alaska on opiate challenges and harrowing challenges this summer , we had very top doctors from the virginia come to alaska for that. doctor lee and doctor drexler, so i want to thank both of you. i want to focus on an area that i do not really see in a lot of the recommendations but i know it's in there because it's an important topic. when you talk about delivery of care, the issue that i'm very focused on in alaska is the delivery of care in rural communities, extreme rural communities. mr. chairman i know i'm sorry i missed that and having the secretary and doctor here i know they're still here, the the gentleman be able to chat at one of the breaks or something on the travel sharing agreements

that are concerned right now. it relates to this issue. i was back home in my state over the summer like all of us, in a lot of the communities there seem to be a very different approach to delivery of healthcare in some of the far-reaching communities in alaska that we do not have roads , or we have unique challenges given the size and distance. some of it relates to how the virginia interacts with other health organizations and clinics, tribal organizations in the far-reaching communities. one of the things that i saw because i asked everywhere i went. i went to a number of my communities, there there seems to be a very different standard depending on the community even depending on veteran sitting next to each other. i always meet with veterans no matter where i am in the state. some said i can go right down

the road to the local clinic or the local native with organization. others say say i have to fly to anchorage or seattle and that can cost thousands of dollars just to get from some of the different communities in alaska. some say the virginia pays for all of that and puts us up in a hospital another say you are on your own, literally in the same community. so i'm just wondering on this issue how much he looked at it what recommendations you have. more broadly with regard to consistency and delivery. it does seem very different, even in the same communities, different veterans have very different experiences. >> first of all i think what you are describing is the challenge of veterans health care system that is so diverse and covers the entire country. to be able to provide meaningful access in every single part of where veterans live and work.

so we felt that was one of the major driving forces for a more integrated model so that in communities were virginia facilities may not be available that there is easier access to integrate with existing providers within the community. we also felt there is a need for better integration with other federal providers which could apply certainly within the native american community across the country. the consistency of care frankly in this country applies, the challenge you describe is true with veterans and non- veterans. northern michigan we have access issues. in some areas we have no ob services within 200 miles for for women who may be trying to deliver. it is a challenge. that is one of the reasons we feel it's important to take a local look in each market to try to provide better access. the question of why some veteran

has virginia pay for, others don't that may be an eligibility determination which i cannot respond to. really looking at the diversity of markets and how to best provide the care, particularly when veterans are moving. it's it's not as if that veteran population is stable. the facilities available in each market are variable as well. some may have outpatient facilities that accommodate a lot of it needs, some may not. the need to move from inpatient to outpatient care is something we see across healthcare today. it's a a challenge. surly something we have conversations about. >> are there recommendations that relate to this in the commission report? >> the concepts of the virginia system incorporate some of the questions u.s. >> does a focus on extreme rural communities? >> yes. >> thank you.

>> thank you senator are you okay on time? i'm going to go to senator blumenthal next. >> think mr. chairman. i want to thank you for all of the time and energy that you devoted to this very important work to both of you. mr. harvey, i think you raised, and passing one of the simple questions that faces us, why have a separate virginia healthcare system and i think you have heard some answers here which we see in our daily, literally in our daily lives when we visit virginia healthcare facilities, not only do veterans want to beat with fellow veterans, but there are ways that veteran care is tremendously enhanced by professionals who see them

literally daily, hourly, for the same kinds of wounds, injuries, and so forth. i might just add, in an area that is receiving more research, there is an article yesterday in the new york times about the study being done on hospitals and measures of their quality and how when consumers are better informed not only about the metrics of outcomes but also about how they are cared for, actually the outcomes are better when the emotional or social factor is part of the measurements. i think in many ways i see the virginia healthcare system is not, and i think you share this point of view, why should we have it, but it offers the immense opportunity potential to

actually lead the nation in terms of quality because it provides that opportunity to attract the best and the brightest as it has in certain virginia facilities. the challenges it faces as i think one of you stated in your testimony are the same challenges the rest of the healthcare system does. winning more primary care doctors, more psychiatrists, psychiatrist, more equipment, at more affordable prices. more pharmaceutical drugs there we can negotiate but rising healthcare costs is a challenge that mirrors the rest of our system. what i have not seen so far and maybe chairman you can talk a little bit about it, consumer

protection, making sure that that there are policies and procedures designed to monitor the quality of care that veterans receive outside the virginia healthcare system. the metrics and the evaluation can be applied to the virginia healthcare facility but what about the healthcare outside the virginia walls when there are choices offered with the choice program comes into play in whatever form it may. >> a couple of comments in response to that. one is is that the more unified and integrated the so-called outside providers are within the virginia system, the greater the opportunity to evaluate performance, set clinical standards, and apply the same approach that is within

virginia to the care that is received within the community. that is a very important important and different concept than the choice concept or the way the virginia has paid for care within the community. within our recommendations we also suggested that performance metrics need to be comparable. we should have really the same metrics of performance within the community as within virginia. in those metrics should be a requirement of participation as a vetted provider within the virginia system. i think the more that becomes the model it begins to delay some of those fears about care being provided differently. weather is a sure pain management and opiate use or other elements of care that are provided. >> mr. harvey did you want to add anything. thank you for your service. >> the only thing i would add senators that you have mentioned and we address this part of a report that the business of cultural competency of the healthcare provider.

understanding this veteran has a particular type of experience in being sensitive to that. as i said perhaps when you are out, i note that the virginia has a card they suggest using with various questions to ask the veteran patient to elicit some of the experience so as you are factoring this into the diagnosis and the analysis you are getting at the dr. you have that. so cultural competency and understanding the military background is an important thing. you get through a system like the virginia, you're not going to get it at washington hospital center. >> exactly. thank you so much. senator bozeman and then we'll

go to panel three. >> thank you for being here for your work on the commission. before i get started i want to think senator mcdonald and his team. mr. chair, we had a meeting last week, senator mcdonald and a lot of people here were in my office given me an update on the transformation of progress on the breakthrough priorities. i think it's great work and have confidence in what they're doing. have to give special thanks to senator mcdonnell coming to my office the following day to give me a report on toxic substances program. i think we're making progress and i appreciate the continued work. thank you both for being here. i'm going to jump to three recommendations were think the virginia may have some concerns and i may understand why.

i noted that my staff took and one note on discussion of privatization. i never miss an opportunity when i see a word privatization never mentioned to mention that i do not believe the virginia should be completely privatized. , and a story. i don't know of any u.s. senator that feels a full privatization is a good idea. i think there's an opportunity for veterans to choose and what we should do is create a system that lets a better and choose whatever pathway that is right necessary to provide timely care. i believe we agree that. i say say that because anytime i see privatization there somebody who says they're some senator that wants to give it to the private sector. i think there's a therapeutic value to some virginia presents veterans being among high concentrations of veterans and until i see to the contrary i would never supported. on the other hand, i think there are opportunities to use non- virginia providers in choice and that's what were getting it. recommendations for has to do with an engineering resource center a place to work in management consulting and i think the virginia may have concerns with this. probably less to do with the end result and martha process.

we have a lot of centers of excellence that are emerging. i visited national there's a new icu liberation campaign. i did a surprise visit actually and visited with them, they're very hospitable and i was impressed with the results. it results. it is one of two programs on the state. as a management consultant i would be less interested in creating other groups and organizations with managers and communication channels and ways to create a web of subject matter is parties and centers of excellence that we can leverage. that probably has less to do with the concept of more to do with the implementation. i will get back with the department. you have any comments on that particular recommendation question. >> i think we have heard in terms of the response that perhaps the -- which is the specific component of the virginia that we recommended be the center of this performance improvement work and may not be

the choice, which that is certainly not a big issue for me, but i think the focus clearly was on how to drive a performance and provement culture throughout virginia and focus on clinical and business process improvement. >> i think there is a lean process design that was in my state, and i see some best practices that we need to proliferate i did want to move to the board of directors when i was probably the one that you don't have me. the reason for that is that i feel like this committee is the closest thing to the board of directors as we should have. if we add that other layer i would be interested in your feedback and why it's different, but but if we had that other layer than i think we could have leadership and get monthly

updates from two different groups potentially. i don't know if that is necessarily productive. i enjoy our monthly flogging and would not want to share that with everybody. but in all seriousness i think it is something we should look at a may able joe down more the recommendations. but i worry about if we have that layer down i think it could be another level of extraction that can move members particularly members of this committee and members as a whole from some of the details going on. i've invested over the last year a lot of time with the leadership and transformation. i think the more we learn about it and the more we measure week to week progress the better off we will be. i would have to learn more and read more into the recommendation to make sure it's not putting us further away from the line of sight that is helpful. did you have any comment there and i don't have any remaining time but i will follow up on recommendation 17.

let me put it this way, on paper i think no one and senator blumenthal has been great on this issue. i think there's no doubt there veterans who should probably receive care because the nature of their separation was related to an injury or event that occurred. their behavior was driven by something that was maybe a temporary injury or a permanent injury that we simply didn't know. we talked about it before, shall shock whatever we used to call it in the past. it's more about the implementation and making sure it does not disrupt the virginia from the thinks are trying to get to with the people who are in the system and who deserve care. we want to work toward the same goal it's more the means rather than the ends. >> continuing, we appreciate you all very much. we appreciate the ideas you put forth i think it's very helpful.

in your testimony you talk about the ongoing leadership challenges facing the organization, completing a culture of risk aversion, separate from your recommendations regarding the board of directors and under the secretaries appointment process i would like to get your thoughts on how vha can get after the risk aversion and distrust issues. that's a difficult problem. also as you do that comment about, we have heard a lot about the senior leadership in conferences and workshops, to have any thoughts as to if those are working or not working or if we need to change those also things like the diffusion of excellence, is that getting down to the short tank competitions,

is that getting down to local level the weight should? and then again, what other steps that we should be taking to try and improve the culture which is a very important. >> it's a very important question something the commission spends a lot of time on. i would just just say first that i think secretary mcdonald and undersecretary -- are making significant progress. i think the worry we have is not so much the leadership development work going on, it is having continuity at the top for more than a couple of years. it's very hard to change culture when you don't have a consistent pattern of leadership. at all levels starting at the top. our concern was how do we have more stable leadership, oversight with expertise and that was the reasoning behind the governing board if you will, the board of directors is to have healthcare expertise overseeing the transformation process with stable leadership in place, that is how culture begins to happen in a positive

way and people start to take more risk. there's a culture of safety around speaking up which is critical in any transformation. those were the ideas that we really tried to move forward in our recommendations. >> in the short time. >> those things are great, i think they're fantastic and in fact i know they're working with a professor from the university of michigan who i know very well. i taught taught him his class. he's terrific. and what doctor has done to really engage the teams is fantastic. >> mr. harvey, you highlighted the long-term challenges the virginia has had with it solutions. >> yes or. >> particularly related to scheduling. could you talk about that. as you mention we spent several years trying to get a scheduling system. lots of money. what is your sense regarding the

vha's future willingness to consider off-the-shelf solutions , again how we make progress on this? >> let me start by saying we met with the virginia's chief officer laverne council, i personally was very impressed and others i have spoken to within the virginia who know that part of the world have been impressed by her confidence and experience and she brings a lot to this. my concern is that the va, for reasons not entirely clear to me seems to have just had a terrible time getting it rights. so what we are now saying is that you should do this very complex system, commercial, off-the-shelf that will do health records, it will do

payment business practices with choice doctors, it will do coordination with the veteran administration and it will do scheduling and all of these things. proof of concept is something i would like to see. i really honestly don't think they would be able to do all of those things right now. since in fact they have not been able to get the scheduling just that one part right. the vista system which is the electronic health record is an old system. it was one of the newest when it came in, it was the best for a long time and it has been replaced by other systems and transitioning to some other system that can do these other things is good to be a huge jump. you want to do it right because it is going to cost lots and lots of money. >> thank you mr. chairman thanks

to both of you for your testimony and for your months of hard work on the commission. we are going to make sure this is not a dust gather on the shell. this is a thought-provoking that results in what we need to bring to the virginia and we appreciate your service very much. >> we will immediately welcome our third panel and look forward to hearing from them. [inaudible] [inaudible] [inaudible]

[inaudible] [inaudible] [inaudible] [inaudible] >> as our witnesses prepared to testify at let me make an observation if i can. on behalf of the members of the committee, and on behalf of the staff of the committee i would like to take the bso's how invaluable your help and support has been over the past two years in the work leading up to veterans was being developed. we

have never had a situation situation where the bso's were not ready to come forward. we appreciate your input very much. sometimes when you're third on the panel you might think you are an afterthought but you are not an afterthought. many of the things we develop here come from the testimony we bring forward. and many things and many things we learned that we should do differently with them from you. we look forward to your testimony and we will hear from the following individuals, mr. jeff steele, the american legion, legion, joy healing, the disabled american veterans and we were delighted to have you in georgia for the annual convention about three weeks ago. we enjoyed being there. it. it was good attendance on the governance part anyway. >> are iraq and afghanistan veterans of america, commander renee, the, the military offers association of america, mr. carlos veterans of foreign wars, mr. richman weidman, veterans of america. we welcome all of you to be here and we'll start with mr. steele

you are recognized up to five minutes. >> chairman, and ranking member and members of the committee, on behalf of our national commander schmidt and over 2,000,000 members of the american legion we thank you for conducting the hearing today. generally the american legion is an agreement with many of the commission's recommendations. however, the report contains that it a fundamental flaw which must be recognized and addressed. of the three commissioners who refuse to sign the final report, the american legion is most closely aligned with commissioner walker who stated in his dissent that quote the adoption of this proposal would threaten the survival of our nation's veterans health care system. it's a choice of millions of veterans who rely on it. a sentiment we have heard today. the american legion believes the strong, robust healthcare system

designed to treat unique needs of those who serve our country. we recognize that in the best of circumstances there are situations where the system cannot keep up with the healthcare needs of the growing veteran healthcare population requiring services and therefore they must seek care in the community. thus we support the creation of fully integrated healthcare networks with the virginia maintaining responsibility for the care coordination. these networks must be developed and structured in a way that preserve the virginia's capacity. without a critical mass of patients the virginia cannot sustain the infrastructure that supports and makes virginia specialized services world-class. providing veterans unfettered choice as to their provider jeopardizes this critical mass. the american legion also opposes allowing a complete option of primary care providers within the proposed vha care system because we believe the commission analysis is faulty. the commission supports this recommendation based on the estimate that was quickly using medicare rates.

the commission however gave no consideration to how medicare rules would apply to the current quality of care provided through the primary care physician. vha physicians are not restricted as to the amount of time they're able to to dedicate to each patient or the number of presentations per patient. medicare and the other hand only provides payment based on ten to 15 minute consultations which would deny veterans for quality of care they are entitled to through their earned benefits. if scored the cost of this recommendation would be triple if not more and is financially and stable. a better proposal is found in bas plan to consolidate community care program. the american legion supports allowed virginia setting up tiered networks. we understand it would empower veterans to make informed choices by identifying the best performance providers in the community and enabling better

coronation of care for outcomes. the rest on the principle of using community resources to supplement gaps and better aligned resources. we believe it can expand veterans access to healthcare. however, as the virginia begins to involve more community providers the issue of how medical malpractice contains are handled becomes important. as it stands if the veteran is injured by virginia dr. they can file a claim, it will either begin or increase their level of service-connected disability and the injury would be covered by virginia for the veteran's lifetime. no such protection exists for contractor care. it's essential to a ensure the current processes treats malpractice claims the same regardless of where they receive their care. finally, we recognize that the cost for these reforms remain a significant concern. the plan was presented to congress in late 2015 and was well received on both sides of

the aisle. some members of congress that the cost ultimately we strongly believe that this is a cost that must be met for v-8 to meet the needs of our veterans. mr. chairman, i cannot conclude without remarking on the broken appeals process. modernizing the appeals process is a number one priority. the voting today on chairman builders bill. senator rosenthal have just come from a press conference announcing his bill, senator rubio also has a bill. the status quo simply on acceptable must be reform. we have worked with you personally and with the committee, what are we going to do to get this done? with that, i am happy to answer any questions you may have. >> thank you mr. chairman. members of the committee, since

the scandal in excess crisis of 2014 a vigorous debate has taken place about how to best provide timely, high quality, comprehensive veteran focus to a nation's veterans. there have been dozens of hearings, numerous investigations, stakeholder engagements, enactment of choice act, comprehensive independent assessment, and finally the report from the commission on care. all of these efforts were undertaken with the goal of getting to the root of the crisis. in transforming the virginia better serve our nation's veterans. the commission examined a range of ideas including proposal to privatize and dismantle the virginia healthcare system. ultimately ultimately rejected the radical ideas instead reaching a consensus on a comprehensive set of recommendations for the long-term transformation of the virginia. dav supports the commission and recommendations as detailed in my written report but i will focus on a few world remarks

that we have concerns with. we support the commission's commission's first recommendation calling for the establishment of high-performing , integrated community-based healthcare network. with the virginia acting as a court nadir of care. virginia and the independent budget bso's in the bso community, men in that community put for similar plans. the commission plan however does differ in one crucial aspect, specifically as mentioned previously how it would manage the provision of care among virginia and non- virginia network providers. in order to reach consensus the commission recommended a compromise option to let veterans choose non- virginia doctors within a network, and where virginia would have timely access to meet their needs. this open choice option was increase cost and shift resources out of virginia likely

resulting in the downsizing of the healthcare system. the problem is, if choice is elevated is most important principle you're likely to end up with parallel systems and veterans will have to choose between, rather than an integrated system that is more likely to provide high-quality care and be responsive to individual needs, the commission's economists estimated the open choice option would increase virginia spending between five and $35 billion annually. they noted there is no clear evaluation of the potential impact this choice option would have on virginia's role as a whole. its ability to deliver comprehensive care and specialty services or the impact on virginia research, education, and other critical missions. additionally this option, according to the commission could shift an estimated 40% of medical care currently provided

by virginia into the private sector. this reduction in work volume would force the virginia to cut services and close facilities, thereby depriving many veterans of the choice to use virginia for all or most of their care. to ensure reliable access as well as high quality and care for all enrolled veterans, virginia must have the resources to address the many deficiencies identified in the independent assessment including modernization of virginia by it and infrastructure needs and the flexibility to organize and manage the network and the care provided. we have concern about the recommendation to establish a board of directors to govern the veterans health care system. while we support greater continuity of virginia leadership to facilitate long-range planning creating a separate and independent governing board for vha would hinder the ability of the secretary to coordinate

interrelated virginia healthcare services and benefits program. instead we recommend they adopt a review process for improved long-term planning and budgeting purposes similar to that used by department of defense and homeland security. in closing, we concur with the majority of proposals put forth on the commission of care and we greatly appreciate the efforts of the commissioners to find workable solutions to complex problems. we are pleased that a number of recommendations are underway as noted by virginia secretary in the my virginia initiative. after two years of discussion and debate there is a clear path forward and it is now time to take action and start working toward creating a healthcare system i veterans need and deserve. thank you. that concludes my statement. >> thank you.

>> chairman isaacson and members of this committee. on behalf of iraq and afghanistan veterans of america and more than 425,000 members and supporters, thank you for the opportunity to share our views on the to share our views on the commission of care report. there few issues more important to the healthy transition home of our generation of veterans then ensuring an exceptional and sustainable va. we know from research our members are increasingly turning to the virginia for healthcare. in our most recent survey 29%% of members reported using the virginia exclusively, up six percentage points from the previous. those using the virginia in combination with others insurance is currently 63 percent, of five percentage points. as more veterans return and as we face the challenges of physical and mental injuries we need to know the virginia will deliver for us. we must get this right. the commission on care report was intended to map out a path to the virginia and in general to the virginia and in

general is pointed in the right direction. we agree that we need to reform vha. our analysis is detailed in our testimony submitted for the record. today's remarks will focus on the general analysis of the report as well as three of the 18 recommendations. we have. we have six general comments on the report. one, the report is presented as a series of independent recommendations, fails to acknowledge the success of implementing a single recommendation likely depends on the execution of others and will require extensive time and resources to execute effectively. two, the, the report fails to consider how the recommendations to bha will impact the virginia as a whole. particularly the ability to correlate with the vba and nca. three, the report fails to analyze the impact of reform vha's ability to conduct research and clinician. >> four, it does not acknowledge the challenges faced by virginia due to the misalignment of demand, resources and

authorities. >> five, the report failed to take into account reforms and programs the current virginia secretary has already planned or implemented. six, planned or implemented. six, the report recommendations are broad and can be left somewhat open to interpretation. after the specifics of the recommendation we broadly agree with most of them va's response to the report but we would like to focus the remainder of the remarks on recommendations one, nine, 17. specifically i aba i opposes creation of board of directors and we support us to remind path to eligibility other than honorable discharges. on recommendation one we support the integrated network of care that includes community providers like primary care providers managing veterans care. however recommendation one is too broad lacking critical pieces of analysis and with a fatal flaw, the external primary care provider. it also assumes that community providers will be available and able to absorb demand by creating a network. >> on recommendation nine we understand the reasoning behind

the establishment of board of directors and agrees that leadership is critical to reform. we have concerns raised by money clearing the virginia and don't support this recommendation in a burdensome bureaucracy. on recommendation 17 we agree with providing mystery my path for eligibility for those with other than honorable discharges. those with ot h discharges can be the most vulnerable in the bomb population. giving temporary eligibility will allow for access to critical services without delay in healthcare due to the current process to determine eligibility. it's important to stress that with this change will be a resource burden on the virginia that would require congress to support. with with increased demand comes increasing for resources.

in closing i would like to reiterate, one reforming vha into a 21st-century healthcare system will require significant correlation between the next president, va, congress, via cell partners in the veterans we serve. two, this changes will also require a significant financial investment that, at the expense of cutting it existing benefits. these cannot be silent within themselves but must be part of a comprehensive plan. thank you for your time and attention. >> thank you. >> chairman, military officers association of america appreciates this opportunity to give our views on the commission on care report. we are particularly grateful for the opening and collaborative process that was established in order to receive information and feedback from veterans themselves as well as the bso's and mso's representing the constituency. overall we support most of the commission's findings and we are pleased to see many of the report recommendations incorporate the changes that secretary mcdonnell and bso's have been advocating for since the implementation since the

choice act. in responding to the report i would like to put up front that we want to see the exhaustive work of the commission and the critical legislation proposed by congress and administration be connected this year. the panels before before us have already discussed that, the budget, veterans for stacked and appeals modernization. the main focus on three specific recommendations. first of all we support establishing high-performing integrated base networks. while virginia loan cannot meet all the healthcare needs of the veterans, the system does provide a foundational platform in which to build. that is clearly stated up front in the report. we believe in the new system

needs to preserve well-known programs and competencies in vha's mission in the areas of clinical, education research and national emergency response. these are intricately related to the broader virginia mission and american medical system. we are pleased the commission recognize the va's primary role of courtney in healthcare and veterans navigate the system. that said, the virginia must retain responsibility for managing virginia veteran health information and patient outcomes to ensure quality and continuity of care and services. second we agree with the commissions recommendation to create an integrated and sustainable culture where all the programs and activities are aligned and leaders at all levels of the organization are responsible and accountable for improving organizational help and staff engagement. such transformation requires modernizing virginia's leadership in human capital management system across the enterprise. such improvements will require the necessary funding and

authority to make it happen. as with many of our partners we support the concept of longer-term appointment for the secretary's health. we however are not supportive of establishing a board of directors. we directors. we believe congress is role of oversight is essential and adequate in holding virginia countable. congress must continue to be the veteran's strongest advocates. finally, we agree with the commission's proposal to establish an expert body to develop recommendations for virginia care, eligibility and benefits design. the commission recommends that virginia revises its recommendations for those with other than honorable discharge. the commission believes that the adjudication process since determining characterization of discharges takes far too long.

it is very strictly interpreted. it prevents veterans from getting the care they need sooner rather than later. instead we recommend congress direct to virginia to provide more information on the current scope of the problem, what the process is, what the potential cost and the impact would be on vha if this recommendation was implemented. in conclusion we appreciate the senate and house committees of veteran affairs unwavering leadership and focus on improving health care for our veterans. in closing i would like to share quote from one of our veterans in the field. who articulates what our perspective is. i quote, i will tell you that our virginia has a very solid reputation and despite what is heard in the national press, i know from both personal experiences and from experiences i've heard from others who use the virginia in durham, we are

very fortunate. the virginia medical center works well and the staff is committed to its mission. when i walk through the virginia medical center in durham, and struck with two things. the first is how complex it must be to manage such a facility. the second is what i see as the faces of people who have nowhere else to go, the v virginia is there from there. we believe this virginia medical center is the rule rather than the exception in vha. it is our view that we must leverage these best practices and invest in this type of culture across the system. our veterans our veterans and our families deserve no less. i thank you for this opportunity and look forward to your questions. >> thank you. thank you mr. chairman. i would like to thank you for the opportunity to present our views. the vs the fw thinks the commission and i would like to echo my friend rené on their

willingness to involve us in the process. the vfw believes that the commission has made some meaningful suggestions on how to improve the health care the virginia provides veterans, the vfw urges congress and the virginia to consider the recommendations we have supported and alternatives to the ones that we oppose. we strongly support the commissions recommendation to improve the virginia clinical appeals process. due to the lack of systemwide processes centers have experienced vast differences when appealing clinical decisions often delaying the care they have earned and deserved. the vfw members have first-hand experience with the pitfalls of the fragmented virginia fuels process and believed it must be

reformed to ensure veterans receive appropriate response to their grievances. this includes the ability to provide evidence to support appeals which many do not permit. the vfw also supports amending va's current health care eligibility recommendation to ensure veterans with other than honorable discharges have access to life-saving care they need and deserve. the vfw also supports the commissions recommendation to establish high-performing, integrated community base networks which leverage the capabilities of the private sector and the public sector to meet the needs of veterans in each community. the vfw is glad to see the commission also agrees that virginia must remain the core for veterans. and help them make

informed healthcare decisions. doing so is vital to ensuring veterans receive high-quality coordinated care, rather than fragmented care which leads to lower quality and threatens patient safety. that is why the vfw opposes the commissions proposal to give veterans a list of primary care providers and hope they're able to find one willing to see them. veterans in need of primary care must be offered the opportunity to discuss their preferences and healthcare conditions with a nurse navigator who can help them find a provider who fits their preferences and clinical needs. the vfw also opposes the recommendation to establish a government board of political appointees to determine when and where veterans receive their healthcare. virginia needs strong leadership not more bureaucracy. however however we do agree that exemplary undersecretary of help should continue to lead vha

regardless of the political changes in congress and the white house. instead of precluding the president from replacing an undersecretary for health, congress and virginia must evaluate ways to make the position more attractive to executives with experience running successful healthcare systems. that is why we are pleased when doctor scholl can accepted the nomination. he's not the typical person who is occupied that role. doctor scholl can is the first noncareer virginia employee to be confirmed undersecretary of hell since doctor kaiser who led the largest and most successful healthcare transformation in virginia's history. congress and virginia must ensure that the position of undersecretary of health attracts more candidates like doctor kaiser and doctor shogun, not career virginia employees who seek to protect the status quo.

the vfw also supports most of the commissions recommendation regarding capital infrastructure. we agree that waving budgetary rules and improving the enhanced use authority will enable virginia to expand access. however the vfw cannot support bracket commission. the skit process already addresses the issues of unease property. it is congress who failed to remove these properties. the reason they have failed to act is the same reason it failed to act under another process. local pressure from the veterans community. the solution is to develop a better communication plan with the impacted veterans and develop a replacement plan that ensures veterans to not experience a lapse in access to care. veterans fear losing virginia care, and no commission or board

will fix that. mr. chairman, thank you for the opportunity to testify. i'd be happy to answer questions you may have. >> the vietnam veterans association. >> thank you very much mr. chairman for allowing us to be here. i will deviate because much of the material i may have covered in a summary has already been covered by my distinguished colleagues. so i will will concentrate just on couple of things that we consider to be very important. the first first has to do with recommendation number 17. in the ministrations not concurrence with it. we understand their position but it is really up to the congress at the first opportunity to get emergency appropriation so we can move ahead to those people who have an ot h or other than honorable discharge. most of of them as a result of administrative procedures never had access to counsel, never had

a full record of court-martial, but rather were pushed up as they were deemed no longer useful. vietnam veterans have a long history with that because that happened to many people at the end of the vietnam war. even as it was going on for the kids, i say kids who enlisted at a tea and were sent to vietnam at 18 or 19 and came home, they were on a three year enlistment the military service did not want them when they came home. and they did not want to be there, and they copped an attitude because of the experience in the boonies in vietnam. so they got in trouble, sign here son and you can go home. so they did. so that has ruined many of their lives. that unfortunately that pattern is still going on today from fort carson to bases in texas, to write here where people who

are being unfairly pushed out and labeled as other than honorable simply because there is someone in nco or the officer court who has taken an active dislike to them. we have been very concerned about this ever since our inception. many of us have been active in discharge of great services before it was founded. we continue to to be concerned with this thing. it has become more difficult over the years to get discharges upgraded with an objective person with it agrees absolutely that discharge should be upgraded and they should have their benefits restored. we have filed several class-action suits against dod and we certainly were assisted by former senator and secretary

of defense chuck . that has open the door. with the lawsuit pressing instead of a success rate of 4% it has gone up to 45% before the board. in terms of separation, the secretary of the navy has issued a directive that is helped dramatically and has the marines who should have their eligibility restored as well as navy people. what we need is for secretary fanon and secretary of the air force to do the same thing. what is needed is to make sure that we have the money that is added into the budget as these things take hold. this is a group of people who are most at risk for suicide. particularly the younger ones.

the older ones have already done so. so it is something that the passage of the final -- to make sure the fairness to veterans act is included in that would be huge step. i would stress that the leadership of this committee which on so many issues we greatly appreciate mr. chairman you and your colleagues in the ranking members efforts. in needs to be turned to getting emergency appropriation so virginia can be ready to handle it. the last witches i will just touch on instead of going into detail because of limits of time is the procurement recommendation. given the 18 max zero supreme court decision handed out at the end of june in -- versus ba, it

is, everyone in this room knows how rare it is to have an 18 max zero supreme court decision. they were absolutely clear about what must be done. the question is, whether virginia doesn't. instead of concentrating on rearranging the structure, we need to look at what they are doing and how they're doing it including the excessive reliance on the delegated authority for the federal supply schedule. i will close it there and once again i deeply appreciate, on behalf of all of us the sound leadership from this committee. for both you and senator blumenthal. >> thank you. thank you. we appreciate your input in time. mr. steve, with emphasis added at the end of your testimony you said what do we do? addressing the the appeals process and the

appeals reform in terms of the veterans administration. i will answer that question for you. my good friend senator blumenthal has introduced a version of his bill sometime today. chairman miller, the house has introduced one, we passed a demonstration project and the committee in a proposal by sullivan and the obama administration have been working for about three months on appeals reform bill. and my correct mr. secretary? >> yes. >> the question is what we do? we have to get everybody has an interest in getting this done and getting their heads together and let's get it done. and that's how it's going to get done. i'm going to make a suggestion. the 445,000 pending appeals that we have right now in backlog we

shouldn't do anything to reform the appeals process in the future until we tell these people how the world we are going to give them an answer from the past. i'm serious as a heart attack about that. i think. i think one of the things we need to do is say we need to make sure we are reforming so it doesn't happen again. but we don't need them being in a black hole in it way that they should have gotten it. i hope to help, i don't have don't have a dog in this fight. i'm not squaring a bill around saying it's my way or the highway. but i'll i'll be glad to work with the ranking member, mr. secretary, dennis dennis mcdonald, with all of your vs organizations, chairman miller in the house, let's find a a way to find the 80% we agree on and make a deal rather than always worrying about the 20% we don't find agreement on. when we do it we have to make sure the people who have already been left behind in the appeals

process get an answer to the question they asked which is the same one you do, when. i think that his answer to your question. >> thank you. >> did i hear correctly that you all were opposed to recommendations one, nine, and 17? >> sir we are opposed to an external primary care number one, we we support recommendation 17 which offers a streamlined path for honorable discharges. >> i got two out of three rate that's pretty good. >> what is your organization position on the veterans for spell? >> sir, we support the provisions within their but we strongly oppose the pay that's been authored in our 30,000 messages to to congress have also echoed that. >> i heard that in the testimony, the reference to the don't take away any benefits. i like to make a suggestion to all of you.

when we are trying to address the concerns that all of you bring to us to improve the benefits for veterans and make the virginia work better, we have to find ways to pay for improvements in the future. that doesn't mean we want to take money out of richard blumenthal's pocket as a veteran or anybody's, but it may may from time to time just as we're going to have to do a social security and other things in terms of entitlements, we have to reform eligibility in the future to pay for eligibility the present. it is very difficult for us to move forward if out of right field we get an objection that doesn't give us fair warning and a chance to explain ourselves which is what happened to veterans first in that particular situation. so i just want to say for the public in the record. i sit here as chairman i think richard is the same as ranking member. we are ready any time that anybody thinks we're doing something to hurt a veteran were not going to intentionally do that but we want to look at the

future to deal with the challenges of the future. >> mr. chairman, i think think is that as we are memorializing, should stay for the record my own view that there really should be no requirement as to a pay for it when we're talking about benefits for veterans, that that simply matter principle with me. i recognize that the majority has somewhat a different position. there's no requirement in law or policy so far as i know that we could not go to the floor and ask for a budget point of order. i think it would pass and i am prepared to support that effort, and, i will continue looking for other pay force if that is a requirement outside of veterans program. i believe that the veterans first bill is a dramatic and historic step forward in any

additional funds required to support it should come from non- veterans programs. you and i have worked together very collegially in formulating this bill. i hope we can continue to do it so he for it passes we will find alternatives. i really do appreciate your leadership mr. chairman, you you and i have spent many, many hours in seeking to address this dilemma. i know you have done it in good faith. this bill hopefully will pass in better form than what we have right now. >> i appreciate those comments. and i subscribe to them but the point i'm tried to take to the bso is this pretty pc is doing something that you have an objection to her perceived it

might be a benefit challenge to, come to us first and talk to us senator blumenthal myself and see if we can first will make sure what change were making and work together to make a change because a lot of times one little problem in the machine can stop everything else from happening because we didn't address it talk about it. that's the main point. i agree with everything he said, but who is in charge requires us to put up a forward on the floor. we can't go to the floor but since we have the requirement were trying first to try to meet the requirement before we decide we have a battle. >> and hopefully meet that requirement. >> and that's what were trying to do. >> outside of the virginia program, the virginia mission in the virginia budget.

>> i'm sorry to take so much time but i think both of those points need to be addressed both in terms of let's get the appeals done and get it worked out and not leave behind the 445,000 that are waiting. let's make sure the future we have differences of benefits we talk about the first before we declare war on each other and end up slowing us down for making progress. with that that said, i'm going to go to my ranking member senator blumenthal. >> thank you mr. chairman. i want to ask about the board of directors. i apologize i was not in the room for some of your testimony but i have read it. i have taken from that testimony that there seem to be very broad reservations, perhaps i should say opposition to the idea of board of directors for berry understandable and well merited reasons. ms. augustine you've made the made the point that it's an additional bureaucracy and that in fact it diminishes potentially accountability. and i think the point has been made by many of you, have i

correctly interpreted your views? >> yes, sir. and in terms of the other recommendations, if each of you could just give me what you regard as the most important recommendations that you have supported in other words, i understand that you have oppose some, but in terms of your finding merit in these recommendations and i don't want to put you on the spot here, but just to kind of cut through the really excellent testimony you offered, is very complete, excellent, but just in terms of what you regard as the most important of the recommendations you support.

>> i will go ahead and take it go first on that one. i think the modernization recommendation number seven that is the virginia it system is inclusive of everything regarding the disparity that exist and have been well documented in the scheduling system. so many other parts of what today has modernized healthcare and without their there cannot be an integrated network that has seamless access between the community provider and va. i think that what is probably the largest one that impacts of so many other things. if that were resolved and tried to tackle that one first and foremost, many of the other issues would be automatically resolved within that one. >> thank you. i would like to add that, in

terms of, i think this report, it has been clear to us that the report has been provided in the hole. if you start taking and piecemeal in that you are not going to get the results of the recommendation going forward. but for the sake of answering the question, i think from our perspective that nothing can really happen, real cultural change transformation will not occur without an investment in leadership in the human capital management system. >> senator i would like to echo the point, i want to say recommendation number one although we do not support exactly how it is written, the need to reform the weight virginia purchases care and how you integrate the private sector into the delivery of care model is vitally important.

as was discussed when the secretary was testifying, the virginia, the choice program is due to expire, there is an urgent need in reforming how the virginia reimburses emergency room care. that that is certainly vitally important, but also how virginia expands and develops its capital infrastructure is also vitally important, number six because not many virginia providers are able to hire, you need somewhere to put them. the way it is done now really needs to be reformed.

>> i wouldn't go the comments from my partner from tav that recommendation seven is vitally important to every other recommendation and modernization impact on the va. as we look at integrating a network of care that expands beyond the va, as we look at integrating human capital management programs that ties back to it and assuring the it and the structure can handle the changes and meet the needs of the virginia is vitally important to the success of transforming the virginia. >> thank you. i will conclude just by saying stable leadership. the virginia the virginia needs to find a way, congress needs to find a way to incentivize top performers like mr. shoko and mr. mcdonald to serve our veterans. stable leadership. >> the continuity of leadership is a problem whether through statute or for practice which affected could be done. particularly undersecretary level on up is something that is very difficult because when people come in for relatively short period of time and i believe political appointees across the board serve on

average of one year nine months historically, whether whether it's democratic or republican administration, that continuity lack hurts all of the agency's effectiveness. frankly we cannot afford to have those kind of lapses at the virginia, particularly in healthcare delivery system. >> i appreciate your comments. i know the session is not the last we will have on these issues. i would note that the recommendations that i believe you have identified are all either underway or seen as feasible by the virginia. so i think we have a lot of consensus in one of those criticisms made of the commission's report i'm not sure who made it, i think it may have been the i aba is that it failed

to take into account that actions already underway in the virginia, reforms already ongoing. so i think your support that you've indicated in the commission support for the work that is underway really indicates that we are putting our shoulder to the same wheel here. again, my thank you for your leadership, i to just finish by saying thank you for your support for the appeals process reform bill that i introduced earlier today, we can disagree on the details but there is absolutely no question that the present system is broken, the president thinks so, the vs owes think so, our veterans think so,

the congress should think so and should act. i very much respect that the chairman is looking at all of the options available. i am not vetted to any single solution. i'm happy to be persuaded that there are better paths to the same goal. i think there again we should be able to reach a consensus on appeals reform sooner rather than later. time is [inaudible] our side. time is is [inaudible] the veteran side when there is still a on appeals of these claims. just to state what you all know, these claims do not seek handouts or hand ups. they seek benefits that were earned through risk and sacrifice to our nation and injuries are wounds that cause

these claims to be made. so this nation has to do the job. thank you. >> i want to thank secretary mcdonald and our witnesses for other comments today. they were bragging about your pretty good. >> i appreciate bob mcdonnell last night he is a 24/7 guy working for veterans and we appreciate it very much. all are bso's, will count on you to help put your oars in the water and move forward these last two months. we have a lot of things that are this close. it's a matter of us making up her mind that working to get it down. if we can find 80% agreement let's make a deal, don't listen over the 20 percent. i appreciate you taking a long time that we had to wait. it was great testimony and input, it will end up benefiting the people we're here to serve and less of veterans of the united states of america. with with

that said this hearing will adjourn. [inaudible] [inaudible] [inaudible] [inaudible] [inaudible]

[inaudible] >> c-span's washington journal, live every day with news and policy issues that impact too. coming up on saturday morning, tim mullaney, economics, miss for the street.com will help us break down the recently released jobs numbers and what the recently released jobs numbers and what they mean for the health of the economy. then celeste katz, senior political correspondent for mike.com will discuss what role millennial voters are planning campaign 2016 in ways campaigns reach out to them. andrew of the ram corporation on the suspension of talks between the u.s. and russia over the conflict in syria. watch c-span's washington journal, live at 7:00 a.m. eastern on saturday morning. >> wisconsin republican party

will be hosting a fall fest. donald trump will be there tomorrow along with rob johnson and governor scott walker. c-span will bring you live coverage of that as they talk to voters. it begins tomorrow afternoon at 3:30 p.m. eastern. >> donald trump to campaign with house speaker paul ryan this saturday in wisconsin. christina marcos is following the story for the newspaper and is joining us on the phone. thank you for being with us. >> thank you for having me. >> how did this come together? >> it has been a long road for paul ryan and donald trump. if you you recall as recently as last december when it wasn't clear trump would get the republican nomination, and everyone thought it was a long shot paul ryan was denouncing his proposal to ban muslims from the country and since then he has criticized trump on a lot of fronts. then for weeks he declined to

endorse donald trump after he clinched the republican nomination. as payback donald trump was endorsing ryan at his house primary over the summer. now here we are when they're making their first campaign appearance together this weekend. >> is called the wisconsin fall fest and sounds like a typical republican event in that it is happening in a key swing state. the republican governor, scott walker is in attendance, what is going to happen, how will this on full? >> this event happens annually. ryan and other wisconsin officials regular go to this event. a source familiar with the plan he told me that trump had expressed interest in doing an event with ryan. so the the speaker extended an invitation to come to this event that he goes to everywhere year anyway. so this will be interesting. as of right now there is an there and are not any

photographs they see out there donald trump and paul ryan appearing together on the campaign trail. for someone who has distanced himself quite a lot from donald trump even after he did officially endorse and, there's potentially be a little awkward for paul ryan. >> and senator ron johnson in his own battle for reelection is being challenged by russ feingold who defeated him six years ago. this is one of the states that both parties say they need if they want to capture or maintain control of the u.s. senate next year. >> that is right. and ron johnson will actually be at this event too. but paul paul ryan and donald trump are going to on saturday. so it's an interesting strategy compared to some of the other vulnerable senate comments lake in new hampshire and pennsylvania whose it very much distance themselves from trump

and are generally don't like to say trump is lazy but they say it's a non-game. ron ron johnson meanwhile is going to appear in person at this event with donald trump. >> let me go back to the relationship between house speaker paul ryan. he was mitt romney's running mate four years ago. the former massachusetts governor in 2012 saying that he is advising people to vote for gary johnson. he did so in a tweet. so this relationship between the house speaker and donald trump or lack thereof, how is this going to change evil, or unfold with 30 plus days to the election and will have an impact? >> this event will come just one day before the second presidential debate between hillary clinton and donald trump. in the last ten days it has been some of the worst ones of donald trump's campaign and the

aftermath of his derogatory comments about former ms. universe winner. so it will be a pivotal moment for donald trump if he wants to make a comeback in this weekend's debate. >> donald trump in wisconsin this weekend with house speaker paul ryan. and the reporting of christina with the hill newspaper. thank you for being with us. >> thank you for having me. >> how do we measure greatness in america? the height of our skyscrapers? the size of our bank accounts? no, it's measured by what we do for our children. the values we pass on. i spent my life fighting for kids and families. it will be my mission to build a country where our children can rise as high as their dreams and hard work takes them. that means good schools for every child in every zip code. college that leads to

opportunity and an economy where every young american can find a job that lets them start a family of their own. we face big challenges but we can sell them the same way families do. working working together, respecting one another, and never giving up. i want our success to be measured by there's. i'm hillary clinton and i approve this message. >> what does electing donald trump president me for you? families making 60,000 per year, you get a get a 20% tax rate reduction. working moms, you get paid maternity leave and an average 5000 per child tax reduction. business owners your taxes get cut to 15% so you connect expand. donald trump, prosperity for you, america great, america great again. >> i'm donald trump, and i approve this message.

>> the second presidential debate is sunday night at washington university in st. louis, missouri. watch our coverage at 7:30 p.m. eastern for preview of the debate. at 830 the pre-abate briefing for the audience. at 9:00 p.m. live coverage of the debate ball by viewer reaction with your calls, tweets, tweets, and comments. second presidential debate, watch live on c-span using your desktop, phone or tv. listen to the debate with your c-span radio app on the app store or google play. >> every weekend book tv brings you 48 hours of nonfiction books and authors. your some of our programs this weekend. saturday at 7:00 p.m. eastern hillary clinton's e-mail controversy is the topic of an author panel discussion with peter schweitzer, author of clinton cash.

and tom fitton, author of clean house. then at 10:00 p.m. eastern afterwards, mary thompson jones details the day to day work of u.s. diplomats and looks at the issue of leaked diplomatic cables in her book, to the secretary, leaked embassy cables. she is interviewed by paula, former undersecretary for democracy and global affairs during the george w. bush administration. >> i think it's going to be part of government life and the speed at which and the multiplicity at which we communicate with each other now not only in long cables, but short e-mails, text, social media, tweets, all of that is going to be part of politics. >> on sunday, nobel prize-winning economist joseph

stiglitz on the future of the euro in his book, the euro, howell, currency threatens the future of europe. go to book. go to booktv.org for the complete we can schedule. >> is c-span's campaign 2016 coverage continues with the debate between the candidates for arizona's first congressional district. republican paul and democrat tom discusses second amendment, arizona's coal industry in recent allegations relating to mr. -- hosted by the arizona horizon, this is 30 minutes. >> good evening and welcome to the special election 2016 addition of arizona horizon. >> tonight shows a debate, a debate, will hear from candidates competing to

represent the district one in arizona. this is not a formal exercise, it's an open exchange of ideas, and opportunity for give-and-take for one of the states most important offices. interjections and interruptions are allowed provided all sides get a fair shake and we'll do our best. this is the tenth largest congressional district in the country. it stretches from page to just north of tucson and takes in much of eastern arizona. about 25% of the district's population is american indian. the congressional seat is being vacated by democrat and kirkpatrick. we now move on to our debate. the candidates a now county sheriff and republican paul bamboo and democrat tom -- each will have one minute. tom will start first. >> thank you. thank you for horizon. i grew up in a working-class

family and that family work day in and day out. every weekend i wash and put together a notebook of what was going to occur with his ability to provide for family and the coming weeks. the bottom line here is i had a strong sense of hard work us strong sense of community. what is happening in america and arizona today is dysfunctional congress. we have to make sure we start working for the middle-class and working-class families of america again we have to look at what our children need and the opportunities for their future. i worked under child protective services successfully bringing people together in unifying. >> okay thank you very much. now we turn to paul. >> as you may know me of the share for the past use of

panella county. i lead 600 plus men and women and our job is to protect families and protect arizona. we have done a good job of that with the largest drug bust in the history of arizona. fighting the cartel, i have also had the honor to share our nation as an army officer. i have served 20 years and i served a tour in iraq and i commanded soldiers on the border. i'm for enforcing the law, securing our border and protecting america. i don't feel our nation is more secure more safe that it was eight years ago. our economy is struggling, national debt is 20,000,000,000,000 dollars. is $20 trillion. we have to fix her country. i will be a part of the solution of her country of lowering taxes and regulation and putting america and our citizens first. >> thank you. let's get going.

tom, why you for this position representing this district in congress and not him? >> i this district before many areas. i looked at issues statewide issues, education, healthcare. i have had a very successful record in the legislature and making sure i work bipartisanship across party lines, sometimes against against my leadership, sometimes with my leadership in order to provide solutions that not tear people apart. and make sure that working families are thought of first. i believe that my skill set, my experience, both in law-enforcement and in business allow me to have the perspective to do that congress. >> same question, why you not him? >> this is about jobs and the economy. clearly a lot of people in our state are struggling. the government has become too large and too costly. evidence by $20 trillion deficit. we have to cut spending.

we cannot continue to think that we're going to spend our way into prosperity or tax our way. that has failed. it has failed here in the state of arizona, i'm an outsider, coming from and looking at our core service i have had an 8% budget cut now in the past two years. i've had to keep 53 plus vacancies in the sheriff's office. nobody could convince me in washington that we cannot cut back, we can't set priorities and live within our means because this really threatens not just our economy and hurts the taxpayer while 95,000,000 americans are out of work, it threatens our national security. >> when you get back to washington, cutting back on

spending in general, is focus a priority for you? >> investing in our future is a priority. making sure we live within. making sure we live within our means is a priority. i'm not going to haphazardly cut across the board when we have education issues to deal with, dressing our infrastructure needs, addressing addressing the security of our nation, whether it is with our military, our borders, these are prime areas we have to invest in in the future, not just move back inches we have to protect the american citizens. my record identifies clearly that i can do that. i cut taxes when appropriate and for business. property taxes from 25 to make 20 percent. 20%. personal income taxes and $500 million for small business and people throughout our state. when for corporations and export. i have have that experience and background. >> cutting where appropriate as

opposed to just cut into cut. >> not just that. when you hear the keywords is investing, that is code for more of the same. more the same is not going to fix her country. it's not going to bring trillions of dollars offshore back into the united states and grown build jobs here in the united states. . . and we wound up having an economic crisis. >> a perfect example is right here in arizona. when we had nationally on that point fannie mae and freddie mac and you see that all of these loans that are propped up by government and you see this

housing crash collapsed a class class -- place and our government was a party to this picking winners and losers. what i say what you have here in arizona the forest service and the epa that has come in in the name of trying to protect our environment and what they have done and a lot of us talk about it the bill harming and destroying an environment. when you see the forest service that while they are saying they're trying to protect their forests 20% of our forests have been destroyed and burned in the last 12 years. we are not able to environmentally complement lumber and industry. >> paul hasn't cut taxes in his career and i have. i have on a consistent basis cut taxes to improve the working conditions of working-class families and small businesses in arizona. paul has not had to run a small business like i have and make sure paychecks go out to the workers in the business making

sure that we expand that business. i have a lot of experience both in the private sector and the government sector and making sure we do not overregulate. regulation is a cost factor and i want to make sure that cost factor is not passed on to businesses to hinder their ability to hire. >> i can tell you what i haven't done and this is very important because what we are talking about is going from republican and you lost your election because you voted for massive budget increases under governor napolitano. governor brewer told me watch out for tax of tom o'halleran because a 64 increase in our state budget. the reason we had to sell her state state capitol the senate e legislature is because we didn't have money. after you left office so we have had to live with that the structural imbalance government. governor to see us fighting for her recovery and is not about spending more money. a much is like -- much as you'd

like to sake attacks as the record shows 64% increase and that's the wrong type of philosophy of investing sending to washington at a time when we are about to collapse. >> moderator: your response. >> tax and time, we had almost 1 million people enter this legislature. we had a 27% inflation factor. we had to pay back $2 billion worth of funding for schools and maintenance that had been deferred. we dealt with a lawsuit of almost $600 million we put more money in our universities and colleges and our k-12 education system to improve the future of our children and dealt with child protective service reform and the ability of children to be properly -- have health care and are the kids care program

and many more including $10 million a year into border security. >> moderator: if the lease can you -- when inflation increases. >> you are talking to a sheriff who has the responsibility for public safety and the fastest-growing county in our state is one of the fastest growing counties in america. my budget did not grow by 64%. in fact it's been cut back. it's been cut back a%. that's millions of dollars. you can't just say well her state is growing and we have to increase spending by 64%. that's how we got into this mess we had to sell all the government buildings. governor brewer one of the first thing she said as this is embarrassing for a stay. i want the legislature to buy back the building, the nine story tower that even the governor's office was saying my god, that's fiscally irresponsible. >> we cut budgets when they needed to be cut.

in good times we cut taxes and improve their infrastructure to the state and improve their children's futures. the whole concept that because governor brewer said she was in trouble doesn't mean that it was because of what occurred before. we improved the entire -- we went from a rating in the legislature of the midteens according to capitol times to over 50%. of people new things are being done for them and for their future. you can always cut at of at the ideas to prioritize those cut so you don't hinder the future american when you deal with the issues of mortgages in america the republicans congress and the republican president should have dealt with those issues for six years. instead they didn't show it. >> you took these votes and the fact is when you were fired from your job as a legislature that the leaders in our state had to pay off this debt not just for

the state buildings. we have the highest per-capita debt per citizen of any state. we all remember the catastrophe that the billions and billions of dollars in california and to try to get out of that mess. we were further in debt per-capita than they were. i want to raise the ship coal because it deals with us and tom and i talked about it and about jobs. we have four coal-fired stations in arizona they happen to be in the district that we are seeking to represent that i want to make it clear that i will fight to preserve coal and an energy source and not just because of the three to 5000 jobs connected to those generating stations, the coalmines. hillary said she wants to close the coalmines and unemployed these miners and then the train conductors and engineers but also our electric grids. everybody pays electric. the estimates are increases of 30 or as high as 40% immediately passed on to the ratepayers so

we have to discuss that issue. montu let's get to coal industry jobs and the environment. >> i do want the coal industry issue to pass by. paul knows very well that i have gone around the state saying we are going to protect those jobs. this regulatory environment without talking to our local communities without understanding the needs of our school districts and understanding the long-term viability of the national energy plan and not as a country whether it's been the last decade or the last two decades investing seriously and clean coal technology. we need to do those things. >> you can't have it both ways. >> the last debate we were and you said publicly that you supported the epa's plan. >> no, i didn't. i understand. >> the republic reported it that way. >> no, they didn't. >> okay.

>> reporting across all the newspapers and the people who represent markers in these factories and coalmines is that i'm against the epa regulatory environment and just what i said a second ago is what i've been saying. >> okay well let me share this. we were both in hoboken and we talked to the train conductors and engineers which i don't know if you remember but a third of them were on furlough. there are about 120 of them in the room. tom spoke first and then i spoke second and they asked him a question and you can ask scott the union president and the other members there and they recollect that you told them you don't trust the republicans to clean up the pollution in the environment and therefore you support the clean power plan. >> you weren't there. >> i was there. >> you were in the outer rim menu it just got there late. i understand totally when you got there and that's not what i told them. as you said they recollect.

>> here's why. why would you name, everyone in the room there were democrats and they voted almost unanimously to endorse me. he gave me a 5000-dollar pact check in recently said it is we know you are going to fight for coal as an energy source and you will fight for jobs. >> they represent workers in the coal industry and the power generation industry have endorsed me. >> you can't say something on group and say something in a different group. >> the bottom line here is -- the bottom line here is simple. i've been endorsed by the vast majority of the menu been endorsed by one. >> most unions will support the democratic candidate. >> is one of the few opportunities that was given to speak to the union and i won them over almost in a mostly in their democrats is they know i will fight the epa and stand up

to the president just as i did on the 2nd amendment which i understand you have changed your position on the 2nd amendment. >> moderator: 2nd amendment did you change your opinion? >> i am a police officer my been endorsed -- endorsed by the nra. i believe felons should not be allowed a loophole to purchase firearms. >> the nra has unanimously endorsed me -- you would be surprised? >> i wouldn't be surprised at all because any change in the process will move to that idea. >> anderson cooper called me on the show and said sheriff i know you are big critic of president obama when it comes to the lack of border security and enforcing the law executive action and he said i'd like to have you on this town hall with the president to ask him a question.

i said i get asked the president directly and he said yeah. i came on and i said to the president is he tries to make the same arguments that you are trying to make better false arguments. any executive action or any infringement on our 2nd amendment freedom you were a police officer in chicago and you should know this. >> moderator: let him respond. >> people should be allowed to have protection in their homes and their cars on their person. i agree with all of that. i don't believe that people that are felons and other terrorist should have any ability legally to secure weapons and i worked as a federal officer to make sure those weapons were off the streets. >> i'm scratching my head now because you used to be against obamacare now if you are for it and you are it. he used to have a different position and now after two phonecalls in a questionnaire by the nra tom o'halleran is dark.

>> moderator: i need a response please. >> i knew very quickly that they were against the loophole changes so why fill out a questionnaire that would have allowed them to just do what they -- again i am a public safety, took an oath of office for public public safety and i want our protected. i'm not going to do away with the 2nd amendment and i believe we need to -- >> moderator: we need to move on because we are running out of time. i want to get to a general question regarding comets and brought up before this debate. you were once a republican and then you became an independent and now you are democrat. why should voters trust that you have a commitment to ideals when you get back to washington? >> at the same ideals i worked on before. the ideal is simple. to be able to represent the people of congressional district one. those ideals whenever question was i was in the legislature.

no part of my public policies and question whether his representing the people before the party or the people before leadership. i lost my chairmanship because i fought for people and i lost my bills because i fought for people so the idea that i'm not going to fight for the citizens of congressional district one is ridiculous. >> moderator: all right. >> i don't buy that. >> moderator: why not? >> because he did represent a did represent district and they said we don't like what you are doing and you are fired because of all your taxing and you're growing up the budget, 64%. we can't have it both ways and then you ran as an independent just two years ago and you said you would run for congress that the political opportunists. >> moderator: you can't have your math and not to acknowledge the real math. terrell mathis 27% inflation and the set-aside issues for decades that we needed to take care of

20% growth in our population. those are real numbers and the real numbers or how many children were impacted? >> moderator: there have been questions regarding you switching parties. there were questions about you too regarding the school that the state invested in a tourney in having to investigate the alleged allegation of the mexican man threatening to reduce details. >> and now you have the fbi is looking at not legal funds, looking at legal funds. >> not the sheriff's office. this is the reality of the situation. i had in a way primary. we spent $4 million. emerged from the primary when these candidates talk about these things. this has gone on for years years. the day i went home and his allies is that of introducing him and what he stands for attacked me.

>> your inability to tell the truth about the fact that you knew everything was going on and you're in denial. >> an investigation proves what you just said is not the case. not only wasn't interviewed, i wasn't opposed. there was no finding of anybody responsible so that's the case. this is the democrats trying to say and do whatever they can to win the seat. >> the fact is as an investigator i've had cases on this issue. i have had cases time and time again and all of a sudden the video comes out for the person testified in their own words.

>> you knew what was going on. >> this was a school for which kids were expelled. some are incarcerated in there were six therapists in the psychiatrist on staff. that gives you a sense of the school. i was there two years out of 30 years. the investigation started years before i was there concluded after i left. i was never named in any of this stuff. >> moderator: the argument is that your headmaster and executive officer peevey didn't know you should have. >> we talked about that before. this investigation found no buddy was responsible. >> a move to florida. you need to have --. >> here is where i wanted to go at the question. >> what about that trends?

we haven't even talked about veterans. >> moderator: people were worried about you because you switched parties and people were worried about you because of all the time level investigations and allegations. >> surprise surprise at election time. >> moderator: how would you respond to someone who is the focus of that many high-level allegations? >> people who know me is not just the sheriff but as an army veteran why on earth would i get an award as the hero of public education? y. last year was i recognized nationally as a protector of children? this is what i've done and this is why it's such in a personal affront to me. it's a false mirror. it's done politically. >> you saw someone else with these high-level investigations would you not be concerned? >> that's different than what you just said.

>> moderator: the same question goes to you. how would you feel about a candidate running for office who is picking apart --. >> that person the passport of a gun and if they had taken a look at their party instead i think you are wrong and i'm going to make sure children of our state are protected over the fact that you are threatening to take my chairmanship away i trust that. trust my past actions and they need to understand that paul babeu is a taxpayer. >> moderator: we have to stop right there gentlemen because we have to get to the statements. going in reverse order in opening statements we start with paul babeu. >> for me it's a great honor to serve our community and to serve our state, to put arizona first in every regard, to put america first.

that's what i've done at the sheriff, 20 years and also in the army, served as a private working my way up to a major serving in iraq. i have always put the safety and security of our nation first. that's not the case by this administration. i want to change that. i want to put arizonians and their jobs first preview for tonight about coal. i will protect coal and the jobs associate with it and prevent a 30 plus% decrease in rates to pay for utilities. i'm on the side of reducing taxes, cutting regulations. part of the paul rain plan that there's a better way for our country. if you want that, if you want a better way and a greater opportunity for our country than i ask for your vote and i ask for your support. my purpose to serve you. >> moderator: thank you very much announces closing statement tom o'halleran. >> i'm on the side that works for the american families and the citizens of congressional district one.

i have improve the schools in arizona until the republicans came in and decimated funding for the schools in 2010 and 2011 and 2012. i have looked at our structure in this day. i have worked on making sure our forests are cared for in our water is taking care of in the rural areas and most importantly i have a record that shows that i worked with people. i will work with anybody from either party, whoever the president is, you name it for the betterment of the citizens of congressional district one i will be there for them because i always have been and i want to thank the voters and i want to thank -- make sure that we understand i'm the best choice for congressional district one because i have the record which stands for that. >> moderator: gentlemen thank you so much. we appreciate you coming in. thank you so much. candidates in thank you for watching the special election 2016 debate for errors on the district one. keep watching the political

coverage in this very important election year. that's it for now. i'm craig simons, thank you for joining us. you have a great evening. as hurricane matthew works its way towards the carolinas president barack obama is warning that matthew is still a dangerous hurricane. he met in the oval office today with fema administrator craig fugate and homeland security secretary jeh johnson. the president talked to reporters after the meeting for just under 10 minutes. >> obviously everybody has been frantic in the course of hurricane matthew and i just received an update from our fema director craig fugate as well as the rest of her national security team and i just wanted to make a couple of key points. first what we are seeing now is matthew having moved above south

florida and some of the largest populations working its way north and the big concern that people are having right now is the effect that it could have in areas like jacksonville on through georgia and from what we have seen significant damage in portions of south florida. think a bigger concern at this point is not just hurricane-force winds, but storm surge. many of you will remember hurricane sandy where initially people thought this doesn't look as bad as we thought and then suddenly you get massive storm surge and a lot of people were severely affected. so i just want to emphasize to

everybody that this is still a really dangerous hurricane and the potential for storm surge, flooding, loss of life and severe property damage continues to exist and people continue to need to follow the instructions of their local officials over the course of the next 24 to 48 to 72 hours. those of you who live in georgia should be paying attention because there has been a lot of emphasis in florida but this is going to keep moving north through florida to south carolina. there are large population centers there that could be vulnerable so pay attention to what your local officials are telling you. if they tell you to effect weight you need to get out there and move to higher ground because the storm surge can move quickly and people can think they are out of the woods and then suddenly not be in a position in which they and their

families are safe. so pay attention to local officials. in the meantime i have been in contact with the governors of all four of the affected states and i want to thank them all for their leadership. there has been strong cooperation between federal and state and local officials. fema has worked diligently to pre-position resources, assets, water and commodities and as the hurricane moves north what craig and his team will be doing is moving those resources further north so that anyplace that happens to get hit badly will be in a position to immediately come in and help. i really want to emphasize the governors have been on top of this. state and local officials have been on top of this. they are the ones who are tracking the most closely what is happening in your particular

community in your particular area. you need to pay attention to them, do what they say. do not be a holdout here because we can always replace property but we can't replace lives. i want to thank craig and his whole team as well as department of homeland security, my own national security team for staying on top of this. we are going to monitor this throughout the weekend. our thoughts and prayers are with folks who have been affected. even if south florida's damage wasn't as bad as it could be there people who have been affected and for them they are going to need help. last point i would like to make is we are still tracking what happens in areas like haiti that were hit more direct way. haiti is one of the poorest countries in the world. it has consistently been hit and

battered by a lot of national disasters to compound what is art a great poverty there. we know that hundreds of people have lost their lives and there has been severe property damage and they are going to need help rebuilding. i would ask all americans to go to the american red cross and other philanthropic agencies to make sure that we are doing what we need to do to help the people in need and we will continue to provide information. if you are interested on how you can help the people of haiti and others go to whitehouse.gov and we'll provide you directions in terms of where even the smallest contribution is to make a big difference. thank you very much everybody. fema is in a good position right now.

we had some concerns last year when we were in the midst of budget negotiations. i think we did a good job of making sure that fema was properly funded and not to make them blush but we happen to have one of the best public servants in america craig fugate and they know how to manage money correctly. that's not going to be an issue. of course we always want to be cautious about making assessments with respect to damage. we are still on the front end of this hurricane. we are not on the backend so we don't know how bad the damage could end up. we don't know how severe the storm surge could end up being and we are not going to know for three, four, five days with the ultimate effects of bizarre. if we end up having really significant problems and really severe property damage the

stafford act comes into play in our ability to provide through emergency declarations and other mechanisms or help to local governance, that's always going to be a question we have. as you know we still have flooding in louisiana that is left a lot of people homeless. over 100,000 people lost their homes there and we still have to rebuild. there is that log of need from natural disasters around the country. during the lame-duck -- lame duck session we have to figure out how to fund effectively. the issue is not so much fema's funding for immediate emergency response. the issue is going to be making sure that after in this case the hurricane but in other cases

flooding or wildfires are out there natural disasters after they happen are we in a position to properly help people rebuild and we will obviously make those assessments after-the-fact and then we will talk to congress about how we can help out. alrighty? thank you everybody. thank you. [inaudible conversations] i'm going to be doing a little campaigning and a little boating too. all right, thanks guys.