do you want to just stop at the store and what we are seeing, we are seeing sales start very well and now

they've been getting hungry and higher because people were studying to become more accustomed to the system and there is the reason why more and more people are buying marijuana from the store than the market. it's preferable in every way. but if you are a producer for there it is mexico or some other state don't achieve to be off of you, you want to look for your overhead by reducing the amount of security you need to operate underground comic is where it's going to come from your coming from colorado coming as we know it's happening because we know how much is being exported out of the state. >> president obama announced today his administration made a decision to reject building the keystone xl pipeline and it

wouldn't event beginning of a long-term condition to the economy the move was made to have the united nations summit on climate change in paris next month. when mr. obama connects the policies to counteract global warming a wild rejection of the pipeline is largely symbolic mr. obama sought to telegraph the other world leaders that the united states's history is about acting on climate change. you can read the rest of the story on the front page of "the new york times" website. this statement from paul ryan if the president wants to spend the rest of the time in office catering to interest that's his choice to make that it's wrong. in the house we are going to pursue a bold agenda of growth and opportunity for all.

i thought there is only one person about whom i would write if i were to write a second biography. i remembered and of course i did write that book. >> i thought i'm going to be standing next to the president speaking to 3,500 of the most important people in the world in the room here in dc.

who knows how i will feel in a moment. i had the idea that i might do that. i thought maybe i will give him the books later. i will use the word if i feel the chutzpah in a moment to be able to pull off the goofiness i will give it a. >> on his writing career in the best-selling biography and crossover between religion and politics. >> i think it's important for everybody to take politics seriously but never to make what we would call and idol of politics. they would cause them to care for the poor and injustices and it's a fine line at something i talk about fairly often.

sylvia burwell discussed the success of medicaid and the national association of medicaid directors conference in washington. this year marks the 50th anniversary. after the secretary's remarks the panel also talks about the program's success is and what changes can be made to improve it. this is just under two hours. >> good morning. i'm not nearly sophisticated enough to dance on my way. i don't think anyone wants to see that it's a good way to start the program. good morning and welcome to the fifth annual national was as the ocean of medicaid directors call conference.

this is the highlight of the year for those of us in the medicaid world. as i said this is the fifth meeting, and every year we try to do a little better and be a little bigger, outdo ourselves, put together an agenda that is substantive, provocative and keeps people coming back for more and by the time i see 900 people here at breakfast i think we are doing okay. so thank you all for coming. i'm the director here and it is a pleasure to have all of our friends and family here. they have a domination of thought-provoking plenary sessions as well as the deep dive into the breakout on the many issues of great importance

this is our best conference ever except next year will be even better and i wanted to get moment to stop and say that we should note that this is the 50th anniversary of the medicaid program. so let's raise our coffees and say happy birthday. [applause] ..

that 50th anniversary is a theme we're going to try to weave throughout the next couple of days and you'll see that and you will enjoy that. we're delighted that amongst the 900 people we have here, we have medicaid directors and state agency staff from 48 of the states and u.s. territories, a terrific turnout. some of whom came very, very far to get here, and so we definitely appreciate that. we're very, very excited, in a couple of minutes, to be welcoming back to -- as a repeat visit, the secretary of u.s. department of health and human services. sylvia matthews burwell to help kick us off. i want to highlight a couple of

other things going on. after he secretary we'll move right into a panel looking at medicaid, the past, the present and the future, and again, on the 50th anniversary we'll hey medicaid directors who span the past five decade, talk about where the prom has come from, where the program is today, and where the program is going. we will also have later this afternoon a fascinating panel that is going to be -- the -- surrounded by a couple of his fairly famous predecessors, mark mccell lon and tom sculley, who are never shy about sharing their thoughts and views on the healthcare system. very excited about that. and then another big event tomorrow morning is an indepth

focus on what i call the willy sutton philosophy of medicaid, which is follow the movement we have a section tomorrow looking at the five percent of the medicaid population that drives 50% of our costs. the dual eligibles, people with co-occur substance abuse and meant health disorders and the way we're trying to approach issues around homelessness and justice impacted individual -- terrific, terrific sessions, and then we are closing off the session tomorrow with a closing plenary with vicky wochino, absolutely terrific. so, let me just mention one other thing and then i'll introduce the next session. but one of the really exciting things, why it's pleasing too have a lot of people show up to talk about medicaid, and in fact i hear that john oliver had a session on medicaid on his show

earlier this week. i have not seen it. i have heard it's a little blue so perhaps don't show it to your kids, but it's certainly exciting to see medicaid in the mainstream like that. and i think what's really exciting about what we're doing is that in many ways, we're standing on the cusp of a new era. of the program, and what the program does. some state medicaid agencies and directors and staff are u-ing are in a new dawn of rethinking how the u.s. healthcare system works and you'll see that theme throughout the next couple of days and you'll see the theme in some of the products we put out, including our fourth annual operations survey, which should go live on the web right about now, with an in-depth look at the issues that directors are facing, the types of projects they're tackling, and the way that they are trying to, quite

frankly, drag the rest of the u.s. healthcare system into this new era. how we're trying to take some of the failures of the broader healthcare system, an overreliance on uncoordinated fee for service. silo delivery models and a method of payment that incentivizes volume as opposed to value. what you can see from states all over the country is that these are the things that we are trying to fix. we are trying to improve the healthcare delivery system. we're trying to make sense out of the payment incentives that exist, and quite frankly, these things are hard. these are not easy. the healthcare system in this country is 18% of gdp and trying to change that is difficult and it is slow-going, but it is vitally, vitally important, and so i hope that you will join me

in over the next couple of days appreciating and celebrating the work that is going on in medicaid, especially around those patients who just have not been served well in the broader healthcare system and who medicaid is trying and striving to improve the experience of care for. and medicaid, as you all know, is big, it's complex, it is hard to talk about, we cover half the births in this country, we cover a third of all kids, we cover the majority of long-term care. the majority of hiv aid treatment and the mental health. it's a big, complex program. we'll spend half a trillion dollars with our federal partners and that's going to go up and up and up. and this really is a testament to the challenge of the job that the medicaid directors, and i think a real testament to the successes they're having,

they're able to bring some rationalization to a dysfunctional system. the medicaid experience for consumers on the program. so with that i'm going to hopefully gracefully exit the stage and turn the microphone briefly over to nemd's board president from the great state of arizona, who has been, as many of you know, a real leader in medicaid in terms of leadership in terms of investing in the program in terms of thinking about medicaid as a recall 21st century solution to healthcare issues. so, please join me in welcoming tom back up to the stage. [applause] >> good morning, everybody. >> good morning. >> on behalf of my peers i would like to welcome you all to the

2510namd fall conference. you may notice some new faces amongst medicaid directors. the average tenure currently for a medicaid director is one year and five months. but despite that, when you look at the operational survey you see that states are aggressively pursuing new initiatives to modernize and continue the evolution of the medicaid program, and this conference is really an opportunity to highlight a number of those areas where we are looking to improve the overall delivery system by leveraging medicaid in our local communities. our agenda over the next two days highlights some of the important areas for medicaid directors. progress with the duals. managed care. quality for kids and pregnant women. value-based purchasing.

i.t. systems. and a number of other important topics. one other item that is threaded throughout the agenda is, i think, one of the most healthy things in the medicaid program, and that is the tension of federalism. the role of the federal government versus the states. and it's a conversation that we have had in this country for 240 years, but it's something that plays out on a daily basis, in terms of the medicaid program. what is the role of the federal government and what is the role of the states, and we have a number of different agenda items to really focus on that and to continue those important conversations. but as we begin this conference, i think it's important to remember, at the end of the day, why we are here and that is to improve the lives of the members that we serve, and i had the opportunity recently to go out and to meet with one of our nonprofit providers and their

board, and at the end of the meeting i was walking to my car, and an individual approached me and she talked about the challenges when she was trying to advocate for somebody that was facing some significant depression issues, was potentially suicidal, and she talk about her struggles in navigating the fragmentation that exists in our delivery system, and the story turned out positive in that she was able to get the individual into care, and they're doing well. before i could take yet another step, a second individual approached me and they talked about how important medicaid was to them, and they showed me their arizona medicaid card, their access card, and they said they no longer needed medicaid, that medicaid was there when they needed he healthcare coverage. it had saved their life but now they were employed, they had other coverage, but they kept that card as a reminder of the importance to medicaid in their life. and for me it was very poignant

moment in terms of having this aspect of, there's still a lot of opportunity for improvement in the medicaid system, for the individuals that are on the program, and at the same point in time medicaid does so much good in our communities in serving the individuals that are on the program. so, without further adieu, i would like to take the opportunity and it is my pleasure to introduce secretary burwell, who was sworn in as the 22nd second of health and human services june 9, 2014. secretary burwell is committed to the mission of en-under ensuring every american has access to the billing blocks of healthy and productive lives. secretary burwell has led large in that complex organizes across the public and private sectors. most recently burwell served as a director of emb. i'm a former budget director myself so i always appreciate that. and a lot of other important

roles throughout. secretary burwell was a rhodes scholar. she hales from west virginia and lives in washington, dc with her husband and two children. so please join me in welcoming secretary burwell to our conference. [applause] >> thank you very much. i know your good with numbers. on the tenure point, the average tenure is a little ahead of me i'm not quite at one year and five months. it's wonderful to be here today, and as you all know, medicaid turned 50 this year and at hhs we have been spending time looking back at the decades of progress that we have all made together. you all may not know that i also

turned 50 this year, and i just hope that i am aging half as well as the medicaid program. and i also want to recognize and thank vicki wa which rino who i have had the privilege of knowing and being able to work with in the 1990s. at that time she was a teenager. we were both at omb. i well reflect on your earlier point. since i spoke with you last november, we continue to make important progress for our nation's healthcare system. just last week, the president signed a budget deal that will help states avoid more than 1.5 billion in medicaid costs for part b premiums to support care for older americans and those with disabilities. and over this past year, we have seen the expansion of medicaid in pennsylvania, indiana, and alaska, and i want to congratulate montana, who yesterday became the 30th

30th state, plus d.c., to take up medicaid expansion. [applause] >> thank you to the leaders of those states who are here today, who are also working with us to work on solutions for expansion. last year, i talked about the families across this nation, more than 70 million americans, who depend on medicaid. and over the last year, i've had the chance to meet more of the americans whose lives have been touched by this program. keena hicks is a single mom who told me about her struggle. she is a health aide for seniors but she had no health insurance for years. she told us about working through persistent leg pain and the didn't see a doctor because it knew it would mean she couldn't pay another bill. when pennsylvania expand med cad say was able to get coverage and it's a good thing she did. she learned her fine fibroid

tumors had precancerous cells and the schad a hit recollect -- hysterectomy. when we asked here about the new coverage, she saved it means the world to me. i have two sons that really love me dearly and i know that they depend on me. you all know people like keena. people for whom method okayed is a lifeline, and just isn't about today reside check -- today's checkup or this year's finances. we're actually learning that medicaid happens a long-term course for a healthier life. since we met last year, a number of new studies published by the national bureau of economic research have quantified the incredible impact that we have always known this program has. there are long-term benefits that can go well beyond health improvements for those who have coverage. children who had access to medicaid and chip as a result of coverage expanses in the 1980s

and 1990s, were more likely to complete high school and graduate college than similar children who did not have access. they were less likely to be hospitalized as adults. and by the late '20s, women who gained coverage as children, had higher earnings. another study by economists from yale and the treasury department, estimated that the federal government will recruit more than half the cost of childhood medicaid expansion through larger tax payments associated with higher earnings, and medicaid is a key component of our mission to bring affordable, quality health care, to all americans. since provisions of the aca took effect, we brought the uninsured rate to historic lows. in fact, we estimate that 17.6 million americans have found health coverage, and many of those have been covered

through medicaid like keena. medicaid is good for families, and good for communities. there's simply no greater resource for helping some of our most vulnerable neighbors fine quality, affordable health care. we know that if every state expanded, more than 3 million additional americans could have access to coverage. these are often working families and many are veterans. we're working hard to make this case and we'll continue to work with states to find solutions that work for their needs. alaska is one of our most recent examples. to help meet the needs of the state's american indian and alaska native population wes updated our policies at the indian health service and tribal facilities. we're also working with them to improve access to care by changing the way some services, like transportation, are financed, and to better coordinate care. expansion is a priority because the opportunity it offers is so

important. we know that these situations are complex. that people you serve are some of the most vulnerable, most diverse, and often have as what mentioned the most challenging health conditions. that's why it's important to get this right. as secretary, i don't go anywhere between the months of november and january without mentioning the health insurance marketplace. a few days ago on sunday, we kicked off open enrollment and although people who are eligible for medicaid and chip can enroll or renew coverage through the year we have the potential to capitalize on the public attention on the issue of health insurance right now. so i hope you'll join news spreading the word about health care.gov and this opportunity for even those in the medicaid and chips displays. as we build on the mission, of helping more americans find quality, affordable health care,

there's another role that medicaid needs to continue to play, and it was mentioned earlier. that is the engine of transformation. we're in an exciting time in health care. as you know for years americans struggled to mav gait -- navigate a health care system that failed to put the patient first. doctores have been paid for the amount of tests that they ordered, not the quality of care that patients received. but over the last few years, there has been a growing consensus to change that. we have a plan to transform our system into one that works better for the american people. it's a system that delivers better care, spends our dollars more wisely, and puts patients at the center of their care. it builds on three strategies. first, we need to change the way we pay for care. so that we encourage quality,

not quantity. second, we need to improve the way we deliver care. that means better coordination and more integration of health services. i means engaging the individual patient and empowering them to take control of their health decisions. it also means insuring that by-riz can access care so people can get the services they need to improve their health and well-being. and finally, we need to better organize and use data and health information in care settings. we need to increase transparency and cost and quality and make sure electronic health inflaming information is useful for the doctors and the providers as well as the patient. we're working at the federal level to support these channelings but it's already happening in many of your programs. we have seen health home programs in 19 states and the strict of columbia missouri's home health programs, according

to recent analysis, conducted by the state, these programs have helped create a 12.8% reduction in hospital admissions and an 8.2% reduction in emergency room use for health home enrollees. five states are leading on shared savings programs like minnesota's integrated health partnership program. the program aims to improve quality and lower costs through innovative care and payment approaches. in 2014, the program saw a savings of $61.5 million. other states are exploring integrated care models outside of shared savings or implementing alternative payment models. we want these innovations to work so we're providing resources and technical assistance through the medicaid innovation accelerator program and the state innovations model program. these programs help advance innovations in medicaid to raise

health outcomes, lower costs, and improve the way that we deliver care. and with new 11-15 demonstration we can support an entire continuum of services for physical and behavioral treatment, and in august, california became the first state to take this step and we're hopeful that other states will follow. many of you have heard that we have set goals with medicare to tie payments for how well, rather than how much, providers care for patients. we know that many medicaid programs are already leading the way in designing and implementing these innovative pavement models. some of you have joined us in these goals and we hope all of you will move in that direction. hhs is working closely with namd to chart a strong, ambitious course, for tying payments to quality in medicaid. as we go forward, i hope that each of your states will set and

reach your own goals that make ours look downright sluggish, and we'll be there to support you. because when you work for a community as diverse and as important as the 70 million americans that you serve, promoting quality, patient-centered care, is more important than ever. that's one of the reasons we created the healthcare payment learning action network, and we're bringing public and private partners together to move forward in this transformation, and i want to thank the national association of medicaid directors for your partnership and participation in that effort. we will continue to look for opportunities to create a better, smarter, healthcare system. i know a lot of you al are thinking about how to foster a healthcare system that supports the development of innovative pharmaceuticals and provides affordable access to

medications. to that end, at hhs today, we're announcing that we're going to sponsor a forum this month to bring together the stakeholders, including states, to share information on how we can address this complex problem. as we move toward a system that is quality-driven, and patient-centered, medicaid is one of our most important drivers of that innovation and transformation. we want to accelerate that progress, and frankly, we want to work together to be sure people everywhere understand that medicaid is leading in smarter spending and quality care, and that's why your partnership is so important to us. you are on the front lines of care delivery and the transformation of our health care heck -- healthcare system elm want to hear what works and what doesn't, how we can support your efforts and how we can work together to better deliver

impact for all the people that we serve. we won't always agree but we can always find common ground when working for the american people. i want to thank you all for the work that you do every day. it means so much to so many. and i want to thank you for being our partners because we are stronger with your help. together, we can do more. together we can help our communities overcome obstacles. chart a better path to wellness and even save lives. together we can winds the kind of healthcare system that the american people deserve. thank you all, and i look forward to hearing what happens of the next five days. [applause] >> that was fantastic. thank you so much, secretary

burwell. i would also like to point out that in the five years we have been doing this, she is the first hhs secretary to come present to us, and now even though she has been in our position less than the medicaid director tenure of one year and five months she has now done this twice. so it's a testament to her leadership, and we very, very much appreciate having her here to kick this off. so, a couple of quick things before i introduce the next panel. in keeping with the theme of thanks and acknowledgments, there's a number of folks i want to make sure we acknowledge. first and foremost, all of the namd staff who are so critical in putting all of this together, from soup to nuts in terms of content and everything else. i'll ask those of you who are here to stand up. there's a couple of folks who

are working back at the office, but andrea moreska, kathleen noland,. [applause] >> lindsey browning. and jack rollins. [applause] >> and then tes moore is back at the office, live tweeting everything we're doing and saying. to thank you to her. i also want to thank the team at arb meet examination events who have been, i think, outstanding in terms of putting -- helping put together the logistics for a 900 person breakfast and meeting and hopefully making the experience for all of the exhibitors and the sponsors and the participants as smooth as possible. so, ann michaels, marie, and victoria, thank you for all them. they're in the lobby there.

i want to thank north by name because i don't want to put a target on your back but all of the namd board for your leadership throughout the year and throughout all of the years in terms of helping the staff stay focused on what is truly important for medicaid directors and medicaid agencies. the current leadership with tom and john mccarthy of ohio, has been very, very strong over the past year. we very much appreciate the full board. i don't want to make you stand up our call attention to put a target on your back but thank you to all of you. then i want to begin to acknowledge some of the many sponsors who helped make this conference happen. i'll thank a couple knee, i'll thank some more now. thank even more. otherwise i'm standing up here thanking people for 20 minutes and that's not dynamic

conference going. so, i want to thank for sponsors tonight's reception, which i hope you can attend. rsa medical. i want to thank the diamond sponsor and the sponsor of this morning's breakfast, senteen corporation. all of the other diamond diamond sponsors including ameriry health, maximus, sellers dorsey, well care health plans and then blue cross blue shield of illinois, montana, new mexico, oklahoma, and texas. and then thank the sponsors of today's lunch, which is cgi. so, thank you. again, lots more sponsors who we'll acknowledge soon but i wanted to get those folks up there. but now, enough of me. and i want to introduce the next panel which i think you'll find absolutely terrific. let me actually invite up to the stage now.

judy moore. who is the co-author of "medicaid politics and policy." so he literally wrote the book on medicaid. going to moderate our plenary seeings which is medicaid at 50. past, present, and future. and our panelists will be, namd president, tom bet lack of arizona, and former medicaid directors deb bacharach of new york, chick milligan of new mexico and maryland, and vern smith of michigan. so, with that, i am going to turn over the mic to judy. we're having a very relaxed talk show format and i'll pad for time while vern gets mic'd up -- he is good. with that, judy, thank you. we look very much forward to the next session. thanks, everybody. >> thank you. well, i think