that will put us behind the tip of the spear, which is the va, but we will do telemental health and start with medication management in a particular market to help give them more supply and then it will also do psychotherapy on that same backbone that will allow us to test out in both urban and rural areas how we jointly want to make sure that people are taken care of and leveraged supply in the private sector when it's not available in the va. and i would just say that making sure that providers are understanding of who a veteran is. and then we select carefully who we place people with is really, really important. and so we've put a million dollars into a nonprofit that's actually constructing the teaching information that will be made available to providers all over this country as it

relates to understanding a veteran and evidence training that va and dod have specialized in, and actually make that available from a distance perspective with a coaching apparatus on the back end that we designed in concert with va and dod and that information will be available free of charge to providers all over this country that want to step forward and be helpful. >> i agree that telemedicine and home-based health care is great for small supplier, it i cannily the area of mental health. i've seen many veterans who have troubles who benefit from it, and there are issues that have ton worked out and somebody from san diego might want their same provider and not mesh well in another area. i want to caution, it's not a panacea. i think the optimum health care is person to person. in so many instances, hearing

nurses talk about, for example, decubitus ulcer. you can see it on the screen, but it's not the same as appreciating how bad it is when you're there and seeing it in person and happy to see my doctor once a year when i do my annual exams in person. there's something that doesn't want to loose, but don't want to see it as end all-be all care, but for opening care to veterans who need, you know, services. >> great, we have a question at the mic? >> hi, thank you all for being here today, dr. taylor winkleman. it would seem as scary as the 2017 deadline, august 7th deadline is, it provides us with an opportunity to introduce changes to the program and as a veteran who remembers what it was like living 98 miles away from a facility before veterans choice

came in, i can certainly related to the benefits and challenges that we face. and mr. gillums i recommend you would extend something to extend title 38. but what would your ask be for improving this ap better more cohesive vision put together.

>> but. >> we have to actually have to have changes. this program as was describing came very rapidly and was in it implemented rapidly with congress could change the law for times already which is great and we have other ideas to let the programs work better bed number one is primary-care issue and in some circumstances we have to rely on other health

insurance so what does that mean? were have to pay the coach pay and deductibles and premiums and no other program works that way. so it is exposing them to some financial conflict they never had before and a lot of them more upset about that not knowing they have to pay the specific portion. number two we need to be able to work better with community partners especially in the rural areas. right now the choice law limits the v.a. that medicare so now that makes sense to some locales but not others so we have to pass that flexibility to partner with providers at a higher rate because a lot of times but definitely have issues sometimes it isn't that is the flow but it is too low without flexibility of pavement and then i

mention the other things to coordinate care better to share information that we have to leave of the program we have invested a lot of infrastructure and we have learned lot. behalf to revolve it should not be completely scrapped as it will go through the same growing pains of a few years ago. but it is how we continue to take what is there for what makes sense for our veterans and community partners. >> i imagine some other panelist imagine what needs to happen with the program put. >> the issue of the primary-care facility that they will not qualify if

there was not to the v.a. center within 40 miles. with a veteran that is 3 miles away from the facilities to work through those issues it is those negotiations with the veterans of ministrations but that has been issued and that there is close facilities with that care of need but they cannot utilize >> just to comment on that piece, it is one of the things we have to be aware of. talk about 40 miles from the primary-care doctor or 40 miles from others and a lot of people look at that model definitely would have

a very large financial impact. apart from that and with that referral patterns with the service connected to veterans if we cannot provide wraparound services because a lot of those are deferred samara else outside the system then becomes hard to gain competency to recruit doctors in the area. so figuring out flexibility for those veterans that need to be seen. sometimes it is too long but i do raise some concerns about completely because what that will do is contract for those that want to use it because you must

not be able to build up the wraparound service if you don't have that volume more expertise to do that. >> i concur so open access is not the right place to open up investing a lot of infrastructure and to make that stronger to make sure it has sufficient supply is important but for the last 15 years we employ people from every set coded this country and has spent very different from many of their conflict. and they don't have to displace where they are they may take a year or two off the have a right to do that

with the benefit they have earned. and we all agree that it makes sense but how do we draw the parameters? said from that perspective congress needs to decide how does it want to deal with the responsibility and there is a lot of money that is paid in travel and the lot of money paid when someone doesn't get what they need of a timely basis. because when they are really sick is more expensive. for those things you want to be and the v-8 facility absolutely a top-notch academic is a witty could regard this of where you live in the state that they're great could get the orthopedic service across the state and i think you

will sort through those. and when reflects properly to make that work. >> and some ways there is the bigger conversation about what is the obligation and if the decision is and has an annual budget every time there is an increase of demand beyond what was expected rejected there will be access problems and this will be true for community care as well. particularly if you increase the eligibility. so in the bigger picture what is our responsibility to veterans or our commitment and how to be paid for that?

>> we have had several questioners want to know how to get claims paid faster? what is the answer? >> this is one of the things that i spend a big chunk of my day on one of the partners delivers care and what we are realizing there is the number of the root cause issues to major to pay providers. one gives back to the eligibility peace six source seven or eight different programs with criteria that if you don't match the but exactly right and you are providing care for a veteran

that lurk ... 40 miles then we don't have the authority and that is unfortunate because uh criteria is so many of them that a veteran receives care that we don't have the ability. so how do we get to that eligibility criteria that is clear for the patients and providers that there isn't any ambiguity? medicare is pretty simple. u-turn a certain age you have a card and you are good to go. and to get to that love all of clarity it will be hard for providers to know that.

to make adjustments to the allies the biggest area right get complaints about provider payments relates to the emergency room care. er care is a plan to consolidate is very fragmented. in some circumstances it is the primary pair of those conditions and in other circumstances it is hell last resort. by a lot and statute we pay 70 percent of the medicare rate fell with doctors with the er it is considered payment in full but they have to carry a chunk of that of their accounts receivable and then they cannot pay us until we get the law changed. that is around the unauthorized care we have to

figure out that the services connected or not. so we could pay the bill to get this more in line with a progressive industry does. does require some investment and if we can get the good criteria in the king said of the system and then we can leverage the community partners. when you actually go to the medical records and then the emergency room you cannot do that by the computer.

and with that knee injury service. way to complicated it takes a long time. to get to a system where to the kennedy adopters to know what they are able to deliver. end however we need help in we cannot meet the standard that we want to meet from the legal and congressional colleagues. >> now responsible for paying 322 million appointments i will tell you what we don't collect. if you go back to their try care 20 years ago about

three months in it was obvious it never paid claims properly. now walking into a scenario he did not create. of that dates back the long time that the v.a. was paying claims by market by market by market. that is not a very effective way to do with. it is hard to get to core competency. and now to consolidate what that looks like was a very needed change. en to have that one direction on the government side. in the institution and to file properly. did to be in a place where the claims are denied. and then to send the next

that is not in anybody's interest anywhere. and with a provider perspective at us start and then get a ride across the system to make it the fastest in the most accurate from those types of programs , you also have to pay one way. right now those from the community they pay one way and file one way if it is through choice it goes down the different ways so of mansion trying to figure out how does this work as a consolidated pipe. we had a project in arlington and texas the

members of congress from the area because to have a community-based outpatient clinic. the son of the hospitals have a 50% denial rate. they did not know how to file accurately. within five weeks together we drop dead at 10%. that makes their historical pattern of pavement changes dramatically. it is part of the responsibility starting with the provider fighting accurately than it does to us to make sure reprocesses the work and then to do inconsistently and that it cycle's back. as an actor that's spent

time 20 years ago and those in the provider community so from my perspective and then they are riding my side and there is no separation was what they try to accomplish. and then the va pays as. and then to figure out what those pieces are that needs to be changed but there is another pragmatic component to get this work right at the end of the day. we will test that then take what we learned to apply to the rest of the enterprise. >> i would expand on the

comments as a provider leered used with the intricate rules medicare is the great example very tight around the medicare recipients but as providers we know what those rules are to incorporate into those processes we know what a medicare recipient comes in for a test what the diagnosis has to be if you can imagine the fear of had their own rules we could develop the systems and process. one pipeline nor one set of rules.

and that is very beneficial. >> one or two more questions. please fill up the blue evaluation for before you leave us today. >> the commission on care reports. with the advisory board and one is to eliminate the requirements that are possibly in constitutional but hypothetically what would bidi impact of either of those changes. >> double comment on the of latter.

and with the response and to those recommendations. just like mom and apple pie those that our most controversial. that people leave and then to, but that eligibility criteria when myself as a doctor but getting to that same goal way to do referrals with the hide networks to create a partnership of that utilization and an that wrapped around customer

service says it was laid out in the consolidation plan and also the way we need to do that. the specific legislative changes and also the budget. and that is a point we hope to get to. >> to all those veterans looking at the numbers 9 million are enrolled in a v.a. 6 million use v.a. health care. most have other waitresses medicare or private insurance through blair and

they choose whether to use v.a. or other sources based on a number of factors that is cause and access. if you opened up what you will see is a gigantic increase the demand. and then the va will pay for it and because the v.a. benefits don't have the co-pay. and go through your private insurance or deductibles and and just uh number that is one thing to consider. the other thing to consider

is do we maintain uh va health care system are transition to a private sector model? you cannot have both with open access. the reason is that people choose to use private sector v.a. care. and you felicia understand the quality of care decreases there is the tipping point and is not reasonable and as they close and from my perspective needs to be thought out it isn't just uh death spiral. is moving into the private sector.

said nike's said that so eloquently. but as a clinician what is missing is coordinations was the thinking about the way the program works it is the reimbursement system you handle your own care and the government pays the bill but what went missing from my relationship perspective is how do helpful the american health care system to make sure their needs are met? the greatest extent that people do it on their own while there is a small segment of the population for many it doesn't work. and if you look at the critical perspective, do we want to have a coordinated

system floor by themselves? >> you can have the last question. >> my eighth question is what is going on in technology those seven giving patients the opportunity so has it considered partnering with apple or other technology companies to have their own medical data they can have a dialogue greg. >> we have spent doing that for a while. is the very easy way to

download the version of your health record to share with their community providers so we have an entire digital services team to leverage that are thinking of creative ways to exchange information. >> i was pleasantly surprised. and with your medical records so if you follow a claim for certain benefits benefits, it works wonderfully.

>> we have reached a the end of our time. please fill out your evaluation form. thanks to our supporters and to our panelists for informed conversation and to all of you. [applause] [inaudible conversations]

things welcome perfectly, but the outcome-- >> just to be clear, even though things woke zero well, your point is there is an no intentional effort to alter the outcome of the election. >> it is the inevitable results of america being america on election day. >> you have been watching elections for a while and you are one of the country's experts picked is that surprise you that things go awry on election day, particularly presidential elections? >> it doesn't surprise me because and there are a variety of reasons why things go wrong,

so on the presidents we went around and held meetings and public groups to find out why lines form and we talked to election administrators at this date local level, stakeholder group and the voters themselves and one of the things we found was that every four years we pay a lot of attention to elections and it's usually as mentioned earlier, in the month or so before the presidential election , maybe in the primaries if there interesting this year's been a roller coaster, but in the off cycle years when they go to their legislatures trying to get legislation for reform for improvements, for resources, for funding they don't have the attention they should get and many of those reforms are known and tried and true around the country and they are in the

presidential commission on election administration on the american voting experience, so there are set reforms we know can improve the voting x-rays in the united states. many states have picked up some of those reforms and recommendations and will be trying them out. this will be the first presidential election. they've implemented them in the last clear since the report and that's important to know that it's not for lack of trying. in many cases and if you look at the national conference of state legislators, they keep track of what's trending, of reforms and elections are being introduced and passed, so we have more states with online voter registration. we know it can improve the voter rolls and we have more and more states joining crosscheck programs and we know the efficiencies there-- >> could you stop there and back as.

>> not everyone has followed these reforms are at the commission's report. i think it's well written and not-- can you just push a little bit? >> certainly. we were passed by executive order to look at 10 different areas of election administration. everything from voter registration, providing language assistance, military and overseas voters, voting technology, you name it. it's was a buffet of election issues, so we came up with a myriad of recommendations, bipartisan and unanimous by the commission and the commission cochaired by bob bauer whose president obama's former general counsel and then ginsburg who was governor of-- romney's attorney.

so, it was unanimous and bipartisan and we came up with reforms like bipartisan legislation being something we should do to modernize our registration process, so if you want the foundation of your democracy to be accurate at the polls on election day, let's really look at how voters are registering, when they are registering, when they are keeping their information current because the majority of voters believe when they change their address with the department of motor vehicles it changes their registration. states have different interpretation of the national voter registration act and whether or not that's an automatic often or opt out, but states are revisiting some of the ways they're keeping their voter registration accurate. with specific recommendations for military overseas voters, making sure their permanent registration because in some states they will cancel a military or overseas voter at the end of every year, which we

did not believe was appropriate, so there is a wide variety of recommendations and things as simple as a valid layout and design can be as important in making sure that a valid is actually being recorded as the voter intends. yes yes, it is no know, how many times can i cast a selection. is a vote for two or three so we know their usability best practices that should be done, but in many cases states are precluded from doing that because it's in statute that every thing yesterday and capital letters. has the worst possible way to present information, so there are ways to lessen the lines and make sure there's more integrity of the system everywhere and i think election administrators are trying to get those reforms passed and they may have been unsuccessful, but there still is a lot of work to be done.

>> doug, i know you are an internal optimist and while there has been, you know, a pale cost of election officials, after all these are folks who are really doing the work of democracy here in the united states. the comments are an opportunity here particularly given where technology is? are there some areas where you look at-- areas where we have had trouble and so the areas that she has just listed in these you talk about after or during presidential elections where we have the solution through technology and new innovations. >> absolutely and your correct am an optimist. in this case i think it really applies to one of the things i appreciate about election officials and why like working with them is this commitments to

the notion of improvise and overcome. when there are long lines think about how weak layout the polling places and layout ballads and i will point out that our program at the university of minnesota is running a course on election design, so check us out on the. they work together. they talk to one another about how to get the word out to voters in advance about early voting or vote by mail or but have you. they study one another and learn from one another all the time. as we've come into this new more technically involved your with online voter registration, you see jurisdictions share ideas about how to protect their online voter registration databases from the bad guys out there who want to steal personally identifiable information or quizzing them share information with one another on how to make those systems successful to people with disabilities or people who

with whom english is not their first language. i talked about the election community and that's actually real thing. this is a group that doesn't expect to be universally acclaimed in some ways. the bricks that are thrown at them, they are the great catchers of american democracy and there used to being in the line of fire, but inevitably they come together and find a way to identify a solution and chat with one another in a way that works for voters in the country at large, so every probably is an opportunity and election officials, that's everyday thing. >> technology, it's the future in every main of our life. does technology offer a way, for instance, on voter registration with high-level certainty to identify who the person is that his registering and whether they

are actually eligible to vote, which is one of the main concerns of those worried about reading. >> we certainly see that and asked him he the commission report recommending online voter registration was one area which was maybe not surprising to tammy, but surprising to me was tremendously bipartisan, the online voter registration and bright red straits, bright blue states in every shade of purple partly because it mirrors the two concerns that the parties have and makes it easier to register, but states tend to break in some kind of eligible to check whether it's evers license or something else, so there are opportunities to make voter registration more available. in several states have set up something, eric for short but it's electronic registration information center where they share information data with one another not just identify people

that might not be eligible, but more importantly to identify people eligible, but unregistered and states are reached out to them and either physically sending them an application or giving them an-- a link to an online registration portal. it's easier than ever in this country, i'm confident to say, to register to vote and justice court to check and update your registration. it's easier than ever to find out where do i though, what are the rules and technology has made the distance between election offices and their voters as short as the distance from your thumb to your smartphone. >> is it also the case that our confidence that the rights people are registering? that the technology also improves the integrity of the process and of the security confidence we can have with only eligible citizens registering casting ballots? >> i think yes.

citizenship and/or other checks are being baked into some of these online registrations and the ability whether it's through eric or the so-called campus crosscheck where states share lists, they are checking and double checking all the time in the field, so i think that our confidence, the evidence suggests confidence in the quality of the voter registration is and should be at an all-time high. >> i would to get one step further and that is that doug is correct am very biased for online voter registration because it started in arizona, and it's been my soapbox for over a decade, so i'm excited to see its adoption or part of the reason i'm excited about that is that not only does it have all of the deficiencies that doug mentions, but also allows additional security when you have third-party stakeholder groups, political parties, candidates out registering voters and even have them

registering on paper and handed it to that person then it may or may not ever get to the election administrator. that voter feels they registered because they completed the piece of paper and handed it to someone with a clipboard and it turns out that if you have a clipboard you can do just about anything because people trust a clipboard for whatever reason, but instead we have online voter and there are hundreds of organizations that have leverage online voter registration to register the voters right then and there and the information goes immediately into the official state system and many of the states have created very efficient systems to turn around that data electronically and send it back to the party, the christian name registration to let them know this person is registered. so, it's good for the political parties, the candidates, for the stakeholder groups out there

doing this effort. if they could shift there were quite-- from registering voters to getting out the messages and getting out that electorate i think they would be thrilled to shift their efforts in that way. >> let me jump on that quickly. that's the upside and i think you also raises challenges the. with the advent of online voter registration, two things to worry about. number one, can the system handle the load. we have seen states where they physically can't, where the rush at the last minute and i believe virginia was like 3150 people per second were trying to register online in virginia and that i daresay is like "american idol" at its peak. states have to be ready for that and the other side is in the packing context that's personally identifiable information: name, birthdate

and valuable information to people who would steal it for illicit purposes, so the challenge for election officials isn't necessarily the election process like getting the data is bad for elections, but it's bad for voters and people can get at it, so we are starting to see homeland security and individual states educate themselves and educate their stuff about things like phishing attacks or injection attacks and looking for backdoors and side doors into their online portal. i'm not saying that's insecure, but we have to treat voter data like the absolute gold that it is because it is gold to people who do bad things to it. >> i went to pick up on the hacking issue. we have seen hacking, large retail companies. we have seen hacking of bags. we have seen hacking recently of political parties and campaigns. should america be worried

whether it's wikileaks or perhaps russians effort can hack our voting system either in terms of the registration rolls or in terms of the ballots cast and then counted. >> those are definitely two distinct things and all of the examples we have seen in the media has had to deal with voter registration and it's also important to consider that in many states the vast majority of information on the voter registration file is public information or obtainable and very inexpensively and for $25 you could get the entire voting role for the entire state. other states it's more cost prohibitive. in my state it was a penny per name, which sounds like danny-- that the election of 2 million registered voters. when we are talking about but a registration information, online voter registration is a little bit of a misnomer.

it's online voter registration application process, so it is not automatically give that individual access to the database. it does not automatically put that person's information onto the voter file for that state. its application in the same way if i am a clerk entry in that data i'm applying it into the system where will run the background check and balance against the department of motor vehicles, bouncing against other state agencies for states that have set up more expansive. it's an application process and states have redundancy of their voter registration files, so if i'm going to register or going to my registration online in the states what i actually see what happen in my information to see if i'm already registered and finds my registration as my old address i can change it and it's actually hitting a redundant system that either gets uploaded

every night or uploaded every hour. it's not the full system itself, so you're only accessing a duplicate, so there are these redundancies in the system for voter registration and that's what we have seen in the news. it's also important to know that most states provide the voter file, the vast majority of information of voter filed to the political party and that's where they get their canvassing door-to-door lists and how states provide for the candidates and so that's where that information was hacked. it was not hacked at the official election registrar, reporter, supervisor of elections offices in the incidences of the political party pack. >> doug, is this a real threat of hacking and maybe vote totals will be change that the russians could come in and pick the winner of our presidential election? >> i think the answer is no. again, because of all of the

different ways in which we check and test the system. there may be some people who fear that, but i don't think it's terribly likely. i wouldn't without far. i think it's impossible to change the outcome of an election remotely. the threats we are talking about are the systems like the registration and even then it's just information, not outcome, so to be worried that somehow a bad actor whether it's a state actor or partisan actor will be able to interfere, give between about the outcome is next to impossible if not impossible. >> i would say the other caveat is to say that they could do so undetected because that's really what is at stake here, so let's say they did get in and deleted half the voter file in the jurisdiction. of those voters are still going to show up and vote or request a

ballot, hopefully. when they do so, if they are not on the voter file they have the ability to cast a provisional ballot. in that case, that jurisdiction would be looking to see why do we have this huge influx of provisional ballots and they would be able to look back and say where the similarities. if all these people had their registration canceled on the same day at the same time or what have you in the voters vote would count because they would be able to track it back to the transactional laws in every system. which staff member keyed in someone's voter registration or changed someone's voter registration and there are ways we can monitor the system. there are chains of custody documentation, so being able to do it undetected is critical and when you talk about the ballot casting and tabulation, it's also important because every thing is important to know, but

it's very rare and i say that because i'm not aware of a single jurisdiction that has their equipment connected to the internet. the vast majority of states actually have standards and laws that require that you cannot have it connected to the internet and there are protocols in place to make sure that the same downloading the new election onto each piece of equipment is it a different stick used for each type of equipment, so there are a long laundry list and we have one portion outcome, that we are talking about some of these things, so there are resources available for election officials like as doug mentioned the department of homeland security has offered a whole host of calls with secretaries of state and state election directors and election officials, but the election mission, i mean, we

would be remiss if we didn't talk about the outstanding role they have been playing in all of this. when the commission i was on, the president's commission was doing our work there was no commissioner and we now have three of the four from the last couple of years with outstanding work to advance the technology to get new standards approved, to work on the next set of standards that will really allow for such increased performance of an election in the oncoming years. now, we just have to decide who's going to pay for the new equipment because the equipment we are using is aging and the vast majority of election officials feel this will probably be the last presidential election where they will use the current equipment, so that's gets another layer of this onion. >> i have questions from her audience and i want to move to them. before i do that i want to follow up quickly.

given the next generation of voting machines that will be coming online, do you think it's imperative, given questions about breaking, concerns about hacking that whatever new machine comes online should have a paper ballots to provide the competence to voters were set just, you know, so antiquated and inefficient that we should move past it? >> i believe that every single state has some requirement for a paper record for the next iteration of voting equipment to purchase. currently there are only a couple states that don't have a paper record, but they have very stringent testing and postelection audits that occur to ensure the validity of the elections. when you talk about things like stuffing the ballot box, every jurisdiction does a reconciliation audit to make sure the number of people who signed in should actually be the same as the number of ballots

cast, so everyone does that sort of balance and there are other states that do things i can count on its which refers the paper record to the electronic record. what many of the new iterations voting equipment are looking to have a sale have some sort of paper record and in most states that is consider the official ballot passed by statute. >> quickly, whether or not it's paper, every state needs to have a voting system that is auditable in every state that's not already doing it should do a public election audit, so we can make sure the outcome that was reached was the outcome the ballot supports, so right now paper testing is the best way to audit. some sort of technology that allows us to independently verify the guts of a machine without a paper ballot, i don't know, but the important thing is that the system be auditable and

that we actually audit the system is. >> here's a question from the audience and the question is, good conversation, but this has been quite technical and the questioner says isn't the case that the critics of the system who are warning about raking in some of those warning about hacking have already done quite a bit of damage by raising confusion, diminishing confidence and casting a pale over the coming election results that we will have in three weeks time? tammie. >> i think that's the concern. this is technical because the elections process gets down in the weeds really quickly. it's all in the details, so it's much easier to make a false claim that is broad and expansive and vague and then have to come back it with actual details of what's going on, so i

think that's really the challenge we are faced with here. when you have-- i believe it was recently there was a hearing not far from here on the hill about this for a topic and one of the congresswomen said i do believe the russians or anyone had any intention of rigging or hacking anything, but they have already crated chaos and by creating a chaos they had in fact been successful and i'm hopeful that that plays out to be untrue in the long run on november 9, or later on in the month. hopefully election administrators will have thanksgiving because that's always a question if you will be done counting to have fixed-- thanksgiving and i think that's what we will really find out is if in fact i believe they may have underestimated the tenacity of the american voter in the american electorate because i think everyone will make sure

that they understand what their options are, so if they have to go to the polls on tuesday the eighth, that's what they will do and if they had the opportunity to vote early we are seeing record numbers of absence the ballots that allow voters to vote by mail. we see large timbers of individuals showing up at early voting sites that open across the country already. i saw yesterday like something like 1.5 million people are devoted, so i think the american electorate will turn out. they are registering a record numbers, so i think-- but, again i'm an optimist like doug here, so hopefully-- >> this is really the challenge here, that all the kinds of things that most of you comment on and try to understand and analyze that come up during elections, misfeasance, just stuff happens. is this thing on the reality

that because we are having a conversation about regaining and giving it attention it will now give credence to the idea that plain vanilla administrative slipups become seen in a sinister light? >> i guess so. certainly pretty heated rhetoric and whether or not the charges are false i think their fossil viable. i think we have the data and we will have the ability to show that the system works the way it's supposed to work even when stuff happens on election day. we are actually seen americans react in this election. i blogged a couple weeks ago, voters are voting sooner, checking the registration multiple times and they will make damn sure that ballot counts on november 8, so yes there is sort of a raised concern that the system might not work, but each individual

seems to be taking a role in making sure that her vote actually gets cast and counted on election day, so am i worried that there's a lot of negative energy? absolutely, but am i worried it will prove to be a problem on election day? no, not because i think with the data to show it won't be. >> let me put a crush and that's been asked, which is art we by talking about breaking giving it attention and more credibility than the charges deserve? >> i have heard this brought up in the last couple of weeks and i would say that if we were not discussing it, if we work refuting it has sometimes silence is legitimizing the stated claim, so i think it's critical we are out there talking about all of the safeguards in place to ensure that our systems are secure and that there is integrity in the process.

but, i do hear that on occasion and i understand that perspective, but i think if we are out there with the correct information that the wrong information will continue to be conveyed and we need to be out there selling. >> doug, select have a question. or what to put you in the day after the election when one of the major candidates that loss makes the argot that they lost because the system was rigged. had a we responded. >> proven. coming there will be piles, reims, terabytes of data available to show that the system worked the way it was intended to work. many states allow was called a contest procedure where you can contest an election. we had one in minnesota, but you can allege no problem but you

have to prove it and put enough votes in question to be the outcome in doubt, so right now it's rhetoric. i think if it happens after the election and becomes an allegation in such allocation needs to be backed with proof and if there is proof that when we will hash it out and if there's not prove it's just rhetoric, so prove it. >> to paraphrase the first lady michelle obama, if one of the candidates those in the direction of breaking than your suggestion is to go high to the data? >> with all of the data, but again prove it. it's interesting, talk is cheap and i say probably multiple times a day, and it election geek, not a political junkie. i understand the rhetoric we see right now is the aretha franklin of politics. understand that, but when you come for that election system especially the day after election day you need to have proof. you can't just say the system

does not work. you have to prove it. election officials don't have the time or money to prove the negative. >> let me give you an example of the kind of proof that those who are doubters, you have worked for a few states and you did a study in 2012 on election roles and it showed that many states had done a good job to keep the election roles accurately are now, those who are suspicious of the election system point of the study and say 18 million names that are fraudulent on that list what's wrong with that? >> we don't have time to cover the whole thing, but that study was done with the intent of showing how the current registration system sometimes lags reality with regard to people that died were people who have moved.

large numbers of those registrations are people who moved from one place to another and tammy mentioned this, but when you pollute-- move even if you are on the ball enough to know you need to register at your new address you might not realize you're supposed to let the old address that you don't live there anymore. does that create a duplicate record? yes. if you try to vote at both places you will most certainly be found out. do people who die remain on the roles? yes, some-- sometimes notifying the election office of death takes more time, but those sorts of things are usually quickly identified and there will always be a way because we are a nation of many hundred million people who are constantly moving its like one in six people move, tremendous mobility in this country and the voter registration will always lag reality. one of the benefits of online voter registration is that it gives voters the possibility to

both check and update the registration more quickly and with the help programs like eric to help states track that movement as well. is their lack? yes. does it mean 18 million dead, relocated or otherwise fictional people with past ballots on election day? no. >> i would absolutely agree and pushback that those are 18 million fraudulent registrations because the vast majority of those are eligible individuals who had the audacity to move, get married and that sort of thing and when many times people have life changes they are not thinking of contacting their supervisor of elections or the county auditor to let them know they have moved and we also know studies prove that the voters believe that when they do a change of address at the postal service that it updates their address automatically for voter registration and that's not the case in every state, so some

states do it that way with national change of address. state of minnesota started doing that as well and found great efficiencies in the. so, instead of assuming our population is going to know the nuts and bolts of our election laws or having our election laws reflect what our-- the people we service believe the services and i think that's important moving forward. >> thinking forward, to after the election, what would be some concrete feasible reforms that either washington or the states ought to be looking out and passing that would create about the reality and the appearance of fairness in the election system? >> i have a long list. so, i would say the best place to start is the president's commission report.

shameless plug. in all serious there is a number performs and i have been talking with-- and i would say whether this should be a federal effort or the state suffer is subject to debate and that the whole mother panel, but i think everyone should be reviewing the state in which they live and whether or not their existing guidelines reflects a progressive way of servicing their electric and what a mean by that is that many election laws were written 50, 62 years ago. and they have been updated over time, but there certainly so ensconced in paper and older processes and procedures that they need to be reviewed. one of the things i have mentioned it to state legislators as well is to make sure they are look at deadline. it's incredibly necessary to cut

off voter registration a month, two months in some cases before an election because you have to use all the information keyed into the system or handwritten into the books and get them prepared to go to the polls. online voter registration is almost an instant process to get that update and if you're using an electronic poll book at the polling place you can update that over the weekend before tuesday's election get it deployed in plug in time, so there are ways to reflect what we need and what we knew in our everyday lives. so, i think that's really what we need to be talking about and as i mentioned before the funding because we need to start considering revenue stream for our elections that it's something every 10 years we decide we need to put a chunk of money into voting equipment and then have these little stopgaps along the way. it's critical we pay attention to it and that we devote

resources to it. >> doug, what's your agenda items for fair elections? >> i think we need to up our investments in the american election system. tammy is correct we just have to invest money whether it's federal money, state money or something partnership between states and localities we need to find a way to make the cost of elections manageable for election officials so that ought to go hat in hand to the legislatures every decade or so. do we need to invest in the rules on law? tammy's right many of our books, our laws on the book to you with an election system that was more like 1910-- 2010, i mean, we are not thinking about poll books and the like and finally we need to invest in the community itself and obviously at the university of minnesota with our election administration we are investing in the next generation of election professionals, but

we need to understand the job is changed. you are not just someone who is collecting and tabulating votes. you need to think about cyber security and identity theft and you're someone who needs to think about the layout and design. you're somebody who needs to think about the different communities in your jurisdiction, language, disability what have you coming to vote at your polling place in your job of an election ministration is much more complex both in ministry to me it ever was, so we need to invest in a new generation of election officials who can make the ask for funding who can make the ask for improving procedure and also do the day to day work to make sure the process works for their voters. >> the president's commission that you served on, one of the recommendations was for a concerted effort to create training for election officials to create a profession or two

report the profession. case a little bit about that? >> sure. part of what we included has to do with really went down just mentioned, recognizing the very skill set that you need to be an election administrator looking at it in a wide perspective, so we know that there are states that have certification programs of their election administrators, so in order to to conduct a election in the state of arizona you have to go through certification program. it's a weeklong training that goes over the laws, federal laws, state laws, a wide variety of things you need to know. what we find is a lot of election administrators in some cases they run for office, but in others they are appointed and and/or hired on as a job and maybe don't have any experience whatsoever. i speak from personal experience

of having no experience in it and it's quite a learning curve, so having an established way for someone to educate themselves on the job is necessary. most do not wake up when they are five or six and family to be on election administrator and that's too bad because it's an exciting profession and once elections get in your blood you don't turn back. it's a career path that runs the gamut of every possible thing you can imagine, good and bad. there's never a dull day and no two days are the same and it's an exciting and very very fulfilling and rewarding position, so that's for the election official, but we also recommend it to make sure that there are procedures in place to train our poll workers and our other election ministries staff because in some cases the workers train the first time they work in and they never have

to go to train again, which as we know elections change a lot from one election to the next. the laws change. we have procedures that change, so the training piece of it is really really important. >> doug, i went to ask you about one of the challenges that strikes me and a curious what you think of this, which is there as been conversation about our criminal justice system that officials in the criminal justice system ought to look like the communities therein. there is enormous generational tidal wave of folks in that election world who are retiring our thinking of retiring. does that create an opportunity to create a new generation of election officials that looks like america? >> absolutely. i think right now as tammy mentioned most folks did not wake up to find a way to be election officials. is the accidental profession, someone who started as a poll

worker who was in another area of local government and telling to election senate got in their blood. we have an opportunity in this country with the wave of retirements coming in the field. right now what we tend to do is take existing election officials and teach them about how to reach out to communities and their jurisdiction and make polls available to people with disabilities and reach people from different ethnic or language communities and that is an important challenge, but at the same time there's also an opportunity right now to take people from those communities, people with disabilities, new immigrant citizens, and teach them election administration and make the profession of election ministration look like not just the electorate, but the population at large. i talk about shorting the distance between the voter in the process and in many ways picking the professional look more like the population and also shortens the distance

comfort wise for everyone in communities that the system works for them, so the humphrey school at the university of minnesota is dedicated to the issue of diversity in a wide range of issues and we're excited to continue that work in the field of election ministration, so the short answer is yes see next line you. >> thank you. , to circle back to the conversation we were having earlier in response of the audience question. one question is what do you think of efforts like registered poll watchers, which a number of states have created. there's concern that this in some way intimidate voters. is this a strategy to chase off eligible voters or do you think of this as quite legitimate ends constructive way to create

greater confidence of both parties at the election site and be part of verifying. >> so, i think that what the critical distinction here is whether or not they are sanctioned officials, mechanisms in place for individuals to be observers, so most states have political party observers in candidate observers and are allowed in the polling place and are able to observe all of the functions within the polling place, but there are restrictions on what they can and cannot do. they can't be within 6 feet of the voting equipment or speak to the voters. they have to talk to the supervisor of the poll workers and those sorts of restrictions, but they are observers and they are there to observe and the have unencumbered observing access and then there are other observers that will be outside the polling place outside the election and they can speak to

voters and set-- that sort of thing, so that's the way many states handle it. i always had great value in that sort of observing effort because the jurisdiction i came from had 2 million registered voters in the book of the time i was there we had over 1100 polling places, hiring 8000 people to work the polls. did they all go to training? no. did they all pay attention and training? not always. did they sometimes misremember what they heard and training? at times, so having observers there can be helpful and they were, cell phone and say apple doesn't quite understand this piece. send a troubleshooter over and i was incredibly helpful. however, if there are credentialed individuals trying to flood polling places or prevent access and as mentioned i was in arizona and we did have that one election with individuals, not in my county, but they had video cameras.

they had machine guns strapped on their backs going up to voters getting out of their cars and challenging their right to vote. that is prohibited by law. so, that's where it's important that we know who will be participating in the process and whether or not they are following the actual process, which is wonderful, but if they will will be actors going out to the polls to try to intimidate individuals or restrict americans rights to vote, that is incredibly problematic and that's why we have laws to prevent that intimidation. it will be important for everyone to know including poll workers, sanctioned party observers and voters themselves that if i see something like that, who do i notify, who do i call and that will be important that the information is out there so if something like that should occur where able to address immediately and

prevented from impacting additional voters. >> to make this a sharp line, donald trump has been saying at campaign rallies, we have got to watch the voting places to prevent raking and other sorts of concerns about elections in stolen. if i understand you correctly and correct me if i have this wrong, what you are saying is that is fine, come watch, but come in through the process established by the republican party, democratic party to be a registered poll watcher and states where the process exists and become a constructive part of that process, but don't come to the polls with and i did that you are going to intervene with voters trying to engage with their constitutional rights. >> i would say follow the rule of law.

so, there are laws about this. there are access points that individuals can get in and observe in many states, so any concern to citizen should contact their local political party and find out what they can do to participate. mini election miss traders frustrated because they are looking for poll workers and the last week before an election jurisdictions will see 10 to 15 and some cases 20% of their poll workers will cancel. on election day you will have five to 15% that won't show up at all. i've been observing elections blasco blears and i observed jurisdictions where one out of seven-- and one polling place out of 71% showed up, so if you're concerned yes, the observer. that's great, but i would challenge individuals to instead be a poll worker, go to the training, but no you will be

there and you will service every voter regardless of their party. you will service everyone. you are not there as a point of challenging individuals. if that's in touch that i think we need to revisit the laws and understand exactly what your rights are as an observer in your state. >> interesting thing to watch is that we've had concerns in the past or cause in the past for large numbers of people to observe that the polls, poll watchers, challengers, what have you. my experience has been with rare exceptions like the one tammy described, those folks often don't show either at the result of that fans of election night or more talk than action. the one thing i think election officials will be prepared for those folks to show up on election day, but there's no guarantee that they will.

i know election officials are probably more so than ever this year thinking about how they set up lines of communication with their polling places in case someone does show up with either the improper attitude or is a little more aggressive than the law allows because they will want to figure out how balance the desire to keep voters safe, but also not to drive off voters with the position of armed camp at the polling place. one of the things we will get to watch will be if all of this talk about people at the polls exley comes to pass an experience suggests it may not. >> don't freak out yet. >> that's right. be ready, but, i mean, i don't freak out anyway, but i think it's worth being prepared. better to be ready for it and have it not happen then the alternative. >> tammy patrick, given your experiences and someone who has watched elections and help run

them, what would be your advice to states that are thinking about how to respond to the one we hope will be a very rare incidents of voters being intimidated and interfered with? what is the correct procedure for dealing with that sort of unusual situation? >> i think election administrators across the country already have plans in place, contingency plans for a variety of reasons whether it's on exuberant poll worker, watcher, observer and nevada-- the medal at the instance may be , so they already have plans in place. i would suggest to make sure you review your plan to make sure their up to date and they are current with the way in which doug mentioned, the command center in which you are already communicating with your poll workers. having your field rovers understand what to do in any sort of emergency situation

whether it's a fire or an if an element tree school goes on lockdown or anything can happen in these sorts of things do happen in elections and so there should already be procedures in place, so revisiting them as we get closer to election day making sure poll workers are aware. don't want to scare off poll workers because i have worked through very similar situation back in 2008, and our poll workers were concerned, but they were so resilient because they said no one is going to scare me away or prevent me from doing my job. i have worked the polls work 30 years or 20 years and i will be there. you can count on me, so i think it's important to know what the processes and to follow those procedures. >> doug, you have worked with the media for a number of years and you are a highly respected source.

looking at the press and press of elections and particularly the administration elections and thinking about the current context in which, worries about either intimidation or towards action. would be your advice to the press about how to cover the administration elections this year québec i've talked to election administrators i think too often reporters reach out to someone like me and i am always happy to talk to them, but the people who actually do the work of the people who know the answers and we had a lot of coverage, hacking, regain, delays and registration deadline with hurricane matthew. if i had a nickel for every story about election administration that doesn't actually quote an election administrator i could have retired years ago. these folks have e-mails that

they answer and they love their jobs them up to talk about it. i know the candidates like to talk. i know that the campaigns have a lot to say, but you would be surprised at how much people actually do the work and know about the work and give context to and grounding in the issues discussed, so seriously there are thousands, tens of thousands of election officials across the country, probably one or more in your jurisdiction and if you're a member of the media, don't just call over the next three weeks, get to know them between elections and learn about how they do the work they do. i won't come as of the media not to cover what's being said at rallies ms part of our political system. but, make sure you talk to the folks that do the work when you are writing your stories are filming your pieces for your readers or viewers. >> when you say election officials, is there a particular

office? should members of the press be going to the secretary of state, should they be going to county having should they be going to the actual voting precinct? where should they head? >> my recommendation would be to find your local election official whether it's a county clerk or what have you. the secretary of state or some equivalent state official will most a lot, but the folks who are the day to day grenade catchers of america election menstruation will be your the ones to pick your polling places, maintain the machines and harder your poll workers and they will know what the polling place look like on election day and they are really smart capable people. >> do you want to jump in on that? >> i agree wholeheartedly. i think it's wholeheartedly-- it's a hard question to answer in terms of who to contact because in some states you have four or five different county agencies that have some role in

the election process. you might have a reporter that's in charge of voter registration and early voter in an election doctor in charge of voting on election day. you may have all of these combinations, so i think looking at your local county, parish, whatever that jurisdiction, township, melissa pahlavi in some cases, but i think most people in the media will now and i didn't it's important also reach out to the secretary of the state and i would also articulate to follow them on social media. many are putting out all sorts of great content that you can use for stories that are positive and that can help inform that electric moving into election day whether it's what they bounce are being mailed out or when-- or for early voting location or absentee. there's a lot of great content out there that you can harvest pretty quickly. >> secretary of state in minnesota just recently used facebook and absolutely smashed

the previous one-day record for the number of voter registrations that was successfully done, so it's a good example. let me ask you about-- obviously in some states these are partisan figures and from the perspective of the media they want someone who doesn't have an order in the fight, so can someone who lets say friends were set could as republican or democrat, can they be trusted on election night to give kind of a fair telling of the perspective from the trenches on election operations? >> i think the vast majority of secretaries of state took the role very seriously as a nonpartisan role in the election on election day. i mean, everyone has some sort of partisan angle or perception and everyone tries to check that at the door. there are exceptions to those

rules, but i think on election night in leading up to election day if you want a perspective that the secretary of state's are good places to go to to find out about statewide procedures, legislation to statewide results usually accumulated at the secretary of state's website. >> i think this has been absolutely stunning conversation and we covered a lot of big issues circulating and i know for some folks there concerned that even talking about it kind of gives credence to charges that may not be things we have to worry about, but i agree with you to and i think with conversations and the more you know what goes on with election ministration the more confidence people should have in the system and its integrity. we will count on you two in the days coming forward here, to thank tammy patrick and doug chapin who runs the certificate of election ministration at the

university minnesota. thank you very much. [applause]. thank you. ..