the best stuff comes not from them. and, you know you -- so often you have something from somewhere else and then you go to them. if they want to play ball which they clearly did with you, then they will. if not then you have a choice to make to do your own story either way. the question for you is if you did -- they make his life is threatened case to you or did they say, no but if you wait, we'll do this? >> the case they made was if we were to -- what they were concerned about i have to be careful a little bit because some of it is off the record conversations. in general what the white house was concerned about was inflaming miami before it happened. and in some way, that would cause some kind of incident that would stop the negotiations. and, therefore indirectly put allen gross's life in jeopardy

because he had threatened his own life at the end of the year. this was december 17th. this was getting close to the end of the year. so they made that -- they didn't have to make that case that strongly. they said you know this could foul up the negotiations. there wasn't any -- and they made it clear to me there was nobody right now who is anywhere near as close to the story as you are. it's not going to break somewhere else. if you're patient you'll have a better story. we won't jeopardize the man's life. we decided that we would -- we had a good clean kill we might as well just stay with that. >> how do you develop a source like that whom you -- who will tell you at a critical moment it's perculating and have enough knowledge of that person's workings to know that you would trust them and read them correctly? >> part of it is, you know, who they are.

this person was involved in the negotiations. so if you know that, if you know that somebody has that kind of direct -- this was not a third party. this was not someone in the press office. this was not a secretary or something like that. this was an individual who was directly involved. so -- how do we get to know them? we get to know them by being there and going on these trips. and you know you have to say too -- each one of us works on this panel for distinguished organizations. it's not necessarily the reporter in general. they're not -- it's also because of our audience and our readership. we have -- you work for an organization that has some influence. and that does help. ap, you know i don't have to tell everybody what everybody does here. everyone on this panel have influential viewers. we have massive viewers as

opposed to maybe less influential than maybe "the new york times" or npr. we have 10 million, 12 million viewers that evening. and so when they want to talk, they want to talk to us. so that's one of the ways. >> i want to go now to scott horsily, everybody listens to npr, right? i love scott's reports because i know when i hear his voice i tune in because he's chosen something complicated and he's going to explain it to me in a way that makes sense. one of my personal favorites is the pension smoothing, his explanation of the concept of pension smoothing by comparing it to a pension smoothie. then i think there was even a blender in the audio somewhere. anyway. scott, could you talk a little bit about how you approach the story? which stories you choose what you're looking for at the white house, what your general approach is. >> sure. had obviously some of the stuff is the same as anybody on the panel. you get good sources, good

information. the twist we have with radio we don't have the advantage of pictures. we try to bring sound into stories whether it's the blender of the smoothie or anything else. sound is the one thing that the white house thinks not at all about. i don't know how many times we've been on the road with the president and they will have choreographed an absolutely beautiful picture at the gold bn hour. he's standing in front of a -- colonial building in south america and the sun is sinking to the right angle. it's gorgeous and they say let's go to the vans and the children's choir starts singing. or on the campaign trail, the president was -- loved to visit factories. they would shut the factory down. assembly line or whatever it was

so he could go through and take a tour. there would be no sound. at one point i complained to somebody on the team once in a while it would be nice to actually hear what a factory sounds like. they took us to a spaghetti sauce bottling plant. i learned a lesson why they shut down the assembly line. all the people on the assembly line crowded around to get their picture taken with the president. it was like lucille ball. it started a little piece of cardboard got caught in the conveyer belt. we couldn't use that sound anyway. part of the trick is to try to think about some sound that will make the story come alive. the sound might be a blender, it might be kids singing.f1 i was frustrated on our recent trip, we stopped in jamaica before we went down to panama to meet with the cuban leader. and the first thing the

president did was go to the bob marley museum. but they didn't let the full press pool into the museum. they only let still photographers. there was only pictures of the president looking at the albums. it was frustateerating from me. from our standpoint you could hear strains of one love playing, which would have been a nice bid for our radio story on arrival in kingston. but we didn't get it. >> actually scott e-mailed me from that. whenever there's a problem with access in this way, the board and the members of the pool start lining up e-mail and we're communicating to each other about problems. he told me the sound track to this huge conflagration in kingston was one love by bob marley. how much -- what mix are you looking for at the white house? you do explanatory journalism you break news, are you looking

for a particular mix in your beat reporting? >> we obviously try to report the news of the day. we want to be -- there was a time when npr saw itself as sort of a supplementary news source. we figured our listeners were getting their news from the local paper and we would be something different. the old joke in our company was do the news late and call it analysis. but for better or worse for many people we're not a secondary news source anymore we're a primary news source. so we feel compeá to actually just keep up with the same day's news. but oftentimes what diffrinchates us is our explanatory journalism or our quan context. after two and a half years you can say smisthis is unusual or peter

can say this is unprecedented or not unprecedented this is what happened in the previous three or four administrations. i think one of the things we try to bring is some sense of context, some sense of history. some sense when the president is being pressed to respond to ferguson, well, this has been something that has dogged the president from skip gates you know. to bring some of that history to bear. >> that's a great transition to peter baker of the "new york times." who has covered three presidents in three different eras. in fact, in the past year has written about the obama white house, the clinton cand candidacy and the bush family tumpt to attempt to build a dynasty. how does this administration compare to others you've covered? >> a great question. in some ways, there's nothing new under the sun, right? every white house i think comes in to office thinking you know

we just reinvented the wheel here. we'll do it differently than everybody else has done it before. we're hot stuff because we won a national campaign. they did something rather extraordinary because they convinced enough of america to give them their votes to send them into power. they come in and they're certain they will do it in some way that's never been done before. the first year two years of a administration you hear a lot of first times and never befores. and mark knows and a lot of the guys steve, wherever he is j dave jackson, george knows, very few things have never been done before on some level. it's done differently. the modalities are different. we're doing twitter and we're doing mere cat and all these things. >> he looks at me. as if i would know. >> you're young and hip. i don't know what that is. i don't know what mere cat is. >> it's a little animal. >> that's what i thought.

>> so some aspects of it are different. that's about modalities and tactics, not about broader themes. and so as you watch the obama white house struggle with its second term. it feels familiar to anybody who watched bill clinton struggle with his second term or george bush struggle with his term. katrina is not the same thing as a broken white house and syria is not the same thing as an impeachment. each of these are different. a lot of the broad strokes, the larger currents of politics and governance are familiar. and so it's great to keep that in mind when we do our reporting and to try to help readers and listeners and viewers understand the perspective of what's going on. and so i think that's -- that's what makes the job fun in a lot of ways. >> so you have the perspective that many of us envy which is the historical what other

presidents have done perspective. how do you maintain what other people envy, which is fresh eyes and a new take. so do you work that into your reporting? >> it's a great question. in fact, it's -- i do struggle every once in a while waking up and saying that's not the story. we've done it before, heard it before, nothing new. somebody else managed in fact to take whatever it is and find the fresh aspect of it and bring the new eyes to it and it makes a great story. and i kick myself for being too fuddy-duddy. but i'm lucky i have -- like all of us we all have partners. i havñ two great partners, who are both seasoned and veterans but also bring a freshness to it. and so that helps to have perspective and ñring different strengths to a team like that. and then i usually read about it in the wall street journal

look like an idiot. >> one thing i wanted to say, as radio reporters and tv reporters we get the benefit of the print pool reports. where the one print pool -- one print reporter is assigned each day to write up whatever the president does. and when christie or peter or carol do pool duty, you know all these folks who have had lots of experience and could easily phone it in they never phone it in. their pool reports are so thorough, so detailed even on a completely throw away trip -- i think one lesson of that is you never know what's going to be throw away six weeks later. you never know when some seemingly meaningless detail on a nothing venture to cleveland to give a speech that nobody is going to care about two days later will take on an added resonance six months down the

road. because they pay attention every day and don't phone it in, they -- six months down the road when it's meaningful they have that. >> that's the concept of the pool. you guys know how a pool operates, right? we spent a lot of our time as an association fighting for the access of the pool. when we can't get in the whole press core into something, we're send in an elect group of usually 13 people when we're traveling, 21 people when we're in the white house to gather information. their first responsibility is to share it with the rest of us and the rest of the people who use the platform. the print poolers share our reporting with everybody else in america before we write our own stories based on it. that's because it's a big responsibility and we feel like the public has a right to know. that's a public service that we perform. so i want to ask the panel, peter i can't help but notice you've got some documentation sitting over there which may help to answer this question. but what are the big challenges -- what do you think are the biggest challenges for

you in covering the white house and how do you overcome them? >> not that i'm hyping up rival publications but i have some interest in this politico. they did a survey as they did last year of the white house correspondents in time for this event. it's useful. for anybody who hasn't read it take a look. they have 70 of us to respond this year. the previous number, they ask a lot of questions. some of them are surprising and some of them aren't. asked of those who have covered multiple news outlets which are the most friendly. 3% mentioned barack obama being the most friendly. and 65 the least friendly because we're in the middle of it. we're frustrated with them for this or that and we have glossed all over the frustrated we had with bush and clinton. it tells you that's part of the adversarial relationship that

goes with that. how many times you ask a president at a press conference 63% of our colleagues said never. how many of you have interviewed the president. 80% of our colleagues say never. to me, that's a shame. to me, the most telling one is how have have you interviewed someone in the last week from the white house who isn't paid to talk to you. not a communications or press staffer and 58% of our colleagues said never. in the last week. and, you know, okay we're not all going to get a chance to ask the president a question at a press conference or not going to get a chance to interview him as often as we like. we ought to be able to talk to people in the white house that go beyond the press staff. three out of five of us haven't been able to get past that wall in the last week. that tells us something about if you talk to your colleagues here who have done it longer than i have you'll hear stories under bush 41 other

administrations they had a lot of contact with a whole lot of senior people beyond the press office. i've seen in three administrations that's shrunken slowly and surely. you have to be what josh is, you have to be there all the time to recognize opportunities to take that knowledge and translate it and big stories at the right moment. you have to use sources outside the white house to come back to the white house, right, as we did with cuba. we heard about cuba right here. and push them to answer our question whz they're not going to volunteer for it. you have to listen for sound. you have to take the experiences i think and not count on our white house officials to hand things over. they're not going to do that. >> go ahead. >> i wanted to ask a different question. >> gofor it. >> one of the things that's come up a lot is with the ability for the white house to now go to twitter and facebook and

interviews with youtube stars and local news anchors at the white house and a whole host of folks -- if you looked at the president's interviews he does them mostly with people who are not in the white house covering him on a day-to-day basis or are very familiar with his policies and where he's been and where he might be going and all of that. they're kind of parachuting in and do an interview and parachute out. so it's raised the question of does being a white house correspondent matter? i guess i put that question to you guys of does it matter, why does it matter, and if people can get information from else where, what's the difference? >> i think you need it all. you know i don't think it hurts to have outside people come in and ask questions. we are in a bubble. you know we are -- we have to recognize that. where we live where we work.

i know you do and i know most many of us do, we try to get out of that. i'm lucky in that i have a partner as well into does most of the day-to-day. i go in, and i try to work outside that box. i can't blame the white house for wanting to get outside of that room and to -- because with when i do, when i go to denver, when i go to seattle, they're not talking about the same things we are talking about. they're not focused on that. they're not focused on the intrickeracies that we are. i think where we see that most, carol, is at the white house briefing. the -- too often the quest, in my opinion has been, to get an argument going. to get some kind of conflict.

there are very few questions or they're not enough questions, let me put it that way. that are actually asked to elicit information. now, yes, the follow ups have to often be more combative because the information isn't coming. the original question is frequently -- is designed to pick a fight rather than to seek some information. and i think people outside the beltway, when i visit them are tired of that. it's part of the noise. and they want the kinds of questions that sometimes we hear, when local news people come in from out of town and they're in the white house thinking of. their viewers in denver care about it. i think we need both. we need the inside baseball stuff on occasion. i think they're wise and -- to go outside of us myself. >> i do -- i think you are right about some of the combativeness. you know, it struck me during the va hospital scandal the va

has been a mess for years through republican and democratic administrations. i think the american public would like to see the va hospital system work better than it does. and i think there's no reason that has to be a political scandal. i don't know why eric shen shecky's scout became the story. you know, when he was out, we and the white house briefing room lost interest of the story and the administration lost a little focus on it too. i would -- i do think there's something to what you're saying about the combative tone of the washington centric news media. when you talk about the challenges, the beat, my colleague, altused to say if you get a story and there's already a whole bunch of reporters there go find another story. which i think is good generally. but not applicable to what we

do. it's rare unless you get a good scoop of cuba, it's pretty rare you're going to really be in a whole different playing field than your dozens of very talented colleagues on this beat. >> when you do those are some of the most important moments. i think we're all intimately and painfully aware that we're no longer the only game in town. you know, there's nobody up here sitting here from, you know, medium or, you know, all of these tumblr or other ways people are getting information. that's created issues not only with outside media coming in but also the white house by-passing the media and going to the people through their own social media channels. i think that the aspect that we maintain as beat reporters at the white house, is the accountability function. and that's one that is not -- that people that parachute in for a story are not in a good

position to really do. you know it's that one phrase that they've been using you know, for a month and suddenly it disappeared and you notice it because you've been hearing it every day. it turns out there's a policy change underneath that. you know, or it's the -- you know, the issue that you press deeper and like jim you break a major important story. you know, or uncover some type of you know, shenanigans that are not likely to be uncovered by someone who is coming in because the white house is trying to reach, you know a different segment of the population. >> i don't personally object to the white house running an offense. i think they can -- it's up to them to craft their message and try to explain their policies and believes in a way that's persuasive. if they want to speak directly to the american public by whatever medium is available to them i actually don't object to

that at all. my concern is that when -- that they not go around the independent free and adversarial press core, which is at the white house every day and has this kind of situational awareness you're talking about. i like vice and medium and, you know -- pick your acronym i like them all. i think more voices is better. but we need information to work with. and i feel like the beat reporters are a critical part of that mix. now we've got about 20 minutes left to take some questions. i'm looking out at the scholarship winners. i will start with you. >> so you mentioned medium, that's come up a lot. i notice the clinton camp used that yesterday to respond to the donor thing. do you think -- because i know there is definitely been an uptick with the obama administration using social media and other means of getting information out and you talked about that a lot. is that a precedent that you

think we're going to see going forward or is that something that's specific to this administration? >> oh, i can't imagine that the next administration will do any less. they'll probably have even more tools i would imagine to sidestep the free and independent and adversarial press, is that what you said? >> in alphabetical order. i mean that's part of the challenge of fighting is being vigilant. because the thing i need to worry about is something i probably haven't heard of yet right? whatever the next invention is. >> i think -- >> josh the press secretary said when we challenged him any administration would do this if they have the tools we have. it's hard to argue with that. >> i think whenat you hit on though it's fine for them to do -- to find all these other things. if they were doing that and not answering questions at a daily briefing or not making the president available, which he has recently been very

available. as far as press conferences are concerned. a unique rash of press conferences lately. then that would be an issue, i think. as long as -- if they want to put out an unfiltered message, first of all our audiences are smart enough to know that's an unfiltered message. they really are. we have to give the audience some credit. that's fine. but if they did that and then the president didn't come out or josh didn't come out and sit in front of us to me, that would be an issue. i don't find it an issue as long as they continue to do that. i think there is an issue what peter was saying, is that they do not make people outside the press office available. that can be a problem. i have to say, maybe i would doubt that you have that problem. and i don't really have that problem. but i understand that smaller perhaps smaller -- that's what i was talking about -- organizations we work for

smaller organizations i think have -- maybe smaller and perhaps fox news and some others that they would deem as combative, might have an issue. but i don't. >> i think -- i mean, different organizations get different responses it's true. we have the same problem. it's mostly how things have changed over time. i was saying to tom earlier thinking about his days when he covered the ford vice president was on the plane all the time talking to the vice president all the day. we don't do that today. when jim baker was chief of staff, every day at the end of his day he called back reporters. i can't remember the last time dennis mcdonough made a round of calls at the end of the day to a bunch of reporters. he tries, i'm not criticizing him. i'm saying the culture has changed. the culture that people are involved in these decision makings are less available, more removed and more separated from

us by a paid staff that is paid to get between us. >> i remember reading one of the great pieces in the new yorker one day he talked about i wandered down to the nfc offices. >> with an escort. >> i thought, wow. imagine that, just wandering around the west ring and. >> that's something maybe a lot -- unlike congress, right you can walk around congress and you'll find 535 sources willing to talk to you. >> begging to talk to you. >> the white house physically you are not able to go very far. you are stricted to a very tiny space, basically which is -- >> the vestibule. >> that's right. that's why josh and scott, the ones who spend all day there are heroes in my mind because it's cramped and claus rophobic. you can not knock on people's doors and say what's going on. yeah. yeah. probably, like in the dod you have -- the reporters there will tell you have more ability to

walk around. i think that's true at state. it's a shame. it means that fewer non-scripted spontaneous conversations that would lead to understanding and clarity. >> did you have a question? >> yes, i did have a question. earlier in the round table discussion you spoke about the leverage journalists have over the white house where they can possibly produce a story through social media with their twitter handle and say hey this is what happened, yet we're sitting here wondering, well did this really happening. what leverage were you speaking of that we have to tell our stories to the viewers. we can reach tens of millions of viewers at one time. why not come to us? >> what i think i said historically we had more leverage. any administration which ultimately was going to have to be responsive to voters, even if they didn't like the press kind of had to deal with us to get their message out. that is still true. i mean i think the public still

does distinguish what they read in the "new york times" or see on abc from what comes out in the west wing week on the white house website. i hope they do. but at that leverage is less than it used to be because they do have more avenues to distribute their message without us. so i think you know, in the old days, like it or not they had to deal with us. that's less true than it used to be. >> i was in on that conversation you were referring to i think what scott was saying the leverage we have we represent millions of readers listeners and viewers. that's hard to turn away. >> they do not like having the photos described as you know state run media. so when we do -- when we go public with our kmantscomplaints and we do it in a united way. but occasionally when they tick

us off that gets the president's attention. >> even when we're not doing it publicly we are always in there every day pushing at increasing inkremts ofire and anxiety that we do. yes? >> you mentioned about the there is now the army of paid staffers that, you know they are to get between you as correspondents and the folks actually making policy. i think i read somewhere in washington in the last 30 years there has been like a three fold -- like 300% increase in the number of pr people as the number of journalists have gone down. i'm wondering, they create kind of these pseudo events and try to kind of set the agenda for the day. that's their job. i'm wondering how do you find something else there something unique there? >> we pretty much ignore it. i have to say we ignore the

staged events when he goes to different places, because he wants to announce a new thing on trade. so he goes to a port. i can't remember the last time we did a story about whatever their agenda for the day is. television news doesn't work that way. we go in case something unusual happens at that event. but we don't cover that event. and what we try to do, you know, what i try to do, i can speak for myself in this, is, you know, focus on things that i'm interested in, that i think our viewers are interested in and not worry about their agenda. about the white house agenda. and come from the outside in. come with information that they can't ignore. because they know that my 10 million viewers at 6:30 are going to see this information. they need to get their spin on

it, get their information out about that particular issue. that's -- i rarely report from the inside out. that's what i would say. >> what they're doing is no different. the guy that flew the gyrocopter into the capital if he had delivered 500 letters, that wouldn't have made the news that night. everybody does stunts. that's not unique. one thing that's kind of interesting is communications staff in congress, there's a political scientist at the university of maryland francis lee, i think lee francis or francing lee francis lee i can never remember. she's tracked the change in how many staffers primary job is messages and communications as opposed to legislating. it's remarkable. it's probably -- i bet the change there is bigger than it is at the white house. >> i guess i don't have as big a problem with the press dealing with press folks.

i think it -- if they're inpowered, it really depend particularly in the white house at how the top staff, senior advisors, the communications director, the press secretary depending on who it is decides to empower people who are on their staff. and there's instances where those folks are given a tremendous amount of leeway to share information, they're in the meetings, they understand what's going on and it's worth talking to them. there is times when it's notworth talking to them at l. they know nothing. they do, they're not going to tell you because they're afraid of their own shadow. they're not empowered and they're not useful in that sense. and the same goes for the ilhill, there are some press folks -- i'll give you an example of the white house ben rhodes his official title is strategic something communications director for the nsc.

that belies the fact he's probably the closest foreign policy advisor and longest standing foreign policy advisor the president has. if there's something to know he probably knows it. >> the good ones are great and they're knowledgeable and in the meetings, my point they shouldn't shield us from others as well. >> no, not at all. then that's what i mean increasingly there's a sense that they're just there to block people from talking to us as opposed to them having information to talk to us and them being facilitators -- you know, a lot of times you'll call a senior official who is not in the press staff and get a call back from the press staff. which is always like, you know -- and that's a designed system. i'm sure there are stars handed out to whatever senior folks do that. >> that's what the agencies doo

too. >> the agencies in general. >> there were some chuckles this week when the president burned a whole lot of jet fuel and generated a lot of carbon to supply down to the everglades to celebrate earth day. but the fact of the matter is the backdrop of the everglades got that story in every newspaper with the photograph of him on the walkway over the swamp, that's how you get your message out. >> also you can go to the events they put on, but you don't have to see what they want you to see. like, i think josh made the point earlier, when they are changing the lexicon within the white house, it's reflective of changing policy or viewpoint. those are things that are hard to hide if you're paying close attention. >> i think to your question about, you know, the tension between letting them set the agenda and setting your own agenda. there is a story they want us to write every single day. we all will get e-mails, six seven, eight p.m. with some

embargoed thing for tomorrow morning and we're supposed to get super excited and pop out these thousand word stories at 6:00 a.m. about a progress report on nothing. basically. and, you know, i think we're in a unique position as a wire service we do have to kind of cover everything. even if their progress report on the auto industry is not that interesting to most of our readers. the detroit free press is a member and people in droit wantetroit want to read that stuff. we have conversations every single day about how much does this merit. this thing they're trying to make a big thing out of can we do a blurb on that, kind of dispense of it and focus on what we think is really important today, you know, and vice versa. what the that little thing they kind of mentioned and tried to brush under the rug, that's actually the news today. we're going to make a big deal out of that and we're going to

kind of briefly dispens with this thing they're trying to focus on. we have to do both instead of making a choice between one or the other. >> i typed the word embargo into google translate the other day and it came back no news. it's their way trying to make something is big happening. if it was big news they would not give to anybody on embargo. not a wide audience of 10,000 people they're e-mailing it to. >> there was a story yesterday morning in usa today about the growing use of fact sheets by the white house. i didn't -- i saw a summary of the story. maybe i'm not entirely sure if the whole story carried the theme. they were using fact sheets as a proxy for executive action. our rule of thumb is the longer the fact sheet the less they're actually doing. the cuba fact sheet a couple of

paragraphs. progress report on fuel efficiency in the automobile sector might be 14 pages. >> there is usually a section in it called building on progress we've already done. which is just a long summary of things they've already done and you're supposed to get really excited about it. >> we have time for one more question then i'll go to ezra. >> most of you have expressed a support of the increasing diversity of voices in the news world. i guess my question is with that diversity of voices and with so many different faces on the landscape in covering the white house and d.c. as a whole for those people who maybe don't have the clout of "the new york times" or abc or -- a bigger known organization, how do you navigate reporting on the white house or reporting in d.c.? on top of that, how do you then cultivate the sources you're saying many of the sources come to you not necessarily because of the quality of the reporting

but because of the audience and viewership you bring with you? >> i started on the beat with politico, which is not a small news organization, but it's not "the new york times" and it's not the wall street journal which is the news organization i worth for work for now or abc or npr. i was low level on the team -- god, it was like ten i think at that time. and i made it my job to be there every single day. and do every little scrap of a trip that nobody wanted to do. and, you know be -- trying to stick my head over the pack and just get in the mix. and -- as much as i could and talk to as many people as i could. and i, you know, didn't have a family or anything or i spent a lot of time not at home and out and meeting people. and just getting sources up.

then you develop relationships in that way. and that -- then when you're three or four years into covering it or a year into it or six months, you know, someone is willing to talk to you, not because you work for the splashy news organization they want to engage with, but because you've been around and they know you and so they talk to you. the other way is to find a story that you want to do and -- or a topic that you really like and just get in there and pitch stories and that's how you get in front of people who are behind the press operation and that's how you get into their offices typically. if you're not working for a big news organization and also just sitting by -- back and noticing stuff. the president -- when i was on the lower level of the white house team you know, there was obviously the senior people were going to be doing the big story of the day. and that was not left to me. i would do things like, oh the

president is giving a six minute speech on abraham lincoln which is his favorite president it's on the capital and he had to bring his teleprompter. he took it everywhere he went. that's something that the folks who were writing the story of the day necessarily weren't keeping an eye out for. and then you start -- when you start writing stories that get noticed white house folks realize they need to talk and deal with you. it builds on from there. >> also the news world notices who is leading on a story who is on the cutting edge of a story. i'm looking around the room and i'm seeing a lot of people who work for organizations that aren't as big as my colleagues but they're leaders in particular stories. the white house decides they have to deal with people on that subject matter. then it doesn't matter who it is. if you are the person who knows the most, people will talk to

you. >> step one is acknowledging there are certain limitations. jim talked about the catchchet that some of the others have. before i worked here i worked at the hill that was at the bottom of the totem pole as far as news organizations in this town. the only way to make any headway, you know, at that level, i think, is to be smarter than the people who are too rushed with their daily deadlines, covering the beat to be able to do the -- connect the dots between, you know here is three things obama is doing, hold on there is some overlap there. it's enterprise. it's not going to be you know an announcement that because frankly, you know if -- a lot of what we do a lot of the news that comes out of the white house is choreographed it. they're not going to cohoreograph

it to a certain news outlet. you have to show that you're analytical skills and your ability to provide the context and analysis for your readers you know, gives you the ability to do a compelling story despite that lack of access that some of the larger news organizations have. then as carol was saying from there it builds on itself. you know people start noticing gosh that person at that little outlet is doing that great stuff. we should talk to him about this, he would have an interesting take on that. she seems to really get this, the intrickacies of this issue. it starts to build. >> let me just say one more thing about how you get from a small place to a big place. be patient a little bit. it's not bad. i covered chicago city hall, that's where i learned how to be a political reporter. it was amazing. i covered, you know jane burn

herald washington, rich daily. i covered grab you by the lapels politics. go do that. you know when you -- the first thing i would recommend just talking to you students is not go to the white house tomorrow and start writing small story and trying to get in. go you know to springfield illinois, go to some big city or even a small city and cover the city council meetings. you'll learn when people are lying to you. you'll learn who to trust. you learn how to make sources. you learn how to smooze. those are tools that are not natural and have to be learned my biggest advice is to start out small. >> i started that way too, as most of us did, in florida as covering the annual fireworks story. >> it's useful to make a lot of

mistakes which you will do on a stage that's smaller than the white house. >> i would come back i agree with everything everybody said up here. i can add one more thing, the best stories you'll get. the stories i feel best about, never the ones the white house gave me. never. and they don't give us nearly as many stories as everybody assumes they give us. particularly "the new york times." this is mythology. they give "the new york times" everything. i wish it were true. >> we'd like an audit of that. >> the wall street journal is the one they gave the story to the other day. the stories that are best are not the stories with the president. i don't remember any interview with the president that broke big news. i just don't. the stories that are big are the ones you have developed for yourself. because you have a good ear paying attention and working from the ground up those are the best stories, not the things they give out. don't worry about stuff like that. it's not important. >> with that, i think we've run out of time. i want to say thank you to you

guys for your great questions and let's thank our panel. [ applause ] this weekend the c span cities tour has partnered with time warner cable to learn about the history and literary life of

lincoln, nebraska. >> this is one of the most important american writers of the 20th century. she was given almost every literary award possible in her lifetime before she died except for the nobel prize. she was known for some of her master pieces like the death comes to the archbishop a lost lady and many others. in 1943 she had made a will which had a frurestrictions in it. one of which she did not want her letters to be quoted in whole or in part. she left behind at least 3000 letters we know about now. fortunately the biggest collections are here in nebraska. furthermore in her will she left one other important thing. she left it to the sole and uncontrolled discretion of her exetter's. they believe as educational organizations that belongs to our shared heritage. we ought to know more about her.

>> an important historical figure in nebraska's history was solomon d. butcher. >> solomon butcher was a pioneering photographer out in custer county in western nebraska. he took photos from about 1887 1886 until the early 1890's of homesteaders in sod houses. and was able to tell the story of the important development in american history. i am going to show you one of my favorite images on the solomon butcher collection. it's the photograph of the cristman sisters. it is four sisters who each took a homestead claim in custer county. this shows women homesteaders. it was the first time that women could own land on their own. it didn't belong to their husbands, it didn't belong to

their fathers. single women could own their own land. that was a really big deal with the homestead act. so each sister each of them took a homestead near their father's ranch. they each built a small house on the homestead, which was part of the homestead act. and they would take turns staying in each other's house and working each other's farm. so the sisters really pulled together and made it in nebraska. >> watch all of our events from lincoln saturday evening at 6:00 on c span 2 book tv. and on american history tv on c span 3. our live coverage will continue at 4:00 eastern just a couple moments from now here on c span 3 with a hearing on veteran's care. in a recent memo a senior

official with the department of veterans affairs allege gross mismanagement of contracts. a house oversight some committee will hear this afternoon from va executives. it will include the memo. live coverage starts at 4:00 p.m. eastern, about ten minutes away. here on c-span 3. right now, though veterans affairs secretary robert mcdonald as he delivers the commencement address at the university of utah. secretary mcdonald is a graduate of the university having earned his mba there in 1978. the ceremony was held at the john m. huntsman center in salt lake city. it's about ten minutes. [ applause ] >> thank you. and thank to president pershing dave, for that very kind introduction. and of course thank you, dave, for your service to our country. member of the boards of trustees and president pershing thank you for inviting me to share this important evening. let me begin first and foremost

by congratulating the graduates. you've labored long and hard. you've done excellent work. and we're all here today, tonight to honor you and wish you the very best as you continue your life's journey. [ applause ] but equally important are your faculty, your family, your friends here this evening. they've supported you. they've encouraged you. and they're a large part of the reason that you're here now. they've often sacrificed in ways that you never knew. and to give you the opportunities that you wouldn't otherwise have. so graduates, decide tonight to make a similar difference in the life of someone else. i applaud the university's new tradition, the red, white and blue tassels and cords for

graduating veterans. to all veterans graduating -- [ applause ] to all veterans graduating tonight, congratulations and thank you for your service to our country thank you for volunteering to serve. thank you for your and your family's sacrifices. and i am deeply honored to be your secretary. i gladly accepted this opportunity not only because of the respect i have for president pershing but also because of my love for the university of utah. it's been nearly four decades since the university granted me an mba. i was a young man then. to you ready to graduate it may seem like time passed slowly to get to this point.

well, hang on because things are about to start moving at light speed. so first takeaway. don't waste a moment. live every day with a clear purpose. fast forward with me for just a moment. let's say you're at your life's end. maybe you're here in a hospital in salt lake city. you're surrounded by people you love and people who love you. and those people ask you, did you accomplish your purpose in life? it would be a sad moment if your response was, "well, i don't know. i never decided what my purpose would be." purpose is first and most important. purpose is first and most important. my life has had a continuity of purpose. for me it's always been about

improving the lives of others. that's why i became a boy scout. it's why i choose to become a west point cadet. it's why i became an officer in the united states army. it's why i joined the procter & gamble company to serve the world's consumers. and it's why when president obama asked me i didn't hesitate to seek senate confirmation to serve as the secretary of the department of veterans affairs. my whole life has been leading to this privilege of serving veterans veterans. the power of institutions like the university of utah and the department of veterans affairs is that they help us discover and pursue our purpose. they help us bring meaning to our lives and to our work. they bring people together who share a sense of purpose. and they provide an opportunity to be part of something greater

than ourselves. the core of utah's mission is to serve serve. it's to serve the people of utah and the world through the discovery, creation, and application of knowledge. veterans affairs is derived from president lincoln's charge in his second inaugural address. as the bloody civil war was drawing to a close lincoln directed us to serve and care for those who have borne the battle and for their families. it's the best and most inspiring mission i know of. so both utah's mission and v.a.'s mission reflect core beliefs that call on us to make a difference in the world. but how do we make a difference and how do we make a difference in the world? it sounds like an intimidating proposition and i can't tell you exactly how. there's no formula.

there's no road map. there's no smartphone application. there's no surefire way steps to follow. but there is a north star to guide you. and that north star is a sense of purpose a commitment to make a difference with your life in the lives of others. and that's the sole message i'd like to leave you with tonight. many of you have probably heard of lauren eisley's story of the starfish. but let me repeat it for those who haven't. there was a young man walking down a deserted beach just before dawn. in the distance he saw a frail old man. as he approached that frail old man he saw him picking up stranded starfish and throwing them back into the sea. the young man gazed in wonder as the old man again and again bent over, picked up a starfish, and threw it from the sand to the water.

the young man finally asked, old man, why do you spend so much energy doing what seems to be a waste of time? the old man explained that the stranded starfish would die if it was left in the morning sun. the young man replied, but there must be thousands of beaches and millions of starfish. how can you possibly make any difference? the old man looked at the small starfish in his hand, and as he threw it to the safety of the water, he said "it makes a difference to just this one." in 1966 robert kennedy told the starfish story, but he told it in a different way. he said each time a person stands up for an ideal or acts to improve the lot of others or strikes out against injustice he or she sends forth a tiny ripple of hope.

these ripples crossing each other forming a million different centers of energy and daring, they build a current that can sweep down the mightiest walls of oppression and of resistance. one person can't do much? well, gandhi did it in india. martin luther king did it in the united states. nelson mandela did it in south africa. but we don't need to be a gandhi or a martin luther king or a nelson mandela to make a difference in the life of just one person. let me tell you about one of the best days of my life. it wasn't when i graduated from west point. it wasn't when i graduated from the university of utah. it wasn't when i was given the opportunity to serve as the chairman and ceo of the procter & gamble company or the secretary of veterans affairs.

one of the best days of my life was when i saw a paralyzed veteran wounded in combat walk get up from their wheelchair as if they'd been able to do that for 40 years and walk. some might call it a miracle. and in a sense it was miraculous. but not in the way you might think. his name was billy. and they could walk. because some good people trained him how to use a device we call the exoskeleton. it wasn't so much about getting someone to walk. that is important. but it's important because of what happens when you don't walk. when you don't walk, your muscles atrophy. your bones become brittle. and your gas trotrointestinal system

stops working the way it should. it's important to get the human body functioning again. but to billy the most important thing was this. he could look you in the eye again. it was that simple. it was about being able to look another person in the eye. it was about his sense of human dignity. the miracle wasn't billy standing. the miracle was his sense of purpose, that giegd light that drove some very good people to make a profound difference in the life of just one person. and others will follow. tonight is a great moment to dedicate or rededicate ourselves to this quest. finding our purpose, making a difference in the life of just one person. don't wait for that one big decision. don't wait for that one big opportunity. start right now. if you get in the habit, the

rest will follow. if you're worried about no longer being a student after this evening, don't. be a student every single day of your life. life has a great deal to teach you and to teach us all. thank you very much. god bless you. and congratulations. [ applause ] live now to capitol hill as the house veterans affairs subcommittee on oversight and investigations is meeting to discuss the procurement of non-v.a. health care services for former soldiers who usually receive medical care from the department of veterans affairs facilities. this is just getting under way. >> -- resulting in massive waste of limited taxpayer resources. in serious jeopardy to the quality of health care received by our nation's veterans. in our previous hearings on procurement on may 14th, 2015, we focused on the mismanagement

and misuse of purchase cards and avoidance of contract requirements, spending limitations, and warrant authority. v.a.'s senior procurement executive, mr. jan frye, testified that these unauthorized commitments were in the billions of dollars. mr. frye has indicated similar levels of mismanagement and abuse in the procurement of non-v.a. health care services by vha. by far the most prevalent method by which veterans receive non-va care is through the individual authorization, so-called fee basis process. under title 38 of the code of federal regulations, section 17.52, va is authorized to obtain non-va medical services when demand is infrequent and the needed health care is not

available in house or through an existing contract. unfortunately, va uses this process even when these requirements are not at issue. moreover va admits that the execution of these authorizations does not comply with the contract requirements of the federal acquisition regulation, or f.a.r., and veterans affairs acquisition regulation v.a.r., v-a-r. he'll testify by long-standing circumvention of the v.a.r. and f.a.r. in the fee-based authorization process, va has illegally obligated billions of dollars. he will explain that va incurs billions in improper payments that represent material weaknesses in va internal audit controls.

significantly, in 2009 and 2010 the oig reported on serious problems with the accuracy and efficiency of claims paid through the fee basis program. the oig reported that va medical centers made hundreds of millions of dollars in improper payments including duplicate payments and incorrect amounts. most troubling is that vha had not established fraud prevention or detection controls because it didn't consider the program to be at significant risk. oig estimated that va could be paying as much as $380 million annually for fraudulent claims. and in may 2014, contrary to va's assertion that previous illegal purchases can be institutionally ratified, oig reported that va further

violated the law by institutionally ratifying illegal purchases and avoiding important checks and balances. today gao director of health care randall williamson will testify about the continuing limitations in oversight of health care service contracts and will focus particularly on the inadequate management of clinicians who provide services under contract with va facilities. we will also hear from united states army veteran christopher labonte, whose horrific experience with va rebts a case study and the risk associated with non-competitive contracts, with affiliates and the importance of quality control and oversight of contract performance standards. as i said in the purchase card

hearing, violations of procurement laws are not mere technicalities. it is not just a matter of paying a little more for needed supplies and services as some apologists for va have asserted. among other things, without competition businesses may be awarded -- business may be awarded based on cronyism and the directing of business to favored vendors including those who may be employees or former -- of former va officials. without contracts patient safety provisions are not legal requirements. va's mismanagement of the fee basis program is not a justification to dispense with f.a.r. or v.a.r. requirements.

if the atom bomb can be built and wars conducted under the acquisition regulations, surely va can deliver patient care under them as well. with that i now yield to ranking member kuster for any opening remarks she may have. >> thank you, mr. chairman. this afternoon's hearing is a follow-up to our hearing two weeks ago, and today our focus will be on the legal basis underlying va's purchase of non-va health care and the practice of va in obtaining this care. at the end of the day we can all agree we want to see our veterans receive the health care they need at precisely the moment they need it. but i want to make clear that neither i nor my colleagues view this laudable intent as a blanket rationale for not following laws, regulations, or proper procedure. federal and va acquisition regulations exist for a reason. they exist to ensure that there's proper competition when appropriate and that the best

practice and price possible is obtained when the government purchases goods and services. for the va these laws protect veterans, save taxpayer dollars and ensure our veterans receive the highest possible quality of care. va states in its testimony that it's had a 30-year practice of using individual authorizations without applying federal acquisition processes and procedures. at the same time it seems that the va has taken the position that individual authorizations are indeed contracts and should be viewed as such even when acknowledging that va officials appear to have acted in a manner inconsistent with procurement law. now va is arguing it needs new statutory authority "to resolve what has emerged as serious legal questions to its purchased care authorities." this new authority would explicitly exempt va from

procurement regulations and requirements and allow the va to continue with the same practices that it has been following for the past 30 years. i personally am not convinced this is the best solution given va's significant lack of oversight in this area. in fact, i would argue that the problem is not that the legal questions have arisen over va's purchase care program but that for too long va has operated a program where the legal basis has been challenged and yet va has never changed course or modified its procedures. va's authority to purchase care without having a contract in place is predicated on individual authorizations being used "when demand is only for infrequent use." i'd be interested in finding out how much of the $7 billion expenditure for non-va care in fy-2014 has been obligated under this authority as compared to

situations where contracts are in place. as we examine the current legal authority for va's purchase care program and whether this authority must be modified we must first get to the bottom of how this program has been operated over the last number of years. it's absolutely critical that we understand how va's legal interpretations change and were communicated and enforced. it's hard to expect accountability when there are no clear signs pointing out the way. the testimony of mr. frye and the various legal arguments made by the va in litigation makes it seem unlikely that over the last number of years clear policies and procedures were in place. gao's testimony points out "significant weaknesses in va monitoring and oversight of its non-va medical care program." perhaps it is now time to stop applying quick band-aids and resolve right now to fix what is wrong. it took years for va to get into

this problem, and it will take time to fix it. but the first step in addressing the problem is to acknowledge these problems and quickly and forthrightly come up with a concrete plan to fix them. finally, i'd like to thank mr. labonte for appearing before us today to relate his story, which is absolutely horrendous. mr. labonte reminds us that the bottom line is the quality of care for veterans. this quality can certainly be impacted by lack of accountability and process when it comes to making sure that all relevant laws, regulations, and policies are followed. and with that, mr. chair, i yield back the balance of my time. >> thank you ranking member kuster. i ask that all members waive their opening remarks as per this committee's custom. with that we have the first and only panel at the witness table. on the panel we have mr. edward murray acting assistant secretary for management and

interim chief financial officer of va office of management. mr. greg gidens, principal executive director of va's office of acquisitions, logistics, and construction. mr. norbert doyle chief procurement and logistics officer of the veterans health administration. miss phillipa anderson, assistant general counsel for government contracts of va's office of general counsel. mr. jan frye, va senior procurement executive and deputy assistant secretary for the office of acquisitions and logistics. mr. randall williamson, a director of gao's health care team and mr. christopher labonte, united states army veteran. i ask the witnesses to please stand and raise your right hand.

do you solemnly swear under penalty of perjury that the testimony you are about to provide is the truth the whole truth, and nothing but the truth? [ all reply ] thank you. you may be seated. mr. murray, you are now recognized for five minutes. >> good afternoon, chairman coffman, ranking member kuster, and members of the committee. thank you for the opportunity to discuss the department of veterans affairs' care of veterans by contracting with community providers. mr. chairman, the subject of this hearing involves some complex territory related to procurement process, legal interpretations, and the processing of hundreds of thousands of purchase care transactions per year. i know we will be discussing these areas in detail and that the committee's oversight is important. they will always depend on a mix of in-house and community care with care in the community

continuing to grow to ensure veterans get the care they need in a timely way as close to home as possible. so while the discussion here may be technical we're discussing transactions that represent the purchase of health care for a veteran who needs it. when purchasing care in the community, vachlt depends on both federal acquisition-based contracts and non-f.a.r. compliant agreements also agreed to as individual authorizations. these agreements are used in many situations because a provider may have a relatively small number of veterans referred by va as part of their total patient mix. for those providers it may not make business sense for them to enter into a f.a.r.-based contract to provide care. this is especially true in rural areas. although these agreements are not f.a.r. compliant, v.a. utilizes internal controls to ensure carob tand from a qualified provider and the services billed are consistent

with va regulation before a claim is paid. these practices safeguard veterans to protect taxpayer dollars. va's use of community care has risen dramatically. in fiscal year 2006 it was roughly $2.7 billion. for fy-2015 we estimate $10.4 billion. over those years the different authorities for purchase care have not been applied consistently and have been marked by conflicting interpretations. with the determination by the department of justice that individual authorizations are contracts and therefore must be f.a.r. compliant va began reviewing its internal processes working toward development of a plan to improve immigration transparency, and oversight of all purchased care. we have recognized these problems and proposed a solution. last year in informal discussions with committee staff va noted issues that would need to be addressed by statute. in february's budget submission

we noted the department would be putting forward a legislative proposal. on may 1st we provided a formal proposal for comprehensive reform including very specific requirements for non-f.a.r. based agreements. the legislation would authorize the secretary to enter into veteran care agreements when f.a.r.-based contracts are not practical. with payment rates tied to medicare rates. similar to community care purchased throughout the veterans choice program. the legislation recognizes that f.a.r.-based contracts should be used when they can but also allows the responsible use of non-f.a.r.-based agreements. every two years va would review all of its non-f.a.r. based agreements of a certain size and evaluate whether changing to f.a.r.-based contracts is more appropriate. i believe you will find the legislation provides strong protections for veterans and taxpayers. mr. chairman, we look forward to answering the committee's questions. >> thank you, mr. murray.

mr. frye, you are now recognized for five minutes. >> chairman coffman, ranking member kuster and members of the subcommittee, thank you for inviting me to testify today. you just heard mr. murray provide the department's position on the illegal purchases of billions of dollars in non-va care over multiple years. if you're not now confused, i am surprised. i would be completely confused if i were not familiar with the facts. we obviously do not intend to admit our collective failures in leadership and stewardship of public funds. mr. murray stated there was and is confusion, inconsistent application, and conflicting interpretations. as va senior leaders we have had many years to correct these deficiencies. mr. murray also stated there were conflicting interpretations of the law. here are some facts that may help you decide if conflicting interpretations exist. in october 2012 a very senior vh official informed me trouble was looming as they had been violating the law on a wholesale basis with regards to purchase of non-va care. i asked him for details about legal documents he handed out.

he declined to reveal anything. on october 22nd, 2012 i began a personal inquiry into the matter. i sent this same vha senior official and his subordinate a written statement addressing his plight, hoping i would receive additional information from him. he declined to respond. on december 3rd, 2012 i sent a note to a senior executive from the offices of general counsel requesting a legal opinion as to whether individual authorizations for non-va care were considered f.a.r.-based contracts. i received no response. receiving no response i followed up again on december 231st and for a third time on january 15th, 2013. on february 28th, 2013 nearly three months after i requested the initial opinion, the office of general counsel provided me a legal opinion dated september 10th, 2009. this opinion categorically declares procurements of non-va fee basis care to be f.a.r. based. there's absolutely no confusion in this legal opinion. in spite of what you've just heard to the contrary. neither my predecessors nor

myself have ever granted authority for vha to acquire non-va health care except by f.a.r.-based methods. you may wonder as va senior procurement executive i had never previously seen this legal opinion and why there was such obvious reluctance to provide it to me. that is an enigma. mr. murray and myself testified under oath to this subcommittee in 2010 stating fee basis care was not f.a.r. based. if this legal opinion existed in 2009, why was it kept from us in preparation for the hearing? given the apparent recats trans engaged by vha and counsel i submitted a hotline complaint to the offices of inspector general in march 2013. the oig initially refused my submission, questioning my motive for submitting the complaint. i stubbornly persevered and they subsequently accepted it. i am unaware oig ever investigated. in april 2013 i requested senior leadership assistance from vha and the office of general counsel in conducting ratification actions for these massive violations of federal law. i received no offer of

assistance from either office. in may 2013 secretary shinseki was briefed on non-va care authority options. he was made aware of our illegal actions. i was not invited to the meeting. in june 2013 i wrote a letter to representative issa then serving as chairman of the government reform committee outlining my concerns in these illegal matters and others. my letter never made it to him. two senior officials who were apparent friends, one from the house oversight committee and one from vha conspired to keep chairman issa and the american public from learning of these matters and other serious va violations of federal laws. in april 2014 the va senior assessment team voted to close ongoing discussions of illegal purchases of non-va medical care with mine as the lone opposing vote. in that same meeting the va office of management sponsored a motion which passed to raise the reporting level for va material weak nesses from 400 million to 1 million. i believe this was an effort to avoid reporting illegal matters

to the american public from the thru the annual statement of inside process. from july to november 2014 we collaboratively developed a legally sufficient method to acquire non-va health care. vha senior leadership rejected the method in november 2014. the illegal activity continues unabate unabated. this past friday deputy secretary gibson elected to make my disclosure of these and other illegal acts a personal issue with me. his demeanor and actions in both open and one-on-one meetings were clearly meant to intimidate me and to cast a chill over me and others who might be tempted to report violations in the future. i will allow you and the court of public opinion to decide for yourselves if what i briefly described constitutes corruption malfeasance or dereliction. no investigation has been conducted. no ratifications of illegal procurements have been executed. improve payments continue. veterans receive health care without protection of mandatory terms and condition, and no one is liable. i believe these are two relevant

questions. how can we hold subordinate va employees accountable if we as senior leaders selectively pick and choose the laws we want to observe for sake of convenience? when will the va senior leaders be held accountable? there were more than a dozen of va's most senior leaders in the july 11 2014 meeting. the issue of illegality was positivity affirmed. not a single leader save one subsequently acted in any way to protect the government's interest on resources. we've lost our way. senior leaders are required to obey and enforce federal laws. our actions and inactions do not fit anything i previously experienced in over 40 years as a military officer and civilian public servant. mr. chairman this concludes my statement. i'm prepared to answer all questions the subcommittee may have for me. >> thank you, mr. frye. mr. williamson you are now recognized for five minutes. >> thank you chairman coffman ranking member kuster and members of the subcommittee. i'm pleased to be here today to discuss our work on va's

programs for delivering care through non-va providers. non-va providers treat veterans in community hospitals or doctor's offices using either a fee for service arrangement or a prearranged provider network. non-va providers also render care in va facilities under a contracted arrangement or affiliation agreements with university medical schools. in fiscal year 2013 va spent almost $5 billion for non-va provider medical care for more than 1 million veterans. as more veterans seek care outside the va system, it is important to ensure that non-va care is of the highest quality and it is reliable accessible and efficient. three recent gao reports identified numerous weaknesses in va's management of its non-va medical care program. and today i will focus on an issue va needs to resolve in this area. in may 2013 gao reported that va does not collect data on wait times for veterans referred to

non-va providers. therefore, va cannot assure that veterans are receiving access to medical care that is comparable to veterans receiving care at vamcs. also vamc krchltcs do not have automated systems capable of collecting data for all services and charges tied to a particular episode of care during a veteran's office visit or inpatient stie. as a result va does not know how much it is paying for episodes of care from non-va providers and cannot ensure that non-va providers are appropriately billing va for veterans care. in october 2013 we reported on weaknesses in va's process for contracting with non-va providers to provide care at non-va facilities and specialties that are difficult to recruit that supplement va clinicians in high volume areas or fill critical staffing vacancies. specifically, we found that contracting officer

representatives at vamcs who monitor contract performance on a variety of contracts for goods and services including clinical contracts had heavy workloads and lacked training on how to gauge and post-award monitoring of clinical contractors, which compromised diligent oversight of non-va providers. robust va oversight is essential to ensure that non-va providers deliver high-quality care and fulfill the responsibilities of their contracts. finally in march 2014 we reported serious weaknesses in the way va was administering and overseeing this program for reimbursing non-va providers for emergency services for non-service connected veterans. processing and reimbursing claims for non-va providers, we found patterns of va non-compliance with its own processing requirements, attributed largely to poor oversight at both the local and

national levels. therefore, some veterans were likely billed for care that va should have paid for and many were not informed that va had rejected their claims for reimbursement for care from non-va providers. as a result, many may have been denied their appeal rights. while va has made progress in addressing recommendations we made on these three reports, only about 1/3 of them have been fully implemented. moving forward as new components are added to va's non-va medical care program such as patient-centered community care referred to as pc-3 and provisions of the choice act, it is anticipated the number of veterans seeking medical care through non-va providers will continue to grow. it is vital that va establish robust oversight and accountability in its non-va medical care program such that relevant va staff at every level understand the importance of and are held accountable for ensuring that veterans receive

high-quality accessible and cost effective care from non-providers. this concludes my opening remarks. >> thank you, mr. williamson. mr. labonte, first of all, thank you so much for your service to the united states army and you are now recognized for five minutes. >> thank you for giving me the opportunity to speak to this committee today. i christopher kevin labonte had jaw surgery on august 16th, 2013 at the atlanta va medical center. in my specific case there have been numerous unethical and negligent issues i've had to face. i've provide aid written statement which explains in detail these events and issues. i was coerced into a highly invasive surgery which was performed by a student with no qualifications or educational background to even be present in the room, let alone the emery lmfs residency program. i've submitted evidence to prove this statement in my written statement. the atlanta va medical center has also been negligent in my health care.

they have been complicit in allowing unqualified personnel to gain entry into the va medical center and also providing some of the worst health care i've ever experienced. i have also submitted an index of medical evidence along with my written statement with imaging proving the willful negligence from not only the va medical doctors but the administration and their corruption. on the day of my surgery the atlanta va changed consent for paperwork to lieu abraham mohammed heron a student from kuwait to be the primary surgeon performing my surgery. i have no recollection of signing this document as medication was already administered for oongzite presurgery. in surgery not only were bone shards left any mouth which caused further infection and bone loss, months down the line abraham mohammed heron cut my infehria levial nerve. as a result of this surgery i have a medical condition called neuralgia from damage to branches of my trigeminal nerve. 's in known suesside disease it's described as one of the

most painful medical conditions known to man. the va surgical report admits to damaging a portion of this nerve, cutting it during the surgery on august 15th, 2013 by ibrahim mohammed heron. according to ibrahim mohammed heron's social media pages he has devout islamic views. i'm an army combat veteran that deployed to both kuwait and iraq. i was deployed to kuwait at the same time that ibrahim mohammed heron was astending the university of kuwait. it's no secret many people from this region want to harm u.s. soldiers. my question to the va was why was ibrahim mohammed heron allowed to operate on combat vets whom he would have had difficulty treating objectivively or this ill intentions towards? the veterans medical center should be sensitive to the needs for veteran to feel comfortable and safe with their doctors. the va medical center should be more sensitive to this issue than any other facility in the country. as a combat veteran i should have gun given the choice to have ibrahim mohammed heron involved in my care on any level

especially performing a highly dangerous surgical procedure that required me to be unconscious for an extended period of time. i wake up every day in chronic pain. if you can imagine the worst tooth pain i've ever felt, that is how all the teeth on the right side of my mantdible feel constantly. i have to take muscle relaxers three times a day for the facial pain and muscle spasms. i take narcotic pain medications four times a day for the chronic pain musculoskelical tain and nerve pain. i take anxiety medication to keep my facial muscles from tensing and compressing my nerves which not only causes sharp facial pain but also severe migraines. these migraines feel like someone is kicking me in the skull. i struggle with facial deformity in my lower jaw. my diet is limited to soft foods. according to my current team of non-va doctors i'll not only need continual medical care for my mouth and jaw but i'll have to wear medical prosthetics in my mouth the rest of my life and also have chronic pain and require pain management for the rest of my life. i am extremely disappointed in the va health care system.

the va's priorities seem to be in the following order -- one, profit. two, hospital reputation. three, protecting the high-level bureaucrats. four, protecting negligent doctors. five, cutting costs at the expense of veteran health care. and finally six, veteran health care. i refer to it as death care as health is barely taken into account. from my experience the atlanta va medical center's motto should read delay, deny, and hope you die. >> thank you, mr. labonte. the written statements of those who have just provided oral testimony will be entered into the hearing record. we will now proceed to questioning. mr. labonte, how long have you been waiting for va and/or emory

to address the situation created by the surgery? >> since august 16th of 2013. >> okay. so nearly two years. >> nearly two years. it'll be two years this august. >> okay. mr. murray, in the september 2011 fha fee care program white paper it was recommended va conduct a cost-benefit analysis of contracting out the processing of claims as with other payer medals like tricare, medicare medicaid blue cross blue shield, et cetera. and their applicability for va. what was the rest of the cost benefit analysis? >> thank you for your question. i'm not aware of that being conducted. but i believe i'll ask my vha head of contracting activity if he's aware of that analysis. >> sir, i'm not aware of that analysis. >> mr. frye, any comment?

>> i'm not aware. i can't give you an answer on that. >> okay. mr. frye, va secretary mcdonald was publicly critical of you after the last hearing conducted by this subcommittee. on may 14 2014. the secretary -- is this 2015? >> yes, sir. >> i'm sorry. may 14 2015. the secretary stated that he was aware of the problems and characterized your memo as "just showing what he," meaning mr. frye, "needs to improve." he further stated it is your "responsibility to fix it." what is your response to secretary mcdonald's statement? >> i think all of us make comments sometimes and wish we could retract them. i'm not sure mr. mcdonald had

read my 35-page statement to him at that point. since that time mr. mcdonald secretary mcdonald came to see me last week and he expressed appreciation for me raising these issues. in answer to your questions specifically, i don't run contracting. i'm responsible for overall policy in the va and i have one of six heads of contracting activity who does report to me but i do not run contracting for va. i think anyone who reads the document that i provided to the secretary will see i have struggled in trying to right the ship. and i certainly was asking for assistance from he and the deputy secretary given that i have been unable to on my own fix what was wrong. again, i make comments sometimes i wish i could withdraw, and perhaps he does as well. but i sincerely believe at this

point that the secretary appreciates and probably is more angry than i am at seeing this waste given that he is trying to move us forward and every time we try to move forward and this malfeasance is uncovered we move backtoward twelve. >> i hope you're right he is upset. your testimony states va didn't collect data on wait times from non-va providers leaving the department unable to analyze such critical data and did not provide critical oversight and monitoring of related claims or even the performance of the services provided. gao made 22 recommendations to address va shortfalls but how is the department addressing them at this time? >> on all 22? i could provide that for the record. they have made progress. it's not like they're ignoring us.

they are meeting with us. they're making progress. but to consider a recommendation closed from our perspective we require some rigorous documentation. and va hasn't provided that documentation as of now on many of those. >> okay. thank you, mr. williams. ranking member kuster. >> thank you, mr. chairman. i have a question at the top just to get to the bottom of the issue as to what legal authorities provide the basis for the purchase of non-va care. so i'm asking our representatives from the va to provide the following documents. the 2008 guidance from the chief acquisition officer and office of general counsel that non-va care was not governed by f.a.r. i think that was the original 2008. and then the may 2013 white paper provided to secretary

shinseki on non-v.a. care authority options. and then finally and i don't have a date for this but i think from the testimony it's 2014. the department of justice ruling that referenced that va must consider all fee-based care actions as being f.a.r.-based. i'm interested in going back but i also want to try to go forward where we go from here. i think whenever we're talking about health care we're talking about sort of a triangle of access, quality, and cost. and it seems to me part of the problem that we have in terms of public policy going forward is the sheer scope of this problem because part of what the choice act entails is to bring in private sector network coordination through triwest and

healthnet. essentially, that's what we're talking about here. it's massive in scope to have individual contracts, and my district is a rural district in new hampshire. i know about these contracts. i know about these authorizations. could you comment, and we'll start with mr. murray, but i'd be interested, mr. williamson, with your knowledge reviewing this if you had -- even if it's an opinion at this point do you think we can get out of this morass by simply changing the rules of contracting or do you think that we should try to bring in the authorizations and even the f.a.r.-based contracts into these private sector networks? and i'll just set it up to mr. murray, if you would. >> so the choice act does have triwest and healthnet as the two

what we call third-party administrators. and as you know, we have not got off to the start -- as quick a start with those programs as we would like. rest assured that all leadership, the deputy the secretary are doing our uft most to exercise those programs to the maximum ability, extent to get care to those veterans that urgently need it that have earned it that deserve it. the model looks like -- i go to the access meetings every morning. many of the members of this committee have been invited to the morning access meetings. we believe it will be a very effective model for providing care in the community to our veterans. >> can you envision a time in the future where those networks will be sufficiently extensive where you would have dealt with the cost issue,í, whether it's medicare reimbursement rates, whether you would have the quality issue addressed via the

oversight by these third-party administrators, can you envision a time where we wouldn't need to have these one-off individual contracts? >> i will defer that question in a moment to the acquisition folks and the vha gentleman here, norm doyle. but it's about signing up building the networks having those providers in the network, the right type of providers in the network and certain geographical areas of the country. we see this in the morning through our meetings with the dep sec and senior leaders within the health administration that it's all about ensuring we have the right clinical care, right physicians, in the right parts -- >> is there an attempt to get the physicians that you're already dealing with through these individual authorizations? is there an attempt to get those physicians into these networks? >> absolutely. absolutely.

so health administration leadership leadership, if dr. curbman was here he could tell you. reaching out to their current provider network and getting them signed up or encouraging them to sign up for choice through triwest or healthnet. all hands on deck everybody moving full bore to do that. >> we'll have to come back to mr. williamson on another round. my time is up. but thank you. >> dr. benishek. you're recognized for five minutes. >> thank you, mr. coffman. thank you all for being here this afternoon. i think to me what i've learned from this is that it's not as easy to get health care in the private sector for the va as one might think. i think the tricare model is

interest ing interesting. but they pay tricare the medicare rate and then tricare pays the actual providers less than the medicare rate. in my district nobody really wants to sign up for any of this stuff because it doesn't pay very pl. it's been, you know, problematic. some of the choice people offer choice but there's no providers that will do choice because they're actually getting paid less than medicare rates because they pay triwest medicare rates but triwest doesn't actually pay the actual people providing the care of those rates. and to get those numbers it's been tough for me to figure that out. my concern more is for today a little bit, is about this apparently illegal activity that's been happening. i'm just wondering, let me ask mr. doyle, were you aware that some of these things were

illegal, mr. doyle? that's what mr. frye seems to -- was telling us, that a lot of these purchases are illegal and then there's the legal opinion that this is not the way it should be done from a long time ago, that you didn't know that was the case. you're sort of in charge of procurement of outside care, right? >> yes, sir. as the chief procurement and logistics officer for vha i do do -- we do do contracts for non-va care. >> so is your opinion different than that of mr. frye, that this is not illegal? >> i'm not a lawyer or a judge but i refer to my legal counsel and i don't believe they would say it's illegal what we're doing. >> so there's a difference between what you believe and what mr. frye believes. is that right, mr. frye? is there a basic difference here? or am i talking about two different things? it's a little bit confusing to me. >> i think what counsel will tell you is these aren't illegal, they're improper. it's illegal to go through a

stop sign in my neighborhood but it's improper to spend billions of dollars outside the law in the va. it makes no sense. this is the same argument, the same specious argument that counsel used several years ago when there was an argument in these chambers about the buying of pharmaceuticals without contracts. and at that time the deputy secretary was here at the table and he in his oral statement was about to make the statement that it was improper and not illegal. and this body absolutely confirmed that it was illegal. if we were going to a court of law, the supreme court i'd love to have the argument made that these are improper, not illegal. but this is the court of public opinion. the court of public opinion, not a court of law. these are -- >> let me -- isn't fee for service providing different than contract? i mean, i'm a prior physician. i worked at the va for 20 years. i was a fee for service

physician. so i didn't have a contract. i agreed to a fee. and frankly, i wanted to do a contract but it was so difficult to get the contract, it would take months or more than a year to get the contract negotiated and completed so they couldn't get it done, so they actually preferred to do it fee for service because they could get that done right away. i don't know what exactly the details were. >> i'm sorry to hear you weren't on contract. it sounds like an unauthorized commitment. i'm not familiar with the methodology they used to bring you on. but if we're required to have a contract, we're required to have a contract. >> all right. well, let me go to a different thing. mr. labonte, let me ask you a question about your care. you say that you don't think you signed a consent form before you had narcotics or some sedatives. >> i signed a consent form after i was administered anesthetic to calm me down before the surgery. they had me sign a digital pad.

i wouldn't really call it a consent form because i never saw any paperwork. i don't recall signing it but apparently i scribbled on a digital pad under anesthesia to give the resident ibrahim heron the primary surgeon slot during my surgery instead of martin b. steed, the surgeon that was supposed to be conducting the surgery. to me that sounds illegal. but i'm not a lawyer. >> well, it's highly unusual in my experience that anyone -- i mean, where i come from nobody's allowed to sign a consent after they've had any drugs. so i'm just -- that's usually witnessed by somebody. i imagine you have all these documents. are you doing a lawsuit in reference to all this? >> there's a court claim pending. what's also unusual is ibrahim heron is the only resident in the entire omfs program that has a bachelor's degree instead of a doctorate. so i found thaun usualt unusual too.

there's also things unusual about the atlanta va medical center. >> well, i think maybe that needs a little more work than we've seen here today, mr. chairman. i'm out of time. thank you. >> thank you, dr. benishek. mr. rourke you're recognized for five minutes. >> thank you mr. chairman. ms. anderson i'll ask you because mr. frye earlier summarized what he thought your response would be to the question. was this or was this not legal? >> not to put too fine a point, these were not illegal actions or illegal activities. yes, they were not f.a.r. compliant. an illegal contract, and i'm speaking as a lawyer an illegal action or illegal activity it's not enforceable. these commitments are enforceable. in fact, the federal acquisition regulations acknowledge, understand that there are times

when officials not authorized to commit the government, they do commit the government and there is a formal ratification process. the courts and the boards have recognized that when the government makes a commitment, pays receives the services that the government can't hide behind the fact you that didn't follow the f.a.r. the government received a benefit. and there is a legal theory for recovery on that. so i respectfully disagree with mr. frye's position that these are illegal contracts. >> it sounds like i may or may not be following the distinction. it sounds like this is a obligation by way the va is legally bound to fulfill. did someone at the va do anything illegal in committing the va to this obligation?

>> if we're addressing merely the fact that a person not committing -- not authorized to perform -- enter into a contract, the answer is there was no illegal activity. >> so for mr. murray then to follow up if this was not illegal was this improper? >> thank you for your question. it's -- proper is an interesting question because if you establish the obligation, the provider providing the service the provider billed correctly, and the provider was paid, one would argue that it was proper but not f.a.r. compliant. >> should the obligation have been entered into in the first place? was that proper? >> so thank you again for your question. so was it proper?

proper. i'm struggling with the word proper. can i -- yes. can you -- >> i'd like to address that. and this is and this is going on the appropriations area. so -- if funds are available one, we have the authority to contract. done improperly but we do have the authority to contract for these services. funds are available then they are proper, the payments are proper. from an appropriations and authority. >> so let me ask this follow up question mr. murray. have these actions been ratified. has it been blessed by the va. we're concerned about what's happening here and we want to know what the basic question is

whether this was proper or not. >> as we know the office of inspector general recently reviewed unauthorized commitments in the purchase card program. for those that were identified by the oig we did 100% review of that entire sample and we referred those to they'd of contracting activity for, for ratification -- review and ratification if appropriate. that's where those are. now that's with respect to purchase card transactions above the micropurchase tlempb holdhreshold. if they were identified which the va regulations say you can go to 10-k, if they were above the $10,000 authorization for fee care one could logically say they probably required ratification.

and if they required ratification, one could make an argument that perhaps were not proper. >> okay. i'll allow a colleague to pursue this because if they choose because i'm out of time. for the record i'll ask mr. williamson what is knowable about the cost of purchasing this care without contract $7 billion. do we know it. is it knowable. i know we don't have time so i'll ask the question for the record. i yield back to the chair. >> thank you, mr. o'rourke. >> thank you, mr. chairman. i am aiming this in the direction of mr. murray and mr. doyle, i'm not sure but there's a business in my district that supplies specialized shoes diabetic shoes to the va. this service didn't have a contract. in november 2014 they were notified that the custom

orthotic appliance and related service requested a request for proposal. they were denied for not meeting the minute requirement of having a podiatrist on staff. who sets the requirements? my second question since this business did not have a contract how tuning the va was paying them for the services they provided? >> well -- >> it doesn't matter. >> i'll take that. >> okay. >> i'll need to explore more the specifics of this case, but the requirements if it was done by division 11 was done by the local contracting office and they work for me and my organization. they worked closely with the prosthetic folks at that medical center to develop the requirements. it's not set by the central office. i don't believe in this particular case. now, i don't know about the contract situation or not but it is possible that they were being

brought under the micropurchaserchase threshold of $3,000. >> the owner did say they would receive a purchase order that would have a credit card number on it an expiration date. they couldn't purchase more than one set of shoes, those or inserts per time. and my question is when you're talking about this particular organization serviced about 200 veterans in my district and now they can no longer do that, there's no long ear competitor. when businesses that are highly specialized that service veterans get stuck in this cycle in the va between -- they are not setting the rules, they are responding to an organization saying yes we'll join with you in partnership to provide specialized care so you know, it's harmful to folks on the other end of this trying to comply getting an rfp in the mail saying now you have to sign up for this. they had been providing this for a couple of years already and

get thrown out because they didn't have a minimum certification and it was okay as long as they got paid through the credit card order. don't you see an inequity when you're trying to keep service providers available. they have no idea what's complicit or not complicit. >> this sound like if they were doing repetitive orders for the government one could make the argument that's a split requirement. if it's a split requirement that goes above the threshold of $3,000 there should be a contract in place. >> you can check this out for me if i give the info -- >> yes. >> i would appreciate it. i yield back, mr. chairman. thanks. >> thank you. you're recognized for five minutes. >> thank you mr. chairman. i feel like i missed something here. i'm just trying to figure out why, maybe mr. murray you can answer this question. why is there such a reluctance

to apply far regulations when you're talking about nonva care if you give that answer sucking singtly because i have a lot of other questions. >> i don't sense its a reluctance at the leadership levels. in fact all leadership levels i see, pc 3, choice provideder agreements seem to be the preferred approach for providing care in the community. and if you want to delve into this the chief acquisition officer the head of contracting activity for the health administration might have some sense for why this is true or could be true in the field. >> all right. one of the things that we tried to address and we try to do with the legislation request that came in was to recognize that there are some vendors that may shy away from doing business with the government. we're not known as being the most streamlined or most easiest to deal with.

vendors have to give bradstreet numbers, apply for federal contract wage statutes. there's a lot of additional activity they do to do business with the government. what we try to recognize with tlejation is there's an order of precedence. we want to start to deliver care in our va medical centers. next is with contracts. next with agreements. our last preference would be what is termed individual authorizations. so we want to have that as really kind of the backstop as we go through this priority this hierarchy of providing care we see that as the least preferred option but one we don't want to take away from approximately 400,000 veterans that are being served by some of those small providers. >> it's become a $7 billion backstop. right? >> i don't know all seven of that. all seven i believe is for overall fee and some of that is

happened for far and nonfar. >> the problem is that there's no comprehensive auditing that's been done. mr. williamson what i see a pattern of is either gao or inspector general saying here's a problem, here's how you fix it and an intentional or negligent failure on the part of the va to take recommendations and actually implement them. so can you just tell us what you've recommended the va do and where they are still lacking? >> well, of course, as you know, we put va on our high-risk list very recently and part of the justification for that was that they are not implementing many of the recommendations. in fact there were over a hundred recommendations we made that va has not implemented just in the health care field alone.

so, there are 22 recommendations, i don't want to use all your time up but let me give you a couple of examples. one is we recommended that va keep track of wait times for veterans that went to nonva providers. they not yet done that. we talked to them about it. they still haven't done that. >> what's the reason for them not having done it? >> we don't really know. >> when you ask them you tell them -- >> i think what they are looking at -- they want to close a case from the time the veteran starts the process of getting an foimt the time that the claims paid. they want to do that in 90 days. they are tracking that. but for some reason they are reluctant to track the 30 days. >> why? >> good question. i don't know that they've given us a great answer on that. >> what would be a good answer?

is there a good answer. >> they probably don't have the systems to do it. it takes a lot of work. it does. it does take some good data. but that's not a good reason necessarily for not doing it. >> mr. williamson, so you've laid out a blueprint for how the va can improve whether it's tracking wait times doing better audits to see where these multibillion dollar expenditures are going, and i guess -- maybe there isn't an answer to this. it seems to me that you have not been able to get my satisfactory answers as to why your recommendations have not been implemented. maybe you're not the right person to answer this. i don't know if anyone teva i haven't heard mr. murray give my explanation as to why. >> well i think part of it is it always comes back to the