have been our co-workers that were treated at nebraska. and even recently the gentleman in new york, they were all wearing level four gear. how did they get infected? can the virus live in other mammals besides primates, bats, rodents and humans? i have worked and lived in africa for about 25 years and i have eaten my share of bush meat. it's something like a groundhog. and so what does it mean, where does the virus live? the point is that can it jump into the animal population here, we need to know that. as with other viruss, is it possible that ebola can be asymptomatic? we know for a fact of three situations where blood were drawn on patients who were nonsymptomatic and all three tested positive one of the problems that exists today in liberia where

samaritans purse is working is there's no protocol to move blood from liberia to laboratory where these tests need to be checked and results found out. i will just say i'm not trying to be a fear monger, but there are things we need to look at critically and should not be afraid u to ask questions. if my written testimony, there's one paper from the new england journal of medicine that reports that 95% of the cases of ebola incubate in 21 days. the inference is 5% not until 42 days. we need to know what the 5% means. while the media coverage is already decreasing and people feel that ebola has peaked, we do not think it has. i totally agree with dr. frieden, i think we need to vigorously and in a sustained manner fight this disease in he said he would be right back. >> thank you.

good morning, silas. >> good morning, silas. >> good morning, jeanne. good morning, mother. >> how are you feeling? >> i'll tell you as it is i'm awake. nick would brother pick a more convenient hour for his homecomings. up for whatever good news he's bringing us this time. >> good news? you know perfectly well he has never come back from one of these trips yet without bringing home some earthshaking discovery. jean, what was it last time? it was a kind of machine that

was supposed to so faster than by hand. >> that was it. >> i will tell you, when nick gets here, if he has any more of those wild ideas, we will ship him right back to san francisco. >> hello? where is everybody? why, that's in the. >> i thought we were supposed to meet him at the station. >> well, that snack for you. >> mother. >> net, we were going to meet you at the station. >> i couldn't wait. i caught an earlier train. mother, this is hester converse. >> how do you do? how nice to need you, misses barkley.

right --ntleman on her >> i know. jared and eugene. >> you do? ck!ni >> and you must be audra? where is he? >> he will be here soon. you are all just the way nick described you. that trip from san francisco seemed like a thousand miles. now that i'm here, i can't really imagine what i was so nervous about. hester and i were going to you had a chance

to meet her and really know her and she had a chance to know you , but i think were going to tell them right now. we're going to be married. [laughter] >> well, what do you know. congratulations, neck. >> thanks, jerry. before beauty, my boy. >> mother, are you going to congratulate me? >> yes, darling. and now, to a most charming, gorgeous, and completely captivating addition to our family. >> sorry i'm late. nick, you were to do win until

-- >> we were just hosting my prospective bride. converse.ster eath.is my brother h >> what did you do, knocked her unconscious and drag her here? [laughter] welcome to the berkeley family, hester. ath.hank you, hee what are you waiting on? what you go ahead and kiss her? and might be your last chance. >> i'm just off the range. >> nonsense. it sparkly dirt. it's barclay dirt.

and i love it.

vaccines, antivirals, early detection, et set ra. what's become obvious from this ebola crisis is a national readiness plan is absolutely necessary. our biocontainment unit is one of four in the nation. the capacity and the number of units in the nation must be increased and a national readiness plan that trains must be established. the number of actual beds is under 20. the number of usable beds is under 10. and i assure you that every unit such as ours will always maintain at least one bed if is ever needed for a staff member that becomes ill. that immediately knocks the number down by four, five or six. the university of nebraska medical center and emory are working closely with the cdc on how training might be most effectively delivered. it must begin soon and we have done so in advance of any

funding considerations. as congress considers funding, i urge that this include a number of items and i will just read them by title as they are contained many my briefing documen documents. a national training in ebola and highly infectious diseases to develop a tooer training system. training should include setting up an accreditation program that indpeptly nationally accredits organizations, emergency departments, et cetera, to establish and maintain their skill level of readiness. an annual maintenance of funding for increased role of existing biocontainment units. we have funded the readiness of our unit totally off internal dollars up to this point. funds to expand the number of treatment centers and existing biocontainment units, specifically to increase bed and staff capacity within existing units as well as new units.

and finally, reimbursement for care for ebola patients not covered by insurance. ladies and gentlemen, we have the expertise and know how to contain ebola and other infectious threats. however, we must ensure that our nation's health care professionals are adequately trained, properly equipped and rigorously drilled. i thank you so much for this privilege. >> thank you, dr. gold. >> thank you, chairman, i'm the commissioner of the texas department of state health services. i have been in that role for eight years. this last month has been one of the most tough as the commissioner of state health services. on september 30th, the texas state public health laboratory diagnosed the first case of ebola in the united states. the diagnosis of mr. duncan with ebola set in motion a process we in public health refine through continued use, tried and true public health protocols, including identifying those individuals who have had

contact, making sure they are monitored, providing care of those infected, isolating individuals and when needed, using quarantine. the magnitude of the situation was unprecedented. while mr. duncan was one man in one city in one state in the country, the outcomes with his case could impact the whole state and other 35r9 parts of the united states. we along with our colleagues and dallas and the cdc and prevention took the responsibility to contain the spread of this disease very seriously. we organized a local incident command structure to handle the event and at a state level we activated response. while our mission was to protect the public's health by eliminating the number of people exposed to the congress, the challenges associated with carrying out that mission were numerous. the care of mr. duncan presented its own challenges. identifying the first person in the united states infected with this disease, the infection

control challenges, transportation, the ability of experimental treatments and vaccine, training for health care workers on the higher standards of infection control and personal protective equipment, guidance and supplies. . and when mr. duncan passed away, we handled issues related to carrying his human remains, which remain highly infectious for months after death. unfortunately during the care, two nurses became infected. nurse who is had put their lives and their careers on the line to take care of mr. duncan and to protect the public's health. concerns relating to the handling of these three e ebola patients included questions about decontaminating their homes, automobiles, decisions about how to handle the their personal. effects, monitoring of pets and patient transportation issues. and addressing the public's concerns.

identifying potential contacts and monitoring those individuals had some risk of exposure that also involved many challenges. decisions about who to quarantine and what level of quarantine, balancing public health and individual's rights, providing accommodations for those confined to one location for the 21-day monitoring period, quickly processing control orders, coordinating two system checks a day for each person under monitoring and managing the transportation and testing of laboratory specimens. throughout all these specific challenges, our experience in dallas exemplified successful responses to emergency situations. having clear roles and responsibilities among the various entities involved strong lines of communication, and an incident command structure staffed by trained emergency management and public health professionals to ensure the response's direction really requires a partnership at all levels of government and

throughout state and federal government. the outcomes in dallas proved the strength of the public health's process. hundreds of people were monitored in the state. two cases of ebola resulted from the direct care of the case and they were detected early in the disease onset and they recovered. no cases resulted from community, poe sure. at this time, texas is providing active monitoring for individuals who arrived in the united states from one of the outbreak countries. texas has monitored 80 individuals under the airport screening process. texas is also like other states working to ensure that capacity exists in the state u to care for patients with high consequence infectious diseases like ebola. two centers are able to stand up on a short notice to receive a patient and texas is working to identify additional capacity within our state. as ebola screening and monitoring transitions into our routine processes, our focus in texas is now shifting to include

complete evaluation of the response in dallas and a discussion of how to improve the public's response system in texas as a whole. and sharing our experiences and our lessons learned nationwide. governor perry put together a task force for response to evaluate the texas system and to make recommendations for improvement. we take that extremely seriously. i believe this discussion among government l and nongovernmental individuals among varied stake holders and including experts will result in a texas and the nation being better prepared to handle the next event. while we do not know what form the next event will take, we do know that there will be another event. as i tell my colleagues at the state and national level, it's my expectation that as a commissioner of health that i'm going to have to manage one major disaster each and every year. one unthinkable event per year. that's why the funding that is

provided to states through the hospital preparedness program is very important to what we do. that partnership is really critical. finally, i want to thank my colleagues at both the dallas county health department and the cdc for their work and their support in this really was a team effort. thank you, sir. >> dr. gold, i know you have travel plans. will you be able to accommodate that. >> yes, sir. >> i'll recognize myself for five minutes. dr. gold, you mentioned a number of comments about what needs to be done with the administrati administration's request for funding. i don't know if you had a chance to read it. have you? >> at least in general terms, yes. >> would you know whether or not there's an adequate plan to support the request yet? >> i don't think the granularity is in the written materials that have been provided. >> would you do us a favor as someone at a hospital, would you get to the committee specific

recommendati recommendations? in fact, i would ask that of all the panelists. it would be very helpful to have that kind of granularity. you have been o africa. >> yes, sir. >> the cdc has guidelines for health monitoring and movement for health care workers in africa. now they classify as those who have had direct contact with those sick with ebola while wearing personal protective equipment. you have cited that some people wearing equipment have still contracted ebola. >> it's an obvious fact, yes. >> so this some risk have no mandatory restrictions on public activities. there's no requirement for returning health care workers to avoid public transportation like subways, bowling alleys, et cetera. i want to add, we have done a survey of members on this side and every single member who

asked hospitals in their district has returned comments saying all those hospitals said for the first 21 days, those health care workers are not going near a patient. they will be furloughed, they are to stay home, taking temperature multiple times a day. do your workers follow guidelines such as this when they return? >> e we actually have written our own protocols and guidelines back in late july when dr. brantley was coming back. we contacted cdc and asked them what their protocols were. and frankly, they told us just to have our staff check their temperature twice a day. if they got a fever gorks to the local health department department. we didn't feel that was adequate because we came through a serious bout with ebola and had a more realistic encounter with it than perhaps other people had. so we created our own protocols. we check our staff through direct monitoring every day four times a day. and we do keep them in a

restricted movement, no-touch kind of protocol for 21 days. >> so your protocol goes beyond the cdc recommendations. >> there's no question our protocol goes beyond. >> that's not necessary, do you agree? >> there was a question a minute ago about cdc disregarding what we're say iing. cdc is a large organization. they create a policy. so if you call them and say, well, we think we ought to do this. they say that's not our policy and don't engage any further. that's just the reality that we have run into. i don't mean any disrespect to cdc, i'm very appreciative of them. but for us, we live in a a small town. or national headquarters has 40,000 people. what we have ran into is that the spouses of some of our returning staff don't want thunderstorm coming home. the staff don't want to be around our children. we don't want to spook everybody in our community.

>> you're ering on the side of extra safety. let me ask another question. a it listed there are some problems for people, the ngos, charitable workers traveling back and forth to western africa. is that a fact there's difficulties with travel. >> i think that's one of the greatest vulnerabilities that the united states has to fight the disease in west africa. there is not a dedicated humanitarian bridge. what has happened, there's been a lot of talk about a 21-day waiting period would make it onerous for volunteers and wouldn't go. for volunteers not to have an assurance that they can get a flight out. i promise you they will not go. >> how many airlines can fly in and out? >> i think it's 200 a week. that's general population. i u don't moe how many relief workers. >> we don't have a bridge for relief workers. >> there are two airlines.

one is brussels air. you just walk. you go anywhere. you're not monitored for anything. the second one is royal air mo rack. if they should decide it's not in their commercial interest to continue flying in, there will become an effective commercial quarantine on liberia. what's the backup plan? >> plus as i understood, getting supplies to west africa is a huge problem. we understand twice had to lease planes. >> $460,000 a piece. each one can take about 85 tons. but logistics in and out for cargo, logistic for people, we have a great vulnerability there. there's one organization that is flying like a nonprofit. they have done four flights. that's great, but that's not enough. >> let me make sure i understand what would you recommend. the united states government could help sponsor a charter flight twice a week from the

united states to africa, from africa to the united states, so workers, government workers, volunteers, ngos would have a clear bridge to be tested before they got on the flight, tested during the flight, tested when they land. at one point the united states would simplify this process. >> i 100% support the concept of a humanitarian air bridge from the united states directly u to west africa. there would be 1,000 details to work out, but we have a vulnerabili vulnerability. if brussels air stops flying for commercial reasons, we'll have no air access. >> thank you. i'm out of time. i will yield to mr. green for five minutes. >> thank you, mr. chairman, and thank you our panel for waiting today. and to follow up, it would also be more certainty because, like youd said, just walking around, it would be the testing and i assume these health care workers would love to have that because

they don't want to infect their own families. i know in october there were a lot of seemed like unusual statements being made about ebola. when the state of texas developed protocols right after that, i appreciate that, because it really sounded like everybody was getting back to normal and saying, okay, this is an illness, we're going to deal with it and this is how we can do it. so i appreciate the state doing that. let me go on with some questions. dr. gold, one of the interests i have, and i said earlier, is that how did the university of nebraska develop this facility? i think it was in '05 and was it a combination of state, local, university funds, federal to develop the largest containment lab in the country? >> thank you, the unit was opened in 2005. it was planned shortly after the 9/11 events, the anthrax scares

and it was done predominantly on university funds, to some small extent state funds and i believe there were some department of defense dollars involved in the planning as well. however, very importantly, the maintenance of the staff which costs about a third of a million dollars to maintain the preparedness has been totally bourn by the university and medical center. >> i appreciate that, because the leadership -- i'm just surprised that no other university would take that lead, and i appreciate nebraska doing that. my colleagues know my daughter is there and was recruited to come up there in '09 and i appreciate -- although when she told me back in the '90s, she wanted to be an infectious disease doctor, i don't want you to treat me anything you know about.

she's like most medical professionals, that's her job. we want to make sure we protect them to do that. nebraska center now has treated several patients. what is the spending that's required to prepare the hospital to treat an ebola patient? >> the direct costs that we have experienced and we have compared notes closely with emory and we're not far apart is approximately $30,000 per day for each patient admitted. the average length of stay, i guess it went down over the weekend a good deal, but for the two patients that went home was 18 days. they were both treated in a relatively early stages of their disease. that's the direct cost of equipment, supplies, nursing care, et cetera. as i say, that's extremely close to the number that the folks at emory have come up with. that does not include the cost of the preparation, which i just

referred to and it does not include the cost of what i would call the opportunity cost, which is this a ten-bed unit that's otherwise used for medical, surgical admissions that would otherwise be completely full with routine patients receiving their care. >> okay. are the policies that were in place prior to the current outbreak still in use? or has the university made changes as protocol and guidelines based on real life experiences? >> we do evolve our policies and procedures. we learned a lot from each of the patients, particularly the first patient that we housed. we put a completely self-contained laboratory unit in so laboratory specimens are not transported outside the unit. we are also privileged and there's been a lot of discussion about waste management, is we decontaminate all the waste as

it leaves the unit. so there's no transportation of waste material outside of of the unit. which makes it much safer for the community and it also makes it much less expensive for us to have that built into the unit. this is only because the unit was planned as it was constructed prior to 2005 understanding that the disposal of infectious waste would be a big problem from logistical as well as expense. >> mr. chairman, i know i'm out of time and i appreciate because from where we were at six weeks ago, we have evolved and i'm glthe experiences we're learning from and i appreciate our panels being here today. >> the gentleman yields back. >> thank you, mr. chairman. and baring with us what is a long and informative hearing. dr. gold, there is a difference,

though, between the type of patient you get at your center because they are referred. there's not a direct access where someone thinks, i've got ebola, i'm going to go to dr. golds center in omaha. dr. duncan came flu the emergency room with all of the other patients that came in that thursday night and his case had to be out of the other load that was in the emergency room. . but in your situation, a patient only comes after they have only been identified. is that correct? >> thus far, the patients that we have admitted to the buy cocontainment unit have all come with a diagnosis, a pcr diagnosis of ebola. however, given our national representation, the number of phone calls, e-mails, even emergency room visits has actually been quite interesting with people with illnesses saying please tell me if i have ebola.

>> well, let me just ask you about that so patients who arrive in your emergency room -- i mean, you outlined how you have a dedicated laboratory handling of the specimens from an ebola patient, but that's someone you know about. somebody comes to the emergency room and have fever, headache, all of these other complaints, in addition if someone thinks to do the pcr ebola test, but they are going to get a any number of other blood tests and these tests would go through the normal auto analyzers in the lab without knowing that that patient actually had an ebola possibility or is that, in fact, separated out of your room? >> yes, sir, we have put protocols in place and widely shared them for triage screening in the emergency department. if there's any suspicion that a patient has a travel history or symptom complex, they are immediately sequestered. there's a specific nursing

protocol for personal protective equipment, et cetera. there's a notification of the team and the laboratory specimens are processed through the bibiocontainment species ev before we know the results. we are doing pcr testing on site now, which make s it a lot faster and a lot easier. otherwise, it would have taken days previously. >> but again, i would just point out that that is in a perfect world. in the rough and tumble e.r., all of those protocols would not immediately be available. we'll get back to that, but i just have to ask you, the typhoid mary analogy, that's the first time i have heard of that. we all remember of lore. do yours carry the ability to

infect people when they are asymptomatic? >> we don't know. that's the question. a typhoid mary was dealing with bacterial infection. what i do know for a a fact is there have been a number of asymptomatic people whose blood has been drawn and tested positive. and i think that there is something about the pcr test that i heard dr. frieden say in medicine you never say 100%. the thing with ebola is if you don't bat 1,000 every day, somebody dies. >> and someone else is exposed. >> my point in saying that is not to raise fear, but we need to keep it contained. >> you raise a point of two of your doctors were infected and you weren't sure why. e we had two nurses in dallas that were infected and we're not sure why. and again, that just underscores that there's probably not known

about this disease than what is known. that's why i began this we all ought to step back and have a little bit of humility. i would extend that to mr. waxman and he's not known for his humility. we all have to have humility in dealing with this. i have to ask what you did in dallas to sort of restore good order and discipline at a point where it really almost veered toward being out of control. i mean, it took a lot of courage to exercise those control orders on the individuals when you did that. i will admit to being somewhat surprised turning on the news and hearing that had happened. what were some of the things that went through your mind as you developed that? >> so we don't take control orders lightly. in texas i can put a control order. it's not enforceable until i get a judge to enforce it. but we have to get the monitoring done in an event like

this. we have to make sure that people do not have fever. if i could got knot get that done the way i needed to protect the public's health, i take taking the public's health extremely seriously so we put a control order in place. if you do that, you need to make sure you provide the support services around that individual to make sure there's food, other support there so you can make sure it's as humane as possible. with the nurses, following the nurse that became infected, we needed to make sure we had monitoring in place. we also as we looked and stratified risk, it looked to e me that the biggest risk was inside that room with mr. duncan. so for those individuals, we said, it's best during this time period that you don't go into large public settings, movie theaters, churches, et cetera. it becomes a very large evaluation when that occurs.

unfortuna unfortunately if somebody becomes infected. we're a i believe to work with that staff. they took this very seriously, to be able to limit their movement for the highest risk individuals. >> very good. dr. gold, are your patients reimbursed by insurance when patients are referred to you? >> we are in the process of having those discussions with the insurance carriers and with their employers, but to date we have been unsuccessful for a commercial carrier. i can't really tell you anything has happened in the last 24 to 48 hours, but they have not responded. >> thank you, i appreciate that. >>. mr. waxman is recognized for five minutes. >> thank you, mr. chairman. i'll take five and maybe take an additional two like we saw from the other questioner. president obama sent to congress a $6.2 billion supplemental budget request to enhance the

response to the ebola outbreak. the president's request is intended to both fund both immediate and long-term needs in the united states and west africa. dr. gold, you can both speak to the readiness of our public health system here in the united states. the president's budget request designated $621 million to cdc for domestic response, including funding for state and local preparedness, enhanced laboratory capacity and infection control efforts. it also designates $126 million for hospital preparedness. can you comment on the need for additional funding for state and local public health authorities? what are the top funding priorities? >> thank you, sir. as i outlined in my comments, state public health, local public health is having to do a lot of work right now. having the laboratory system out

there to rapidly diagnosis individuals is essential for us to make the diagnosis and isolate individuals. the ep deemologist that contact individuals, talk to them, figure out the risk is essential. the hospitals having predesignated facilities so we can care for those individuals is very important. this isn't the only event. we have had had multiple events west fertilizer explosion, hurricane ike, that system to be able to rapidly respond is essential. a lot of that is paid for by hpp funds. my hpp budget was reduced by 36% this last year. >> hospital preparedness and give us some examples of areas where additional funding would be helpful. >> i think the additional funding would be helpful to

build the educational programs to get the referral centers as well as community hospitals completely up to speed. the additional fundings will allow to scale -- infectious crisis of this nature for which we currently do not have resources. and to build a sustainable infrastructure such as serum reserves such as core laboratory testing, et cetera, so we have and sustain a national preparedness level. >> thank you, i want to pivot to the funding for international efforts. mr. isaac, samaritans purse has been on the ground since march and understands the environment there. i want to talk to you about the ngo perspective on continuing needs and efficient use of

resources. what are the main priorities on the ground in west africa? and what resources are needed to accomplish those efforts? >> so if i may just add something to what you said, we're been there for 11 years. the disease broke out in march. so we have a large footprint. we have 350 staff, about 20 ex-patriots, we have a lot of capacity in the country. and when the drz broke out, we 100% focused on fights it. what we are seeing today that we think that other resources are needed for, this is very practical, but you know what, logistics are everything. there's a lot of discoordination and confusion right now between the u.n. players, unhos and the dod about gaining access to air lift. there are no protocols in place about moving blood samples. so if cdc goes to an area and there's 12 people that test

positive. they call us in. we're not able to take the blood samples out. we have to move them out by land. a rapid diagnostic test is one of the greatest things needed there. and i think frankly that if the u.s. military was running the coordination cell, things would get. -- would be done quicker. >> the u.s. is helping and committed to helping in liberia and provided resources and funding as we continue our aid efforts, we must also keep in mind the need for flexible response. initial reports indicate that there are empty beds in ebola treatment units so the aid efforts have adjusted accordingly to monitor occupation and only build additional as needed. i hope we can quickly pass the president's budget request. we heard from this panel our first panel about the urgency of

the task at hand and the public health catastrophe that will occur in west africa if we fail to do so. thank you very much. >> certainly i'd like to see that happen too. i hope you'll take a look at they need a bridge to move people back and forth because that's a struggle right now. i recognize mr. long for five minutes. >> thank you, mr. chairman. and i thank you all for being here. not only that, but what you do on a day-to-day basis. i for one really appreciate it. dr. gold, you said -- let me ask you something before that. dr. martin was taken to your facility, correct? >> yes. >> and the reports that we got. on the news, turned on the radio and said there was a doctor with ebola that was very critical was

the first thing i thought. and i probably had the same thought a lot of people did. that's probably not a good thing when they say that he's very critical. he later deceased just a few days later. and i apologize i had to step out of the room, which i normally don't do. i'm usually here for the whole duration, but was there a reason that he was delayed coming to this country for assistance, for help? do we know? because that seems strange that he would be that far gone before they would think about flying him out. >> it's unclear to us what the logistics were that might have delayed it. as we are told that he had an initial blood test for ebola that was negative and only three days later did he test positive. when he tested positive, there was a period of time before at least we were contacted. i don't know whether the transportation organizations or

the state department were contacted, but from the time we were contacted, the plans for transfer were put into place virtually immediately. there was also a good deal of uncertainty how stable he was immediately prior to transfer, but once the decision was made to transfer him, rest assured he got every conceivable treatment. >> i'm sure he did. i wasn't implying that at all, but i was curious why they waited as long to try to get him. when i heard that first report, very critical. >> it's common for people to test negative even when they are symptomatic. we have heard about other people who have tested positive who were asymptomatic. this is not 100% certainty disease. we're learning an awful lot about the spectrum of how symptomatic people get versus their viral levels, et cetera.

>> let's switch up the topic a little bit. you said in your written testimony that you have coordinated with the cdc and hhs on readiness and treatment. can you tell us more about that collaboration on what specific issues have you advised the administration? >> we are working with emory, with the cdc on standing up educational protocols, visiting institutions to help them enhance their readiness, hosting teams from other institutions across the united states and nebraska. we have recently had a team of nine or ten people from johns hopkins university as well as putting together a series of protocols that would be used for accreditation or certification of readiness and maintenance. >> when you say you advised the administration, have you spoken with mr. klein, the ebola czar?

>> yes, sir, many times. >> did they accept your recommendations and did they reject any of your recommendations? >> we're working specifically with dr. lurey who was your guest earlier and we speak probably daily on the development of these protocols. there's a conference call that's scheduled for friday. >> you feel they are taking your recommendations. >> yes, sir, so far. >> and mr. isaac, we were talking about earlier you were in your testimony people traveling on planes and being checked temperature wise every so often, three times a day? >> our staff are under protocol to take their temperature four times a day? >> their own personal temperature? >> no, we have staff in our ebola task force that call them every day and we keep a log of it. i could call my office and tell you where every one of our people are. >> but you're talking about your staff, not their patients.

>> yes, our staff. >> okay. >> we're just monitoring their health. >> i misunderstood earlier. you hear reports about checking their temperature when you get off the plane. i think we need to do a travel ban as i mentioned before. they say take their temperature and then they say they cannot be. symptomatic, not have a temperature and still have ebola. my question is still invalid. but thank you all again for your service and what you do and for being here today. mr. chairman, i yield back. >> thank you, mr. griffin you're recognized for five minutes. >> thank you, mr. chairman, i appreciate that. thank you all for being here and thank you for the work you have been doing there for 11 years. it's a good organization. not just there but around the world. speaking of that, in your written comments you said many public health experts are telling us we know the disease, how to fight it, how to stop it. everything we have seen suggests we do not know the science of

ebola as well as we think we do. i touched on this earlier in the previous testimony related to, i believe, the reservoir speez shees is what dr. frieden was talking about what dr. frieden talking about. you touched on that in your written testimony as well. you asked the questions, can the virus live in other mammals besides pry mates, bats, rodents and humans. you attached a study related to pigs. do you ask this question because your people on the ground have some questions or just because it's a blank slate and we don't have much research on it? >> i think ebola is potentially a much more serious disease than it is given respect for. what we are seeing is that it is flexible. it is deceptive. it's sneaky, it's agile. every time somebody thinks they have it figured out, it shows us something new.

i think we as a society can't make assumptions we know what it is and what it will do. i think we need to be extraordinarily careful about letting it come onto this shore. while it is true that when it has come here, we've quickly identified it and isolated it, the truth is that, as these doctors can tell you, particularly the gentleman from texas, if he had 10 or 20 or 50 cases down there, it would consume his capacity to isolate it. so while we can isolate it, if it were to get out from under us, it could quickly exceed our capabilities. that's why i think it is so extremely important to invest resources to fight and stop this disease in africa before it gets off that continent in major way. >> i appreciate that. have any of your people there in africa indicated to you that they're concerned about animals that might be carrying the disease? >> we live ebola 24 hours a day. that's all we talk about. we talk about it all.

we are worried about it. evidently in spain, they thought the little dog -- they killed it. in texas, you put in isolation. i'm glad she got her dog back. i'm a big dog guy. >> i would refer you to a study that came out in march of 2005 in emerging infectious disease -- i guess that's the name of the pub ligs, a cdc publication, i'd be happy to get you a copy of it. it's available where they talk about the potential of dogs. it says although dogs can be asymptomatically infected, in other words, they don't get the disease, but they're carrying the antibodies for the disease and this study says asymptomatically infected dogs could -- doesn't say they are -- could be a potential source of human ebola outbreaks and of virus spread during human outbreaks which would explain

only epidemiologically unrelated human cases. it goes on and talks about there are cases in the past in africa where they don't have any idea where the disease came from. i asked dr. frieden about that. he said maybe bats but they still don't know what all the reservoir species are. in a prior hearing when we were here in october, i said what are we doing about animals coming into this country. it was more or less laughed off. but it is a concern. wouldn't you agree mr. eye sacks? >> i do agree. i'll tell you why this is so important, this isn't the flu. this is a disease that kills 70% of the people that get it. if you look at what the disease has done this year, 5500 people dead, 13,000 cases. that's extraordinary. none of us have swam in these waters before. i don't think we can use case studies that come from 1976 to today to make assumptions about an unprecedented event that

crosses national boundaries. it's now in mali whek r when you look at the disease, the caseload may be going down in liberia, but the disease is spreading geographically. we fear very soon we'll see it in sierra leone and it's already been identified in mali. >> i appreciate your comments on that oovmts i liked your term travel management because i do believe we want people to be able to get there to provide human taryn relief like your organization does. at the same time i think we have to be very, very careful. with that, i yield back. >> recognize mr. ton co-for five minutes. >> thank you, mr. chair. state and local health departments and local hospitals serve as the front lines of treatment and containment of infectious diseases in the united states n. the case of thomas duncan, the country saw the challenges faced by local health departments and hospitals dealing with an unexpected infectious disease. dr. lakey, now that you've had

some time to reflect on mr. duncan's case and how it was handled, can you talk about some of the challenges texas health presbyterian hospital faced in terms of preparedness? >> yes, sir. i think the first challenge was to recognize the first case ever in the united states, a rare disease in the united states. everyone is watching what is occurring in africa. to think that that was going to occur in your emergency room on a busy night was a challenge. i think there are a challenge related to the national strategy. i say national because there's experts outside of government that review those strategies on infection control. the assumes that any community hospital can care for an individual that has that much diarrhea, that much vomiting, with that much virus in those fluids, i think was a faulty assumption. it took a really dedicated team to be able to care for that

individual. i think one of the lessons learned was that health care nurses, physicians, they take their responsibility extremely seriously. they showed up to take care of mr. duncan and their colleagues. i think a lot of people were worried that health care wouldn't show up, that health care providers would not show up, but they showed up. i think there was a lesson related to the level of personal protective equipment, and that was changed. so higher level of personal protective equipment. i think we learned that you don't have to wait for a temperature of 101.5 to diagnose the individuals. we lowered that temperature threshold because we wanted to make sure we identified individuals early. we identified them with temperatures of 100.6, 100.8 which by the previous guidelines wouldn't have met the criteria for testing. those are some of the lessons there. >> in what ways could the dallas and the texas state public health departments have been better prepared to handle an

unexpected case of ebola or any infectious disease? >> i think there's several components to i think the necessity to train -- i think health departments across texas and across the nation had been preparing. there was a lot of information that we had been sending out, but that's different than saying this is a real event and i have to be ready right now. i think one of the things that we're doing right now, to make sure we improve ourness is not only making sure that all hospitals are ready to think that ebola is possible and in the differential diagnosis, isolating those individuals and informing individuals, but make sure there's a system across the state where those individuals then can be seen and be tested before you get to a level of a hospital that can care for those individuals. no hospital wants to be an ebola hospital. it's just hard on your --

getting other individuals into your emergency room, if you're labeled the ebola hospital. so there's reluctance across the united states to step up and be that facility. but that is one of the things that we're working on right now. >> thank you. dr. gold, as you said in your testimony, university of nebraska medical center is recognized as a national resource for your readiness to provide care for ebola patients. you have successfully treated ebola patients. just last week another patient who sadly passed away was brought to your facility for treatment. can you briefly describe the protocols and procedures unmc had in place that ensured staff was appropriately prepared to care for ebola patients? >> yes, sir. since the unit was stood up in 2005 the staff of between 40 and 50 people have been sustained, and that staff meets on a monthly basis to go over policies and procedures, emerging trends in africa, in south america, et cetera, as

well as works closely with the military through strat come. that team also drills four times a year and they do real exercises in the community with waste disposal, with paramedic transport, et cetera. we also practice donning and dofing, use of various types of personal protective equipment, dialys to be management, et cetera. all the typical procedures and protocols are not only learned but actually practiced hands on realtime at a minimum four times a year for every staff member. >> thank you very much. mr. chair, i yield back. >> thank you. mr. terry, five minutes. >> dr. gold, what are the costs and impacts of being prepared when you are preparing and practicing four times a year when all of those pieces within the community are also participating? >> the actual out-of-pocket

costs have been calculated to be between $250,000 and $350,000 a year to maintain the core team of nursing support, techs, respiratory therapists, et cetera. that doesn't count the inkind time that our physicians and other leaders put into it, as well as does not count the time of the maintenance of the unit, the air handlers, water supply, auto claefs, maintenance of stock of equipment, et cetera. that's just the personnel time that goes into maintaining the readiness. >> in your opening statement, and i handed this in one of my questions to the cdc, is that for the level of facilities that unmc and emery are and when you train and practice like this, there should be some maintenance funds to offset those costs? >> well, we certainly agree with that. i believe the cdc over time has

had a relationship with the emery organization, predominantly to protect the employees of the cdc of highly infectious agents in their testing laboratories and around the world. we have not had that type of relationship and would think it would be appropriate perhaps for the ur structure or some other vehicle that exists. >> are you being homered? >> sorry? >> emery being in atlanta and cdc being there, are they just giving money to the hometown hospital, or is there some contractual relationship? >> just like we need a way to take care of our employees if something tragic were to happen and they were to become ill, they need a way to manage their employees as well. and i think that was the original basis of the relationship. we would very much enjoy a similar relationship. >> and i think you are on equal if not better footing, medically

speaking at least. speaking of that, just to pick your brain a little bit here and maybe someone has already done this. you've had two successful patients that got to hug all the doctors and nurses that helped them. and then we had the last patient that came in that appeared from the tv video to be in super critical condition. what in your opinion is the reason that perhaps this physician, latest patient passed away? any takeaways of how you were able to treat the first patient versus this one that came in a more critical condition? any lessons learned? >> i think the most important lesson learned is the earlier we have access to freet any patient here in africa, the better the yield is going to be. this particular patient had renal failure, liver failure, was unconscious when he arrived

in the united states. what we've learned is that those are all very bad predictors of outcome. the earlier patients that we cared for did have early organ failure, but were reversible through good supportive care. they all received experimental medication, as did this patient. but i believe that the organ system failure we dealt with over the weekend was just far too extreme. >> with just this one example, it's probably not certain, but is there just a point of no return with an ebola patient, their organs have already shut down? is there a way of making -- of treating them so they can survive, or is it just at that point not survivable? >> i don't think it's possible to predict. young people -- this gentleman was in his early 40s. the thinking was that it was worth an all-out effort to

attempt to save him. and i don't think, if you could take the exact same patient twice that you could predict the outcome. >> appreciate it. dr. gold, you and nebraska medicine and unmc make us proud. i appreciate all of your efforts. >> we have a great team, thank you. >> you do, with mr. green's daughter. >> gentleman yielding back? >> i yield back. >> recognize mr. green for one minute of wrap-up. >> thank you, mr. chairman. ski unanimous consent to place in the record a statement by the american federation of state and county municipal employees urnling congress to support the president's emergency funding of $6.18 million. >> without objection. >> mr. chairman, i want to thank both panels today. i know the first one is gone --

[ inaudible ]. i appreciate our witnesses being here, but also for the panel that was put together, and that's what our oversight investigation committee is supposed to be doing. to follow up on my colleague, i'm the first time in history that the intelligence from your children went back down the tree. i appreciate that, first time in mankind. thank you. >> so noted for the record. i want to thank this panel. you have -- give you 30 seconds here? dr. burgess? >> i was going to thank the panel, too. i have been through a number of these hearings. our committee, of course, has done hearings. i was allowed to sit in homeland security and they did a field hearing in dallas. i sat through the hearing on foreign affairs last september. this has been the most informative panel that i have had the pleasure to hear from. i really appreciate it. i know it was a long day and i know we made you wait a long

time. but i really appreciate you guys sticking with us and sharing with us the information that you shared, because it's been absolutely critical. i'll yield back. >> through, doctor. i want to add to that. i almost had the feel that the first panel we had today was speaking the ball. we got this, and we can be confident and i don't agree. after we had our hearing several weeks ago, put forth recommendations, we needed some level of travel restrictions, people ought to be isolated for 21 days. what i hear, not only did you do that along with the hospitals of so many colleagues, but your employees didn't complain. they recognize they don't leave their compassion at the borders of africa. i thank them for that selflessness and altruism, not only while they're there but on returning home. from this, several takeaways, people with level four gear can still get ebola. we don't know all the routes. what we don't want to have is a false sense of security, that everything is fine.

i worry that -- the first hearing this room was packed with cameras and people in the press. at this point in the hearing, what you've told us should still tell us, we have to keep our radar up, full alert here. we have a major battle for this taking place in africa, very difficult time forgetting people in and out of there. if any of those airlines stop their flights which could happen at any moment, we're at a loss for moving people and supplies in and out of there. along those lines, i hold to it that we should still have people do 21-day restrictions from touching patients when they come back. i'm glad hospitals are doing that anyways. i hate to think what would happen if that did not occur. quite frankly, i think the hospital would have to tell other patients if they did have some employees who were with ebola patients. i want to echo mr. eye sacks, we ought to have a bridge for people going to and from africa, so many charities, catholic

relief, methodist and so many groups i've heard from, doctors without borders. we need a way for them to easily go and come back and we can help monitor them. this is one less thing to worry about. with the amount of money we're talking about going through this, especially when you look at $20 million going to new york city to monitor the people exposed to that doctor, that would pay for a heck of a lot of flights. please stay in touch. committee members will have questions for you and we ask that you respond quickly and in a timely manner wi [captions copyright national cable satellite corp. 2014] [captioning performed by the national captioning institute, which is responsible for its caption content and accuracy. visit ncicap.org]

>> we hear from president obama. and more on the houston pipeline. and global response to the ebola outbreak in west africa. >> joseph clancy provides an update wednesday on secret service operations following the resignation of director julia pearson. the house judiciary committee is investigating the follow-up to security breaches at the white house. the hearing is live starting at 10 a.m. eastern on c-span three. c-span3. >> a confirmation hearing on wednesday for the nominee to the deputy secretary of state. mr. blank and is the deputy national security advisor. you can see this hearing live at

2:30 p.m. eastern on c-span3. >> here are a few of the comments we recently received from viewers. >> i have to tell you to see these people in person, to hear , it is so important to understand the context and listen to the statement in its entirety. --i have been walking watching book tv for a number of years and i think it is the greatest program on tv. authors like how these take the time to not only summaries on what they write but the moderator always does a great job of stimulating the conversation. -- that is what i look

forward to on the weekends for me. to watch as much as i can. c-span all the time when i am home. it is the only station i have on most of the time. it is absolutely excellent. i watched all of the debates around the country. thank you for the book talks and for the history. i like all of it and i think -- i am thankful i am there and i use in my classrooms in community college in connecticut. thank you very much. >> continue to let us know what you think of the programs you are watching. e-mail us at comments at c-span.org or send us a tweet at c-span #comments. like us on facebook. follow us on twitter. >> president obama condemned the deadly attack injures them that killed five, including three

americans. comments came while he was meeting with the ebola response team. the president's comments are about 10 minutes. >> one moment. >> i've got my team here to talk about ebola but before i do, i want to make mention of the horrific attacks that took place in jerusalem. we know that two attackers senselessly and brutally attacked innocent worshipers at a synagogue during their morning prayers. obviously, we condemn in the strongest terms these attacks. a number of people were wounded and four people were killed including three american citizens. our hearts go out to the families who are undergoing tremendous grief right now.

secretary kerry has spoken to prime minister netanyahu. president abbas has condemned the attack. tragically, this is not the first loss of life we have seen. too many israelis and palestinians have died. at this difficult time, it is important for both palestinians and israelis to try to work together to lower tensions and reject violence. the murders today represent the kind of extremism that threatens to bring all of the middle east to a spiral from which it is very difficult to emerge. this violence can get worse over time. we have to remind ourselves that the majority of palestinians and israelis overwhelmingly want peace, to be able to raise their families knowing they are safe

and secure. the united states wants more from all parties involved to make that a reality. i now want to turn to the topic of this meeting, the ebola situation. obviously, some of the attention of the crisis has ebbed over the last several weeks but challenges remain. we have seen most recently dr. martin scalia, a surgeon who contracted ebola in sierra leone, he was flown back to get treatment. he was already in critical condition and sadly passed away early monday morning. our thoughts and prayers go out to his family. beyond this tragedy, we have established that when ebola is

properly diagnosed and treated that we have a great chance of curing it. of the patients who were treated properly, all have recovered and are back with their families. after the unfortunate passing of mr. duncan, we learned lessons from dallas. we put in place new protocols, more protective gear for health workers. we racked up training and outreach for health workers. we added screening for travelers to the united states. we put in place rules for public health workers to monitor travelers for 21 days after they arrive here. as we saw in new york with dr. craig spencer, one of the greatest health workers who has traveled to the region to try to fight this disease, our efforts to identify, isolate and treat

ebola patients can work. america has proven that it can handle the isolated cases that may occur here. but as long as the outbreak continues to rage in the three countries in west africa, liberia, sierra leone and guinea, this is still going to be a danger not just for america but for the entire world. we are nowhere near out of the woods yet in west africa. in liberia, our efforts are paying dividends. we are seeing the curve bending so that we are on track with diligence dealing with the hotspots that may reemerge, to get a handle on that disease.

we are still seeing an increase in cases in sierra leone, although our british counterparts are doing an excellent job to coordinate the situation there. in guinea, the numbers are lower but they are often in very remote areas that are hard to reach. the bottom line is that we know how to treat this disease given that it is such a significant outbreak in these areas. it underscores how important it is to continue to push forward until we stamp out this disease entirely in that region. until we do, there are threats of additional outbreaks. given the nature of international travel, it means that everybody has some measure of risk. here at home, we have made great progress in preparing our health care system to deal with any

possible threat. scientists continue to make progress with vaccines. but we have plenty of work to do. all of this means that although we should feel optimistic about our capacity to solve the ebola crisis, we cannot be complacent simply because the news attention on it has waned. we have to stay with it. that is why i'm calling congress to make sure it approves the emergency funding request that we put forward to respond to ebola domestically and internationally. the funding is going to help us strengthen domestic health systems so we can respond to her cases that may arise. it is a much-needed resources to sustain our effort in west africa. it will accelerate testing and approval of ebola vaccines and treatments. it is going to help vulnerable

countries to prevent and respond to outbreaks of various communicable diseases. the more we can catch these things early, the less risk we have over the long term. as i've said before, in some ways, we are lucky. ebola is a very difficult disease to transmit. if we have a comparably lethal disease that is airborne, we have much bigger problems. this gives us an opportunity to start putting in place the kind of public health detection infrastructure around the world that is necessary should additional pandemics arise. this makes it necessary for congress to act. this is not a democratic issue. this is a basic issue of the

health and safety of the american people. i hope that congress is on the case on this issue. all right. thank you very much, everybody. >> with the temperature below freezing, 58 new incoming members met to take the class picture. the last weekpent in orientation, learning their way around the capital and their new duties. the new congress usually meets 3 start their term on january as laid out in the constitution. the next year the third false in a saturday so new members reported on tuesday the sixth.

tuesday evening the keystone xl pipeline bill failed to garner the 60 votes in the senate. it was expected that the president would veto the bill if it passed. rarely are in the day, house republicans leaders spoke to reporters about the measure and future action on the bill. this is 10 minutes.

>> good morning, everyone. as we approach the thanksgiving season, it is appropriate to take a moment to reflect on the freedoms and opportunities we enjoy as americans. i find myself grateful for the group i get to work with and trying to make sure we continue to have great opportunities in this country moving forward. we have been listening to the american people, we have had hundreds of bills that will expand opportunities across this country and we have advanced solutions to make people's lives better. tot we need right now is come together and unite around these policies that we can move forward on, focus on what unites us, rather than what divides us. let's come together as a white house and congress, the republicans and democrats, senate and house, and let's get the job done. last night, i was encouraged to eyethe senate passed the partisan childcare options bill for low income families that will expand more opportunities for working families across this country.

we expect the senate to act on longtime legislation that has broad support of republicans and democrats on the keystone pipeline which again means thousands of jobs for people all across this country. these are bills that we need to get on the president's desk. the time for leadership is now. this is not so much left versus right as past versus future. what kind of a future are we going to have? we are committed to one that is full of opportunities for people doing what is good and right for americans. >> good morning, everyone. where back at work this week, continuing to make the american people's priorities our priorities and clearly that means the focus on jobs.

with another bill to promote manufacturing in the house this waitingre are job goals action in the senate. tonight, the senate has an important opportunity to send a keystoneuild in the pipeline to the president's desk. let's be clear about this. the keystone pipeline veto would send a signal that this president has no interest in listening to the american people. an overwhelmingly popular bill would be a clear indication that he does not care about the american people's priorities. it would be equivalent of calling the american people stupid. >> good morning. i don't know if you all had a chance to wish the speaker say happy birthday yesterday, but we sang to him in conference. [laughter]

there is one message coming out of this election, the american people expect this new american congress to work in the best interest of america. it is a unique opportunity for us to work together. if you look at the history of this country, in divided government we have achieved big things. ronald ragan had a divided congress and had tax reform. bill clinton had a divided congress and senate, reform the welfare and balanced the budget. we have a unique opportunity after this election. those in the senate that have been stopped about keystone pipeline had a unique, new opportunity. so we moved it in the house and hopefully in the senate. i hope the president take the same advice as those other presidents of working together. a lot of you have seen the tape of jonathan gruber, one of the architects of obamacare, where he talks about a lack of transparency giving you the opportunity to fool the american

public. the one thing in congress we always do is greater transparency. this week we will have three bills of dealing with transparency. chris stewart dealing with the epa advisory board, to make sure you have opinions from all sides. making sure the epa, if they use data to make a decision, that data has to be made public before any decision can be made. and then also our own majority whip, the bill on manufacturing. i am excited about what the new year brings. i am more excited about what a new american congress brings. i am just disappointed about what i hear in the white house. i know the president, i know the democrats have their leadership race today. i saw that situation before when i came in in 2006. the one thing i will say.

if the president had two years with the house and senate and did nothing on immigration but he will not allow this new congress to convene before we have an opportunity to do something about it, i think you should rethink that opportunity. >> this week, the house will continue our focus on creating jobs and getting the economy back on track. if you look at what we did last week, we took a quick action to continue to push the keystone pipeline to the president's desk. what was the president's response? he issued a veto threat and then try to hide behind this concept that he needs to keep studying the issue. this issue has been studied more than maybe any pipeline in america's history. for six years, this administration has hidden behind studies where everyone that has looked at it should move forward.

the american people are tired of the president hiding behind studies. they want those 40,000 jobs and increased energy security in our country. they do not want six more years of studies while china tries to take those jobs away from our country. yesterday, the president issued veto threats on the bills that we are moving forward on this week. i will talk about the legislation i moved out of the energy and commerce committee to promote a manufacturing at. this bill would bring certain to to the regulatory process where agencies like the epa come out of rules where they have no way to be limited in the real world, but they bring them out to continue some radical agenda that would kill jobs in america and increase people's household electricity cost. we say there should be increased transparency by the administration.

before the bill has even moved through the legislative process, where an can be debated on the floor, the president issued a veto threat before he allow the process to finish, which is another example that he is not serious about hearing the message from the american people that they want him to work with congress. [indiscernible] he just sits behind in the oval office and issues veto threats on bills that have not passed. the president needs to engage and getting the economy moving again. the house wills keep our laser focus to get jobs moving in the country. it is time for the president to engage in that process as well. >> last week, many of us spent time at home in our districts honoring and paying tribute to our veterans. unfortunately, the bureau of labor statistics has reported

that our young veterans, like a laser especially those of the 9/11 era, are struggling more with unemployment than the majority of our work force. that is why the house has been focused like a laser on helping people get back to work and helping this economy get back on firm, financial footing. we passed the hire more heroes act over to the senate. we are calling on the senate to take up that piece of legislation. american veterans should not have to wait for a new said to be seated in january to receive some help. these veterans deserve an opportunity. whether it is increasing their opportunities for better health care, better mental health, holding the v.a. accountable, or getting a better job, we will help them with that. >> i appreciate you coming up for our first purse -- first press conference. i had a chance to drive out from

wisconsin a couple of days ago with my son. we had a snowstorm. nothing changes. we had a lot of quality time. as any parent, today, i think about my son's future. as i look at jack, i know other parents are looking at their own kids graduating from high school, college, and they are looking at what opportunities exist for their next-generation. i think it looks pretty bleak right now. as they link to this town, they want us to work together. they want us to work on solutions that advance opportunities not only for them but for the next generation. to work together, that means we need republicans and democrats singing off the same sheet of music. we are willing to do that. we are willing to work on ideas that will grow opportunities and jobs and allow people the pathway into a better paying job. we need a president to help us.

we need the president to engage. i spoke to the president in 2008. he said, turning the page on ugly partisanship in washington to bring democrats and republicans together to pass an agenda that works for the american people. bipartisanship does not just work when you have a democratically controlled senate and house. it works when you have a divided government. now more than ever when need the president to engage with us and work with us so we can grow opportunities and jobs. he should not be poking his finger in the eye of the congress before we have an opportunity to work its will. let's fight together for the american people. i hope the president will extend his hand and we can join up and fight for the people. >> [inaudible]

>> there are a lot of options we are considering. but we have something to announce, we will let you know. >> [inaudible] >> maybe. >> [laughter] >> [inaudible] >> [laughter] i continue to purchase my expensive health-care coverage. >> [inaudible] him him >> him him

soon. >> [inaudible] >> there are a lot of options on the table. there are a lot of good ideas out there, and we're concerning all of them. thanks. >> the layout their agenda for the remainder of this year including nothing remaining government funding bills. this is 30 minutes.

>> and want to say congratulations to everyone from the later on down with the houston critic leadership for having been reelected by our caucus by acclamation. i want to congratulate our newest members of the leadership team. we have with this mr. ben ray lujan. and the cochairs but the leader will be recognizing them since they were her appointments but we are thrilled to have them be part of our leadership team. i think we can say without any reservation that democrats come here including the newest members prepared to work on behalf of the american people. clearly, the mayor can people want us to get things done. they want us to focus on getting

the middle class that to where it should be. they want us to help working americans understand that if they give a hard days work they will get paid right. they will be able to send their kids to a good college. want to make sure that health care continues to be something everyone can enjoy. that health security will be there so they have the peace of mind that they can send their child to a doctor or hospital without fearing personal bankruptcy as a result. we know that we have some challenges before us abroad. we look forward to working with president barack obama to make the that not only will american people be secure in the homeland and abroad, secure economically, secure financially , and their neighborhoods and knowing that the future will be cross press their children to come. that is why democrats are ready to lead. that is why democrats ran to be part of the democratic leadership in the house of representatives and that is why we're thrilled to work with our

colleagues on the republican side to get these things done for the american people. with that i will yield to our leader, nancy pelosi. >> thank you very much, mr. chairman. i would like to proudly acknowledge our house democratic leadership. it is an honor to be here with steny hoyer, jim clyburn, xavier becerra, caucus chair joe crowley -- i feel his tall presence. stephen israel, we are so proud of the response. rosa delauro, donna edwards, cochair of the syrian policy committee where we will be going into effect in momentarily. chris van hollen is not because but he is going to be a ranking member on target.

in the interest of time, we have a meeting, i associate myself with the remarks of chairman becerra in terms of the priorities. it is really important to continue the conversation about where we were when president obama was elected. the chairman of the fed said that if we did not act by monday, we would not have an economy. that is what he said in september of 2008. that was the state of our economy before president obama took office. when he took office, the deficit was one point $4 trillion.

it is now under $500 billion. unemployment is under 6%. the market is over 17,000. we experienced 56 straight months of job creation. millions of people have health insurance. there is much more positive data. still, the american people feel uncertainty. they were scared by what happened in september of 2008. while the economy is improving, it has not reached the people that it needs to reach, the middle class. wages and salaries have not been comments or it with the progress that our economy is making.

it is really tilted to the high end. we recognize achievement but we cannot have that achievement be at the exploitation of america's workers. much more needs to be done. perhaps without all the big money pouring in from special interest to counter our argument and drown it out, perhaps in a normal course of congressional debate we can make clear this distinction between where we were then, the path we are on now, and the attempts by some to take us right back where we were. my voice demand that i yield to the distinguished house democratic whip, mr. hoyer. >> thank you very much, madam leader. i congratulations to all my colleagues on the expression of confidence that the caucus has given to all of you. i look forward to working closely with you. this was a tough election. it was a tough election for the american people. the american people are

apprehensive. a lot of angst about the future. 435 of us share two things in common. a, we are all americans. b, we have been sent here by our neighbors to make america work better. we have that responsibility. this leadership team will respond in a positive way to working together to build an economy that provides jobs for all of our people, so that all of our people can make it in america. this 113th congress has some work that it still needs to do. we need to pass an appropriation bill. we need to pass a defense authorization bill. we need to pass the terrorism risk insurance bill so that construction can move forward on a number of projects. and we need to do other things as well.

to make sure that they do not lapse. so that we give confidence to the economy, so it can grow and create more jobs. leader pelosi pointed out correctly, we are in far, far better shape today than we were in january of 2009 when president obama became president. but we are not where the american people want us to be and we are not where we want to be. we are going to work very hard together and look forward to working with our republican colleagues in seeking compromise and forward movement where we can find it. i urge my republican colleagues and my democratic colleagues not to allow that on which we cannot

agree to undermine that on which we can agree. that is what our american people expect of us. that is what they want of us. if we do that, we will re-instill the confidence in congress that our people ought to have and want to have. now i am pleased to yield to my dear friend who has been unanimously reelected as the assistant leader of the democratic caucus in the house of representatives, jim clyburn of south carolina. >> thank you very much. distinguished leaders, this 114th congress, it is a pleasure for me to be here, reelected to the assistant democratic leader position. i look forward to the challenge that we all have going forward. as steny just said, this was a tough election.

quite a bit of soul-searching after the election. i have spoken at length with our leader and i thank her so much for giving me an extended role going forward. so that next year we can begin to refocus our attention on middle income here in america. i think all of us have been reading -- i am particularly concerned with yellen's most recent speech in which she stated that the thing that bothers her most is the fact jessica that over the last 20, 25 years, we have seen the upper 5% in the country gained 38% in their wealth and the lower 95% only 10%. the income inequality that exists in the country today is

something that this caucus is going to focus like a laser on to make sure that everybody feels a positive recovery that a few people are enjoying. i look forward to working with these members of congress to get all of this done and i am pleased now to yield to the newly elected vice chair, joe clyburn. >> thank you. i want to join jim and my colleagues in congratulating all my colleagues on reelection. it is an honor to serve in the house. to add to that distinction, to be elected by your colleagues as a member of house leadership is overwhelming. we oftentimes speak about the respect we collectively have here for the american people.

i would suggest that this afternoon we all collectively respect the decision of our colleagues in the democratic caucus as much as we also like the decision as well. as mr. hoyer has said and our leader said, there are things we look forward to, tackling issues we will be engaged in. we will be working on all those issues and being a part of how that agenda in many respects is molded. this year, we have a number of issues that still need to be addressed. looking forward, to the new members who will reinvigorate us in the 114th congress to do the work of the american people, to strengthen the middle class not see it we can as it has by the republican caucus. with that, i turn it back to the leader.

>> we can move to questions. >> i just want to thank my colleagues, congratulate each and every one of them for the leadership roles they will play and the support they have in the house democratic caucus. it is humbling to be elected leader by your caucus. part of it that i particularly enjoy, how we conducted ourselves when president bush was president was something we hope the republicans can emulate. we disagreed with him where we did, on the war on iraq and privatizing social security, but as mr. boyer said, we did not let opposition stand in the way of cooperation. whether it was one of the biggest energy bills in the history of our country, whether it was our stimulus package which really did help poor people, whether it was issues

that relate to the issue of the president is very proud of his initiative for drugs, internationally, for fighting aids. as mr. hoyer was saying over my shoulder, the tarp. september 18, 2008. we supported the president on tarp when his own party abandoned him. with all initiatives taken by president obama supported by us in terms of the recovery package and other things, the affordable care act, we are able to reduce the deficit, increase job creation and do so many things in a positive way to take us in a new direction. one of the first things this new republican congress is doing is

hiring a lawyer to sue the president. let's hope that is just for caucus consumption and when it comes to working, we find common ground. we have an obligation to try. with that, any questions you may have. >> the other day, the caucus sent a letter reiterating their concern for senior ready. that is something you talked about. i was wondering if you could give a response to that letter. >> i respect the view of the black caucus in terms of what their view of it is. the syrian policy committee shall recommend a member from the committee without regard to

seniority to the caucus as the ranking member or chairman. hopefully, one day soon. i do believe that many of our members that we have now, adam smith, elijah cummings, who else? there are others who were not the senior members on their committee when they were recommended to the committee. we can go back in history. there are people who would not be there. it is a difference of opinion in the caucus. i believe we must have the most talented people and that seniority makes you a contender but it does not make you a chairman. it is not a determination. my other colleagues and i wish to address that.

>> what do you make of this potential proposal of a bill to allow the government to be funded and then go back in time and rescind some of that funding for a potential executive order? is that a way to get around a showdown in december? >> what we have heard from our ranking member in the committee is that we don't know what the committee is going to do. whether it is a short-term omnibus or cr or whatever. we are waiting to see what that is. i would reject to rescissions. it would most likely be vetoed

by the president. we all have a view about that. >> i don't know fully the proposal but i do know this. though speaker boehner and the incoming majority leader have said that we need to put our country on a stable path. we do not put it on a stable path with the thought that you may rescind sometime in the near term. that is not how we grow our economy, create jobs and make our economy better. i would hope the republican leadership would come to agreement. i know ms. lowy, our ranking member, wants to do that.

i know that al rogers, chairman of the appropriations committee, wants to do that. that is the best policy for this institution. much more importantly, it is the best policy for stabilizing and growing our economy and creating more jobs. >> rosa delauro, ranking member on the labor and health education subcommittee of appropriations. we are the only subcommittee over the last two years who have not had a subcommittee markup for the committee. we are the largest portfolio of programming that affects people in this country. also, the largest resources. we ought to move forward on the appropriations bill on the subcommittee level. one of the latest rumors is that some of the subcommittee will move forward, and others may not be part of a cr. it really is, as mr. hoyer has pointed out, that there is a lack of direction for the people

of this country, and especially in the areas which labor health and human services picks up, which has to do with worker training, biomedical research -- and we have seen our health infrastructure between 2010 and 2014 absolutely decimated with the nih and the cdc. there are critically important matters and my hope would be that we can come to a decision and an allocation for those programs that our families in this country are relying on for their future. this lack of direction, or this -- and mr. hoyer pointed out, there may be the will but we haven't seen that really

demonstrated in the committee, for us to move forward on all 12 appropriations. >> let me just add one additional component of this. i believe the democratic party, the 199 or 200 of us in the 113th congress who are democrats, will vote overwhelmingly, overwhelmingly for an omnibus consistent with the ryan-murray agreement. it was adopted by the congress of the united states. it meets the views of our ranking member and mr. rogers and ms. low we have an agreement. in my view, i think we will have

overwhelming support so that republicans will support the implementation of the ryan-murray that is consistent with the agreement so that we fund the priorities that are important for our country. i think they will find a significant, strong support on our side of the aisle. the problem is, unfortunately, they can't find that support on their side of the aisle. >> [inaudible] reports have questioned the amount of confidence your fellow democrats have in you. >> i'm very proud of the support i have received from my members of the caucus.

i had my name put forth after they encouraged me to do so. i go into this role very confident and i go into it frankly liberated. i think the house democrats know that when we go out there to make the fight for working families in our country, we know of what we speak. we are close to our constituents. we know of their challenges, their aspirations, their anxieties. we know the legislative process. while there may be a few people who are talking to the press, overwhelmingly, i feel very strengthened and encouraged by the support my colleagues have placed in me. i'm very excited that as mr. clyburn said, this is the 50th anniversary of the voting rights act. he will be taking the lead for voter engagement. the reason to register, the reason to vote. i'm very pleased that mr. israel will be chairing our communications and policy initiative.

it is very important for us to generate, by listening to members in the caucus, by listening to action on the policy committee, the priorities and the positive initiatives to end and reduce -- hopefully end but certainly reduce income inequality in our country. we have shared values in our caucus. we have great respect for each other's legislative ability. i have never felt more confident going in than i do now. >> you said that it was important that democrats continue the conversation that started with president obama in 2009. i'm wondering, given the realities now, if you will look to the republican example of how

they were able to flip in 2010, if that is a model you can look to, or how you are approaching the next two years. >> i believe some of the republican model is not based on fact. i would not want to copy that model. we believe to the extent that we can engage the public to understand what has happened -- quite frankly, i would hope it would help change the minds of republicans. this is about the american people. and what we want, are initiatives that help the american people. people, because of 2008, were so concerned about their jobs, their wages, their home ownership, the education of their children, their pensions, a lot of that is still existing. they still do not feel confident. our model is to make sure people understand what the choices are

here. at the same time, when we have that conversation coming out of policy and communications, our model is about following abraham lincoln. another republican. i will follow his model. public sentiment is everything. it is one thing to believe in all the good things. it is another thing to have legislative proposals to go forward. it is another thing also to make sure the public understands what is going on. i feel confident about where we started with building letters of opportunity for people who want to work hard, that they can help realize the american dream. indeed, the issue of the middle class jumpstart, with creating good paying jobs here in america, building the infrastructure of our country, making higher education affordable and having equal pay for equal work, these are

initiatives that are very supported by the american people. we just have to make sure they understand how strongly we are fighting for that and what the obstacles are. right now, we have a surprise guest who is joining us. it was the last question but it was not the last conversation. i'm pleased to welcome congressman emanuel cleaver of kansas city, home of the great kansas city royals, here to deliver on a bet.

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>> i want to acknowledge that we great day. ( laughter ). >> the nationals were no slouches either. nationals were great. was a cinderella theme on cards.des, wild so i hope you'll en destroy the ribs as much as i en destroy the world series. last play,own to the movie.almost like a

play in thed teams world series. congratulations. it's just great to get to the world series, but once you get there you really want to win. congratulations. >> thank you.