solution is don't wait for step "a" to fix before you start step "b," before you start step "c." parallel process, you can cut down that time. if we don't do that, we lose people while they're waiting to get their job. >> nursing is another example that it takes so long for us to process a nurse. and how do we advertise? do we advertise just in the va system or how do we do it? >> there's a requirement, i believe, that all federal jobs have to be posted in ---ed a a feder -- at a federal website but i know when i'm reading the richmond paper there's always ads for the va looking for nurses there. everything goes into a website, but, in fact, you use local resources. we also have executive and physician recruiters as part of workforce services that go out and reach out and try to find these people. we leverage them in the mental

health initiatives, and they were very effective. >> one last thing, we've had lots of discussions of how we get additional va doctors into the system and what can we do as far as i guess the medical -- what is it? the medical -- so that they can get, i guess, forgiveness on their loans when they work for the va or whether -- in florida, for example, a lot of our interns go out of the state because we don't have the -- what's the word? they go out of the state -- residency. and so we don't have those slots. what can we do? >> there's two things you're asking about. one is for people who have large med school debt and the average is pushing upwards of a couple hundred thousand now if you don't have help somewhere along the line is can we do debt forgiveness. we have some limited authority. it's insufficient. particularly where we want to place physicians in underserved areas which is the real

challenge, it's less of a challenge -- people want to stay around where they did their residency so in urban areas with bill medical schools it's much less hard. we've been working with hersa who has the program where they pay scholarships and loan reimbursements to people who work in designated underserved areas. many rural, but not all. and it doesn't make sense for us to build another organization within va to replicate that process if we're going to go that route, which i think we should if we can. we've got to make sure. but to tag onto them. they've already got the infrastructure in place, they can move out immediately, and then the other piece is increasing residency slots. va is highly supportive of the residency training programs in the u.s. i think you heard earlier about 70% of physicians get some of their training in the va system. we've expanded that in certain

areas. there's still not sufficient -- well, for mental health it's not that there's not sufficient residencies. in fact, some of them have closed because there's not sufficient people going into them so how does one incentivize that mental health community that more physicians would want to go in there. and that's not a question that va can anticipate but we can support the slots when we need to. i think there's -- the other piece of this and it was also mentioned earlier is how does one leverage the use of both nurse practitioners and physicians assistants and the like, and it's our intent within the organization that people practice to the top of their license, and so i think supporting pa schools, supporting nurse practitioner programs, we have the va nursing academies which are useful to bring nurses into the va system. we're also training people in

interprofessional train sog that doctors and nurses train side by side and learn to work as teams, and people who go through that find that as a very satisfying career move, but we've got to start that early in the training programs and not wait until they grd wa graduate and then try to retrain them to a different way to practice. >> thank you very much. my time is up. you've been very gracious, mr. chairman. >> earlier you made some comments about responding to congressional requests and such. could you restate what you stayed about that? something about criminality or criminal if you didn't -- >> i don't think i used the word criminal but i don't think it is excusable that a physician thinks he cannot talk to his member of congress. nor do i think anybody in va should be -- >> will the gentleman yield? >> yes. >> very quickly, if you can hold the clock, what i'm referring to is them being directed, not that the physician or whoever the clerk may be and obviously it's

in the investigation that a committee is trying to do as it relates to its oversight responsibility in congress, so i wasn't implying that the physician was but it is our understanding at the committee that there have been people who have been instructed not to talk to congress. >> well, do you want -- i can maybe put some context around that because -- >> if you just hold the clock and go ahead. >> okay. so right now, yesterday, today, this past week, as you know, va has been putting out a lot of the wait time data as part of being very transparent about this. there has been concern that at the facility level they may not be looking at exactly the same data that we were releasing. we wanted to be very careful that we didn't have facility or network directors appear to be

misleading their congressionals by saying, well, this is where we are and then having this national data release say something different. so there was a caution put out to wait until we had distributed the data to them that was going to be released, and i will say it was an ill-worded document and it was followed immediately by a statement of clarity. this was not intended that they could not talk to congressionals, to just hold off until they had the data that they could talk to them about and ensure they were getting the right data. you know, we get terribly compromised if we don't -- if we've got one person saying one thing and another saying another, and we want to make sure as we move forward especially and understanding what we put out this week is only the first drill at this, we will be repeating that on two-week intervals. >> thank you very much for that clarity. it does add some light onto the

issue, but i will also tell you this, we were told by dr. lynch two weeks ago because every member of this committee has been asking for the data from their facilities, and we were told that we would receive it once the report was final. the report is final. i got a call today that my local media got it before i've got it. i just don't understand why people in the va won't follow through with their commitment. now, you don't need to respond to that, but that's a statement. i yield back. >> thank you, mr. chairman. i appreciate that. i did want to read from an e-mail that was handed to me by i guess an acting director, and for members of the committee i did not know this. if the director and the assistant director are on vacation or on a management conference at least in wichita va facility, the acting director is the chief nurse, but handed me an e-mail that said please

immediately stand down on any further communications with stakeholders, delegation members, and others regarding the access audit, wait list, and accelerating care initiatives, and i didn't take that very well. >> no. >> can you explain -- this was approved at the highest levels -- >> no, no. >> the stand down message. >> i saw that memo and i personally saw that memo probably five minutes after it went out and i said this is not acceptable. if that cannot be pulled back, then you need to put a clarification memo immediately to explain the intent is not to have you not talk to your congressionals. the intent is to wait until you have the data from us to share with them because -- >> the follow-up e-mail was five hours later, actually 5 1/2 hours later after i had sat there trying to get answers to questions. let me describe, and you might have missed this the other night because i requested this e-mail. the facility eventually provided it to me, your office did, not

the va administration. i requested that at our last hearing and had to get that from the facility, but here is what occurred m one facility and, again, there are numerous examples across the country. i'm trying to draw attention to one facility in kansas that's not in my district. i do not have a hospital in my district. here is what occurred. may 30th, the facility announced or actually had a u.s. senator visit the facility. about noon and was told by i think -- if the director was there that day, i don't know, he seems to be taking a lot of time off. the acting director said we have no problem here. three hours later a fax went out that said we have discovered nine veterans on a secret waiting list. maybe unauthorized. that's the magic word out of there. and that was sent out to the delegation and the public at 3:00 friday afternoon. i began calling. once i landed in an airport, calling, sent e-mails, had no response for five days, no answers. hey, we'll get together with you

but wouldn't answer your questions. then there was a leak to the media of 385 rumored and so i jumped in a vehicle, drove to the facility, and was handed this e-mail and was told go away. go away. and i did not. we stood there -- this is what's concerning is since then they've discovered another 636. so there's over 1,000 veterans on the waiting list, and, doctor, here is what they told me. we didn't know we even had a near list. we didn't know that was in the system. the system that's apparently been around for 20-some years. this facility didn't even know. and i'm not asking you to explain this, but i'm asking maybe this is why we need some more investigation, more people should show up and ask those questions because either they're misleading or worse or, frankly, incompetence if you didn't know you had these veterans sitting on a list. and as i understand the numbers

that were released in the audit do not include other unauthorized list. that's still yet to be known. is that correct? >> if we don't know where the unauthorized list are, we can't include them. >> how are you going to find them then? i understand that you don't know. >> right. >> but you didn't make any reference to other unauthorized lists that were found in phoenix. the types found in phoenix, you didn't make any reference to those at all. >> so the near list everybody should know about, and i don't say this as an apology, but there is a software defect that gives a different number if it's pulled locally than if it's pulled nationally. so all of the near data is being pulled nagg eed nationally and have been directed to go to the national center to pull their data down. but this -- >> how long did you know about this glitch in the data? >> as we were trying to pull this data together. because this is a problem.

we had facilities saying we don't have any -- >> we've had two weeks of hearings. this is the first time you have said the near list is a data glitch. >> the near list is part of the process of scheduling. >> it is not in the va facility that is not accurate or else they're lying to me. my question is it's not just about one center and one hospital. this is systemic nationwide where the -- what you tell me the near list is everywhere. that's what they told us two weeks ago and we go to a facility and they said we didn't know there was anything such as the near list. >> well, i don't know -- >> well, how about you find the answer. and in the future, i would appreciate the documents. >> it was not the appropriate statement and i hope we did get that corrected. >> who did approve that statement? >> it was jan murphy -- well it was put out. not every e-mail gets approved by --

>> a gag order e-mail, i just want to know who approved it, janet murphy? >> jan murphy sent it out? >> who approved it? >> i don't know. i saw it -- >> who approved it? >> no, i can't. >> you can't find it out? >> oh, i can find it out, but i will say we tried to correct that because it was not intended to be a gag order. i thought it was a poor choice of wording. no question it sounds like that. it's not the intent. the intent was to ensure you saw the right data and you didn't get in a conflict of where they were saying one data and then you would see another piece. we want to make sure we're speaking on the same page. >> thank you, dr. jesse. miss brownlee. oh, that's right. i let you go way over. miss brownlee, five minutes. >> thank you, mr. chairman. and thank you, dr. jesse. i wanted to agree with your

opening comments regarding our veterans who work within the va, and i do believe that most of those veterans are working hard every single day and are doing a good job, and i believe that these men and women who served in uniform were dedicated, and i believe these men and women who no longer are in uniform are equally as dedicated. i certainly don't want the men and women working within the va to be discouraged, but they do need to understand that they have been working in a system that has lost its way in a structure that's lost its way. and as a consequence was particularly in this wait list issue doomed to failure. and so i don't want them to miss -- i don't want them to

misunderstand in these discussions that this is not a criticism of them individually but it is a criticism of the system of which they were working in. >> thank you for that. >> and to that end i was also curious to know from you what the va is currently doing, we're all trying to get our arms around the problem, and to fully define the problem and how you have used the vsos to help in that process and how you intend to use the vsos to come up with solutions. >> the vsos i think are incredibly important to us moving forward. they've been incredibly important to us all along, but today, yesterday, tomorrow, moving forward, they are going to be critical. as i said, if we're going to change an organization to one that's driven on value, we have

to do what's important to those who we serve, and they are the reflection of that. and, in fact, i was very poignantly told you didn't need all your numbers to know there was a problem, we told you. you needed to listen to us. i take that very much to heart. one of the things we have done just as a top line is as i met yesterday with the group of the vsos for -- we have breakfast once a month, it went much longer than it normally does because there were a lot of things we were discussing, acting secretary gibson has been meeting with them quite frequently as well as we are moving things forward, but the important thing is that the facility and facility directors are also meeting with their vsos on a regular basis, and in some facilities i would guess they're

probably at among the high performing fa 1i89s, they're listening. in other facilities they might be transmitting, but without judgment or without trying to figure out who is doing what, our instructions forward is you must sit down with your vsos and listen to them. you must sit and listen to them because that's going to be how we're going to judge the progress that we're making. so that's -- it's very insightful on your part and thank you very much. >> if i return to my district and talk to my -- the leadership team in my county, i can be assured they've been instructed to listen to our local vsos. >> you go back -- i hope they have, yeah, and if you go back and talk to your local vsos and they're not getting the attention they get, we've asked the senior leadership in the vsos to transmit the message down to their folks that work every day in the facilities serving veterans to get that

back up because that's the only feedback we'll have. you know, obviously we can make them send minutes of their meetings and things like that, but that's not real productive. it's are people being listened to, and web get that bawe can gk by dialogue through the systems. >> thank you. in terms of my local area, we know the demand is greater than the supply. we know that we need more space. that has been confirmed both by the va and the community. and so i am just wondering, you know, how often the va looks at long-range capital plan updates and if you have any idea when the oxnard will be added to a long range capital plan. >> so there's two questions there. there is a long -- there is the capital asset management program. i don't know off the top of my head the prioritization of

oxnard although i did live in oxna oxnard. i was stationed at point magoo, so i grew up there. i can find out. >> i appreciate it. thank you. i yield back. >> mr. kaufman, you're recognized for five minutes. >> thank you, mr. chairman. dr. jesse, last year dr. steven coughlin testified that va's 2010 national health study included over 20% gulf war veterans and produced important data regarding their exposures to pesticides, oil well fires, and bromide pills. those of us who served in the gulf war remember those. but va has not released these data. dr. jesse, is va hiding vital information about a quarter million gulf war veterans who

are waiting for care just as va has been hiding information on veteran patient wait times? will you provide the committee with all of the gulf war data within 30 days. >> well, i will answer the first question and say categorically we're not hiding data. understanding gulf war illness is crucial. it's crucial, and we need that data to do that. in these data sets, the way that the research works, is to begin to publish the data in the studies that they can put together looking into that data set. this is what dr. coughlin was working on. va is also actually working on moving towards the whole construct of open science that actually put that data once it can be deidentified so you don't

compromise individuals' rights out into at least in a managed public sector that other researchers can have access to it as well. in terms of the second question, i'm not sure how i can answer that. i don't know the size of the database. i can probably say with more clarity and accuracy that we can provide access to the data, but to say that can we hand it over, i don't know that. there are issues related to patient privacy and other things but i'll be glad to work with your staff to try to work through that. >> certainly we're not looking for individual names here. we're looking for the conclusion of the research, and so i think the question is, and let me repeat it again just to make sure you understand it. as a gulf war veteran i'm asking you will you provide the committee with all of the gulf war data within 30 days? >> and i answered you by saying i can't tell you i can do that

because i don't know the structure of that database. i don't know can we provide it if it's not -- if the patient privacy and protections aren't taken out? and so to hand over a large research database, i don't know what -- >> let me ask you -- >> but we could get you access to the data. >> so if we say then that -- because i want gulf war veterans to have access to this data, not just me. if we say then that minus the hippa protections that exist in law, that you're going to turn over all the data relevant to this 2010 national health study concerning gulf war veterans, that part that concerns gulf war veterans. >> i think that's a question that's too complex for right here and now. i will be glad to personally further this conversation with you. i'm not sure exactly what you want. large databases are not something that one -- it's not

just the data. so what are the questions that gulf war veterans want to answer? that's our responsibility, to engage with them and get answers to the questions that they want and need. you know that there are active researchers that have been working within the gulf war databases. there are, you know, several incredible studies that have recently come out in terms of trying to get to the foundations of what might be behind that. but i can't tell you i can hand you over a large database. i don't know the legal authorities to do that. i don't know where it would go. i don't know how it would be protected. but we can have that conversation. i just don't think we can have it here today. >> let's have that conversation tomorrow. because i can tell you as a gulf war veteran, i don't share with you your statement about the commitment of the va for gulf war research. it's not there. it's absolutely not there. it tries to veer off into a

direction that is kind of all in your head, quote, unquote, and mr. chairman, i'd like to enter this for the record, this letter from the president of the research advisory committee on gulf war illness if i could put this in the record, mr. chairman. >> without objection, and gentleman's time has expired. >> mr. chairman, if i may, i mentioned earlier today over at va there is a state of the art conference going on exploring the relationship between mitochondrial function and disease and veterans. much of the research that's come through that committee is pointing fundamentally to a basis of that disease, much of the muscle aches, the myosigh tis, the chronic fatigue syndrome as being related.

we have pulledresearch ers to begin to explore that and the hope is for a structure for a national multicenter trial that would look at potential both the basis of the disease and potential treatments. there have been several out there that showed promise in small studies. they need to be looked at in larger studies but they also need to be looked at with a sound basis to link the pathophysiology to the disease state to the treatment. that is going on today, sir. >> thank you very much. mr. titus, you're recognized for five minutes. >> thank you, mr. chairman. dr. jesse, i have been hearing a lot of news stories and even in this committee where members say, well, the va lied to me. yow, i don't think the va -- most people at the va are intentionally lying but i want to encourage you to have as much open dialogue as possible because with that transparency we can meet our mutual goal of helping veterans.

i have a good relationship with isabel duff at the southern nevada va health system and we talk regularly, meet regularly. i would encourage that at all your facilities or areas. second, i would like to join miss brownley in the request for information when you find out where oxnard is. would you also look at laughlin and perump. if you could get that back to me, i'd sure appreciate it. >> absolutely. >> thank you. and then the third question i would like to go back to what the ranking member was talking about, the restructuring or realignment of the system. i know you realigned the headquarters and you said it was an ongoing process to look at the realignment of the areas. just give you an example of how this doesn't seem to make much sense. my district is las vegas, and so

the constituents there are part of the desert pacific health care network. now, this ranges from rural nevada to central california all the way down to the mexican border, and the state of nevada is split into three different areas. surely we could try to bring a little more order to that regional division. are you all doing that? is that part of what you're considering. >> that's the next step. when they were originally set up and brilliantly so i might add, they were built to provide an equity both in numbers of populations so the they were all roughly to be the same size. obviously the geographies were quite different, but also to follow the logical local referral patterns. so if a small facility is referring to big facility, you wouldn't want to split them up and put them into two different areas. so that's the way it was originally built. it's been modified once if you remember 13 and 14 became 23.

but clearly the referral patterns have changed. clearly the demographics have changed. and it needs to be relooked at. it also does need to be relooked at in terps of the overall structure. if we don't examine every one of our assumptions today, then we're not going to get to where we need to be. we have to question are 21 the right number. are the structures the right number? are the referral patterns the right number. >> is there a time table for doing this? >> i think any time table we had has probably changed, truth be told, because i think, you know, particularly what you heard today and, frankly, many of these ideas that were discussed in the first panel are things we've actually been looking deeply into, but i would hate to say we're going to put out a plan to change the lines because

today we really need to be relooking at the entire structure of the organization moving forward. so i apologize. that's not a solid answer but i think it's the more important statement that we will examine everything. >> i hope when you do, you will consider potential changes in the future, demographic changes, and growth especially. because the hospital in las vegas, you anticipated there be a 2% increase in demand on the system when that hospital was built. it's a 19% increase. i think the veteran population is going to grow generally, certainly grow in las vegas now that the economy is coming back. so we don't want it to be a snapshot in time. we want it to have that projected growth as part of the formula when you realign these areas. >> and as that hospital was put together, there was great thought going into how the primary care base was going to be distributed around it and i hope that's meeting some of that need as well. >> thank you. i yield back. >> thank you.

miss custer, you're recognized for five minutes. >> thank you very much, mr. chair, and thank you, dr. jesse, for appearing here with us. we appreciate it. i want to focus in on some of the testimony that we heard earlier in the day and see if i could get some reaction from you or response. we've heard of a pretty incredible statistic in this committee that, i believe, almost 50% of the appointments are no-shows, and i understand you're often dealing with an older population and transportation and such. but it doesn't seem like a very efficient or effective way to run the vha. has there been any consideration to either and/or telephonic scheduling where there's a conversation about whether or not the veteran can actually make that appointment and, number two, some type of automated appointment reminder. >> so actually we do much of

that. i'm a little bit baffled to hear as much conversation there was today about the fact that we don't. you know, the whole principle of missed opportunities in practice management has been one of the things va has been working very diligently on for years now. so actually when that comment was made, i asked them to fact check what we are for primary care, the no show rate is 11.5%. in my clinic the no-show rate is about 0% because if somebody doesn't show up, everybody is worried about them and we track them down. but we do use phone calls. in fact, the ewl, the function of the ewl is this is where patients are and if you get an opening when you make that phone call and somebody says i can't make the appointment, you pull people down off that list. that's the point of doing that. so we actively do practice management in that regard.

so as i said, i will acknowledge the variation that occurs in the system. some places probably do it great and others maybe not so well, but the beauty of an integrated system is that we actually can have those who do it great help bring up those who are struggling and we try and do that when we identify those. >> so that leads to another question that has come up repeatedly today is what is the practice about sharing best practices. why do we have such variation across 21 different regions and why if you're citing an 11% missed opportunity, why are we hearing these statistics about 50%, half, more than half? >> i don't know. and because, first of all, there will be variation around it and it may be clinic by clinic or provider by provider but getting that variation out of the system is absolutely what's key. >> and is that a metric -- we've

heard a lot about metrics and data. obviously that ran amok in the scheduling -- trying to deal with these wait lists, but because it led to bad behavior. is there a way to incent good behavior by having some type of metric about patients actually getting seen? this notion of patient focused care for veterans so that we're focused on the veterans, how can we make sure that they get to see their medical care provider in a timely way? >> so we actually do have a measure of missed opportunities, no shows and cancellations and that's cancellations both by the patient and by the clinic, and that is -- i want to be careful not to give the sense that that's used as a tool to drive behavior -- >> let's not get into a situation where we pretend people show up who don't show

up. >> it is a practiced management tool so individuals who have their own clinics understand they have a problem with patients not showing up. if they're not leveraging using open slots, that's not effective use of the clinicians time. we may not be as some places as good as it is in the private sector, but private sector clearly has dealt with this very strongly because for them it's a revenue issue, but i would not say we wait for people not to show up because it's a snow day. our providers are busy and we want our patients in there. we worry about them when they don't show up if we're expecting them because particularly in mental health, we track them down because we're afraid something might have happened. >> my time is up but it's something i think if you could take back to your administration, this is a critical point, and something that's extremely frustrating to all of us here.

>> may i thank you for your nice comments about the manchester va. my dad -- >> we're fortunate. >> my dad used the manchester va and he always thought highly of it. >> mr. rourke, you're recognized for five minutes. >> a month ago i received this report from your predecessor dr. petzel. it's entitled wait time for initial visit to patients new to the va. it shows right now zero patients are waiting longer than 14 days to see a mental health care provider. that was for march and for the month before that it was zero and it was like that through the past 12 months where the longest average wait time was three days. the audit we got from the vha

this week shows the same group, these are new patients seeking mental health care appointments, it's actually 60 days which makes el paso vha the fourth worst in the country. when we look at established patient mental health care average wait times it's the worst of all vhas in the country. i want to know what the consequences are going to be for publishing false, inaccurate data. i'm sensitive to the comment that my colleague miss titus made about saying that these are lies, but i don't know what explains it and the consequences could not be more dire for the people depending on this. i'd like to hear concisely what the consequences are going to be. >> we've had a little bit of a discussion about this, and i can't say what the consequences are because i don't know how it happened and by whom. i think at the bottom of this is we looked at data that we assumed to be correct. we didn't challenge ourselves to

find out it wasn't until we got down and did this audit. and i don't know that without looking into it and, frankly, this is why we have the ig and others doing these investigations, if somebody glib r deliberately mislead you or somebody else on this data. there will be consequences. i'm not a lawyer, i can't speak to -- >> let me follow up with this. i shared with you a survey we did because there's such a discrepancy between what va was reporting and what veterans are telling me. we found in that statistically valid survey, more than one-third of the veterans i represent who seek mental health care points cannot get into within 14 days, they cannot get in at all. when you have 22 veterans a day killing themselves in this country, when i learn from one of my constituents that her son, a veteran, came to one of my town hall meetings, heard veteran after veteran go up to the mike and say i can't get

home. on the drive home he said these guys are a lot older than i am, they have been trying to get into the system longer than i have, what does that say about my chances? four days later he killed himself. this is a crisis and frankly i do not see the urgency from you. i do not see the commitment to accountability from you and others to address this. if i knew what you know, i would fly down to el paso and try to discover who those 36% of the veterans who have been denied and locked out of the system are. you're not doing that. we spoke the day after i released the report. we asked for a plan of action. we spoke then monday of this week we asked for a plan of action. i asked you before you sat down. you said you were going to go back to the office and take a look at this. i have been very patient and very cooperative in working with the va. that has not served me or the veterans that i represent very well. i understand you have a lot of demands on your time right now given what we've learned from phoenix but we have a crisis in el paso and in many other places but i have identified it for you. i have given you the information.

i'm willing to help you. i will use my own resources to track these folks down with you. but you have the list, the information, the veterans who sought care and not been able to get it. when are we going to get that urgency from you and when are we going to connect them with the care that they deserve and that they've earned. >> as i said when we spoke earlier, when i get back to the office, i will get the final answer. i don't know why you haven't gotten the plan yet. i would hope that by now all of the veterans would have been dauld and as i said, my concern is the 36% number that you have in your survey. because i'm concerned about the ones that we know but i know we can help them and get them in. i'm really concerned about the ones we don't and how we reach out to them and ensure that people who think that they're waiting for an appointment and somehow we've missed them or dropped off, i don't know. i'm really worried about them and i have offered to come down. we will get a time and figure it out. >> okay. i'm going to use every opportunity i have when you or someone else from the va or the vha appears before us to press this issue because we know about

it, you say that you have a commitment to it. we have yet to see a plan of action. i think we need a s.w.a.t. team flown down to el paso to connect these people. again, i would like to be part of the solution. i offer myself and my office, our resources to that effort but we need to get it done. >> and i thank you for that. i very much appreciate you wanting to be part of that solution. >> thank you. mr. chair, i yield back. thank you, mr. o'rourke. i'd like to read from united states code section 1505. it says whoever corruptly or by threats or force or by any threatening letter or communication influss, obstructs, are impedes or endeavors to influence, obstruct, or impede the due and proper administration of the law under which any pending proceeding is being had before any department or agency of the united states or the due and proper exercise of power of inquiry under which any inquiry or investigation is being had by either house or any committee of either house or any joint committees of the congress shall

be fined under this title, imprisoned not more than five years. this is serious stuff. >> yes, sir. >> and i hope the department gets it. are there any other questions? >> i had one question. >> miss brownley. >> one last question at least for myself. in the earlier testimony today -- well, let me just say there have been a lot of recommendations made to this committee on how things can be improved, and i would certainly be curious to know how the va is digesting that and how they're responding to it. but there was one i think compelling recommendation today to -- before we move forward with a major fix to this situation that we should first do with an outside consultant a cultural assessment within the va and i'm just wondering, you know, what you're reaction is to that, what your response is to

that recommendation to this committee. >> so the answer is absolutely but more. yes, the cultural piece is crucial, but -- and culture is established by leadership. i think -- i take that very much to heart. the organizational structure and design was part of that discussion, and, again, absolutely, and we have been over the past several weeks meeting with a number of people who work in this area, with expertise in this area. absolutely agree it needs to be done. we can't redesign it ourselves. we need the input and, you know, been hagving a number of information with folks at kaiser. how does kaiser's organizational structure seem to work well? how does mayo's structure work

well. we need people who can see across those systems and bring that shared knowledge to bear to us. so, yes, we definitely plan on doing that. we will do it expeditiously. >> thank you. >> we will include the veterans and the veterans services in that discussion as well, by the way. >> if i can just in closing ask one question. in testimony that you presented to this committee in february of 2013, you stated that the pittsburgh va health care systems copper silver ionization system may have failed to consistently prevent legionella growth. do you recall that system? okay. in a december 2012 va report, va leadership was made aware it was poor record keeping, lack of oversight, and lack of

documentation, failure to test the hospital's water level at the at the heart of the disease outbreak. now we know it has led to at least six preventable deaths at that facility. so explain to me how you could testify to congress contrary to something that had already -- >> so i was not aware of that report at the time i made that testimony. and i apologize -- >> are you aware of the report today? >> what's that? >> are you aware of the report today? >> yes. >> has anybody been held responsible for writing your speech or intentionally misleading the congress? >> i don't know that anybody intentionally misled. i don't know where that -- that said report was given to senior leadership. i don't know the trail on that report and, in fact, i was made aware of it only relatively recently, and so somewhere in the traveling of information, it

didn't get widely distributed. i don't know the answer to that. >> has the person that wrote your testimony been held accountable now that you know about the report and it does, in fact, contradict your testimony? >> well, i don't know that the person who wrote the testimony was aware of it at the time either. and i don't know what it means -- the central office was aware of that. i apologize. i don't know the answer to that. there was no intent to mislead. i assure you -- >> but we know your testimony was not, in fact, true. >> well, the testimony is true. it's not complete, but it is true. you know, let me put a rev rebs point on it. the cdc came in. they took extensive water samples, and in those water samples, in fact, the copper silver iron levels were at manufacturer instruction levels and they grew legionella out of

them. we know in water samples with appropriate levels, it failed to control legionella and that's not happened just in pittsburgh va. it happened in other hospitals. >> does it -- i guess my question -- this is pretty critical, but does it bother you that you testified to something, there was a report that differed from your testimony, and you were not provided that information? >> it bothers the heck out of me, yes, sir. >> all right. >> absolutely. >> thank you for being here. we thank the earlier panel for being with us. thank you, members, and this hearing is adjourned.

>> coming up, president obama talks about the in crowed oflence in iraq and members congress respond to the reports keyunny militants capturing sections of the country. after that, the coverage of the dinner.ndents coming up on the next atshington journal" a look the situation in iraq. our guest is michael gordon of the "new york times." then freedom works discusses house majority leader eric cantor's primary loss and impact midhe tea party on the 2014 court elections. and then the recent article the examiningepairations the struggles and treatment are african americans in the u.s. washington journal is live every morning at 7:00 a.m. eastern on

c-span. >> we will need to learn again how to work together. to compromise. how to make pragmatic decisions. upcoming mid term elections, americans will have choices to make about which path want to go down and whether we will make the investments we need in our people. i will leave that discussion to others. of us, in the and nonprofit sectors we

work to do, too. even if government wanted it couldn't and shouldn't try to solve all of the problems by itself. we have responsibilities to do what we can. friday live, watch book tv coverage of secretary clinton starting at 6:00 p.m. eastern followed saturday morning with a book signing in arlington, 11:00 a.m.ve at eastern. both events reair saturday night 8:30. book tv, television for serious readers every weekend on c-span 2. >> next, president obama on the where sunni iraq militants have taken over key country and the possibility of u.s. actions. his remarks from the white house minutes.

>> are you considering drone spikes or any sort of action to iraq?he insurgents in >> this is an area that we have been watching with a lot of the lastott just over couple of days but over the last we have beens and in close consultation with the iraqi government. over the last year we have been providing them additionalcy aftance to troy to atreasure the problems that they have in anbar in the northwestern portions of the country as well as the and syrian border. that includes in some cases military equipment and intelligence assistance and issues. a whole host of what we have seen the last couple of days in kates the degree to which iraq is going to node more help. helphelp from us and more in the international community.

my team is working around the how we canentify provide the most effective them.ance to i don't rule out anything because we to have a stake in making sure that these jihaddists are not getting a permanent foothold in either for that matter. haveof the challenge and i said this directly to prime minister maliki and vice biden has said this in interactions with the iraqi government is that the and sunnif shea inside of iraq as well as the is either going to be a help in dealing with this jihadist situation or a hindrance. and frankly, over the last years we have not seen

the kind of trust and developed between moderate sunni and shea leaders of iraq and that accounts the weaknessome of of the state and that then over into their military capacity. sayi think it is fair to that in our consultations with the iraqis there will be some short-term immediate things that militarily and our national security team is looking at all of the options, but this should be also a wakeup call for the iraqi government. has to be a political this so that sunni shea hookie who care about buig a functioning state to all inside of iraq come

together and work diligently extremists.e and that is going to require concessions on the part of both shea and sunni that we haven't far.so the last point i will make, this the lastened over couple of days i think underscores the importance of point that i made at my forpoint speech, the need tore us to have a more robust partneringproach to countriesng partner throughout the middle east and north africa. able toot going to be be everywhere all the time. we can do is to make consistentlyare helping to finance, train, military forces with

partner countries including iraq that have the capacity to maintain their own security and long and laborious process but it is one that we started that is part of what the counter terrorism i am going fund this to be calling for congress to help finance is all about, us the capacity to extend reach without sending u.s. to play whack a mole ends up being a problem in a particular country. int will be more legitimate the eyes of the people in the region and the international community. it will take time for us to deal with it. whatve to deal with cha clearly is an emergency in iraq.

[inaudible question from the gallery] >> i gave a long speech about all this. torobably would refer you that as opposed to repeating it. basic principle obviously is that we like all takens are prepared to military action whenever our national security is threatened. the issues have to do with the broader international order, humanitarian concerns, concerns rights to navigation, around our ability to with instability or fragile states or filled states and the consequences for populations there and refugee flows, those issues of international

wherever we can our preference should be to partner with other countries. effective if we can work with other nations and that is part of where australia so important to us. you know, there are a handful of world this wehe always know we can count on. not just because they share our but we know we can count on them because they have got capacity. australia is one of those countries. valuese foundational about liberal democracies and view rights and a world that is governed by norms.tional law and and, aussies know how to fight having them in the foxhole if we are in trouble. of a betterhink partner. part of our task now in a world it is less likely that any orticular nation attacks us

our treaty allies directly but youer more typically that disorder, asymmetric threats and terrorist can beationorganizations that disruptive and damaging but aren't the traditional types of so often we have been equipped to fight that becomes that much more important to building new partners who as capable aso be the australians and our own troops and that will take time and resources. but eneed to start now. we learned some lessons over the to startde and we need applying them. >> following a closed door preeing on the escalating violence in iraq, senators spoke to reporters about possible u.s. country. the we will hear from house leaders over the next 30 minutes.

>> the preein briefing was chil. as i speak.apsing the isis is an army, not a bunch of hoodlums. an objective in soria and iraq. the question for the united matter if iraq falls in their hands? a portion thereof and if it tows matter, what are we do?ing to >> ithere is no scenario where bleeding in the iraq without american air power. the iraqi army is on the verge collapse. i would urge the administration to get all of our poem out now. we got another benghazi in the making here. base which we have isr iraqi aviation assets,

they will be grounded when our guys leave. at the end of the day the advantage that the iraqi security forces would have in be lost, is going to and i think it is just a matter before baghdad becomes the central theater of battle. they go muchif beyond baghdad because you are going to the shea part of iraq. information we are receiving is that the strokes that are being -- vehicles being abandoned and the heavy weapons are now flowing into syria. worry about is eventually the king of jordan who has been incredibly good ally and i think he will get caught up in backcontribution this goes to our mistakes in syria. our inability to deal with syria responsibly three years a ago when there were 500 foreign footholdhas led to a in syria that has been a launching pad against iraq. lebanon and jordan are probably

next. to the american people, i know tired ofar weary and dealing with the mid east, but the poem that are moving in to holding ground in syria have as part of their agenda not of the midve us out east but hit our homeland. said thatf the f.b.i. the pipeline for the next 9/11 fromk is likely to come syria. of them. hundreds there are numerous american cities who have gone to the syria.n european jihaddists are now in syria and coordinating in syria iraq. they hold tar terrain. if the presidents willing to adjust his policies i'm willing to help him. bush got iraq wrong early on. i remember meeting with him and senator mccain and the vice president where senator mccain

and myself said what your people is telling you about iraq not accurate. the place is falling apart, you the right security footprint. after rumsfeld resigned the about.ame and the president bush corrected. if president obama doesn't correct his policies regarding syria and iraq, we are going to be in a world of hurt and i would really recommend to the to rethink his withdrawal in afghanistan because what you see in action is going to surely happen in afghanistan at a faster pace. the american people, when people put their trust in you, your sidefight along in afghanistan, and they all lined up getting -- wind up getting subjected to radical islam all over again, getting it hard to have reliable partners and what you see in iraq the collapse of the security forces is lack of

confidence. if there had been a follow on with of americans in iraq aviation assets the iraqi army would have probably fought much better. when there is a vacuum, people sectarian the corners. one of the biggest mistakes president bush made was not happenanding what would after the fall of saddam. i will put blame on myself for mott appreciating the situation as much as i should. learned the hard way. i think the biggest mistake president obama is making was to without any forces behind and he were clearly willing to have american forces. is that 10,000ng or 15,000 would have really made difference. if american air power is not interjected into the equation i how you stop these people. towarde moving rapidly baghdad. >> what should we do now? >> they made a request. it ine to oval wait is

our national security interest to intervene? >> is it? it?s >> absolutely. isisnk the people in the have as their agenda to attack our homeland. the next 9/11 is in the making. soria has become the afghanistan 9/11. it is a place for safe haven for training. to drive us out of the region and have as their goal to hit us throughout the world america. any overseas location, particularly in the mid east is at risk now. so. >> what you want the obama do?nistration to >> they should call their commanders together and say -- matter if this continues to develop the way it is. the president probably needs to on television and explain to the american people what is going on in iraq and syria. don't know what his foreign frankly., quite i just know it is not working,

whatever it is. >> to you wasn't air strikes now? >> i want to hear from the president. i'm not the commander in chief. what tod of telling him do. it is not my place to tell him what to do. shouldyou what i think i do. but the president should address the american people about our options. stay out of it. and articulate the upside and the downside. anause that is clearly option. just to let it play out. my view of letting it play out a disaster for us regionally, home.ster for us here at the other option is to militarily get involved without boots on the ground. power. and how effective that could be, don't know. would have listen to our commanders. putting boots on the ground is toething nobody wants envision. the interim step would be some air support.can would that change the equation?d i don't know.

the military experts would have to tell me this. the end of the day, our assident needs to inform us a nation does it matter at all about syria and iraq? it does matter, what is he willing to do? as a republican, if he believes needs to use air power to change the battlefield equation generals advise us that willingcur, i would be to support it. i remember the conversation with it wasnt bush like yesterday. mr. president, this is not working. i have been to iraq at the time seven or eight times. time i go it gets worse. people on the ground are telling apart.place is falling i don't know what the presidents being told but what i heard today sirred the hell out of me. worst is yet to come and this place is completely falling apart. i don't. don't. here is another question for

maliki should consider resigning. i don't have faith in him. whon't think anybody observed iraq over the last couple of years really believes countrycan hold that together. the question for me is are we supporting a government that a chance to rehabilitate itself and maintain we are able to achieve in the short-term militarily? maliki is a political figure being able to do what has to be done. is just my two cents worth. scenario by which in iraqtop the bleeding without using air power? >> something has to change on thebattlefield to stop bleeding. >> yes, go ahead. >> the president needs to replace his entire national been ay team which have total failure. they are the ones that described departure from iraq as a great success.

quotes that many would attest to that,. >> the president has to learn because he declares a conflict over a not because it president needs to get a reliable team around him to provide him with the available andre the course of actions that would this disastererse that is unfolding before our eyes. >> you said air strikes aren't enough. >> i'm not saying it is not enough. i'm saying that we need to get smartest guys that is general keene and general petraeus and the people that won the war with the surge and get and counsel. air strikes may be part of it. strikes may not be part of it. i would rely on their judgment. i'm not calling for air strikes. for the advice and counsel of the smartest people iraq beforewar in the president of the united

states lost it. >> do the iraqis wasn't our help? are begging. there was a "new york times" story today where they begged last week and the last few weeks for our help. they are pegging for it. >> when do you want besides air strikes? will have to read the article. >> would you consider boots on point?und at this >> of course, not. >> definitely not? >> no, definitely not. okay. >> thanks. >> thank you. >> let me say we just got brief and it is concerning and unfolding as we speak and it to unfold and waiting to see the facts and how quick it will unfold and we have to make decisions quickly here. see what is going to be the recommendations of what we do. they made this decision in 2011 not signing the agreement and wanting us to stay they are a askinggn country and now for assistance and help and i'm

concerned about how we are going and can we engage and should we engage? that is a very concerning issue we have right now. alarming how quickly things are changing over there minute-by-minute, hour-by-hour and day by day. >> should we authorize air strikes? >> might be the only way to get can hold offso we until they can regroup. are noting to a very good job. >> any reason as to why we haven't done it yet? a surprise to everybody. being a surprise and they are to have to make calculations and decisions of dot we to and how quickly we it if we do it. air strikes it was talked about and see if that develops to thee we think that o be best support. i don't think anybody is supporting engaging again as far as troops on the ground. we are concerned about all these

things. we have to get a little better accounting on that. a good briefing and i'm sure we will be briefed more here. >> what is the assessment to ed to the iraq forces? folding?hey >> i think that was a surprise to have four major divisions they diduickly as without even a fight in some of them. that is a concern and why we of that ore apprised more knowledge of that or thought that could have been the the wayn this unveiled it did. >> have they defected to the other side? backey basically blended into the crowd and tried to stay out of the fight and definitely fight, that the is for sure. i think they are trying to rally theyd baghdad and areas think they can hold and getting more support. right nowunfolding and the general will be going back in control and he is the chargely the person in over there. >> senator mccain says that the entire national security the white house should design. for -- the time

>> playing politics right now not a time to do that. and concerningus for that whole region. i always said if money or would haveght changed that part of the world we would have done it by now to be people willing to defend their own country and willing to fight and die for the country. until that happens we will not be able to change their decision do it. >> what is our discussion about today? you think the u.s. should be doing in regards to iraq? >> the -- i mean if they call for aid we should provide it. you know, if they call for provide it.d we left a situation, we left state. a weakened

this was what everyone has been concerned about. been a good prime minister and reach out to the population in a way approach returns to ohio and they have accepting of what al-qaeda is doing in the country and so he has helped create the conditions. our lock of a policy in syria exacerbated that. annot coming to accommodation and leaving troops behind at least at some small accommodated the problems there are there. and i think we should do helpver is necessary to them beat back for a short-term there. happening >> you mean troops or -- >> not troops on the ground. air strikes the which is typically the way we anyto do things to minimize kind of casualties on our side. out ofk, it is getting hand. this has been brewing for some time. long ago andot iraq feels like a vacated lot.

something where u.s. policy was just to check the box and leave. something that again all of us have been concerned about. i might say on both sides of the aisle. so we had a lot of people lose limb and we spent billions of dollars there and when the agreement was reached to have troopsng on the ground this was very thing we have all been concerned about. the things that was so helpful when we had some degree of influence in the region was to have the subtle diplomacy where we continued to work the populations and continued to at least try and reach some accommodation. maliki has done none of that. syria exacerbated that. there hasf presence exacerbated that and now we find ourselves where we are. conduct airs. does

strikes, doesn't that risk just getting dragged back into the iraq conflict? think this continuing as it is certainly risks the region being -- just going up into flames. i mean what is happening again what is happening in lebanon, what is happenin happen yemen, i mean i think that again while wert-term basis can strengtheney themselves we should be open to helping even short-term basis. they don't have the capacity to do that. i have supported from day one the sale of the equipment that asking for.en it has been held up. as a matter of fact, this is exactly what helicopters were to utilized for. and again, has drug out. is -- butt now that this was the concern that they would mott be able themselves to deal with this kind of problem. got to go.

>> thank you. >> senator, have you decided what you think the u.s. should do when it comes to iraq? the would hope to talk to administration but i think i'm very concerned. cheerly shows that maliki was unable to make any accommodations with sunnies and now the most violent of the extremist groups have grabbed hold of the situation to baghdad. march and this could be devastating. know, i would like an opportunity assuming i'm asked personally.iews but this is a very dangerous situation. >> republicans have -- >> republicans have --

>> do you think there is even a public stomach for air strikes? >> i'm not going to comment on that at this time. have said --s >> no one has proposed it. really understand the situation first. and my intelligence staff has briefing. i haven't had a chance to get the briefing. but i will. >> senator -- thispublicans have said wouldn't have happened if the president hadn't pulled all troops out of iraq. let me just say this is not the time for a blame game. sidess the time for both to come together. of people ina lot iraq and there was a lot of on and iraqisg have lost a lot of people. i think there needs to be an approach that everybody will agree with. whether that is possible or not, i don't know. that is what we should try to do. >> in your assessment of the intelligence on this and the things we heard were you caught

guard? >> it is serious. >> were we caught off-guard. >> i will not comment on that. assessment is this is serious. we are essentially withdrawn of military terms contingent that could respond quickly. >> you are asking for a meeting with the white house to give about this? >> well, i would very much to share viewsst on this. this is a subject that we should all be together on and we are not going to be together if there isn't consultation between bodies. it has begin. i think the armed services just had a briefing. the intelligence staff just had a briefing. an opportunity to get informed about what was said, but i will have that. thanks very much. >> thanks a lot. >> thank you, madam chairman.

>> on iraq, do you think the u.s. should be launching air strikes? what should the u.s. do? >> i think what we should do is to provide the equipment and assistance that the iraqis have been asking for. then't know enough of details about the air strikes to comment whether we should or we shouldn't. but it is not like we haven't seen this problem coming for over a year. hasn't -- it is not like we haven't seen over last five six months the terrorists moving in, taking control of western iraq. have taken control of mosul. they are 100 miles from baghdad. the president doing? taking a nap. thingsoreign policy, have gotten serious in iraq here with militants and so on. should the united states use air strikes or when should the united states do? things areif not, really getting so volatile

there, has this time that the states spent in iraq the last 10 plus years has this been for naught? >> you had a multifaceted question there. what is happening in iraq is troubling. esectioespecially when you see s syria.ng in you can take a cab from one to the next. my understanding from the local metropolitan journal that the state department has said that we are supplying some weaponry maliki government. i don't think there is any usetite in our country for to become engaged in anymore military activity in iraq. why is it not? matter why. it is fact. the american people have been exhausted with wars. to talk about iraq and the opposition they have our military

engagement there, we have to go back to 2003. will go back to 2002 and the fall of 2002 when the bush administration misrepresented the american people, took us into a war on a false premise that they knew not to be true. war the american people the would pay for itself and it over soon and we would be greeted with rose petals and we had to go in there because smoking gun might be a nuclear plume. that is what they told the american people. of course, it was not true and they knew it not to be true. i said at the time as a senior intelligence the intelligence does not support threat. you could not find in any of the intelligence available and they to show us everything, any threat.that

we go town the path and should have finished the job in 2002 and instead we take up another war and here we are. war.egets it is just not a good idea. and what h next? what is next? is what the american people would want to know? what is next? it hannah who said that people think that one more act going to ends violence but it is like a flywheel. provokesf violence another act of violence. and here he would are. are.nk -- here we i think this represents the failed policy that took us down ago.path 11 years it was march 19 east of saint when i got the call from condoleezza rice saying the call you asked me to to tell you we are initiating into iraq in a few hours. why? my question, why? exhausted every

remedy in terms of inspections and the rest. me from going back. but before we go forward we have to know what is going on and i people do notican have an appetite for sacrificing troops our precious treasure first and foremost and to be conflict there. >> at thursday's white house briefing, spokesman jay carney answered several questions on the escalating violence in iraq. the u.s.eporters that would continue to offer assistance to the iraqi but is not contemplating sending troops to iraq. minutes.0 >> i know this is confusing. i'm not an oakland a's fan but

i'm wearin wearing that becauset night, 12 u completed an someone defeated season by winning the tompionship and i want congratulate my son's temperature and all of the players and the coach arnie brooks who is a great, grey guy. the bcca's. and that is the only the top.ent i have at can i give this to you. so i will go right to your questions. to say that the president as you know has an event at 2:00. he wouldle keep briefing if will keep the briefing unless everybody decides they want to run over and cover that. i wanted to note that that is currently on schedule and if needs to go over, that is fine. we will keep going. jim? jay.anks, just to clarify on behalf of my colleagues. this is not a swan's song today. >> probably not.

we'll see. depends on how it goes. can i decide that at the end? >> challenge. >> yeah. >> i might have one more in me. >> okay. president just today with prime minister abbott said prepared to. is take military action when our threatened.urity is does the islamic state of iraq the u.s. a threat to national security? >> well, has the president said, jim, we are very concerned about extremistnd the threat in northwestern iraq and the bordering region with syria. question thato iraq is a strong and important partner to us. we have the collaborative relationship with iraq that we have.

why we have provided assistance to iraq including military assistance and increased thatcy aftance the -- that assistance over the last year as the challenges unrest, the civil war in syria have spilled over in the last several days whatd great concern with is happening in iraq. so, when the president made that we have been providing a significant amount of assistance to iraq including military hardware. josh detailed some of that the other day. and we are actively considering from the iraqi government and looking very closely at other efforts we can iraq in thisassist very serious situation. as the president

also made clear, iraq's future be decided by a unified effort among the different inups and political parties inq coming together moderation to fight the isil.ist threat posed by and you know, that is what we discussions with prime maliki and other iraqi leaders about and that continues to be the case. >> have you specifically ruled the use of any u.s. ground forces? >> we are not contemplating ground troops. i want to be clear about that. the president was answering specifically about air thate, and he made clear we are considering our options

of the overall effort support iraq and as part of the assistance that we provide and can provide iraq in this fight. but we are not contemplating ground troops. >> so air strikes specifically are part of the consideration? >> i think the president when he said that he is not ruling respondingt he was to the question about requests for air strikes or would he and that is strikes what he meant. >> thanks. >> yes? >> any concerns that this is maybe a little too late? toi think it is important note that we have been ramping up our assistance to iraq substantial amounts of military material and now.are for some time what we have seen in the past is significant and concerning escalation in the violence in iraq lense and in movements by -- in the violence forces,ovements by isil

jihadists into the country and occupation of some towns and cities in the country. a near-term situation that we need to move very and we are assessing what we can provide doitionally, what we can additionally to assist iraq. ealso have the longer term -- we longer temperature ongoing challenge in our helpinghip with iraq in them to take steps to further unify the country and also to them through the counter terrorism partnership fund, for better prepared to handle this kind of threat now and in the future. were you surprised at of strengthshowing by the insurgency? thatthink that -- i know we have been monitoring this for and have been very

concerned about and have concernd the -- our about the problems caused by the unrest in syria and the war in of thend the porousness border with iraq. the challenges that creates with created for ranger iraq and the need for iraq to have its examsities increased and for iraq -- capacities increased and capacities in a way that meets the challenge. that is high ehave taken the in the paste including delivery of 300 hellfire missiles. of rounds of tank ammunition. helicopter fired rock, machine guns, grenades, snares, riffles m-14 rifles to the security forces and delivered additional ia 407 helicopters late eagleear and ten scan

surveillance platforms on schedule for delivery this summer. i think you also have been told that we recently notified congress of an ait dictional of $1 billion in arms including up to 200 humvees and that is now turned strategic framework agreement, we have expanded our training programs both inside iraq and in jordan. training will occur this summer. this is part of an ongoing effort to help the iraqi security forces deal with this threat. as the president noted, there is also the need for a unified political approach to be taken by the iraqi government in response to this common threat that the extremists pose. an extremist group and the members of an extremist group who do not have iraqi national interests at heart, but who are bent on death and destruction in

isq and the threat they pose within ery individual iraq and therefore we will continue our discussions including in the ongoing consultations that the vice president has with iraqi leaders to urge more unity among the political parties and communities in iraq as they deal with this challenge. >> let me just quickly ask you about immigration. the president last night said the immigration reform is not -- despite the -- does this mean you're not ruling out the possibility of taking some sort of administrative action on deportation before the august recess? >> the president was referring to the effort to pass comprehensive immigration reform. we believe that the broad coalition and consensus that

existed prior to this week's primary in the seventh district of virginia is as strong as it was -- that it is as strong today as it was then. nd the house ought to follow the senate's lead and pass the bipartisan comprehensive immigration reform measure that would provide extraordinary benefits to our economy, to our security, and to our businesses and would deal with this challenge in a comprehensive way. that imperative hasn't changed at all. that is what the president is referring to yes? >> seeing how fast things have been moving in iraq. given what has been going on in syria for such a long time, wasn't exactly the scenario something this administration forsaw for sometime and if it wasn't then should it have been?

>> i think i just said we have been very aware and have discussed here and other venues the challenge posed by the war syria and the extremist activity there and the i.s.l. formed and moved across the border into iraq. and that has always been a great concern. that is why we have stepped up the assistance that we have been providing to the iraqi security forces. >> the surprise is wa? -- what? >> i think the president accurately said just moments ago in the oval office, we cannot be everywhere at all times, whether it is iraq or elsewhere, we need to partner with other countries and their militaries and security forces to assist them in combating these kinds of

extremist challenges. that is what the counterterrorism partnership fund is about that the president discussed in west point and it is about -- and that is very much the manner in which we have approached our close relationship with the iraqi government and the support that we give iraqi security forces -- a ely, you know, the nation, a sovereign nation like iraq has to have the capacity to deal with these kind of challenges. we can assist and we are. we will look at all options in this current near-term situation, but the medium and long term solution to a challenge like this has to be one that is led by iraqi security forces. >> does this make for a great argument for having doctor for the u.s. should have acted sooner in syria? >> i can remember answering

questions probably before you got here, michelle, about our concern and should we be concerned when it came to supplying lethal assistance to the opposition in syria about with where that assistance and in whose hands that would ultimately end up and whether or not we could trust that that assistance would not find its y to extremists who actually had designs against u.s. national security interests or americans themselves. that is why we took the approach that we took and it is also why we have established now for quite sometime a manner by which we can provide and have provided -- resistl assistance took place the opposition armed elements. that is the approach we took precisely because we did not

want and many others did not want for assistance from the united states to end up in the hands of extremists. justin? >> two quick ones on iraq. the first one is it was determined a year ago that airstrikes were wanted against syria. if he makes the same determination here. do you feel it is necessary to [indiscernible] >> there are legal authorities that exist regarding the use of military force in conflicts not in, but elsewhere. we can get more for you on that. the president said today he is considering all options in response to the question about

potential direct action by the united states military. but we would have to get back to you on how that would proceed if that decision were made. >> does this change your calculus for your withdrawal rom afghanistan? sweevepb, certainly some have suggested that a big reason for the insurgency in iraq was able to take hold is there wasn't a ontinuing u.s. presence there. i am wondering if that changes anything about -- >> it does not change the approach that the president announced recently, that we are taking in afghanistan. we are ending that combat mission this year, and pending the signing of the bilateral security agreement will keep a smaller number of troops in afghanistan focused exclusively on the missions the president discussed.

the broader question has to be when we talk about this is, should american men and women in uniform be fighting in iraq today, and is that the right approach for our national security interest should american forces the occupying countries for decades or should we be taking the approach the president took and he ended the ar in iraq and establish a relationship with the sovereign government of iraq through which we can provide the kind of assistance we can provide? that is the approach he believes is right and it coincides with the strategy he has laid out in afghanistan. >> following up on that question -- [indiscernible]

do you have anything that gives you the sthaurns you need to have? >> the president laid out in his speech at west point a strategy that is focused on partnering with the security forces of other countries that helps them develop the capacity necessary to deal with these kinds of threats, because we cannot have u.s. forces around the world in armed conflicts without end. it is simply not a wise pproach. we maintain as the president made clear to use military force unilaterally if needed. we should not partner with other nations' security forces and effort to the counterterrorism

partnership fund that allows those forces to work more effectively against the threat hese jihadists pose. >> does this not undercut the president's argument for a -- i understand you cannot have forces there indefinitely, but ontinuese fact that it c to deinvolve -- >> when you are asking that about iraq, is the suggestion we should still have tens of thousands of troops in iraq? if that is the proposition, then we can discuss that, but certainly not the president's iew. what we can do is consider

requests from our partners in he iraqi government. we can provide the assistance we already provide and have provided to the iraqi government, including to iraqi security forces. hat is military matã©riel, and we can contemplate other requests and take action as needed and necessary, but if the question you are asking is should we have a hundred thousand troops in iraq, the resident's view is no. >> senator tim kaine said the president should present a clear lan to congress. does the president have any immediate plans to consult with members of congress? >> we are in active consultation with members on the situation in iraq and we will continue to do hat. >> how would you would characterize what is happening in iraq right now?

>> and islamist jihadist group composed of mixed nationalities threatening the sovereign state of our iraq. and the iraqi security forces eed to confront that threat, and we are working closely with the government in baghdad and with iraq's political leadership to a valuate the kind of assistance we can provide in addition to the assistance we have already provided and the assistance on its way to help them meet that challenge. >> would you characterize it or are you not ready to be there? >> the way i characterized it reflects what is happening on he ground.

>> the australian prime minister has been critical of the president in the past. some would say offensive, at imes, about him. iven that past relationship, how would you not describe it, especially since they disagree so much on climate change? >> what the president said reflected the very close nature of the relationship between the united states and australia, the alliance between our nations, the friendship, and the tone of the meeting reflected that high level of cooperation. the leaders discussed a number of issues, as you know, and climate change was one of them. they talked about the importance of confronting climate hange.

president obama emphasized the need for ambitious domestic climate policies as a basis of a strong international esponse. the united states will work with australia to advance climate change them a clean energy, and energy efficiency solutions, including in the context of the g-20. this is a topic of discussion, many, as you would expect in a bilateral meeting between leaders of such close llies. >> did you ask him to put it on the g-20 agenda? >> i do not have a specific agenda to lay out for you, but in the context of g-20, this is something that the president believes would be important to discuss. > do you a readout about the t.p.c. and the trade discussions? > i don't.

>> does the president believe -- is in jeopardy? >> the president knows the situation in iraq is serious and there needs to be action taken quickly in order to confront the challenge posed by the isil. i would not characterize the situation on the ground ilitarily. i would refer you to the defense department for that. the president is aware of that situation and that is why he has made clear we are assessing what efforts we can take building on the efforts we have already taken to assist the iraqi government. >> there are reports that forces have assisted in dealing with the isil forces. does the administration have onfirmation of that? would he consider that a welcome development?

>> we have seen reports, but we cannot confirm them, and while we appreciate the seriousness of the situation in iraq and the brutal actions of isil, we urge the government of iraq to take rudent decisions on how to address this crisis in the spirit of national unity. this goes back to the point i was making earlier, that the nly way forward where this could be effectively dealt with in iraq is for there to be political unity in iraq in combating a common enemy. there is no side in iraq that sil is fighting for. this is a jihadist extremist group that is bent on death and instruction within iraq, and it is necessary for the various factions within iraqi politics to come together united by this threat posed to the sovereign state of iraq to rebuff the challenge.

>> [indiscernible] >> i think this is an issue for the government of iraq. in our view they are to make prudent decisions about how they deal with the threat in the interest of national unity. >> you used in your formulation about a unified effort that uilds on moderation. can you, in any way, credibly apply either of those words, sps unified or moderate, to maliki's government in iraq and how much weight does this administration make on his decision-making process? >> i can say we agree that all our iraqi leaders including prime minister maliki need to address and need to do more, rather, to address unresolved

issues within iraq to meet the needs of the iraqi people. however, the threat to iraq's stability right now is isil has an ideology that has little to do with domestic politics. their aim is to take territory and terrorize the people regardless of sect or ethnic or religious affiliation. its ideology would be the same no matter who was in power in baghdad. so that said we will continue to work with our iraqi leaders from across the spectrum to encourage the kind of collaborative approach and governance that would best address these unresolved issues. we urge their leaders to support leaders from all -- this has been an ongoing challenge in iraq, as it tries

to build a future as a sovereign state. in order to do that, iraqi leaders need to have a unified ision about iraq's future that is not sliced into separate visions according to political affiliation or religious affiliation. that is the challenge that iraq's leaders have been grappling with for a number of years now. it is an urgent challenge now. the threat posed by this extremist group highlights the need for iraq's leaders and other actors to set aside some of their differences to join together to meet the common threat posed by isil. >> the president, the vice

resident, and advisers, all in the past couple of years described iraq as a success story. when did it go bad? >> the fact is when we have described what was the case and that is that iraq has over the years taken steps to resolve its internal political differences through peaceful means as opposed through violence, this is an ongoing challenge within iraq. isil is not a domestic political entity. it is a force that is trying to claim territory and wreak havoc in iraq and a force that has no iraqi citizen's interest at heart. that is whirkse as i mentioned before, the threat posed by isi slnch cause for increased unity among iraq's political factions and a more cohesive

approach to be taken by the central government in baghdad when it comes to combating a serious threat. >> i told you so news conference, saying that the risk of losing what americans lost their lives for was caused by not keeping u.s. troops in raq. why are they wrong? >> there is no question that senator mccain and president obama have differed on the iraq war since senator mccain was for it and barack obama was against t. no question going back to 2008 when senator mccain allowed his vision might include tens of thousands of u.s. forces in iraq in perpetuity, that that was in stark contrast as a vision to one held by then senator obama, which was that we should

responsibly end what was already a very long war in iraq. president obama's view is that iraq needs to come up with the partnership of the united states, be able to handle its wn security. and i would note from some of the statements you said today that within a couple of sentences of each other, senator mccain said this is because we did not keep troops in iraq, but he is not calling for troops in raq. hich i am not a logics expert, but it seems to be inconsistency in the statements. the fact is we cannot be everywhere at all times to meet

the challenge posed by extremist it's like isil, but we can partner with iraq, as the president noted today, through the counterterrorism ownership -- partnership fund and our direct relationship and with the assistance we provide the security forces and the iraqi people, to work together to help iraq beat back a challenge like this. ultimately, iraq's future has to iraqi people the and the leadership. >> you ran off a list of equipment we have provided direct, some of which is now in the hands of the isil. and you were reluctant to be more aggressive in syria and it would appear that the problems come over the border into iraq. how much of what we are seeing in iraq now is the result of not taking a more aggressive response to the civil war in syria? >> as i answered earlier, the approach we took was to arefully evaluate to whom we

would be providing assistance in syria in the opposition, precisely so that assistance is not end up in the wrong hands. we have for some time now provided substantial assistance to the opposition in syria, but i think our past history shows and an understanding of the situation in syria and portions of iraq bears out that we need to be very smart about how we and to whom we provide legal assistance and military hardware of any kind, and that is the approach we take. we think it is the right approach in terms of u.s. national security interests. >> a short while ago the speaker of the house described the deteriorating situation in iraq and said and what is the president doing? e is taking a nap. that is the response of the speaker. >> my response is to answer the questions a little more

substantive to the approach we re taking. we provide a substantial assistance to iraqi security orces. i would note in that same briefing the highest elected leader of the republican party did not have any suggestions for an approach to iraq that i could tell, or any policy prescriptions that he would offer beyond the statement that you just repeated. >> on the question of troops going back to the end of the war, the administration, with vice president biden taking a leading role, try to get a status of forces agreement that would allow iraq to allow troops to remain for counterterrorism perations. because of that failure all the troops had to come out immediately. do you believe the situation in iraq would have been any different if you had not failed

to get the status of forces agreement and there have been some residual u.s. force left in raq? >> the agreement to which you refer was one that would have to have been reached between two sovereign nations and an agreement to allow for, under conditions we would find cceptable, a remaining force from the american military was not reached by negotiations between the united states and raq. the point i would make is that a relatively small number of troops designed specifically for the kind of narrow mission we are talking about with post-2014 force in afghanistan would not supplant the need either in afghanistan or iraq for a national security force to take

the lead effect of a in combating any extremist threat from the outside, as you have with isil, or inside. again, if the argument is that we should have, as some suggested going back to 2008, tens of thousands of u.s. troops in iraq in perpetuity -- >> a specific question -- >> i answered that, which is a small force focused on c.t. and troop training and assistance is ot the same as what was called for by others when it came to a substantial, essentially, occupation force in iraq in perpetuity, which senator obama and candidate for senate obama never supported. >> would it make no difference -- >> what might have been in different services, i do not think anybody can answer that uestion.

what i can tell you is that the sovereign state of iraq has security forces that need to be up to the task of dealing with these kinds of challenges. they will have the assistance, that comes with partnership with the united states, as well as with other nations that have the interest of iraq and its sovereignty at heart and provide substantial assistance to iraq as the united states does. that ultimately, iraq must future needs to be decided and defended by iraqis. we are providing substantial assistance and are considering in this current near-term challenge what other efforts we can undertake to help the iraqis in this current situation. but the long term here, and this is true two years ago and it will be true two years from now, has to be one that sees an iraqi future that is defended by

unified political leadership in iraq and by iraqi security forces. >> the president and senior officials have repeatedly over the years and as recently as tuesday described as the president's top foreign policy accomplishment ending the war in raq. given what we are seeing now in iraq, can you still claim that as a signature achievement? >> there's no question the president pledged to end the war in iraq, and he did, and that was -- >> there is no more war in iraq? >> u.s. combat missions in raq. what is also the case and what the president made clear as we wound down the war in iraq is that we need to be a good partner to the government in raq and provide the assistance that we can at the request to

help them meet their security challenges, and we have done that. alternately, iraq's future has what we have been saying for a long time now is that when it comes to threats to the united states and our national security interests directly, the threat