it and lock the brakes and couldn't safely transfer and he had hurt himself several times badly, i made him a custom break to our old design he could hook his fingers and operate that way. .. shortly after the earthquake. and archers have been made now in over 40 countries.

there have been over 100,000 of them made. and, of course, it's hardly the tip of the iceberg. that are easily 50 million people in the world today in developing countries that don't have the first chair. or if they have one, it was one of these substandard chairs, and they have already broken it. our greatest disappointment has been the our chairs cannot provide people with mobility last them a lifetime, or even close. our best chairs last 10 or 15 years. several times, longer than most other chairs, but think about it. how are these folks would replace the chair? our chairs cost $200. that can be for a person with

disability, weekly pay, less than half of what others are bigger illegally paid, even less than that. there's just a way they can come up with a $200 to replace their chair when it finally becomes beyond repair. there are though wheelchairs being made in uganda since 1965 that last much longer. many of them last 25, 30 years. if you look at the chair on the left, it uses a regular bicycle wheel. that's a stumbling block toward making a wheelchair last a lifetime. making it repairable. like a good bicycle last for a lifetime. the regular wheelchair has to have a high string axel and a

special hub, a bicycle axle if it is cantilevered like this, supported only on one in is not going to stand up. the forces are quite -- can bend most commercial wheelchairs. i can cash them in a few minutes. >> but that ugandan chair is the own in the world that has been replaceable or a much, organ retrieval pretty much as long as people give them a lot of tender loving care. the downsides of it a thousandfold. the forks on the outside have three inches to its with so doesn't fit in as many outhouses.

and it is an old-fashioned cheer. like the chairs 100 years ago with a big front wheels make it very hard to get in and out of the chair. so when i was in uganda 20 years ago, this woman said i had to trade shares with her. she needed my chair. it folds and cost one-third as much. she doesn't have to pay for a whole row of seats. and, and she had another reason as well. that i would go home with her chair and maybe i could learn how to make my chair as good as hers. [applause] so we are working on path as hard as we can. i've built nine different type of prototypes. in the picture, talk to see but in the back of my will is a very

thin work that doesn't widen that you. but if i made it strong enough gets too heavy. said number 10 may be a little closer. we are zeroing in but it's not easy. but it sure is worth trying. i certainly learned a lot working with people for whom i have more respect than i've had in my life for anybody. it's pretty amazing. [applause] >> thank you. >> thank you, ralf. tremendous.

showing that ingenuity and determination are key to being in the public interest world, and passion as well as ralf showed so put a. now we will have robert coulter come up. he was a founder of the indian law center tom indian law resource center, back in 1978. i remember dolores saying something out of the pine ridge reservation rebellion several decades ago, "new york times" reporter i believe it was asking about the decoders. said, what did your people call this before the white man came? he said, hours. that is the spirit that robert coulter brings to his 40 years of work as an attorney. he is a pottawattamie indian himself and he's been involved

over the long haul in fight after fight against injustices, against native americans throughout the americas. in fact, he was the author of the first draft of the u.n. declaration of the rights of indigenous people that was adopted by the general assembly in 2007. welcome, robert coulter. [applause] >> thank you, jim. it's wonderful to be here. congratulations to rolf on this 50th anniversary of "unsafe at any speed," and thanks for this -- [applause] yes. and thanks for the opportunity to be a at this time along with so many others. first i want to show you a very short video about our organization.

♪ >> these are the core beliefs of the indian law resource center. for more than 30 years the center has been a global force challenging and building legal frameworks to enhance the lives of indigenous peoples. one of the major causes of the economic and social ills with the native communities is the unfair legal rules that apply only to native peoples in the united states. we have taken on case of you of the shoshone and the mohawk nation and others with the goal of changing some of these laws. we seek to strengthen sovereignty rights so that tribes can better protect their people. this is more critil now than ever. >> one in three native women will be raped in her lifetime and three out of five will be

physically assaulted spent the center's hallmark work is related to united nations declaration on the rights of indigenous people. >> we wanted to be sure and we wanted to establish legal rules that would make it clear that indigenous peoples really do own their land. they really do have full and complete legal rights to those lands, that they have rights that can be protected in courts, rights that are protected by definite rules of law that can't just be thrown out or ignored by courts or countries and their governments. >> the declaration was adopted by the u.n. general assembly in 2007. >> as you note in april we announced we were reviewing our position on the u.n. declaration on the rights of indigenous peoples. today i can announce the united states is lending its support to this declaration. [cheers and applause] >> this is just a snapshot of the work coming out of both helena, montana, and

washington, d.c. offices your we at the indian law resource center are experts in indian law, working to protect and preserve indigenous peoples and their communities. our ultimate goal is to make positive contributions that will have lasting effects. visit www.indian law.org. >> well, i'm not sure that i actually belong up here with the kind of organizations and advocates that have been assembled here. we are an american indian organization, and we just work hard and work about our funding and wonder what we can do to improve the future for indian in alaska native peoples. i suppose in a basic way we are a lot like many of these other

organizations. but let me try to give you a little bit more detail about what we do. what we do is we provide legal representation to american indian and alaskan native nations and tribes. and i mean indian nations and tribes in central and south america as well. we are funded just by foundations, individuals, and a few indian nations. we don't take any government money as a matter of our integrity and independence. as a result our budget has always been pretty small. it's less than 1.5 billion per year, and that's only in recent years. we have in office as short in helena, montana. that's our head office but we also have an office in washington, d.c. that is headed

by my partner of some 35 years, armstrong weakens. armstrong, if you were here, raise your hand or stand up. he has done so much to build our program. [applause] when we began this work in the 1970s, indian nations in the united states were is utterly dominated by the federal bureau of indian affairs. they suffered and extreme poverty. tribes had few legal rights. that's still the case actually. and practically no constitutional rights. nearly all tribes were completely dependent on federal support for food, shelter, health care, and other necessities. indians in mexico, central and south america endured even worse, frequently suffering massacres, murders, genocide and the like. indian communities were and

still are typically denied land rights and subjected to severe clinical -- as result indigenous peoples in the americas and worldwide were disappearing along with their cultures and languages. our human rights work affects and involves thousands of indigenous peoples worldwide, though we just work in the americas. there's an estimated 370 million indigenous peoples in at least 70 countries around the world. now, indigenous peoples, i like to say, our american indians, alaska natives and other peoples like that. but there's a little bit more of a definition. they are people who inhabited a country or a region at a time before other peoples of different culture or ethnic origin arrived and became dominant. well, we wanted to assist

indigenous nations and tribes change the racist laws that were inflicted on them. a reasonably fair and workable legal system is always necessary for economic development and approval of social conditions, but in the united states, that doesn't exist for indian nations today and the result is pervasive poverty, degradation and casinos that were only a few tribes, lawyers and courts have done virtually nothing to assure constitutional rights and fair treatment for indian tribes. it was clear that we would have to do something different in order to overcome the incredibly unjust legal system and the system of federal control that had been introduced for 150 years, ma and still is so entrenched. we decided we must listen to indie nations to ask for our help, follow their decisions.

we decided to work for native peoples of the americas, not just in the united states. now, working for indian nations means we were never trying to work alone. we were advising and assisting indian and alaska indian nation. sometimes many of them in several countries. that was aboard the. we began a long-term strategy to overturn the antiquated and racist body of law that we found almost everywhere. we planned a long camping of writing, education, lawsuits and organizing and changing the law. but we learned after years of work the courts in this country were not open to any serious challenge to the legal system that affects indian nations. the very supreme court that had ruled schools desegregation unconstitutional also ruled that same year that the federal government is free to actually

confiscate indian tribes property without due process, without any compensation. that's still the law in the united states. we need an additional strategy for changing the laws. some of the indian nations that i was representing pointed out that it never relinquished their rights as nations to participate in the international community, as we begin to look to the international community, to the united nations, for ways to challenge the laws in the united states and elsewhere. the then newly relatively newly emerging law of human rights at the international level was really promising because it condemned to no uncertain terms discrimination, genocide, denial of cultural rights, and other wrongs. in 1976 we had opportunity to go to the home of human rights in geneva, switzerland, to the

united nations they are, and i suggested to the indian nations that i was working with at the time that they consider proposing to the united nations declaration on the rights of indigenous peoples. i wrote a draft for them to consider. they did consider it, reviewed it, modified it and took it to the united nations in 1977, and proposed it. to the united nations for adoption. our strategy was that by creating international awareness and pressure on the united states and other countries, we might be able to develop international legal standards about the rights of indian nations and indigenous peoples. we might be able to change the policies and practices of countries who might go to sleep eventually to reevaluate their laws and policies. we had very difficult times. our strategies were scoffed at

in this country at least. many people said we would never acknowledge anything. we had a staff of just five or six, after budget was never more than a few hundred thousand dollars a year. but the process in the united nations soon became the largest and most heavily attended human rights process in the u.n.'s history. for the first time the affected people, the indigenous people were able to produce the in the human rights process, and they were enormously effective. hundreds and hundreds of them went to the united nations to negotiate and advocate for the declaration. our work on the declaration took 30 years, until finally i heard, the genoa summit adopted i in 2007, and the united states gave its approval in 2010. [applause] but it made a big difference because the declaration

proclaimed for the first time that indigenous peoples have the right to exist, the right to exist as distinct peoples. that was not the case before. the right to exist with their own governments, without discrimination of any kind, with the right to own their land and resources and a host of other rights. this was a great change in the tide of history, and it has changed how countries the indigenous peoples your now, in 2013 -- 2014, about two years ago we helped to win four more major commitments from the united nations general a silly. we won commitments to develop a permanent monitoring and implementing body for the u.n. the declaration to see that it is carried into effect. we won a commitment to create new rules in the urine that will permit indian nations and other

indigenous governments to participate on a permanent basis in the united nations. after this we will not have to have special permission to go and fight for our rights. they will be there all the time. we also got a commitment to combat violence against indigenous women, which you heard about in the media. that by the we speak individuals are senior attorney, jana walker, whose accomplish remarkable things in the fight against violence, against indigenous women. we also -- [applause] >> also won a commitment from the united nations to do more to encourage respect for indigenous sacred sites. on the domestic front our project on violence against indigenous women helped to win a major change in the united states law, as you heard, in the reauthorization of violence against women act. they use brilliant organizing a brilliant mitigations work, they

just about the epidemic of violence against native women, and created advocacy and international bodies. and they won the support of women all over the country who helped bring about the tremendous reform in the united states law, returning law enforcement power to indian governments in the united states, power to prevent some forms of violence against indian women. but much more needs to be done. we've litigated lawsuits. we've used federal courts to challenge federal government abuses and sometimes state government abuses. we've changed the united states laws in some important ways, but fundamentally the unfair and racist legal framework is still in place, and we're continuing to challenge it. we are going to have to focus on education to educate a new generation of lawyers and judges

so we are writing materials to do that. it's going to take many more years to change the law. assuring that the united nations takes the necessary measures to limit the declaration of rights of indigenous peoples and to see to the countries respected these rights is another priority for our work going forward. and now we are going to have to implement the new american declaration on the rights of indigenous peoples, because let me say, just four days ago the indian law resource center staff here in d.c., and a handful of amazing indian leaders from the americas over here at the organization of american states succeeded after 26 years of work, succeeded in completing the negotiations on the new

american declaration on the rights of indigenous peoples, and it's stronger than the u.n. declaration. now, that's -- yes. [applause] >> it was a tremendous job they did and there were so few of them, but it had to be done and they did it marvelously. that declaration is expected to be approved by the general assembly of the organization of american states in a few weeks in june. so we are looking forward to that. the greed for indian resources seems to have grown in recent years, much more virulent. at the same time we are seeing a breakdown of the rule of law in the americas, a significant reduction in the willingness or ability of countries to enforce laws or to abide by them. these two factors are extremely dangerous for marginalized people such as indigenous people.

is indian and communities have begun to assert the real legal rights that are being created, indian leaders are being murdered in many countries. this is a very alarming develop and, particularly in central and south america to they are being murdered by those who cover these indian lands and resources -- have it. it's a very urgent situation we must address and must stop. we hope to train more indian lawyers come indian leaders, especially in central and south america to help them defend and assert their rights. i hope that perhaps we can create a, i hope we can create an indian law resource center in that part of the world. i get moved by that because it's been a dream we have been unable to fulfill for many years but perhaps we can do that soon. fund-raising concerns --

[applause] thank you. thank you so much. fund-raising concerns are serious. i'm worried that foundation seem to be trending towards just short-term projects. this isn't good. it took 30 years to get the u.n. the declaration, and it was worth it. 26 years to get the american declaration. series work requires serious time. we need to educate philanthropy to be responsive. i think our greatest need -- [applause] yes. we may need to look to individuals and families where foundations are falling down. for the long-term i think we need to focus more on education and modern communications work. we need to try to engender the rule of law in many countries. and by this i mean encouraging political and social systems so that they are governed democratically by laws and not by the arbitrary dictates of individuals.

well, in this long-term view, i hope that we will see rich cultures and hundreds of thousands of indigenous communities thriving all around the world. but i also want to see a great body of rights, of fundamental rights, recognized for other peoples as well. this need not be just limited to indigenous peoples. i believe that most of the rights in the declaration on the rights of indigenous peoples should be the rights of all peoples of the world. so let's see if we can do something about that. thank you very much. [applause] >> thank you. terrific. what a great lineup we have. this is spectacular. i'm learning so much sitting backstage.

next up is a fellow who is a founder and has been a long-term director of public justice, a great organization. his name is paul bland, but he is not bland. rather, he is a fight every fighter for equal access to the courts in this country, and particularly has been doing yeoman's work in the case and in the face of corporate arbitration clauses, totally unjust, anti-democratic decisions. in fact, corporate arbitration is best defined as two coyotes and a lamb voting on what to have for dinner. paul bland has been in the face of the corporate powers that has created those clauses, and he is now scoring great victories after years of fighting these.

welcome, paul bland. [applause] >> it is incredibly cool for me to be in this building, in part, 35 years ago when i was in college i was there and saw the jerry garcia band. so i'm wearing a jerry garcia tie of you like i was at home. so public justice and what are we? it's a fake name. we pursue our impact of lawsuits to combat social and economic injustice to protect the earth's sustainability antichild predatory corporate and government abuses. so let me break that down. first of all there's a lot of different public interest law firms out there to why do we feel we are different? the are two things about our model. the first thing as we try to leverage resources and that's one of these words like we will leverage and synergize empowerment and circles and so forth. the word leverage mean something for us. we recruit groups of trial lawyers, people who are really

skilled at perrett -- 30 at the facts, taking deposition of unable to do this and we work with them on high impact cases. a lot of our cases will have 10% of the time of 5% of the time but were able to recruit and get some of the smartest lawyers to help us take on some really big causes that we just had our own 14 lawyers that we would never be able to do. the second thing about our model which i think is fairly cool is we work for impact cases. wenatchee is looking for cases in which somebody has been treated badly. so has been cheated. we are different. the people who do legal aid work. i love people who do individual trial cases but we are looking for cases something big, something broader. we look for cases in which you can have an appeal, set a precedent. look for a case we have class action or some other to change the get an injunction that would change the corporations practice. we look for cases where argument occasions can draw a lot of attention to an issue.

the first part of our mission statement i read he was talked about economic injustice. things are pretty bad in the united states with respect to economic injustice. we have the sharpest division between the various wealthiest, the .1%, and the rest of the country that we've had since the gilded age were probably worse than since the 1920s. we rank terribly in the world with respect between the richest and virtually ever bills. most americans live paycheck to paycheck today. elizabeth warren critique of the way our economy is set up, she first articulated in her two income trap book has become substantially worse. in the last 10 years we've had many millions of people who've had their homes foreclosed every year there are a couple million people who have cars repossessed. the american economy didn't get this unfair by accident. it didn't jump. it was pushed. there's a lot of corporate cheating going on out there. there's a ton of predatory lending -- [applause] most people in america don't

understand how high interest rates and fees on the loans they are getting or. it's incredible how many people don't understand the products they're getting. there's wage steps that are extremely wide scale. a ton of people living situations which is like a company down with are no longer considered employers. they are independent contractors but most of the things they need in order to have a job are provided to them by the corporation. have a lot of people who a generation ago are working 60 hours a week and they were making good middle income salaries, another working 60 hours a week and a families on public benefits because the vast majority of the money that is being given to them is going back to the company in various steps. how did this happen? there's a bunch of things that can be done about it. a lot of companies were able to get away with his corporate cheating by using the forced arbitration clauses. there's too bad aspects. forced arbitration is what the company puts in the fine print

which almost nobody reads, a provision that says if we break the law you can't sue us in court, but instead you to go to a private arbitrator and we will pick the company, and then take the arbitrator everything will be secret. whatever the arbitrator decides, is to make an error of law or fact, none of that is appealable to court. most important of all, that you can never bring a class action. even if we cheat 100,000 people in exactly the same way through a predatory scheme, under our contract every single one of you is atomized, you are individualized to get to go out and separate figure out that you were cheated separately, they got what the law is. you have to file your own claim, pay a fee to the arbitrator, you have to go buy yourself. that is really what corporate america's indicators around this forced arbitration clause issue. there's true the amount of evidence in individual cases in the employment area that workers to worse in arbitration than

they do in court. and if they do get an award it tends to be about 25% of what it would be in court. but the biggest element of it is that on class actions. so, for example, it used to be the law in america that you could challenge a forced arbitration clause and if you could prove as the plaintiff that the ban on class action had the effect of guiding a consumer protection or civil rights law and court would strike it down. this is my career for a while. going around from state supreme court and getting different states to adopt a law that said that it's a bit on class action in arbitration clause with gut the consumer protection law and the court with or without. we had three cases against payday lenders in north carolina and payday lending is legal in some places, illegal in some places. in north carolina it was just illegal. they just were not allowed to do it if they were doing it because at the arbitration clause and

they figured we are good to go. we built this strong evidentiary record that out of the court find the arbitration clause in the case defend anyone from going forward. it made it impossible for someone to bring a case. once we prove that we were able to go forward and we had five cases and his world judged i can only have a couple cases at a time. we will do three days in one round, we will do two days in another run. we beat the arbitration clause. $45 million in relief for these people. we paid out checks to 200,000 people. [applause] >> thank you. april 2011, by a 5-format book, justice clear writing the opinion, the supreme court invented a new rule that never existed before which said even if an arbitration clause would gut the consumer protection law, undermine civil rights law, it still has to be enforced the

single worst case finish of the consumer law. in the wake of that case hundreds of class actions throughout across the country can't even wear there was proof that the case, that the arbitration clause kept vacation before. we have two more cases and they were thrown out and nobody got anything. no one's credit was fixed. they continue to be charged the full amount. know what the czechs. the forced arbitration system worked as a splint and it worked really well. we still have not given up since 2011. we've got all sorts of different problems. with anytime a company a mistake insource arbitration clause, they did a little greedy or sloppy we go after them. we have 20 different cases pending right now. this year we have one -- eight different cases like other clause and things of other acts of justice were. we been fighting hard for consumer financial protection bureau, rich cordray's agency, which is just announced a proposal to have a new rule that

for lincoln, 20% of economy, under the dodd-frank act, they have the power to wipe away the forced arbitration clause and his announcement says they will tend to do that and they're going forward with it. the chamber of commerce is losing its mind about this, and fighting like crazy injury all these arguments. we don't need the consumer protection laws because the magic of the free market will work. you've heard that story many times. there's finally progress going on and we're taking down the clauses were companies make mistakes. some of the cases, not handle as many case against dell and hp and t. have more cases against scam artists. we find the cases that are being separate in evolution if you're a predator animal going behind the heard you don't kind of get this leak is, yungas come healthy as. we find the companies with lots of lawyers, who drafted a crappy arbitration clause and we go and

pulled it down as a message to the others, sort of thing. but anyhow there's a lot of issues around the economic injustice with our berries like arbitration, court secrecy, the use of federal laws of lightweight good state and consumer protection laws and we work on different cases fighting against this in order to fight against economic injustice. soakers sustainability. the core problem here is that corporations can externalize the cost of what they do. in other words, when you hear someone say coal is cheaper than solar energy, it's cheaper if you don't count all the different things that it does like it is hard for people to breathe and it contributes enormously to climate change and it destroys streams and so forth. as long as they can take all these costs that the products create and stick them on other people, it looks like it's a lot cheaper than it really is and the company makes a lot more money. that's really our model. for example, sustainability earth, single biggest threat,

will come as a spice no one, is climate change. what are probably the two biggest drivers of climate change? the first is called and the second is factory farms. we've come at this image of the way from a lot of other people who litigate in the financial area. the traditional approaches of about what is the first of all to sue the epa. there's been some great work in that area and our times we see the government but we are much more interesting than the corporations that are polluting. we focus on fast. i think that's a better use of our resources. in the second thing is there's a lot of people litigating over air quality and some great work being done in that area. what we focus on come it turns out the coal plants, frequently dump all kinds of stuff in the streams that render them dead suspect there are places that look like something out of that mccarthy movie, the road where everything is great and there's nothing living. the our dead zones throughout america where cold pollution is gotten to th the point, which is

coal ash and other waste, so the white what every single living thing industries. the second biggest driver of climate change, factory farms, they frequently have dumped enormous amounts of manure into the streams. we have gone after coal facilities. we've got issues of cases we've had success stopping mountaintop removing that which people bring this gigantic machines -- [applause] thank you. sex something out of star wars and they simply read the entire top of the mountain off and then just dump all of the rock into a valley, what used to be a valley. your parts of west virginia that used to be these beautiful rolling hills that are now just flat like a parking lot. what use used to be about this e about ms. flack of what used to be a string is now filled. a lot of people are saying this violates the surface mining control act or what sort of situation? we argue it violates the clean water act because when the

stream doesn't exist anymore we consider that polluted, for example. we had success in that area. with the factory farms, we went after, there were four negative areas in rural washington. we have a bunch of cases like this but this was the first case in a country like this. these theories have so many cows, they cram these cows together just side to side to side. they can't even clean up where they are so they put them in a big concrete bowl or a lesson have been just stand there in the own excrement up to the knees, and to take this incredible number of cows and periodically wash it all out, and they're producing more ways than the entire human population of hoboken, new jersey. then they were having these piles of waste that could be as hot as 50 feet on a light eight football fields wide and they said it's not pollution because it fertilizer. fertilizer is valid. i mean really it's a valuable. fertilizer would be valuable if you spread it over the state of iowa, okay? when you pile it 50 feet high

several football fields wide, it's not fertilizing anything. it's telling everything. what was happening with without getting into the groundwater and the company said it's impossible that could get in the groundwater. it's amazing because it turned out the groundwater is a downgrade from your factory farm and its polluted the water upgrade from your factory farm isn't. we found that the factory farm, they are saying all the water is safe. they bring in bottled water for all the people who work there and lived there. it's like the water is safe enough for you but it's not safe enough for us is the way they were approaching it. we sue these guys and we ended up winning, the first ruling ever. [applause] thank you. that's a polluting factory farm, that dumping waste in a way that agriculture waste them them into thickets of the water supply violates federal statute. we've got a court order, heading towards a court order, we ended up settling. they set up complete new protocols.

none of it will get in the groundwater in the first time in a generation the people who live there, many of them are indigenous americans, we're going to be able to drink clean water for the first time. we have a lot of cases like this. [applause] >> the last thing i want to talk about is abuse of power. there's a lot of different ways in which people's civil rights are violated with experts or quit after several different types of cases. for example, with a case in texas, with dino american guy gets arrested, is behind on child support for two months. he had custody for most of life, the ex-wife as vigilantes behind too much and arresting. three days later he is dead. seven gillibrand on top of them and they said he died of the shakespeare ever been around an alcoholic with the shakes? does not manifest themselves through enormous bruising of your chest, through broken ribs and severe external hemorrhaging. and then the guy also has boot

lace marks on his back and on his torso. he was murdered the this is not okay. the black lives matter movement is not something that's really important. it's something travelers are particularly well situated to go after. [applause] thank you. we have an anti-bullying project where we've changed the way some schools approach things. we had a case in by bush, new york, upstate new york and it turns out that there's an enormous amount of anti-semitism up there. our friends at the southern poverty law center told us there's a significant ku klux klan presence in upstate new york. we had clients, we kids would go to school who are being beaten up all the time, being called all sorts of epithets for being jewish. we had kids were held down. the school system said these kids, they need to get over this. they need to get tougher, you go to protect themselves. totally wrong. that is not an appropriate way for schools to deal with the.

we sued them. we not only got money out of the book of them to completely change the way they approach these problems. we got them to adopt this variety of things to train teachers, ho have vested have to through educational programs. every single incident as soon as there's a swastika on will have to be photographed and washed off, handed over within a day. we have a variety of different things to change the way the school operated. it wasn't just enough to get money. we wanted to have a change in the system. that's what we were fighting for. [applause] thank you. we have a lot of different situations we are going, violence against women on campuses were some schools are pretty good and some schools will try to discourage women from coming for. that's nothat's not okay. as of friday different things we can fight about. [applause] some of these problems seem so big that they were hopeless to people. when we first started working on climate change, for example, a

good friend said that's an issue that is to be. you will never be able to make a dent in that. in the last couple of years we have shut down twice now in the last two years we've shut down one of the 10 biggest carbon dioxide polluters in america. if we are able to hold coal and factory farms to actually internalize the cost of then alternatives will not seem so expensive by comparison. [applause] thank you. and if we are able bit of it by documenting the case, by pushing for government to take action, and now with the change in the, relating some cases, but going after these situations, we are going to be able to make a dip in predatory lending because a lot of the recent predatory lending has thrived and was enforcement. these problems are not hopeless. i'm filled with hope you can filled with anger. i mean, i'm filled with a sense this is a public or the way things are going by don't think it's something we have to give up on.

i think if we doubled down and take that anger enter into something positive and we fight case by case and build a story, we can change this country. thank you. [applause] this concludes our morning session. >> ash carter will speak at the can mince the sermon for the graduating midshipmen at the u.s. naval academy. watch life comes from maryland this morning at 10 a.m. eastern on c-span. later the national oceanic and atmospheric administration will issue their 2016 hurricane season outlook. will have live coverage from the satellite operations facility at 11:30 a.m. eastern also on c-span.

>> go to booktv.org for the complete weekend schedule. >> this memorial day weekend on an american history tv on c-span3, saturday evening at six eastern on the civil war. >> sherman could not have agreed more about the time he captured atlanta, his thoughts on the matter at fully matured. once again a rebel army had been defeated, and other major city had fallen and still the confederates would not give up. so rather than continue the futile war against people, he would not wage war against property. >> georgia historical society president on union general william tecumseh sherman arguing that sherman's march to the campaign was hard work rather than total war and that his targets were carefully selected to diminish southern resolve.

>> picador senate majority leader mitch mcconnell, doing some of the oldest ones in the capital like the republican leader sweet, conference room and his private office. >> i have the good fortune to actually be here on august 28, 1963, when martin luther king made the "i have a dream" speech. i confess i could hear a word because i was down at this and anti-was at the lincoln memorial. looking out at the throngs, literally thousands and thousands of people. but you knew you were in the presence of something really significant. >> and at eight on the presidency, former aides to lyndon johnson and richard nixon talk about the role of the presidents during the vietnam era. >> lbj then push about that were every single day, and that is not an overstatement. a daily body counts, the calls either to or from the situation

room, often at two or 3:00 in the morning to see if they carrier pilots have returned. >> historian h. w. brands is joined by former lbj aide tom johnson, a former nixon aide alexander butterfield who looked over the presence foreign policy. monday afternoon at 1 p.m. on reel america our five part series on the 1975 church committee hearings can be to investigate intelligence activities of the cia, fbi, irs and the nsa. testimony by cia director william colby, fbi chance at them, and as a director, fbi informants and others. >> we are here to review the major findings of our full investigation of fbi's domestic intelligence including the colin kahl program and other programs aimed at domestic targets. f. the ice events of law abiding citizens and groups, political abuses of fbi intelligence and several specific cases of

unjustified intelligence operations. spent for the complete american history tv we can schedule go to c-span.org. >> mexico position on senior health care and other issues facing people as they reach retirement age. we'll hear from former hud secretaries henry cisneros and mel martinez and two former mayors of congress. the bipartisan policy center hosted this event. [inaudible conversations] >> good afternoon, everyone. good afternoon. good afternoon and welcome to the bipartisan policy center. i'm bill hoagland. i'm a senior vice president at

the center, it had the pleasure of helping to oversee our fiscal pension health care and tax policy work. i recently came across a statistic that startled me. the are over 600 million people in the world today over the age of 65, all cards on the table, i'm one of them. remarkable in itself, that fact, but even more remarkable, it is estimated that half of all humans from the beginning of reported time who have been over the age of 65 are alive today. amazing. and now statistics and estimates can always be in error. i am certain of one thing as a look around the room, everybody in this room will be 10 years older 10 years from today. we are all living longer, and that's a good thing. but with the good news also comes some challenges, within agreed a policy issues that we

cannot ignore. the fiscal challenges to me are particularly daunting. in just 10 years, 70% of all federal mandatory spending will be associated with federal health care spending. it's also true that some of the most creative solutions to our nation's aging challenges are also found in the intersection of multiple disciplines. and that applies to our discussion today. in 2013 the bipartisan policy center had a housing commission, and they had a forthright to see that millions of americans, seniors, preferred to age in place, in their homes and communities, as a new frontier in housing. and with aging comes an obvious connection to health, and thus, a senior health and housing task force was launched one year ago to underscore the synergies

between health care and housing and fostering improved health outcomes, public and private cost savings, and enhanced audit of life for america's aging population. it seems to me too often, mike springs has been also that housing and health care are triggered as separate and exclusive areas of concern. the task force's goal was established was to help policymakers break down the silos separating the two and bridge this divide. today, you will hear that this is indeed not only possible, but absolutely necessary. this project complements a number of other efforts that we are under way here at the bipartisan policy center, including efforts we've been working on a long-term care reform, chronic disease prevention and innovation within the health care system, and personal savings retirement. add-on that final point just as an advertisement, in about three weeks on june 9, the bipartisan

policy center commission on retirement security and personal savings co-chaired by former senator kent conrad and former deputy secretary those is good administered james lockhart will reduce their extensive recommendations that have been working on for over two years, and you are all invited. today's senior health and housing force consists of two very distinguished republicans into the equally distinguished democratic members with significant experience and expertise in housing and health policy fields. former hud secretary henry cisneros, former hud secretary u.s. senator mel martinez, former u.s. representative allyson schwartz, and former u.s. representative ben weber. also been tremendous leaders for this effort with a level of technical depth unmatched and we very much thank them for their dedication to this particular project. i also want to recognize at the outset the efforts of the team

here at bpc, led by trent 11 and anand parekh, consisting of leaders in health and housing space come and i think many are here today, and just if you here, would you please stand up if you are part of that advisory group that we have? they were very helpful in all of us. thank you. [applause] >> over the next hour we will hear first from the task force members on the recommendations. this will be followed, moderate discussion with a task force led by anand parekh et al. but an open question and answer period and all of you here in the audience levitt opportunity for some questions. so at this time please welcome a wonderful friend of bpc, the senior health and housing task force member, secretary cisner cisneros. [applause] >> thank you.

bill, thank you very much for your kind words. and thank you for your service. i first had the opportunity to meet bill here at the bpc about four years ago after a career on capitol hill, and now here at the bpc where he is focused on these really importantly shows before our country. four years ago he was helping staff the task force that built with deficit reduction issues and overlap between those questions of the trajectory of national expenditures for medicare, medicaid, social security and the work of this task force overlap greatly. because what we've tried to do in this work is to find ways to shave the increase in costs by having people live healthier lives in their own homes for as long as possible. i also wanted to express our thanks to the macarthur foundation, and the crazy

foundation supported this important work and have supported the bbc's previous work in housing and an aging. over the next 15 years america's senior population is poised to grow dramatically, driven by the aging of the 78 million baby boomers, people born between 1946-1964. the first of those turned 65 and 2011, and every year, 1.8, 2 million people turned 65 years of age. by 2030 seniors 65 and above represent more than 20% of the total american population. that's up dramatically from 14% today. those over 85 years of age are already the nation's fastest growing demographic group. america's changing demographics will impose unprecedented strains on our fiscal health care and housing systems. although these challenges have

been essentially hiding in plain sight come as a nation with severely underestimated the high stakes involved. it truly is one of the most impressing domestic issues before our country. i don't think we really thought through as a nation what it will mean to our ever-increasing portion of our population not only aging and aging without resources and aging without good home circumstances. one of the biggest challenges is the need for more affordable rental housing. the acute shortage of affordable homes affects low-income households of all ages, many of whom are forced to spend excessive amounts of income just on housing. but it is particularly tragic when an older adult, often living alone, must forgo purchasing essentials, like nutritious food or medications just so they can pay the rent, just for shelter. surveys show the overwhelming number of seniors want to,

quote, aging place, stay at home as long as they can in their existing homes and communities. yet many of our homes and communities lack of structural features and support services that can make living there safe and viable. compounding these challenges is 70% of adults over 65 who will eventually require help with daily essentials like bathing in food preparation and medications management. .. large portion of household budget. in addition only a small minority of americans have long-term care insurance covering these expenses. personal expenses are critical source of retirement funding. personal savings are critical source of retirement funding but

for millions of seniors the savings will fall far short of what is necessary to pay for housing, modifications to make housing safer, long-term service and support i described, healthcare and other retirement needs. today's task force report brings attention to these concerns and offers recommendations for congress, the administration, state and local governments to consider. recommendations cover a broad range of subjects from increasing supply of affordable housing to transforming our homes and communities so they are safer and more accessible for seniors, listing the power of technology to help older adults live more independent lives. underlying all of these recommendations, greater integration of america's healthcare and housing systems will be essential, more tightly linking healthcare and other

supportive services with the home can manage running diseases, improve health outcomes seniors and enable millions of americans to age with greater options. over the past year the task force which we witness many success stories, housing providers who made integrated supporting services with the home a central focus of their mission. healthcare providers understood the importance of the home and fight for care and service delivery, local communities who deploy the latest technology to help seniors remain connected to their neighbors and friends. it is time for our country to scale up these efforts so they can become truly national in scope of. make no mistake, healthy aging begins at home. the title of our report is not just a slogan, must be a central slogan of any strategy to manage demographic challenges the head. i would like to turn the floor

over to a gentleman who has become a good friend, senator mel martinez. mel martinez was as you know the mayor of orange county, florida, he was secretary of housing and urban development, and a wonderful human being, and several bipartisan politics. and hopefully more in the future. senator mel martinez. >> i have enjoyed getting to know you and work with you and not only on this but other housing issues and like you, i hope we have a chance to do more in the future and i have enjoyed also working with vin weber and allyson schwartz.

we had a lot of productive conversations, one thing that is important to remember is we live in the current times the city lives in. this bipartisan policy center is a hallmark for what is needed in washington so very much which is ideas that bring together differing points of view, the end of the day, to find common ground to reach common solutions to move the country forward and that is one of the great things i love about doing this work. may happens to be older americans month in recognition of the many ways seniors contribute to their communities and to america. it is fitting the task force releasing its report at this time, our goal, to maximize these contributions as a senior population grows. monthly mortgage payments along with property taxes, utility payments and cost of home

maintenance, upkeep can be a major strain on the budget of senior households. for many seniors housing related costs constitute their biggest household expenditures. a major factor contributing to high healthy costs is scarcity on available rental homes. certainly in a few problems for seniors, it balanced lower income households, many of whom are older adults living on fixed incomes. according to hud in 2013 there were 11.2 million low renter households, competing for only 4.3 million available rental homes, resulting in total shortfall of 6.9 million homes, 11.2 million households in this competition, 2.6 were identified

as elderly households with no children. the rapid aging of the us population, a demand for affordable rental homes and survey the supply the supply demand line is not keeping up with current problems. in coming years millions of older americans will seek the transition from home ownership to rental housing. demand for rental housing will intensify even more with greater numbers of seniors suffering severe rent burdens. by 2025 the number of renter households age 65 to 74, 75 or older who will pay more than 50% of their income on housing will rise by 42% and 39% respectively. as we say in our report affordable housing is the glue that holds everything together. without access to such housing

and stability it becomes increasingly difficult to introduce a system of home and community-based support that can enable successful aging. to help increase supply of affordable homes for older adults the task force proposes significant expansion of low income housing tax credit program. the housing credit is a 30-year-old program that encouraged $100 billion in private investment in affordable rental housing. it is proven to be a great success helping to support construction and preservation of more than 2.8 million affordable rental homes including hundreds of thousands of homes for seniors. as cochairs of the housing commission, we called for a 50% increase of federal support for the housing credit. therefore we were very pleased to see the chairman of finance, senator hatch and senator cantwell also a member of the

finance committee released bipartisan legislation mirroring those recommendations. other organizations have called for high levels of additional support. what is clear is the greater private investment in affordable housing is needed more than ever and the housing credit is indispensable to encouraging this future investment. when i served as hud secretary i considered the section 202 program to be one of our most successful initiatives. many seniors who served on the program are at risk of institutional organization, and supportive services available to them, nonprofit sponsors of the project enhance the lives of literally hundreds of thousands of lower income seniors. since 2011 there has been no funding on section 202, or rental assistance for new units.

and is it time to do something different, with seniors supporting housing that uses project-based rental assistance and the housing credit to finance new construction and attract funding from healthcare programs. our approach drawn from recent reforms to section 811 program is designed to ensure a broader set of actors has skin in the game, not just the federal government, mission oriented not for profits but also state government and private sector developers. by requesting states that commit to funding healthcare the approach suggests would promote the more integrated healthcare and other services. the task force spent time examining the impact of regulatory policies including housing for seniors. this is an issue that deserves more attention than it typically

receives. something i worked at at hud, a big problem in our country. we heard statistics that in florida, 40% of the cost of an affordable home goes to governmental costs permitting impact fees etc.. it is a real serious problem. i displease the financial services committee held a hearing on this issue last march, the national association of homebuilders recently pointed out on a national level government regulation is 20% of the price of a new single home. if we close the supply gap federal regulatory policies must work to encourage, not stymie the production and preservation of the affordable homes. state and local communities must embrace permissive land-use policies that encourage alternative housing structures for seniors such as accessory dwelling units, micro units and

congregant homes. these policies must be a win/win for everyone, expanding the supply of affordable housing options. the bottom line is we need public and private sectors to recognize the need to help seniors age with options in their communities. i want to conclude the issue of senior homelessness, the number of homeless seniors is projected to rise nearly 59,000 by the year 2020. the task force believes one of the wealthiest nations in the world, in which so many older citizens live on the streets without adequate shelter and appropriate care. preventing ending homelessness among older adults should become a major national priority and to help this effort the task force recommends the us interagency interagency council on

homelessness adopt an explicit goal to prevent and end homelessness among older americans in the near future. now it is my pleasure to turn the program over to congressman vin weber to discuss our recommendations to transform our homes and communities. vin weber? [applause] >> thank you. this is my first project with bipartisan policy center and it is my delight to work with henry and mel and congresswoman schwartz. we were on the congressional side of it and the executive side. i want to say what a delight it has been in this first experience to work with staff of bipartisan center all of whom are genuinely dedicated mission driven people. we can be proud of the work we have done and other projects that are emanating from this

place, special notice to my friend bill hoagland who made some reference to his own approaching senior years since i can tell you bill and i have been friends for 30 years, that tells you about my age but it is a delight to work with these folks. i think before i get into the specifics and i will i want to say one of the things we probably said to each other every time we met, a telephone conference call or anything like that was it is the case that america does not understand the magnitude of the problem hitting them. and if you cut through the recommendations and analysis, leave you with that, that would be the thought we face and we kind of know america is aging. we know we -- the country does not understand the magnitude and difficulties they are going to face with the huge number of

retirees and aging population in the coming years. in the course of our work, decided to do a lot of it, we are here to get input from around the country as well. those were very successful efforts. we convened last september a panel at the humphrey school in my hometown of minneapolis, minnesota and congressman schwartz, the same thing in philadelphia, in march of this year, try to get perspectives from different folks with different areas of expertise in those places and take and put in a number of ways as well. one thing we can say is the nature of the communities in the country may differ but the problem exists everywhere. there is no place that is immune from this program with the aging of america and the number of and prepared folks in communities facing it.

the overwhelming majority of seniors seek to age in their own homes and communities and over the next 15 years they are not going to be likely to do so. there will be a mismatch between this desire to age and the ability for a number of reasons to do so. i can they from personal experience this is something very close to me. within months of launching the task force my siblings and i, my mother from an independent home into a retirement facility. i don't have problems with the care but the wrenching difficulty of moving someone out of the independent home where they have been living into a facility is enormously difficult and sometimes it is unavoidable but there are things we can do to make it possible for people to stay longer in independent living. most homes lack the critical design features that allow people to stay longer. according to one study, 3.8% of housing units in the united

states are suitable for individuals with moderate mobility difficulties, at the same time communities, individual homes lack senior friendly infrastructure such as accessible transportation, well-maintained streets and well lived and a formal housing close to retail stores and services which you can see in our recommendations recommendations that are aimed both at the individual residences where people live and at communities in which they live are part of the problem. large part of it is the personal level i think we are all becoming more aware of, household finances. over the next 20 years nearly 40% of individuals over the age of 62 are projected to have financial assets of $25,000 or less. 20% of those over 60 to have $5000 or less. this level of savings we can tell is woefully inadequate to cover the expenses of daily living.

never mind the cost of trying to adopt a structure to the problems of an older person. to accommodate this desire to age in place, it is obvious new solutions and approaches will be necessary and will be adopted. we talk more about the possibilities of that later and we offer specific recommendations. for us, it seemed best to start with existing resources more effectively. we have numerous federal programs of which you are all familiar to provide resources and expertise for home assessment that modification but there is very little coordination, inadequate coordination among these programs and public awareness of them remains limited. the task force to address this problem recommend establishment of a new modification assistance initiative to be administrated by the department of health and human services administration for community living, in this initiative, they have federal

efforts, the inventory programs, and homeowners and landlords to rent to seniors. the initiative would serve as a resource center to inform the aging national network of federal, state and local agencies that provide services to 11 million older adults annually about resources available for home assessment and modifications and we are pleased to congress with a little bit of recommendation did authorized the older americans act earlier this year which supports the aging network. the task force recognized cities and states establish and expand programs to assist particularly low income seniors to property tax credits, grants or forgivable loans. 80% of modifications for aging are paid out of pocket by residents. local governments can release the burden by making funding available to help with these modifications. in my home state of minnesota

the congressional district i represented, a lot of real people that come from a rural area of the country and many of you know we have a disproportionate and increasing share of seniors living in rural communities across the country. 15% of residents in nonmetropolitan regions are 65 are over compared to urban areas and often lack the support network you would get, the us department of agriculture section 504 program is an important source of funds for single-family home modifications for low income rural seniors but the program is a little bit outdated so we suggest a number of ways to make section 504 more effective streamlining the application process, providing better facility between the grant portions and increasing the $7500 borrowing threshold requiring a lean against homeowners property. let me conclude by saying a report does not have all the answers but it is our hope to

spark a national focus on these important and difficult issues. it is my belief that when we face a problem of this magnitude, eventually there will be a response. it is important in our view that we start planning and effective systematic well thought out response rather than dealing with it is a crisis when it is upon us and i will pass the baton to my colleague and friend, congressman allyson schwartz from pennsylvania. >> thank you. i am pleased to be with you this afternoon and to have participated in the task force at my first opportunity to work directly with the bipartisan policy center and wonderful colleague, good way to do this for people. we had lots of discussion and we were able to come to some very

important recommendations so we hope policymakers will take very seriously. thank you for the opportunity to do this. i want to share a quick comment before i start my more explicit remarks. you heard it from my colleagues. this report has a great deal of information. a lot of important facts, the numbers are very real, not exaggerated by any means and they will matter in each of our opportunities across the country. it is more than that. it does point out solutions open to other ideas as well, but very specific recommendations and solutions and it really is a call to all of us in housing, in public policy, outside our silos and begin to understand the interaction between health and the communities and homes we live in and a great opportunity that exists to better understand that. one of the conversations going

on around medicare, medicaid as well, to understand how important factors other than what we considered traditional health factors, certainly seniors come beyond healthcare itself the influence on health status has contributed, premature mortality, that your home, your place and community you live in, your physical environment makes a great deal of impact on your individual health. housing takes on greater importance for older americans since they spent a great portion of their time in their homes. the home is seen as potential site of care for seniors to receive help and wellness services and an essential tool for carrying those chronic conditions. by virtue of rapid expansion of the senior population, more and more americans living with

multiple chronic conditions and experiencing limitations of activities of daily living and what statistics are in the report seems pretty stunning. 68% of medicare beneficiaries have multiple chronic conditions and as a result 93% of medicare spending is spent on these people. understand spending on chronic multiple conditioning, providing care for seniors for multiple chronic conditions in their home has potential to improve healthcare outcomes and reduce healthcare utilization and cost in significant ways. to give you some examples, there is evidence the proposition works. it is growing and catching attention around the country. vermont senior services at home model is demonstrating how housing when combined with

supportive services can slow the rate of growth in medicare spending capable of federal trial at johns hopkins university showing how home intervention can at risk seniors, these are positive development and meeting challenges we face with communities across the country and pretty exciting and intimate ways ringing healthcare and housing even closer together and building on the strong foundation that has already been laid. it is really key. we have to accelerate integration of health and housing. it is about scaling it up. figuring out what is working, and going to much bigger numbers, the task force identified several important policy opportunities including national healthcare system who have to be part of all this.

the public ensures medicaid and medicare, the private insurers including medicare advantage plans that have some flexibilities to tackle these issues head on and healthcare professionals doing all our institutions. quite simply our report is a call to action. the entire healthcare community, when caring for older adults and i want to go through a few opportunities, more in the report, to name a couple key ones. first, the most vulnerable seniors, those who enhance care coordination including those who are senior. for example, 1.3 million older adults, policy subsidized housing. the vast majority of whom are dually eligible for medicare and medicaid which means older and

poor. the centers for disease permit medicaid services, and center for medicare and medicaid innovation, in coordinating health care and long-term care services and support for medicare beneficiaries living in public housing. under this initiative healthcare providers and partnership with housing entities would implement evidence-based care model and programs and be accountable for improving healthcare outcomes and reducing cost. eligible applicants would receive advanced payments. an amount for beneficiary on a monthly basis which would be used to make important investments in care coordination in infrastructure including supporting housing based service coordinators. second is an opportunity to

prevent poor health outcomes in seniors. consider very specific example, one that i think will capture attention, one in three older adults fall this year and not just fall, but fall quite dramatically. it results in 2.5 million emergency department visits each year, 700,000 hospitalizations, and $34 billion in annual healthcare costs. it is very disruptive and very difficult and sometimes life end chang -- life ending experience. many of these are preventable and yet most falls occur in the home. that is why we strongly recommend medicare and other federal agencies make reducing falls for seniors atop priority.

opportunities exist to incentivize and provide technical assistance to help reduce falls. cdc -- not spelled correctly, steady tools for the great resource in establishing best practices. also look particularly in other systems, providers held accountable for providing support and also opportunities to support community-based prevention programs and support public and private sector efforts to modify homes that are talked about and we should be helpful in terms of fall prevention. the upside is enormous. the report issues around fitness and movement and things, maintaining balance as you get older, is a real issue. things that you can trip over far too easily.

simple examples if you have an older adult in your loved one's family and see what you can do about that. the third example is the task force spent time examining the role of technology in helping to play a role in improving successful and healthy aging. for an online survey to 179 stakeholders and asked the question which technologies are most effective and scaleable and what health outcomes can be achieved? interesting results of this, we have resulted in the report, older adults and caregivers and healthcare providers benefit considerably like telehealth,

and improve health outcomes. and barriers and high cost to consumers were reduced, difficulty in licensing with these requirements to prevent adoption using these technologies and barriers should be removed and attention on the hill to telemedicine. let me close, an enormous opportunity, and every one of us knows someone over 65, some of us, even ourselves, let's do it in a way that improves health status to reduce cost, to enable all of those to age successfully. [applause]

>> good afternoon. i want to thank all the cochairs, and moved to the moderated discussion part of the event. join us on stage. >> very important. >> we are hoping we have some time for question and answer today, a couple questions are on the mind of many of you in the audience, many of you watching, we should jump right in and begin with you, henry cisneros,

talk about the cost implications, many of the recommendations has implemented could result in additional expenditures, but that could lead to savings over time particularly with respect to the healthcare system. how would you frame discussion of cost with regard to these recommendations? >> let me thank you as the leader of the task force, and nikki rudnick who had responsibility and the researchers and writers associated with this. i ask those folks to stand to recognize everyone involved in the writing group. [applause] >> a good part of the impetus for this report is in fact increasingly aware of the role

of demonstrating the cost curve expenditures on the federal government and other levels of government. three of the most important drivers of budget deficits and the function of the population is aging as dramatically as it is, 78 million baby boomers, causes the rate of number of people of 65 years of age or older, in the next 20 years or so, the people over 85 to triple, those years advanced and the most expensive years being the final years of a person's life where they find themselves in the most expensive housing they will ever have with the most expensive medical care needs. anything we can do to shave off

the increase by enabling people to stay at home, less expensive than other care and to have the ability of homes, care at home, piece of mind at home that allows us to be healthier at home. all of those are positive aspects of what this report speaks to. it does cost some to expand on home services and create support system of home care specialists that our country is going to need, but the expectation is that those costs are less than what can be saved in shaving off the cost of increase for the most expensive form of care. there have been numerous studies done over the years. one specifically at stanford spoke about trying to create a plateau followed by what they

call compression of the years of morbidity. standard expectation about aging is beginning at 60 or so there is a steady decline and cost increase over a steady period. professor james freeze at stanford expounded a logic to find ways to keep people on a higher plateau for a longer period of time and there is a shorter period which we all concede to the frailties and realities of life, hugely important in terms of creating a dividend if you will for the country. the concept are all implicit in this report. been mentioned personal experience two summers ago, my mother lives in the home which she and my dad bought when they

were married, raised five children, 69 years in that house and could never be talked out of leaving that house even when my father died, we talked about moving elsewhere, it would have taken dynamite to blow her out of that house. it was her garden. she knew the birds in the neighborhood, it was her house. she fell down in the summer of august 19th -- 2014. it went downhill from there. she was 90 years old and we lost her by november. there was a four month period that was very difficult, but she had been at her home perfectly happy, functional at 90 until that. i lived through that, the implications of putting people, keeping a person sustained in a place where they could be happy and there is that inevitable period of time that is difficult.

if we could create those circumstances for more americans they would be better off from a budget standpoint, better off as well. >> thank you. another question for mel martinez, you may want to start with the role of the private sector in expanding the supply of affordable housing for seniors so we know about low income tax credits, you spoke about it today, very successful in covering the private sector investments and other recommendations in the report that engaged the private sector in affordable housing preservation and home modifications. how do we get the private sector more involved and do you think these recommendations will help? >> these recommendations strike great balance between potential for savings henry has been talking about in the investor community, things that would be considered as interesting as low

income tax credit. he is the father of that tax credit, the birth of the tax credit, put it that way. what a success it has been over the years because a tremendous desire for investors to find opportunities for the benefit they receive with the tax credit, some of these recommendations like home modifications which make a home more suitable for someone to live in the home until they are 90. and henry's mother's case. often that is not the case because of the strain, the steps, so many things. the other thing we have to consider which would be a tremendous opportunity for aging is the use of technology and the role of technology. as we look at that we have to remember that not-for-profit sector and private sector are both to be engaged in a way that

i think creates a more sustainable program for the long haul and something we could get done in the short run. when you have the experience we had in the local government arena it is about engaging not-for-profit, private sector, those communities in partnership with government that can make things happen and come alive. that is what we need to replicate and not just look to another program but how do we make things work in a better, smarter way. i think low income housing tax credit, how exciting the recommendations we made a couple years ago have been picked up by senator hatch, chairman of finance and senator cantwell, bipartisan opportunity for something good to happen in an area where over the years so many times people involved in the program say i would invest

thousands, millions more dollars if i could have an expansion in the tax credit program if there was more opportunity. keep that in mind and be smart as we go forward in thinking of solutions for the long haul to make this a more sustainable thing. we also need to realize the enormity of what is facing us will require all of the above, not just going to be up on the hill and not just going to be not-for-profit but the entirety of where country resources are in order to get it done in a way that is sustainable to meet the tremendous challenges we face. >> focusing on healthcare, allyson schwartz, the task force makes a number of recommendations estate medicare agencies, advantage plans, nonprofit hospitals in addition to the recommendations you outlined, with gradual shift in healthcare we move from volume to value. the healthcare sector is increasingly looking outside the

study to realize outcomes and lower costs. is this finally the time for housing in the home setting to become a top priority for healthcare? >> exactly right, it is a great deal of conversation about all of the social, environmental, situational factors that relate to healthcare and healthcare costs. can't get to the hospital, can't get to the doctor in a timely fashion and they can't actually make it there. nobody delivers in their neighborhood. someone who is afraid to fall through, just heard a story about cataract surgery, no one could take care of him when he got home. until finally, a really good guy, medicare advantage plan, the fact that someone went to his home, talked to him about it and come back and help with

those eyedrops, make sure you know what is getting done and had the surgery, successful outcome and he obviously dissolved the problem. that can happen over and over again. and referring to community partners, providing services in areas on aging, send caretakers into the home or understand social service needs on families that are not smoothly functioning as others. they are also saying this is stress on the system to provide all this care so we do need to begin to think about some healthcare dollars, clinical visits in the home is one that is very different, wonderfully successful with nurse practitioners, nurse clinicians and other healthcare providers and a few doctors making house calls back again and getting the

care where that person is and not requiring the health center where doctors -- densely urban or rural area. it is an interesting time and a time for innovation and making sure the financing models enable this to happen is extremely important both in future service and managed care because we know these continue to grow and have a dramatic impact on families, and successful and healthy aging. we can stay healthy longer and many, 10,000 every day, certainly hoping that will be the case and relying on policymaker is not to talk about community partnerships but to be able to do it and some of that

relies on medicare, payment for those services and looking at what happened around states where medicaid is a successful program and one in pennsylvania to talk about, really looking at the best practices and scaling them up. >> i want to ask one more question likely on the minds of the audience. vin weber, we are living in interesting political times, the final six months of one congress and administration, in the midst of a colorful presidential election, soon to be a new congress and administration. >> such diplomatic -- >> how feasible is it for this for the next congress and administration to take down the recommendation? >> that is a good question. i think there are a couple

reasons that might be negative about that. what is the general dysfunction we have seen in washington around all issues for several years and the other more specifically is the inability of congress to come up with big ideas and budgetary problems. we can talk about this for a long time. both of those things are going to get better from our standpoint. it may not be true for every policy area but in terms of the dysfunction of washington we could talk about it all afternoon. somebody remember the famous economist herbert stein, chairman of the nixon administration, had a famous saying and unsustainable train will not be sustained and there is a lot of truth to that. we keep saying we can't go on like this forever, we can't go on like this forever. the truth is most members of

congress, as allison -- allyson schwartz will tell you, don't like the fact they have not been able to do it. talking individually in small groups or away from cameras they really want to accomplish some things and i do believe there will be a shift in that. i don't know what precipitates it. maybe a new president, usually that precipitates something. that will be possible. in terms of doing the things we talked about today, one very basic fact, politics drives policymaking in this town and the average age of the average voter is going up up up. that is the other side of the coin we have been talking about. the political potency, senior voters and those of their kids who have to deal with these problems is only becoming more and more salient. there is a constituency to accomplish this. i really believe in terms of doing the things we talked

about, the broader range of proposals and policy changes that need to be put forward, the biggest problem as i mentioned in my remarks is not that we won't do anything but we will do it later than we should in an unthoughtful way and in a costly way that crowd out other expenditures in the federal government. i don't think we will go on time not responding to the problems of this vast and expanding part of our constituency, all of whom are voters, you could do it wrong, you could do it in a way that is too expensive and you could do it in a way that subordinates every other priority in the federal government because of the price tag attached to it. we will do something i think of great value to this task force, to put it on the agenda in a bipartisan way, encourage

thoughtful action before it becomes a tidal wave. >> add a word to that. i have been associated with four bipartisan policy center's and in my view this is the one that has the most say that demands action and has the potential to create a real bipartisan consensus on action because this problem, there are almost no words to describe how potent this is for the country. if you want to put it in the most romantic term cities and has national security, their won't be money for other priorities but beyond that as a population ages the very character of the country itself will change especially if we leave people destitute, leave them with indecent housing and

conditions where they can't live healthy. this is a global problem. we are seeing japan declining in population, the european nations growing smaller in population and aging dramatically. some will confront issues related to any wedding that requires younger manpower like military service, social security health systems etc.. the whole peer group, to start these questions. the sadness of watching people live their whole life for a variety of reasons haven't ended up with enough money at the end of the day, many of them minorities and marginalized, years of their life they are the

most frail and most dependent, few support systems, just not fair, not right for a country to have planned so badly that we leave people in that condition. this is truly a powerful need to act. >> experts on housing, the healthcare policy, there will be discussion about the concerns and costs around medicare and medicaid. what is interesting about the proposal is healthcare system itself think differently about the factors and thinking much more. what was interesting about this is it brings together, the housing is really about

community. many seniors say in their community, thinking about communities, if i'm stepping on the toes of the next half doing a report by the policy center but the idea of what kind of communities we want to live in that support and sustain older americans and older adults and families and kids as well. quite a bit of overlap. where is their supermarket? is there public transportation? are they a variety of houses with different affordable levels and housing that can be accessible for seniors with disabilities, pushing strollers and it works for you too. it is interesting to start to think about this as we did in a broader context, bring down health care costs means thinking about our housing and our communities as well and i appreciate that as a healthcare

person, to be able to hear that from much more that can be done when we think about housing and the home as a place where seniors live. >> we are right at our 3:00 hour. mel martinez needs to leave at 3:00 but i do want to leave it to one or two questions and then we will be ready for closing remarks. that roaming microphone as well. >> i am a clinical psychologist. in addition to medical care and shelter, social interaction is critical for a healthy life. i wonder when people stay in their own homes and get less and less mobile how that is accomplished there is a village movement that is important and i want to know your comments on that. >> a great deal of awareness,

the home is the site of political care, something that might not have seen someone all day or several days or have a chance at a social direction and it is a great deal of interest in fitness but realizing getting out of the home, getting to a senior center, get to a wine tasting, it is not only about getting there or the exercise or learning about nutrition but what the experience offers you, to do some of these activities in a group is also extremely helpful. we have known this a long time but the idea that you can live healthy lives without any social interaction is difficult and the healthcare sector has to be

aware of that as well. group activities, encouragement to participate in that. some of it starts getting into the home, assessing the home situation, assessing the social situation with a particular beneficiary. >> i will make a couple quick comments and scoot out the door and answer your questions because i can just read you mine. we are not mandating people have to stay in place and i have seen it in my whole family, that perhaps social interaction can make an amazing difference in well-being but it is an option. for those who can and want to. having a community center in walking distance we want to make that option available. as with energy policy that often established all of the above, the second comment is i don't know many people who have gone

to the hill who go through the gauntlet of an election to come to washington to do nothing. i can think of one senator actually. other than that, one exception. i should have left before i intervened. the idea is people want to get something done. they want a way to make the country better and when you look at the overwhelming nature of what is upon us i really do think that is the chance. following comments, i thought they were so appropriate, this is something that i think we can move forward because it is not just another program, not just let's spend more money, it is a comprehensive number of ideas that attack this problem from many different ways so i do hope and i also hope -- with that i have to excuse myself. thank you very much. [applause]

>> we will take one or two more and we will need to wrap up. >> what we described goes across the board of age. as we get older and also income. we talk about using existing resources. most people age in their own existing single-family homes and that is where modifications need to occur but when we talk about solutions we always talk about low income and most vulnerable. i know that is important but there are more people in the middle income areas many of whom have resources that with the right incentive could be leveraged to make better homes. i wonder how and when we can start to also include middle-class solutions. we have better opportunities to make good use of dollars. >> this report speaks to that in

several forms. one is a recognition of the need for more appropriately scaled and accessorized new units for persons who are aging, people leaving mc mansions for the suburbs to find something more suitable sizewise, the widow after her husband passes for example or aging couple or any number of family configuration so that is one issue. the other is accessorizing homes that were not suitable when they were built because they have too many stairs, the lighting is not correct because people have to reach up to cabinets they can't open because they are too high or because they have a knob that a frail wrist can't turn. they need a handle instead to pull it. they need bathroom pictures --

fixtures that are appropriately sized. all of those things we need to figure out as the country how to provide for people to convert their homes into homes that are appropriate for their age. we have done a great job in our country with weatherization of homes over the last 35 years. we faced an energy crisis and decided we needed to feel the loss of heat from houses and prepare them for winter and we have done a fabulous job with weatherization programs. why wouldn't we try to do a homes for life conversion? a lifespan home conversion with assistance for people to make those kinds of changes so they could stay in their homes? that is what is discussed in the report. >> one last question. >> i am jennifer hill from hud. a few things from where we sit. we are convinced their won't be a partisan solutions. thanks for giving us the

bipartisan frame. we can see so clearly before it strikes and so rare that happens so we have clear agreement on the facts that are not always the case in public discussion and we need to maximize the fact there are agreement on the facts and finally aging is universal aspiration and as such it has the ability to make a broad-based consensus because everybody has the story of what happened with a parent and considerations of what happened so we are very interested in what the solutions are for america. and we are concerned about the amount of mortgage debt that people are taking into retirement and we wonder if that is something you thought about addressing in the report. the other piece we are thinking

about our on these home modifications to so many homes that are not modifiable, what does that mean? many people are going to have to move. as we are building are we building senior housing? are we building age friendly communities that include affordable housing? >> she knows more than i do. >> a couple things. they are building prototype homes that are house for all ages. you put in a grab bar in a restroom, need not be a deterrent for younger people for that home but you don't have to