hi i'm nick miceli at td bank we believe all citizens need to be informed about the important financial issues that effect their daily lives. that's why we're proud to support programming produced by the caucus educational corporation and their partners in public television. >>funding for this edition of caucus new jersey has been provided by the new jersey education association md advantage insurance company of new jersey td bank caldwell university njm auto insurance homeowner's insurance and more with a focus on safety and financial stablity the russell berrie foundation and by new jersey natural gas proud to support education in our communities promotional support provided by new jersey monthly the magazine of the garden state available at newsstands and by commerce magazine

[music playing] [music playing] hi i'm steve adubato before i introduce our guests let me tell you some interesting statistics having to do with veterans and an important need that there is to take care of our veterans. there are over 23 million veterans in the united states with 2.5 million having just served since 2001 in addition between now and 2016 over 1. ... excuse me 1.2 million service members will be leaving the military returning to their homes 425 thousand of them in new jersey the question is what happens to their healthcare needs? who's providing for them the two guests we have in the studio right now are dealing with that question every day we are pleased to have major general maria falca-dodson vice president for strategic initiatives at md advantage and

doctor al tallia professor and chair for the department of family medicine and community health at rutgers robert wood johnson medical school. thank you both for joining us. we appreciate this. um maria we started this conversation md advantage one of our long time partners and we know that al you've been involved in this for a long time you have served you understand the need. first of all how serious are these needs of veterans who come home and what are you doing and your colleagues to deal with it? >well steve in fact first of all thanks for being on this show the two of you have been so much to make the public aware of what the needs of veterans are particularly the folks returning from service active service the needs are multiple and in fact they range from housing to getting jobs to just you can pretty much go across the entire waterfront but one of the things that we're now even more aware of is the need in healthcare because there are

problems in the existing system and we're here to address those problems >>talk about some of those problems and specifics >>well there's been a lot of press and discussion about the v.a. and the services provided by the veterans administration which is the largest healthcare system in the world >>they falling short maria? >>they have capacity issues um i think you know as our population has aged that have been in combat world war ii vets korean war vets vietnam vets that combat force has diminished our force is much smaller. world war ii we had 16 million in uniform and today we have 2.5 million in uniform nd that's due to a lot of things it's the way our budget is generated it's due to a technology that allows it and so for a lot of reasons all of those services have

become smaller and yet things have changed in terms of the types of injuries that we're seeing, they're >>like? >>well >>first let's talk about the head injuries and the incredible fallout i mena fallout's not even the right word look at the injuries we're talking about and i don't think people don't understand someone says let's fix that. these are long term injuries >>yes. what every conflict has signature injuries >>sure >>so and they differ and the technology has changed to the point where the ratio of kill to wounded in world war ii was almost one to one and >>for every person killed there was someone wounded >yes it's a little bit more than that >>what about iraq and afghanistan? >>but it's almost one to one in today's conflicts in iraq and afghanistan the ratio is one to eight and so we have so... right >>for every person killed there are eight >>it's a wonderful testimony to the medical care on the battlefield and then being

able to medivac those folks out and get them home to definitive care but it becomes a challenge for the long term as you just alluded to >>and the question is what do we do there and talk about what you and your colleagues have to jump in and help? >>yeah sure just to say a little bit about the v.a. and the v.a. actually is an excellent healthcare system i don't want to give you the impression that they they're not... >>and i would agree with that >>wouldn't you >>yes >>and thank you for your support it's really welcome by the way >>oh thank you [laughter] >>have they been overwhelmed al? >>i'm sorry steve >>al have they been overwhelmed? i think part of the issue is the v.a. like most of the united states health system has been primarily inpatient focused on acute problems right >>inpatient? >>inpatient focus >>yeah >>versus? >>versus the outpatient side so when our folks come back right the needs are often in the outpatient arena subspecialty care primary care and although the v.a. has taken significant steps to loose that system it takes time... it's a issue of shifting resources from the inpatient side to the outpatient side and quite

frankly with all the active combat missions that are going on right now the system is overwhelmed so it's difficult or the v.a. to keep up and we've seen that in terms of the recent problems that have been in the news lately but i think another thing that's important to realize is that 60 percent of veterans receive in fact more than 60 percent receive their healthcare outside of the v.a. system in the private sector and that's where i think the private sector needs to step up and really help with the vets their families and all the issues that they are confronting >>what do they need? let's be specific and tangible what do they need? >>the civilian medical community needs to be educated about properly assessing the folks that come into their practice i guarantee you that a family practice physician internal medicine physician has already been seeing lots of veterans in their practices they may not realize

it because they don't ask the question about their service in korea and world war ii and vietnam but... >>but respectfully i just want to get down to what kinds of things do they need? >>well doctor tallia's folks at the robert wood johnson medical school have been on the cutting edge of this they were the first medical school in the nation to do an all day actually it was several days last year and repeated again this year as part of the joining forces initiative to educate medical students residents other disciplines nursing psychologists pharmacists about caring for veterans about understanding the military culture about doing an assessment understanding the effects of conflict and combat and essentially the wounds of war as we hear it >>and you have found that they need... oh absolutely it's not it's basically a general need within the clinician communities caring for veterans in new jersey and around the country

i mean to get specific of the kinds of things that we're seeing... >>sure because the public needs to know this >>absolutely absolutely physical disabilities right limb loss a whole series of problems that you get from these explosive devices that people so there are physical injuries that they're dealing with right? in addition there's incredible emotional trauma that's associated with being in combat right. and then there are the social issues reintegration back into their families and >>how about employment issues >>well the of course... >>huge >>i'm just talking in terms of you're absolutely right steve i'm just talking about the healthcare related things >>right >>but the employment issue is huge you know retraining there's a whole host things >>retrainign back into society? >>into society exactly right exactly right. these ladies and men come back with incredible stories i can relate to you one story that a veteran told me about you know he was starting to open up to his friends about what it was like to be in a combat situation and you know

there was about three minutes of talking on his part and then all of a sudden his friends changed the subject because i couldn't deal with it they did not... >>could not deal with it? >>could not deal with it >>so who else would he wind up eing in... so who could that vet talk to? >>so what often times happens is they turn to family members but it's the same issue there right because they've been struggling with issues of their own while the vet has been away so they come back and it's reintroduction so it requires a whole host of physical support systems psychological support systems and social support systems and that's where the healthcare system needs to step up to the plate >>and so your operation from the academic and clinical side md advantage is involved and other organizations have be... this has to be a priority for all of us >it has to be a priority for the nation for every corporation for every business for every family because less than one percent of the nation serves in uniform today. and yet you know they step up voluntarily and go overseas and do their

job and they're willing to lay their lives on the line for that and so... >>we owe this program? >>yes >>we do? >>yes we do as a society we do >>and if we don't do this if we don't continue to just from a media perspective if we don't continue to shed light shine a light copntinue to talk about these issues what is needed what's not being done what is being done what has to be done we are failing our vets is that fair to say? >>not only are we failing but then we're gonna be dealing with the sequela of not dealing with the problems right? >>yes >>then we see families in distress we see poor work productivity we see all the consequences of not dealing with upfront... >>homelessness >>a few second there are practical issues what else? homelessness? >>homelessness >>what else? >>well homelessness behaviorial health issues suicide a whole host of problems >>and families breaking up over this >>that wiill cost society more money will cost us more money if we don't deal with it in a preventative way >>it's the right thing to do plus it's the practical thing to do >>yes >>maria now thank you so much for doing this important work we can do it every day and more

work continues >>absolutely >>thank you al thank you maria appreciate it >>thank you steve >>thank you steve >>thank you >>stay with us we'll be right back right after this. thank you >>to see more caucus new jersey with steve adubato programs visit us online at www.steveadubato.org if you would like to express an opinion email us at info@cacusnj.org find us on facebook at facebook.com/steveadubatophd and follow us on twitter at @steveadubato >>mike ritzius is associate director of professional development and instructional issue the new jersey educaiton association good to have you with us >>thanks for having me >>we're about to see a video real quick something called ed camp s.t.e.a.m. which stands for? >>s.t.e.a.m. stands for science technology engineering arts and mathematics >>it's part of our classroom close up partnership with the njea they have a great series on public television called classroom close up there's a video we're about to see that tells the whole story that's all we need to know

right? >>yeah yeah >>let's look at the video we'll come back and talk right after this >>alright [music playing] [music playing] >>teachers love the experience of an aha moment i mean in the reality of this experience it's all endorphin releasing aha moments and the only difference is instead of with the students you're seeing aha moments with your colleagues and it's absolutely just as empowering and just as exciting >>educators came togehter to share best practices and explore educational technologies at ed camp s.t.e.a.m. an innovative professional development event aimed at exploring the intersection of science technology engineering the rts and math. ed camp s.t.e.a.m. is what is know as an unconference. free and non commercial it has no predetermined sessions participants generate the agenda on the day of the event and all sessions are discussion focused >>a camp inspires educators because it really recognizes them as professionals at a

traditional conference the expertise is usually in front of the room running the session at ed camp we say you're all experts you bring expertise in a wide variety of fields and we share that with each other >>i just want to see what's going on. i'm starting an after school club for the kids teaching scratch and i just want to see what other people have been doing and just take a look at some of the technology look at makey makey get to meet some people that's probably the most important thing is the networking for me >>this is the opportunity all educators administrators i don't care who you are where you're at i don't care what you're doing you have the chance to go out and get meaningful productive positive professional development. that's clutch >>along with the wide array of discussions this year's ed camp s.t.e.a.m. included hands on activities >>so we have a maker space today what we're calling the brainery and that's a section where people are able to try different things on and it could be something as simple as science experments

that you could do in your own kitchen at home to more complicated of using a microcomputer to watch videos on your old tv screen >>we're going to be showing the attendees how they could easily take a simple battery operated toy and adapt it for somebody with a disability can use it with an accessible switch so for example we brought sample switches so if you had a child who had impaired fine motor control and they couldn't access the buttons to turn this car make it go by adapting it through soddering it or to print alligator clips using alligator clips you can add a port for a switch so then the child could just hit the button or the ability switch and make the part go >>people are generally very excited after an ed camp and the nice thing about this type of event is that there's a lot of community building that goes on here and the connections they make are long lasting so the conversations that people have during their sessions and in the hallway they continue for a long time and sometimes people make very long lasting

professional connections at these events and neat things come from them >>this is powerful stuff i mean this is part of an overall initiative called ed camp right? >>yes yes >>who are these teachers who decide to go? >>it's open to everybody so one of the tenants of ed camp is that it's free it's open to anyone who's interested it doesn't have to be a teacher it could be a teacher a school administrator we've had parents come in we've had community members one of the best ed camp sessions i ever sat through was run by a corporate trainer from comcast and he was explaining how they train their technicians to be ready to go out in the field and it opened my eyes as a teacher cause i had to understand the world that my students were walking into once they left or schools the idea of teachers driving this whole thing why is that so important? >>um often times teachers feel like the professional development that they receive is imposed upon them they feel that it's not necessarily

the most relevant so at an ed camp at the very least a teacher can volunteer to facilitate a conversation for an hour and that is going to be the most relevant pd they've ever received. and then they also had their colleagues there sharing the things that they're doing in their classrooms and there's a lot of serendipity there's discuss... >>what do you mean serendipity what does that mean? >>so they're going to discover things that they've never even considered bringing into their classroom. since ed camp since ed camp's designed the schedule and the content day of the event they don't know what they're walking into and so they're going to be surprised by a lot of the interesting things that are gonna be shared during the day >>hold in mike what do you say to all those who say you're planning a conference every minute it has to be planned the structure of every minute coordinated every blocking... they have to have all the blocks and the coordination the details you say? >>nope don't need it >>[laughter] >>that's why it's called an inconference is that right? >>yup it's the opposite

of a conference so a conference like you said is a conference can be planned as far as a year out in advance >>yeah >>and >>what's wrong with that? >>well sometimes those things >>become irrelevant after a year and they're not the hot topic anymore >>but sorry we planned it a year ago >>mm hmm >>a lot of things happened here right? >>they do they do and that's not to say the conference the traditional conference model is a bad model you know it's... the two can be complimentary to each other and if you incorporate this unconference idea where you get people talking about the great things we're doing in the classrooms and sharing the pedagogical approaches and the tech that they're adopting and the projects that they're working on and you couple that with the content of a traditional conference and then you give a really powerful learning experience >>you love this? >>i do i love it >>30 seconds what's it done for you? >>oh it's changed my whole life you know it changed my whole perspective on how learning should happen and should be done and it's connected me to some of the

most forward thinking people out there so it's been a huge change for me >>whatever you're doing mike keep it going making a difference. good stuff. stay right there. glad we have a partnership with the njea cause we need people like you stay with us we'll be right back right after this it's really powerful >>to see more caucus new jersey with steve adubato programs visit us online at www.seveadubato.org if you would like to express an opinion email us at info@caucusnj.org find us on facebook at facebook.com/steveadubatophd and follow us on twitter at @steveadubato >>doctor katherine hempstead is director of coverage at the robert wood johnson foundation. good to have you with us? >>thanks for having me >>let's talk about what exactly is happening since the aca the affordable care act has been implemented the number of people who are in fact insured nationally

and in the state talk about it >>well we've seen a really big increase in the proportion of non elderly adults who are insured and in new jersey in particular we just released some really exciting results from a special survey that we fielded in new jersey that shows since 2013 we've had ractically... cut in half of the proportion of non elderly adults who are uninsured from 21 percent to 10.5 percent so that's a really big decline in uninsurance >>cut in half? >>yep >>put up the graphic if you could team let's put up the graphic break that down for us kathy >>well that's... >>kathy if you could tell us exactly why that's significant >>well that's really exciting and it's kind of a manifestation of the change in what's going on with coverage in new jersey and it shows some of the impact on our providers in the states so this is some really neat data that we're getting through our partnership with athena health which is a cloud based medical software company so one of the great things about this data is that it's very very current and in fact it goes through august of 2014 and what it shows is the changing share and the percent of patients in physicians offices who are uninsured versus medicaid

and you can see a real convergence of those lines and that really has a positive impact on providers and also of course it's great for patients >>so for the average person who is not a policy wonk if you will but cares about the fact that you want more and more people to be covered his is a positive sign but we do this program at the end of october we move into the november 15th to the february 15th second enrollment period >>mm hmm >>what is it that we're hoping for in that enrollment period? >>well i think we're hoping to see a continuation of the great trend that we saw in the last open enrollment period in new jersey and there's a couple reasons to be really optimistic in new jersey one of the things that's exciting to me is that we have two new carriers that are gonna be entering the market. so consumers are gonna have more plans to choose from when they go out there to look for their options on the marketplace. so that's... sure >>woah back up i'm sorry for interrupting, having more options always better? >>well that's a relaly good question one of the things

we're very interested in in the foundation is trying to make sure that we're supporting consumer choice in the best way that we can because this is actually a really complicated choice there are many different features of the plans and we're asking people to make a choice that's a lot more complicated than the choice that we might make in our employer sponsored insurance environment so yes in a way more choice is more to think about but we're also working to develop plan choice tools that will help guide consumers through the different facets of the plans >say that again. plan choice...? >>plan choice tools >>for example? >>well really it's a web based application in general and one of the things we're doing at the foundation in fact we've gotten a lot of new jersey carriers to participate with us and so it's a national demonstration but it's got a real new jersey bent to it is to have people compete to see who can create a web based application that can best support consumer choice of plabn in other words let a consumer enter information about themselves maybe that htey take a particular medication maybe that they expect to

use health services a certain amount and have an algorithm so to speak that would sort of guide them you know seamlessly through all these options and help put them in the place where they can make the best choice for themselves >>is it a fact that we... should it be less complicated this next time around in terms of signing up and the glitches or whatever you want to call them the things that we learn the first time around should it be easier this next time around? i think it should be and i think hat it will. i think everybody's learned a lot i mean this is really a pretty monumental achievement for a government the private sector and individuals you know as we just were saying this is a really complicated choice even under the best of circumstances, i think the fact that we have new carriers entering not just in new jersey but there's about 25 percent more carriers entering nationwide shows that carriers are realizing there's a demand for these products they think that there's an opportunity for them and i think sooner or later the whole insurance industry is going to migrate to a direct

to consumer environment not just in this non group market but overall that might take you know number of decades and i'm not gonna prognosticate but i can see that insurers want to be part f that so i think it would... we don't know yet but i think it should bode well for premiums in new jersey that we're gonna have new entrance in the marketplace >>who's left? meaning those who are not insured as we speak rght now and those who are what we're... excuse me that we're worried about not getting insured, who are they? >>that's a great question we've just been doing some research with people who are uninsured and i like to think about it as sort of a stop and a flow so there are eople that flow into eligibility all the time and those people are you know divided into those who are motivated and maybe less motivated not motivated at all so when we do consumer research with the uninsured population we see about 30 percent of people very motivated intending to find out what they're eligible for sign up right away. we see about 40 percent of people many of whom sat it out last time they're persuadable but

they're not sure. and then there is a group of people who for them either it seems unaffordable they don't think it's important they're very difficult to motivate and we find the most important things to tell people that we're trying to persuade are that financial help is available personal assistance is available and that there is a mandate and people, many people will have to make a payment even if they don't get insurance in which case they're paying for nothing >>excuse me final question the fact that new jersey state exchange didn't go that way and relied on the federal government make much of a difference in terms of enrollment? >>i don't think that it did? >>really? >>no i don't think that it did new jersey had a comparable enrollment relative to the eligible population, it's comparable to new york comparable to connecticut >>what does that tell you? >>well i think it tells me that new jersey had a very sophisticated state insurance department to begin with so i think there was a lot of knowledge there and it had a pretty highly evolved

non group market before the aca even started. and new jersey also expended medicaid which is the most important thing that was... >>the medicaid expansion was huge here >>huge. huge. huge here, huge everywhere. two thirds to three quarters of the coverage expansion we saw in fact was medicaid. >>two... >>so that's a very important part of it >>doctor katherine hempstead the director of coverage at the robert wood johnson foundation i want to thank you and also the foundation for continuing to do important work in this field and help all of us be involved in public awareness this remains one of the keys to this effort. thank you kathy. appreciate it. >>thank you very much >>the preceding program has been a production of the caucus educational corporation celebrating over 25 years of broadcast excellence. and thirteen for wnet. njtv and whyy funding for this edition of caucus new jersey has been provided by the new jersey education association md advantage insurance company of

new jersey td bank caldwell university new jersey manufacturers the russell berrie foundation and by new jersey natural gas transportation provided by air brook limousine serving the metropolitan new york new jersey area caucus new jersey has been produced in partnership with tristar studios >>new jersey manufacturers insurance company offers policies that can protect against auto accidents fires windstorms floods and many other serious and urgent situations. tips on what to do before during and after you're confronted with the unexpected are on the emergency preparedness section of njm.com. new jersey manufacturers helping the garden state prepare for the unexpected for nearly a century closed captioning provided by aciem studios

captioning sponsored by macneil/lehrer productions >> woodruff: a brutal attack on a school in pakistan by taliban fighters leaves more than 140 people dead, most of them children. good evening, i'm judy woodruff. gwen ifill is away. also ahead. they're off. the race for the white house begins. former florida governor jeb bush announces plans to explore a possible run for president then, >> there's times i'm walking down the street and i'm accosted. he didn't ask me for my name. first thing he said: are you on probation or parole? >> woodruff: the deep roots of racial bias and how it can affect the way some police officers enforce the law