are unaddressed in the traditional health care paradigm that community health centers are definitely stepping in and filling that gap. as i mentioned with the group visits that we have, ongoing counseling, partnership with community resources, really caring for the whole patient, not just the medical needs. to be awhy very proud community health center position of and we deathly encourage others toencourage think about the medical profession and get involved in centermunity health movement. host: a tweet -- caller: [inaudible] guest: great question. notre realizing it is enough to treat patients, we have much prevent them from

becoming sick, and allow them to live out their lives in the most beneficial and opportune way. would they a good 50% dedicated to prevention. in that i could highlight some programs that we are very proud of at our center. one would be a program called up to reach out and read program in which we encourage early childhood literacy, starting from age six months of among our patients. we know that people living in poverty are less likely to read to their children. these children were more likely to start school two years behind their peers. children from low-income families are already behind because they had not had the .xposure to books great we we give books to each of our children as they come in.

we also address the growing epidemic of childhood obesity. we know this is the first generation that will not outlive their parents because of the epidemic of childhood obesity. a programe we have called we can where we are not only addressing the needs of the obese child of the entire family. bringing in the whole family, we have a demonstration kitchen in which they can try out low-cost recipes, we have volunteer exercise teachers that come in and do yoga and different exercises with the family. really trying to highlight the need for the entire family to be with the children. we are seeking to prevent secondary teenage pregnancy in

our community, and the rates of teenage brings you gone down -- pregnancy have gone down, but it is still there and there are still women who are having a b's earlier than they would like. we have a program in which adolescents can be referred, who have already had one baby under the age of 16, and we have intensive social work, parenting classes, fatherhood groups, to help these parents be good parents and prevent having another baby earlier than they would like. funding foreived the title x grant which provides family providing services to low income women. this is so important, that people are able to plan their families, they are able to not be pregnant if they do not want to be pregnant. so our entire staff is trained on the various family planning methods of including the range of, just as control pills to long-acting methods.

week, i am doing several of those sieges on women who like dish -- procedures on women who want them. i would highlight those programs as instances of revenge and -- prevention that we focus on. so anything that can effect a person's experience of life and we want our patients to be happy, healthy, thriving, and we embrace the entire gamut of what good health means and that is something i'm very proud of here at unity health care. host: a caller from wisconsin. ,aller: i would like to know

you are an extremely educated person, and your doing what you're doing, what influence drugs or drug companies have over the centers and a percentage of cool -- control is over the centers by drugs and drug companies? that is a very good question. obviously, pharmacies and drugs .re important health care overlyot want to be influenced by drug companies and their representatives. that community health centers, that influence is very low. limited area a they can access. they are not eligible for the newer, fancier, more of the drug. in another context i really and

credit our leadership for really the access of the drug company to us and really encouraging us to make educated decisions based on what patients have access to, what they can understand, what really felt it was their lifestyle. one would be if they could not read the label, or they cannot extend it -- understand it as a family member. there's a lot of drug company endless, but i would say that influence is very low here at unity health care. host: dr. anderson, are you staffed 24 hours a day? guest: close to it. it feels that way. we have normal hours at most of our centers, but recently we had

the opportunity for about two extended to have hours at a several of our health sites. two in particular, one which would be my health center and another at the minnesota avenue here in washington dc. we are able to be open from 8 a.m. in the morning to 10 p.m. .t night us to be open for us --thers are open meeting in meeting us. we recently in the last two years have opened up sites that i mentioned, and we are open , and 10:00 p.m. at night

that allows access for patients in the community to come in and use those sites. visit ourusiness walk-in business, but we do encourage that would patients, and we encourage them to become a patient of our center. we. we pay her up- with a primary care physician . in addition to the reason why they came in that day. we also utilize electronic health record in which all of the sites are able to communicate with each other through the electronic records as well as with the department of corrections as we mentioned yesterday. pitifulw, we are at the darkside community health center, and if they patient was seen there needs to see me after access toe direct

their health record and i can provide information and treat them appropriately. similarly, if the hospital calls, and asks questions about a patient, i am able to access our health records from home as well and are by those answers about the patient's needs to we are very fortunate to be utilizing the electronic health wavered -- record as well as by in these facilities. both my site as well as the parkside health center, we received help from the grant the grant that preceded the affordable care act so that we could renovate, expansive and be ready for the newly covered americans who are benefiting from the affordable care act. host: 36% for the funding of committee health centers medicaid, comes from

23% from federal grants, say local and private grants, and contract, 17%, private funding of a seven percent, self fake, six percent, and other public insurance three percent. those of the funding mechanisms for the health centers in the nation. dr. anderson is medical director . how far away from funding problems and decisions are you? have a very astute chief financial officer who was always on top of the numbers. i am not directly responsible for obtaining the funding, but -- we doe one encourage all of our physicians to have granted funding for the things they're involved in. one of our physicians is instituting a new problem called the ark description program. in which we are prescribing nature to our patients.

combat the scourge of obesity , stress and our kids, attention deficit disorder, we see that children are really suffering from not being able to go outside, not being able to interact with nature. that is one example of grant funding that one of our have and has access to is implementing throughout our centers. for the overall funding of our centers, we have a financial isartment that constantly worried about that and constantly on top of that. we encourage physicians to acquire grant funding if they of a project they want to work on, or if something is interesting to them. i think as a community health we provideider, as the services that is always in my mind, and that should be in the mind of any medical professional. health care is offensive, and we

want to provide the best health care that is necessary for the patient, but also keep in mind the cost to not be ordering unnecessary test, not be ordering unnecessary medication, having unnecessary visits if the patient is not needed or they would not benefit from it. while we are not directly involved in financial issues, we do have them in the back of our mind, and we are able to impart the health care that we need. i want to thank our leadership in that, that they allow us to do as much as we can within the services that we are able to provide. if there's something were not able to provide we can always petition for that. we need to provide health care within the constraint of the financial situation that faces us. host: a tweet --

guest: that is something that comes up often. --m not sure what the word what the concept of loophole is used in that context. i took a hippocratic oath to serve patients, to care for the health care needs. we do not ask about nationality, we do not ask about that is -- status of our patients are working, they are family members rate have dreams, they have children, they have a desire to live out their lives just like anybody else has. physician, my goal is to treat the patient and the best way that i can. i was in that community health centers are a way for people to achieve total health, i feel like they are a great mechanism in our community provide hope that they expand. regarding the issue of illegal we serve people regardless of their ability to

pay, regardless of their national origin, regardless of who they are where they come from, every person is served with dignity and respect. we are caring for their entire health care needs. host: the american medical colleges reject that there will be a dock are sorted by 2020 of 92,000. news -- 92,000 doctors. as a medical director, what do those numbers say to you? guest: it says that we need more brick easterners -- practitioners. my colleague will talk extensively about the innovative programs that we have at unity health care to really fill that gap. one of which is our medical

student school and our residency. where he teaching community health center in which we are training the next generation of students and practitioners to work in this kind of context. for example you enter that i did my residency training at harvard ucla mezzo enter in los angeles -- medicalt of center in los angeles, california. driven, and has a emphasis on my merry health care and underserved care. the vast majority of residencies in these days act is mostly in hospitals, and they may have some exposure to the community health care setting but not a lot. we are trading those students and residents in our centers as our home base, people that look like them. students that come from our community, and we know from

experience with both the national health service corps -- other and it seems that entities that people from those areas are likely to return to those areas to deliver health care. that is something we're working on here at unity health care to really provide students and residents with an idea of the vast array of health care services that we provide. i have heard the sunday times of althle visiting our he centers. they are impressed with the array of services we provide to the type of physicians that we have covered just the experience of the patients there. if we can train our learners in our sites, they are more likely to be the people return and work for our sites later. however, another thing that has been a benefit of our program is that even among our staff we have had medical assistants,

nurses come to be and say i was not about being a doctor, but i thought it was outside of my reach. actually seeing people in training, seeing what it entails, they are even inspired to follow their dreams and go if that is a goal of theirs. we have many tangible effects that are both short-term and far-reaching, beyond what we can imagine. we are very excited about that. host: robert in kentucky. the affordable cap -- health care act, medicare is a good program. it has been a good program for years, there's a little bit of flaws in certain things, and i think everybody in the world should be entitled to the medicare. and try to advance the medicare , and improvements of

having the obamacare. we already have a existing medical for people, and we could find a way to advance it to make more dock tours -- more doctors accept medicare and advance it, it would work out for everybody in this country. host: andrey anderson, any opinion on that? guest: thank you for your call. definitely, what you are speaking to, really underlying it speaks to coverage for all. i do think that health care's rifle on that people should be covered. by affordable care act is the law of the length of it was passed by congress, and we are benefiting from many of the provisions that she mentioned, like the pre-existing conditions. previously, people with pre-existing conditions whether it was simple as asthma or having had a miscarriage at one point for many insurance

companies, that would preclude them from obtaining an individual plan or individual services but we are very happy that that has been removed removed from the insurance companies, that people of all health statuses can receive care at any level. we know that the medicare program is for those over 65 and it provides robust coverage. moreuld be written -- robust gevo but when people get to 65 they are able to be covered. i have had some the patients priebus to the affordable care act, maybe they were 61, or 67, they are not -- or 57, they were not ready to retire, but they are outside of the coverage limit, not quite to that point where they can receive conference of services. -- comprehensive services. -- fundamentally, all should be covered, and we

need to have a healthy community. we need to interact with one another, and it is in just to not coverage for one and another when we are all working together in the community. host: do you see a downside to the affordable care act as a physician? guest: hmm. i would say that the downside me be -- first of all, let first say that i'm very supportive of the affordable care act bad i'm happy that we have an administration that sees the need for health care and health care for all. i wish that i'm could be more expensive, but we are working by the congress and trying to make it work in the best possible way. more people do not understand all of the benefits that are open to us of the affordable care act.

i wish that there could be a little more education, more people could know about the services that are offered, especially low income communities, young patients, latino patient, patient to speak spanish or a different language ever they may still feel that health care is not within the reach, coverage is not available for them. we do know that it has been made available through the affordable care act of and there are so many great benefits. i'm a new mother, and i was able to get many services through the affordable care act that i did not even know were available for me the. -- me. with more expansions, more education, more word-of-mouth, and more coverage in our community i really see that we are seeing benefits and we will see them even more in the long-term as this act does more. host: final tweet --

good question. we know that mental health is a problem in our community. death only one underserved area that we are working very hard to definitely an underserved area that we are trying to address. clinicianstal health that work in our sites and within our department of corrections. we know that mental health is often stigmatized in our community. it is an integral part of every person. i tell my patients that her brain is a part of your body to. just as your body can get sick, sometimes your brain can get sick as well. we need to have clinicians were sensitive to that and able to address those needs. one thing that we have done and are center is we have co-located our mental health services.

i mentioned the team-based health approach, previously when i came to our community, we had a mental health community that was on our restore, and it was very clear that you're going to the mental health department. i can create a lot of ideas in people's heads. now all of our clinicians are , theyted from the center would be coming to see me for them at becoming the seed feeder triticum of the beginning to see the social worker, referral, or the mental health provider. they are not stigmatized in that way. helps us to provide comprehensive health services because i might be seeing a patient in my exam room, and next door might be my psychiatrist or the psychiatrist of our team that is seeing another patient. go overuestion i can and asked them and maybe we are seeing the same patient so i highto change mrs. smith's

blood pressure medication, will that interact with the antidepressant and she is taking? because the clinician is right next door, and asked that question and we can have seamless health care that is so important that important in our communities. in addition, we are institution mental health screenings for all were patient. you come to any doctor need your blood pressure taken and your respiratory rate taken, doing also mandatory -- mental health screening and mandatory hiv testing. also for children because that is a large area where there's not copy the service -- comprehensive service. person'se that a mental health is just as important as their physical health and we are making sure that those issues are addressed to ensure the patient's overall wellness. the: services provided by community health services include primary care, event of health care -- preventive health

care, dental of farmers think of theth and substance abuse, funding request or $.6 billion for the next year. that is the quest for community health center federal funding. $3.6 billion in the current funding level. been andreas anderson, the medical director at the unity health care center upper cardozo branch. thank you for your time. guest:washington journal contin. host: on your screen is unity health care community health located a a couple miles from the nation's capital in washington dc. that is just a couple of miles from the capital building wealth. we are visiting their live this morning, talking about the

community health care system in our nation. robinson. keisha she's a doctor of osteopathic of and she is the medical education regional director. what is osteopathic? osteopathy is a philosophy, in which we as physicians go to the schoolstion and medical who treat the entire person. we have a foundation that the iny can heal itself, essence, sometimes in addition to medications and other support. that is the whole premise that the a-day has a natural tendency to heal itself. in essence, i'm the regional director of medical education, with the help of the support of our executive team management at unity health care. oversee our medical students who are osteopathic medical students.

their home base in the main campus is in mesa, arizona. so great about osteopathic medical students who come to our main campus is that they spend their first year in mesa, arizona, and then they come to our campus and rick -- complete the remainder of their medical school education from second-year, their jerk of and fourth year up until graduation. how does the philosophy of osteopathy -- did i get it correct that time? guest: yes. philosophyoes that translate into a patient walking in the front door at unity? so, unity actually has the foundation of that philosophy, and that his notting the entire person, just looking at what problem

they may enter the doorway, but also looking at their mental health, their physical health. when you think about, with incomes in -- when someone comes in with a history of asthma, we can help prepare body's natural tendency to heal itself. to ourteach that students will drink this throughout their education. how do you find these medical students? do you recruit them? we partnered, and the first graduating class of the national association of health of 100 to 1101 medical students. to 11 community campuses in which their duties

are assigned to -- students are assigned to, and they spend the last three years at those centers. school partner with that of medicine, we are introduced to the osteopathic medical students. inue our will cont visit, putting the numbers up on the screen area when did you first decide you want to be a physician? guest: as a young child. i recall my grandmother telling me that even before i could remember. a strongother was inspiration to me in choosing a path that i have chosen. i was sure under the publication of diabetes from repetition to stroke or heart attack, ultimately leading to her death.

i learned that a very early age that i wanted to be a part of the movement to help patients prevent preventable competition from a chronic condition. choosehat made you osteopathy? i would say i chose it because it shows made. i was extremely attracted to repetitive help. -- preventative health. thented to learn more about way the body heal itself and in what avenues i can help a live their life in an optimal way. an additive about learning about osteopathic medicine, that was an additive i was not expecting. preventative health is the core and foundation in my passion for what i do today. the fact that operate --

osteopathy was addressed to me following my undergraduate training to buy had other colleagues and students who chose osteopathic medical schools over other schools simply for the basis of how do you want a function, how do you want to treat your patient? see theot want us to sorent and trade them for throat, you're going to do more investigation about how they can prevent a sore throat if possible, how can we stimulate your immune system so that we can prevent future occurrences . it is all about education. has servedobinson two medicalin centers, and she is now the

direct your -- the direct or. heidi reach out to patients who may not be able to come to the clinic, such as jails, homicide is -- homeless shelters, etc.? the regional director of medical education, and the new york college of osteopathic , how do we reach out to the community? we have a health center within the department of corrections, and a homeless site.

we reach out to the because we offer our services to any and every person in this community regardless of the ability to pay. a lot of times, because i've been with them for almost 10 years now, and i have worked in ward eight in southeast washington dc, which is the area that i am from. asaching out to them w not a difficult matter. seeing their mother, their children combined zynga cousins and their friends and their children, -- their cousins, and classmates. reaches out to the community. host: let's take some calls for dr. robinson. seo is a nurse in tampa, florida. you are on. caller: hello dr. keyes robinson

to buy appreciate you, and your osteopathic medicine. my first baby was born at 22 and my doctor, who was an older man -- man cap at least 55, he and not deliberate and by -- an older man, at least 55, and yet not delivered a baby since med school. but he said delivering my baby was a beautiful vehicle. miracle. i heard you say that you wanted to become a doctor, i wanted to become a nurse or teacher because there's a lot of

teaching in nursing. and i wanted become a nurse ever since i was eight. host: are you an rn? i am.aller: host: are you working now? caller: i broke my arm. please enter your comment for our guest. caller: i do not think the all of us,s how much even though we are older, i'm consistently volunteering at the clinic which is across from the hospital where i worked. 12-16 in icu, and i work hours, and the most i worked as when a 1.5 hours. hours.

host: anything you would like to respond to? guest: absolutely. i am very moved, and understand the passion of how providers and physicians impact our lives on a daily basis. the importance behind that is also making sure that we also have positions in the future to do exactly what was done for this caller. that is to be a memorable component in their life, and delivered her child. i would like to take it back to our medical students, and not communitye becoming a campus for our medical student, our second year medical student, who come here and they are responsible for completing the curriculum that is through the university. this will be the initial

exposure that they have in our community health center settings. having hands-on clinical experience without other providers. this is a very important this is initial impact or impression of how they're going to move forward. they use this as foundation in their future, whatever career they choose them they're going to use this as a foundation for that practicing medicine. in essence, we also have a residency, as dr. anderson alluded to. we welcomed our first year class residents have and that is spearheaded by dr. donovan who is a program director. we partnered with the right-center -- wright center for graduate education. it is extremely important to pay

it forward to our future patients and our future physicians. we are really excited about the import of that, and training our positions. training our physicians and our students to practice within the community. it is about recruitment, it is about retention, we would like to capture all of the future physicians, not only through medical school and residency but also before that. become --t i wanted to become a physician at a young age. just to give them an idea of what it is to be a family practice in addition, a primary care provider, serving the community. thatrch has shown homegrown providers are individuals who are interested

in the field of medicine, whether they are from the area or they are trained and educated in the area. they tend to want to stay in the area and practice medicine. arere physicians who embarking on this longitudinal initiative to further our providers at our community health centers. experiences in our patients lives. --t: eight-week -- a tweet guest: yes. we have social services. anyially, it they need resources or information we definitely refer them to our which services members, is what dr. anderson related to

-- alluded to as our home team component. host: kerry from las vegas. with keisha robinson m.d. live ini couldn't washington dc because of the pricing, used to go to the unity health care clinic in wanda should did easy -- in washington dc. likei referred to places georgetown was because i cannot get a place in your elect. it is not at with what you're all doing but it is with the politicians. i could not afford to live there. when they talk about community, who are they talking about? host: dr. robinson? actually, currently, where i am sitting is in

parkside health center, and cticed here for the last eight years, i can vouch for patients who we have help significantly over the years. it is unfortunate that your experience was not as helpful as i would expect for it to be. whether you will bring referred nsultation or what have you given the price of living has risen, that is definitely true. regards to the services we provide we also make sure that we provide services to the rules for low -- most vulnerable. that includes at or below the poverty level. that is interesting because i would have been very passionate about making sure that you received the care that you d.serve

i am sure that is a benefit for las vegas and the disadvantage for us that you left us. ultimately, i do not know particularly about the politicians and the politics, but they do not being on the front lines as a physician and seeing patients have regional bank -- but being on the front lines, and seeing patients on a day-to-day basis, i fight for you everything the day. anyone, we see anyone payout regard to ability to . that is what drives us. we turned no individual away. that he is calling from pennsylvania. hello. caller: hello.

i have a comment. i'm a viewer of c-span on a regular basis of and i must say that it is refreshing to see guests that are intelligent, articulate, and informed, and actually are addressing the questions put to them. aside from the right thing with the doctors are doing in their communities is a wonderful thing , local ideology aside. >> ♪ guest: thank you very much. we appreciate that. care, we havelth thery strong role model, founder of unity health care. looking at what she has put care tond providing unity health care she is a great role model for all of our providers, all of her staff, all

of our administrative staff members. to live up to what she has done, greatar, it is a really role model. thank you for the compliments, but we have a long way to go, as far as health care. host: in 1975, congress authorized the community health center program a federally qualified humidity help centers receive federal grants and receive reimbursement from medicare and medicaid. over 9000 facilities, about 153,000 employees over 22 million people served, 88 million annual patient visits. that is national figures. .aller from silver spring caller: i am a chiropractor, and i was wondering the way they medical immunity by his chiropractors -- community views

chiropractors. how do communities view chiropractors, and ringing chiropractors into your system and, being that there is a shortage of physicians? actually, one of our board members as a her. ringing chiropractors into our organization is an opening to an avenue in which we can further expand and feed our patients. having aosteopath and lot of insight into the field is fields the dash into the of osteopathy and chiropractic field, i do not think that anyone is going to close their doors to any avenue in which we

can further the health of our patients. host: community health center did you have-- more you wanted to add? mention someed to of the concerns and barriers that we are facing that is very apparent to access to care. i'm sure everyone has seen the projections for the next six years where we will have a shortage of physicians overall. i wanted to highlight the importance of the longitudinal initiative we're doing with her students and a residence. the reason why it is so important is because we are actually training educating our future positions -- physicians. with this being there initial exposure to community-based headings we would like to make sure that our students and our

choose to, i think it is a great foundation to enter the dark shirt -- the introduction to their future endeavors. with that said we have a shortage of physicians. we're making every effort we possibly can to increase access to our patients and our community. have six residents and our first-class event we will have 18 in the next three years. we will have 30 students in our next or years -- three years. learners.ve 48 i think that is very important to point out in our initiatives .nd our growth

host: meet accountability standards, that is according to the health and human services department. barbara in florida, go ahead. caller: i would like to know if could --or [indiscernible] host: what was that? asking the so called death panel,. . is that something you wish to address?

host: we are going to move onto trish in florida. i'm wondering if you could answer a couple questions for me. for several years i've been struggling with a bladder infection. host: i'm sorry, we will not be able to diagnose problems over the air. could you get to the crux of your question? myler: i have pain all over body, and they diagnosed me as fibromyalgia which they just

give me a pill for. what would you do differently than what my doctors are doing? host: dr. robinson? if you were my patient i would definitely have to reevaluate you from the beginning to get a fleet history -- to get a complete history. not just your systems but other avenues. the field of osteopathy, we look at mind, body, and spirit. a force in a driven area for your whole optimal health to occur. we would have to look at the history with specialists and recommendations work even in what has worked and not work. if yourly, circumstances warrant, certain areas of treatment that an osteopathic physician can provide, and we can move forward than that.

we do not want to eliminate any of the celestial i could be part of the collective extended achieving your optimal health. host: we've been talking with the regional director at unity health care, located just dc in the washington capitol building. thank you for being with that, we want to thank all three of our guest. s. allowing us to be >> before the recess, a subcommittee held a conference. they heard from athletes who suffered from concussions including former usa women soccer goalie. c-span.s underway on on c-span 2, more from book tv.

a number of recent after words including author john rizzo. and on c-span 3, more american history tv. american artifacts. we'll start with programs on the national postal museum and the dar museum and be shaw memorial. then the civil rights in alabama before we wrap up with a look at a news. >> i hope this the last time and if necessary to take the time of the house to discuss the subject of the koran -- iran. let me echo the sentiments and thank him for the privilege of having served with him on the committee. it is been a difficult past. he said it will preside over sometimes contentious and

confusing process. i think the committee has in fact showed something it can be proud of. the conversations with the senior officials and the white house with a commitment that as of january 31, they will have completed their declassification of the materials that they have voted to release. i have given my word to the gentleman that if the white house fails to meet the deadline, i would join with mr. hamilton and coming back to the floor at the appropriate time to seek a further extension of the iran-contra committee. i do not think it will be necessary. my colleagues and the importance think is after the adoption of

the resolution, investigation, the committee will continue to the sky onto march with a very limited staff. as of march 1, the documents will be transferred under appropriate procedures and after that date, members of the select tomittee on iran, for access the materials will require a majority vote of the house. think mr. speaker, it is a good package. one that deserves the support of the house. it satisfies the concern of many that have expressed in recent days and i'm delighted we were able to work out of the accommodation. i would ask the chairman and to yield and join with me with respect to explaining specifically what is intended in that paragraph of resolution, paragraph number two, the closing out its affairs.

mr. chairman, our resolution provides only what accession to the provision that the committee will have note whether investigating power. committee tohe receive materials and to requests made prior to the date of the adoption. will the gentleman please explain for the benefit of the house, what is covered by the exception? >> the gentleman yield. >> previous lead discuss with the gentleman from a wyoming 2 pending request of which i am aware. i am not aware of any other request. >> more highlights from 35 years of house covers on our facebook page. c-span, for 35 years bringing the public affairs events directly to you, putting you in the room at congressional hearings and briefings and conferences and offering complete gavel to gavel coverage of the u.s. house all as a public service of private industry. >> more about health care with vice president joe biden. notes atred keynote

the conference in washington, d.c. he emphasized the importance of community health centers helping people understand and enroll in private plans. this is just over half an hour. >> ladies and gentlemen, the vice president of the united states, joe biden.

>> good morning. can you feel the excitement in the room? we are so proud today to have with us the vice president of the united states. [applause] this is our opportunity to publicly express our gratitude to vice president joe biden and to president barack obama for believing in our community health centers and for moving forward with the promise of accessible and affordable health care to millions of americans. as you know the vice president's just back from a mission to europe where he met with leaders from poland and the balkans about the crisis we are having in the ukraine.

from a personal perspective we want to make sure that he knows how much that we appreciate his being here. [applause] >> community health centers love joe biden. [applause] >> throughout his public life, including 36 years in the united states senate, he has truly been a man of the people. a fierce fighter whose work has advanced the ideals and principles upon which this great nation was founded. he is a leader who has stood shoulder to shoulder with us in the fight to expand health care access and sustain a strong safety net in our nation. joe biden knows health centers. [applause]

he knows what they mean to our communities and the people that we serve. and from a personal experience, he also knows that tragedies and hardships that often befall families through no fault of their own. and he has stood up for the working poor, the frail and elderly, and most vulnerable in this nation. he clearly understands and is a huge advocate for the expansion of behavioral health services in this country. [applause] like all of us, he believes that government has more responsibility to lift barriers, particularly for those in need and provide the opportunities for health, education, jobs, and the chance for a better life in this nation. [applause] he also knows government can't do it alone. it's up to all of us, all of us in the room and those in the

greater nation to ensure that we live up to the highest ideals this country represents. vice president biden exemplifies the true meaning of a public servant. and he serves for the greater good. so please join me in giving a warm, warm welcome for a great american and a champion of america's health centers, our vice president, the honorable joe biden. [applause] >> thank you very much, doctor. thank you. we got this backwards. i came to thank you. thank you very much, folks. it's a great honor to be with you. please, please, let me begin by apologizing, my voice. i just got back as the doctor says, been traveling around the world a lot, and apparently i acquired a sinus infection. so my doc told me i couldn't do

an event last night in new york, which i felt badly about. i said how about this morning? i said, hell, there's 1,000 doctors there. [laughter] i'm fine. there's nothing wrong with that. if you guys can put up with my voice, i'm sure glad to be here with you. thank you again. look, i mean this from the bottom of my heart. you are the blood and the sinew, you are the moral backbone of this country. you and so many thousands of people like you who just believe in possibilities and believe that it's one person at a time. you help one person at a time. and so my admiration for you is equally as deeply held by -- stop moving -- what's this thing called? teleprompter. barack kids me, he said, joe biden, i'm learning to speak without a teleprompter. joe is learning to speak with one. [laughter]

seeing all of you i really mean it. the reason i'm here and barack wanted me to be here is to thank you. thank you so, so much for what you have done. not for us, but for the american people. so many millions of people, vulnerable. so many millions of people knowing what they need and having no access to get it. first off, the president and i think you provided an incredible service that you provide to this country. nothing to do with the a.c.a. just what you have been doing. it's an incredible service you have been providing. you have more than 1,200 community health centers, and 9,000 sites. all 50 states. here's what i want you to think about. think about what those cities, what those communities, what those neighborhoods would be like if you hadn't been around.

i mean it. think of how fundamentally the lives of those communities would be changed without you. those community centers you run, 150,000 hardworking men and women -- feels like that with all of you today. 21 million patients, 21 million patients rely on you-all. more than 3.7 million, about 18% of your patients are children. for them and their families, you're the first place they go for primary care. you're the first time they have probably ever seen a dentist is because of you. the first time they have ever seen behavioral health services, maybe when they walkthrough your doors and benefit from your care and expertise. emphasize care. without you, the country would be a very different place. that's not hyperbole. without you the country would be a very different place.

the thing i love about you all, i don't know you, but i spent a lot of time in the community, the thing i love about you all is in face of all that you see, you remain optimistic. i mean it. it matters. it matters. you believe in possibilities. you're always looking about what can be better. why can't we get this, that, or the other thing done? great things happen when people believe. i have to admit the doc's right. i served -- every time someone says i serve in the senate 36 years, i bless myself. i can't be that hold. -- i can't be that old. during my career, as a lot of you know we senators and congressmen, we are called case workers. i had probably more caseworkers than most in one of the smallest states. i allocated more of my staff's

salaries to people who are the people around the phone going into somebody's home trying to help them with things that mattered. mattered in their life. i was blessed with so many competent caseworkers who not only believed but were determined, were determined to take care of people. one family, one person at a time. that's not some global thing we do. any of you have daughters that are grown, raise your hand. [laughter] again, i -- i always kid -- i have four granddaughters, and i kid -- i adore my daughter, i always kid them and say granddaughters are better than daughters. they go what? think about this. all you guys who have grown daughters. one night when they are about 12 1/2 years old, you tuck this beautiful little butterfly in bed. and the next morning you walk in there's a snake in the bed.

dad, don't cheer so loud at my games. dad, don't kiss me in front of everybody. dad, johnny's really a good guy, i promise you that. [laughter] all you women -- you-all come back to your dad somewhere between age 20 and 24. in my case it was 24. but i've got this magnificent daughter who is -- who's bitten with the bug that she can be the agent of change that she wants to see happen. she's -- all of my kids, all went into public service. i wonder how that happened? now they put me in a home i'll have no window with a view. one of them should have gone out and made a lot of money. my married daughter who lives in philadelphia but works in wilmington, delaware, runs a not-for-profit for at-risk kids. those being let out of the

prison system trying to work their way back in. and she is like all of you. she really believes, she really believes that things can be made better. think of what it's like, it would be like if we didn't have all you guys. i'm getting too maudlin about how much i appreciate what you're doing, but i mean it. this country's always been the defining feature of this country has been about possibilities. we have always believed that anything's possible. and the kind of work you have done has -- reflects that belief. i have been traveling around the country a lot lately. i have been traveling around the country constantly, actually. what i have done since the affordable care act is every community i go into i ask to meet with the advocates. i meet at the diners and coffee shops. a lot come from your ranks. and i met with moms and daughters. i met with seniors and students. i met with small businesspeople,

guys that run the diners. during those visits in those coffee shops, i have gotten pretty clear picture of why i'm convinced this -- the affordable care act is going to work. in miami, i met with a registered nurse and a couple of enrollment counselors from a local health center, where 95% of their clients live at or below the poverty line making $12,000 to $20,000 a year. they said they never thought, they never thought they'd ever be able to afford health care. and the enrollers never have been more rewarded, they say, than watching the look on a mother or father's face or a young person's face when you say, you're covered. you're ok. you can afford this. how many stories have heard and you have experienced where clients walking out of the health care center crying with joy that they never, ever thought this could happen.

but since december that particular center has enrolled dozens of people a day. and their clients, as i said, just never thought this could happen. one of the things we underestimate most, one of the things we underestimate the most to me, any way, is not, i think, the affordable care act, the single most incredible gift is giving to people. is giving to them a sense, a sense that -- it's lifted a weight off their shoulders about -- it's given peace of mind. like nothing else could for them. how many of your clients do you know go to bed at night staring at the ceiling wondering if god forbid they lean over and look at their wife, and she gets breast cancer what happens? or what happens when my children get sick? am i going to be able to sleep in this house the next night? after this happens?

am i going to be able to afford to be here? am i going to lose my home? am i going to lose my sense of well-being? and i think the single biggest thing we do is we give people peace of mind. you give them peace of mind. i hear that more than anything else. in phoenix i met with community health center workers who were once in the shoes of their clients. denied or dumped out of coverage because of pre-existing conditions and they reached a lifetime cap and they personally know what it felt like to live paycheck to paycheck and put the health of their families ahead of their own health. they told me, numerous examples, you all know helping people

enroll at the certainty is one of the most rewarding things they have done in their careers. they tell me nothing beats seeing the relief on people's face when they can finally afford coverage from their selves and their families, maybe for the first time sleep easy. as i said it's what i love about you all is you not only believe in possibilities, you -- these stories i have heard from scranton to atlanta to minneapolis across the country, another reason why you're in it, a reason why you do what do you. the thing that bothers me, anybody ever thought this is going to be easy never had insurance. seriously. assume you're a very wealthy person, you can buy whatever insurance you want. it's a complicated business. it's a complicated business. it doesn't matter whether you have a g.e.d. or ph.d., when you get that -- how many people do you know who have nothing to do with affordable health they come to you because they know you know something and say, i just got this thing about open enrollment. what do i pick?

what do i do? and so it's difficult for people who have been able to have an afforded health care their whole adult lives, why do we think it would not be difficult for people who never, ever, ever had insurance? look, it's complicated. so we shouldn't be surprised that it's complicated for people who never thought they would be able to have insurance. no matter how good the bargain is, folks looking at it for the first time, but that's why they are so vulnerable. with patience and empathy you look these people in the eye. the first thing you do you calm them down. the first thing you do is let them know there is no reason to be embarrassed that it's complicated. how many people have you spoken to? you can tell by the look in their face that they are almost embarrassed to ask you

questions. they do not want to feel stupid. you know it. that is why they trust you. you dispel their fears. you put them at ease. you walk them through the process. it is tedious. to add to the difficulty, we did not help you in the front end. [laughter] my boss, my friend, barack obama is an incredibly patient man. i suggested after going through the first couple of weeks, i would nominate him for sainthood as he kept his patients. -- patience. it got off to a slow start. it is basically fixed. in the last quarter of 2013, you helped 2 million people in the

face of the confusion, you helped them enroll. they walk through your doors, they reached out for you. you made a difference. you answered questions, walked them through the enrollment process. more than 5 million people have signed up for the drive and private health plans. [applause] many more that we are not even counting gained access to health care by signing up for medicaid. [applause] imagine if every governor did the right thing and signed up for medicaid. [applause] i am convinced, as a practitioner of the art of

politics, they will not be able to sustain the heat. [applause] here's the deal. none of this would have happened without you. the fact is, community health centers are the resource for so many people out there. you have been the only place millions of folks have been able to go for basic care. in the process, you have eased many concerns about the affordable care act. you have overcome language barriers. you have been so successful because people trust you. you are about -- of all the places in the world to go, doctors, nurses, hospitals, you guys, who will say this is a good thing, let me help you, this is how it works. they count on you. they know what you have done in the past.

that is why you are our most valuable resource. and why the administration has always valued. we have always valued, never doubted the services you provided. the president put me in charge of the recovery act. that was almost a trillion dollar piece of legislation that pulled us off the brink. we invested $2 billion towards capital financing and operating costs for community health centers. to build new facilities. hard.ght so that was in the face of the most god-awful recession in the history of the united states.

that is not hyperbole -- it caused millions of people to lose their job. they lost their health insurance. we knew at the time of the incredible uncertainty and we knew they would come to the one place they could always count on. you. that is why we invested another $11 billion in community health centers. you know what that means. [applause] you know what that means on the ground. more dedicated staff like physicians and nurses. renovations you needed. constuction on new sites. so many more folks could receive the services that you provide. these investments in health across the country, you have added 35,000 new full-time workers.

you have served 4 million more people in 2012 than you did in 2009. it will continue to increase. it is incredible. that is why we believe in you. you were with us on day one because you believed that health care -- i have been in politics a long time. i was vilified in my home state running by the other team because i thought -- i said health care was a right. that was an amazing notion. [applause] think about how far we have come. from the beginning of my career for the first two-thirds of it, there were still a group of people out there -- another party said health care is a privilege, it is not a right. my opponent and the president's opponent talked about these people -- they expect this help. what an outrageous notion.

think about it. it was the centerpiece of the debate. the most incredible thing about the health care bill -- this is the first time in american history we have legislatively ended the debate. health care is a right, not a privilege. [applause] you know as well as any group of people the peace of mind that that could be restored for millions of people knowing that they have coverage. because of the affordable care act, 105 million americans have gained coverage for at least one free preventative service such as blood pressure screening, colonoscopies.

129 million people with pre-existing conditions can no longer be denied health care because of this act. more than 3 million young adults are able to stay on their parent's health care until the age of 26. it is no longer permissible to have insurance companies cut off services because you have reached your limit. the most vulnerable point in the life of any family and to be told sorry, your insurance has run out. insurance companies can no longer charge women higher premiums. for simply being a woman. [applause] pregnancy is no longer a pre-existing condition. think about it.

the point is that you are among the most trusted advocates of the affordable care act because your mission has been increasing access to health care and giving folks a fair shot and a fair shake. you understand the change in progress comes from the community up. people trust you. that is why i want you, so we can finish the job. we need you. that is why we invested around 200 million to help train and hire around 11,000 staff to help bridge language and cultural challenges. and you have delivered. [applause] you know that already. you see it every day.

i want to remind you of 5 things you probably already know. we only have about 10 days left in the enrollment. health insurance is about peace of mind. it gives you a chance to live your life with more security. every one of you mom and dads out there should be pointing out something to kids out there who think they are invincible. when i do these conferences, in all communities -- i spoke to a group of young advocates, i don't know how many thousands there were. i said remind your friends that even though they think they are invincible, they owe it to their parents to give them peace of mind.

i mean it. a little bit of a guilt trip, but it is real. remind them that your mother is going to bed worried. you owe her. i mean it -- you owe her. [laughter] it is true, think about it. the second thing, this is all about choice and opportunity. i cannot tell you how many people i have known through my life as a public official who have told me they stuck with a dead-end job that does not pay well, they have stayed in a community they did not want to live in for one reason -- they had health care coverage. guess what? they are now free. they are now free. they can look for a better job, move to another community, look at how many people you know who stayed where they were in the

job they did not like and were underpaid because they were scared to death that if they moved, they had a pre-existing condition, or other circumstances, they would be in trouble. the law gives folks the freedom to follow their dreams regardless of where they live or what they do because now they will be covered no matter where they go. [applause] as i go around the country, the thing i find the most -- i hear the most is i cannot afford it. i can't afford it. particularly from young people. my car. college bills, it is tough for them. all of a sudden, they realize, i can get health insurance for

less than it costs me to keep my cell phone. think of how many very poor people come in and talk to you worried that they were not going to be able to afford what they needed and that they would not get any help. a family of four can be making $95,000 year to get help, they are blown away. they have no idea. the most interesting thing for me is that the ultimate way this is going to work on the road is i am talking to your neighbor, finding out, you have this insurance and that is all it cost you. the cost is something you can break down the barrier when you're talking to people. it is affordable. it can be affordable. if the state takes advantage of the opportunity to expand medicare, it changes everything. many folks that you talk to receive a tax credit.

many of them could gain coverage if the remaining holdout states take advantage of the opportunity to expand. in the states that have not made up their mind, we should be pushing as hard as we can without relenting. [applause] the deadline for signing up for private health plans is march 31. there are a few exceptions. the point of the matter is that we only have 11 -- 10 days left. the bigger the number we bank, the more certain of the ability to turn his back, no matter what happens in congress and where this moves. the next enrollment day is in november. this final point i would like to make is remember why you're

doing this in the first lace. these last 10 days, push as hard as you can. expanding access is what makes a gigantic difference. medicare and social security, it is like a -- it is the single biggest social initiative the country has taken since medicaid. this is allowing everybody to be able to have affordable health care. let me close by saying that -- with the grace of god and the goodwill of neighbors, as my grandfather would say, we're going to come out of march 31 with a significant pool of people already signed up with the pressure being put on governors who have not allow their states to take advantage of the medicaid coverage, that

we are going to roll into november, a situation that many more people understand. many more are afraid that they cannot afford it and we will see this thing continue to roll. you are the ones that feel that progress. all i am saying is that you push as hard as you can the last 10 days. the higher the numbers, the more certainty that this will last forever. this is one of those experiences that sounds corny. you're going to be talking about it with your grandkids and great-grandkids. you were part of putting in place something that 20 years from now everyone is going to wonder what is the big deal? doesn't everybody in every country do this? let me conclude with saying, not only do we need you, not only

have you done an incredible job, but we owe you more than we can possibly pay you. thank you very much. [applause] [captions copyright national cable satellite corp. 2014] [captioning performed by national captioning institute] >> c-span, for 35 years bringing the public affairs events directly to you, putting you in the room at congressional hearings and briefings and conferences and offering complete gavel to gavel coverage of the u.s. house all as a public service of private industry. we are c-span, created by the cable tv industry 35 years ago and brought as a public service. watch us in hd and like us on

facebook and follow us on twitter. >> next, a house hearing examines brain injuries in sports. then crimea. after that, vice president biden talking about the contributions of committee health centers. a house energy and commerce subcommittee look at spore safety and brain injuries in football, hockey, and other sports. nfl and nhl officials talk about the safety steps they have taken. we'll also hear injury stories from a professional soccer player and a high school student, and medical professionals explain the science behind brain injuries. the hearing is about three hours. >> all right. i want to thank everybody for being here.

we're now with the full committee ranking member, the gentleman from california joins us. we now have the ability to start our hearing. i will introduce you after my statement and before you start your testimonies. i will open with my opening statement will stop good morning, jan. good morning. welcome to this morning's hearing. today it is my hope to learn what steps are being taken to make sports participation safer for all athletes. every day, parents make choices about whether or not to let their son or let their daughter play soccer or what kind of mouthpiece to buy their son for his first day of football.

unfortunately, it seems like every day we hear about how participation in certain sports can be dangerous. it is easy to understand how what parents see in the news inevitably affects youth participation in sports. case in point, earlier this year, president obama said publicly that if he had a son, he would not let him play pro football. then the first lady wants us all to move. it seems to conflict. messages. now, we want a better understanding of the innovations they made by sports leagues, equipment manufacturers, and the medical community to make all spore safer. one clear example is the nhl, which has been working hand-in-hand with the union to make us safer, dating back to 1997, a recognize the dangers of head injuries and took the proactive step of forming a joint concussion committee, additionally, the nhl also

established a department of player safety at its headquarters, the first of its kind, bringing professional league. usa hockey and usa football, to organizations that help oversee youth sports in the united states have followed the lead of their professional counterparts by employing a multipronged approach to making participation safer. usa hockey now requires coaches to complete an online education module specific to the age group their coaching at. and that includes safety information, concussion education, proper techniques. usa football, which is endowed by the generosity of the nfl and the nfl pa, was the first national governing body for the sport to participate in the cdc's heads of concussions in youth sports. initiatives also engaged in

providing you with non-tackling alternatives to develop their skills. additional usa football's heads up up all program encompasses six elements meant to make use football safer including coach education and concussion recognition. proactive actions like the ones i just mentioned are exactly what parents need in order to be assured that everything possible is being done to keep their child as safe as possible while they're on the field or ice. who runs the university of nebraska's brain biology and behavior center located inside the huskers football stadium has been developing an mri machine that can be used on game day to assess a head injury. this would allow medical staff to determine if a player has suffered a concussion, how severe the injury is, and if the player is able to return. the equipment manufacturers are also using technology to make innovation changes to helmets, mouth guards, footwear, and other equipment in order to

reduce injuries. i feel confident saying that given the recent rule changes and the rate which technology is advancing, when the contacts for today is likely safer than it has been in the past. however, we must accept there is no silver bullet, no helmet or pat is going to prevent 100% of the injuries 100% of the time. this is why we need to consider a multipronged approach aimed at keeping our kids safer also promoting youth participation, aimed at keeping our kids safer while still promoting youth participation in sports which involves listening to how leaders like the nfl, nhl, youth leagues and top-tier university researchers are partnering to make progress toward making sport safer. these are the types of innovations and paradigm shifts needed to give parents the

assurance that all the possible steps are being taken to improve the safety of their child on the field. i would like to thank our panelists for joining us here today. i would like to thank you for making the trips to washington, d.c. from lincoln, nebraska. and my time is over, so i will recognize the ranking member from illinois. >> thank you. this is a very important hearing on improving spore safety. i look forward to hearing from all of our witnesses on both panels about their experiences, proposals, about how to make spore safer for everyone from children to professional athletes. athletes are continually becoming bigger and faster and stronger. despite some efforts to make spore safer, much work remains. 300,000 sports related traumatic brain injuries occur annually in the united states.

sports are the second leading cause of traumatic brain injury among people aged 15 to 24 years old, second only to motor vehicle accidents. this is a crisis and won the subcommittee should do everything in its power to address. we are going hear today from a high school senior who suffered a severe head injury during a lacrosse game in his sophomore year. despite his impressive recovery, that hit later identified as his third head injury, left him with a limited ability to enjoy the types of activities many of his high school classmates take for granted. his story should serve as a reminder that youth sports injuries can have devastating and lasting consequences. and we will also hear on the panel from no olympic and world cup soccer champion goalie forced from the field after a career ending dramatic brain injury almost four years ago. her struggle to overcome the

physical and psychological injuries that followed illustrate that even our sports heroes are vulnerable to the sports injuries. they should be commended for their courage. thank you. for the recovery, and her willingness to testify on this critical issue. a pro bowl and super bowl winning safety and former member of my hometown chicago bears tragically committed suicide just over three years ago. in doing so, he shot himself in the chest to avoid any impact on his brain, she asked that donated to medical research in order to allow scientists to study the impact of brain trauma he suffered over his 11 year professional career. it was later disclosed that he suffered from "moderately advanced" case of chronic traumatic encephalopathy, a disease and to repeated blows

to the head which can result in memory loss, depression, and dementia. the stories prove that even severe career ending sports injuries can occur at any level of competition and this case should make it puts all of is the impacts of brain trauma go way beyond and athletes days on the field and can become more severe over time. we will also hear today from medical and scientific experts who have studied impacts of brain injuries on athletes of all ages. we will hear about the importance of taking athletes off the field of play as soon as your suspicion of a brain injury , and keeping them off into their cleared by responsible and trained individual. finally, we will hear from the nhl, nfl, the leaks responsible for mitigating traumatic brain injury in their sports. i hope to hear what they will implement that will reduce the risk of brain injury moving forward.

i am not advocating for an end to sports as we know it -- or maybe not exactly as we know it right now. i also feel strongly that 300,000 injuries every year are too many to overlook. we should take reasonable steps to reduce the risk. i look forward to hearing from our witnesses. i hope this will help the subcommittee to better understand the safety risks in sports and what we can and should be doing to limit these risks. i yield back. >> thank you very much. this time i recognize the vice chairman of the committee. >> thank you very much, mr. chairman. thank you for holding this extremely important hearing. i want to thank dr. james johnston who will be one of the witnesses who came to my office earlier this morning. thank you. experts generally agree that concussion can be classified as a brain injury ranging in seriousness from mild to dramatic.

this interpret disease control states a concussion is caused by a bomb, blow, or jolt to the head or a blow to the body and causes the head to move quickly. according to the cdc, the sports that reported the highest number of traumatic rain injuries are bicycling, football, ground activities, basketball, and soccer. in 2010-2013, the participation rate of children in youth soccer and football dropped considerably. some have pointed to the increased risk of tbi as a result of participating these sports as a reason for the drop in the participation. the increased spotlight on concussions in sports has resulted in an increased amount of research and brain injuries as well as research on how to improve sports equipment in order to prevent such injuries from occurring. collegiate and professional

sports leagues have implemented standards and revised the rules in order to decrease the number of brain injury incidents. the nhl has been required -- has required its players to wear helmets on the ice in the nfl instituted new standards for evaluating concussions on the sidelines after the leak reported an occurrence of 223 concussions in just over 300 games in the 2010 season. state and federal governments have also been involved in tightening safety standards. since 2009, all 50 states and the district of columbia have adopted laws protecting youth and high school athletes from returning to play too soon after suffering a concussion or potential concussion. this hearing will focus on what more can be done to prevent brain injuries from occurring in sports. this is at the youth level, amateur, and professional level. i look forward to the testimony of our distinguished panels. thank you, mr. chairman.

i have two point five minutes remaining. is there any other member on the republican side that would like to speak with an opening statement? i yield back -- >> missouri, do they play sports? [laughter] on behalf of the big ten, i want to welcome rutgers to the big ten. >> thank you very much. >> five minutes to the full ranking member of the energy and commerce committee, mr. waxman. >> thank you very much, mr. chairman. decades ago, many thought that head injury was serious only if a player was completely knocked out unconscious or suffered a severe contusion. after frequent painful blows, even a young athlete could continue to play. but we now have strong indications that the effects of repeated brain trauma in sports, even those received during one's youth, can accumulate the consequences that are long-term

debilitating and even life-threatening. these consequences can stem from injuries once considered minor known as sub concussive blows which may not be accompanied by any immediate adverse symptoms. serious psychological and emotional disorders have been documented among former athletes that have suffered repetitive brain trauma. researchers a number of times have found evidence of the neurodegenerative disease when examining the brain tissue of dozens of deceased former nfl players. new technologies have enabled to show the metabolic changes in the brain associated with concussions and sub concussive blows. brain injuries in sports can

occur in a wide variety of situations, and different athletes' brains may respond to freely to an injury. sports related brain injury is a complex matter. it requires addressing many issues. so when the title of this hearing suggests we take a multifaceted approach to improve sports safety, i could not agree more. first, we need more neuro science research. they can lead to a better understanding of the risk factors and maybe better treatment options for brain injuries. second, doctors, parents, players need to work together to establish health regulations, game rules in the sporting culture that reflects the seriousness of brain injury and

put the athletes help first. third, we must address the health and safety risks associated with the athletic equipment and pursue a better understanding of how the significant might be improved -- three years ago, mr. butterfield and i called for hearings about inadequate testing standards, lacks reconditioning certifications, economic disparities regarding the safety of football helmets used by millions of american athletes. we are to touch on some of those issues today. but i believe those issues very deep it -- a consideration and are likely to get today. the subcommittee chairman mike consider holding a separate meeting on these matters. i think it is viable the national football league is testifying here today given recent and ongoing disputes the league and its players on

this very topic. however, i believe as traders commiserations should also testify -- i also believe others should testify. mr. chairman, today's hearing is important. i appreciate the subcommittee review of sports related brain injuries. i look forward working together with all of us on this issue in the months ahead. thank you for holding the hearing. i look forward to the testimony of the witnesses. i yield back my time. >> still have a minute left with the gentleman from utah wanted to use it. >> i might just point out that moving physically and conditioning the body is not anywhere near dangerous as subjecting oneself to brain injuries. i don't think they're contradictory. >> interesting, because that issue is we want kids to go out and play.

we want them to join youth leagues. >> and we want sports, but we want the mess as possible. >> absolutely. to use your last 26 seconds, this is one of those where jan and i both agreed was necessary. this has been a bipartisan effort. with that, let's move on to our witness panel. i'm going to introduce the entire panel now and then we will start with mr. daly. we are blessed to have the deputy commissioner of nhl. am, the executive director of usa hockey. then we have the senior vice president player health and safety policy national football league. thank you very much for being here. and the executive director of usa football. then a face of a brain injury,

multiple concussions within soccer, briana scurry, a former professional goalkeeper of u.s. women's national soccer team. oh we will have even cover the other face of high school level concussions. with that, mr. daily cover your noun recognized for your five minutes. >> i would like to thank the ranking members to invite me to testify today in the reactive steps the hockey league is taken to make the best perpetual players in the world. it is the only major professional sport with no out of out of hockey is a physical game. at the nhl level are players wanted to be physical and/or and wanted to be physical.

permitting safe and responsible play in our game, the national hockey league working together with the national hockey league players association has gone to elaborate lengths to do that, and will continue to do so. we are pleased to have this opportunity to share with the subcommittee some of the measures enacted in this pursuit. the national hockey league was the first major professional link to a value of players after they incur head injuries. beginning in 1997 the nhl and the nhl concussion program requires that all players on all clubs undergo preseason baseline psychological testing. after he player is diagnosed with a concussion he goes free and posttest did -- he is tested after the fact to find when he will be able to safely return to play.

that is pursuant to the concussion program that narrow psychological testing results had added value and should be taken into account along with player reported symptoms when making return to play conditions and decisions. the nhl and nhl concussion committee has also taken at affirmative and proactive step to issue league wide protocols regarding the diagnosis, management and treatment of concussions. import link of the issuance of warnings to players regarding the risk opportunity to play before the recovery from a prior concussion is complete is an important component of the nhl and concussion committee citizens option. this is provided regularly to all of the constituencies in our league of including players, all personal, and nhl officials. in addition to enforcing

additional player rules, and more stringently penalizing conduct of a several new rules have been adopted. you're not allowed to hit the head when other contact is unavoidable. with respect to the fighting issue in particular, while it remains a small part of the game of its role is finishing. 75% of the 2013-2 thousand 40 regular-season and 68% of the games played happen obliquely free of fighting. the highest percent since the 2005, 2006. the number of major penalties assessed providing down 50% from last season, and on 31% from the

19 -- 2009-2010 season. in this important area in be the league's intention to discuss any playing world pages regarding fighting darkly with the nhl players association. alternately it is in the hands of the department of safety cover the first link department of its kind of professional sports with this department monitors everyone apart to 131 regular-season games plus all or playoffs games and assesses every hits in a replay to make sure that the links standards for safety and responsible play are being adhered to. when the department determines that the standard has been violent, awful mental discipline is assessed in the form of a suspension or a fine, and the department creates a video thanks points to our players and our fans why the behavior merited punishment. the cumulative effect of these efforts has begun to change the culture of the game in a positive way, as we can see on a nightly basis layers avoiding dangerous plays a gratuitous contact that they no doubt would

have engaged in just a few short years ago. since the adoption of a mandatory helmet rule in 1979 to the nhl together with the nhl pa has an continue to oppose a series of additional regulation carting a player equipment regarding to player safety generally but also to head injuries more specifically, including most recently a rule adopted prior to the start of start of the season requiring face shields for all incoming players. each of the four international concussion in sports conferences between 2001-2012, in support of the federal and state legislative initiatives regarding concussions, and the support and assistance in the development of concussion education for grants for youth and junior age hockey players. to summarize, while worker a amazing that there is

considerable work to be done for the national league has been and will remain absolutely committed to promoting the safety of its players. we firmly believe it is not only the right thing to do for our players but it is the right thing to do for our business, both in terms of promoting participation at the use hockey level, and in maximizing interest by fans and consumers of the sport at the professional level. i thank the chairman of the ranking member, and subcommittee members for your time and invitation and speaking to you this morning. >> thank you. >> thank you chairman, ranking members, and distinguished members of the subcommittee. it is a privilege to be with you today to discuss issue that is a drop for artist of a everyday and u.s. hockey, the safety of our participant both on and off the ice. we have adapted well to changing environments over time and we had to particularly as we wish to thank, who guided a great deal of our decision-making. a chief medical officer, who is the head of sports medicine at

the mayo clinic in rochester, minnesota, and the other is the chair of our safety and protective equipment committee. that committee has been existence for 40 years. it is an important group, helping to guide our board in making it decisions. we have a risk management committee, which is concerned with the safety of the playing environment and the surrounding area. in 1999, in cooperation with figures getting we began an organization called serving the american ranks, or dark, which is essentially a trade and education organization for ice facilities focusing on a variety of operational aspects including safety issues in drinks. in the safety of our participants, we positively affect the landscape through three primary areas, education, rules and enforcement, and risk management. education related to safety happens on an ongoing basis in u.s. hockey, and we will use the many avenues to mitigate. we have direct electronic

vacation with every single home, every player, and prepared from area official, every comment in our organization through database. we are constantly communication with them with educational bulletins and is. our coaches have a huge influence and providing a safe and responsible environment, and i am a coeducation -- in our current coaching education environment, we have the gold standard. two seasons ago we added an online educational module that is age-specific in nature, which also contains critical safety information including concussion education. officials obviously play a very important part and how our game is made safe as welcomed and they receive regular evaluation and education electronically in our video clips and also access to our national reporting system which tracks penalties to help us understand and assess behavior trends.

when annual e-mail posters to every ice facility in the country to help deliver our messaging and over the years that poster has focused on topics like concussion prevention, concussion education, laying rules, and disease, and our heads up don't check program. we have adapted the rules to the game on an ongoing basis for mouthguard and held issues to rules aimed at limiting dangerous behavior. another recent modification in usa hockey game in june of 2011 when our board voted to change the allowable age for body checking games from the peewee or 811-12 level up to the bantam age group of 13-14. this was done despite many voices around the country in opposition to change, which no one seems to like. research based on both athlete development and safety guided our board decision. it is worth noting that two years later, hockey canada followed our lead.

regarding equipment safety, usa hockey took a significant step in 1978 when it called for the creation of the hockey equipment certification council, or hecc. we seek out hockey clement for product certification. it is the same procedure that football uses and certifying its helmets. it is a completely independent body the above doctors, engineers, testers, sports bureau, and lawyers. it validates the manufacturers and indication that the equipment they produce has been produced -- tested and meets the requirements of the safety standards. before closing i would like to share with you briefly our newest off i safety program called safe sport following the lead of the olympic committee, this is to protect our participants on policies

regarding hazing, zero tolerance, locker room supervision and abuse of any kind. in the early 1990's we were when the very first use words organizations to required screening of all adults that have access to our youth. our 34 affiliated associations each have a volunteer safe sport coordinator that helps us as boots on the ground to provide the safest possible environment for our participants. our sport is tremendous and its growth in the last 25 years, doubling the number of youth players we have as we continue to provide opportunities for young people to we know that we have the responsible or to make argument safe as possible, and we will only continue to grow if we are successful in doing so. >> thank you. mr. miller, you're recognized for your five minutes.