dr. coburn. i want to back up a little bit. we have been talking about what we can do in the legislative branch and what you can do at cms and what we can do in law enforcement community. we have not talked about the roles of parents in this and parents are family members. talk a little bit about that. there are some communities doing a good job with federal involvement -- family involvement -- does anybody know? it cannot be just the government. when it's all hands on deck, we need all hands including parents. >> when we did the work and anti-psychotic drugs, we recommended that families need to be more involved especially when beneficiaries are in nursing homes and not necessarily aware of everything being prescribed on their behalf. we very much made the point that this was something that everybody needed to contribute in terms of involvement. >> others? how many of your parents? ok, everybody. you can speak, you can put on your parent at if you want. >> from the medicare perspective, medicare beneficiaries take many drugs a

dr. coburn talked about. and what i -- i opened this question to any of you who feel competent to answer it -- what part of the particular focuses on this population that is clearly vulnerable, they trust their doctors, want to get better. some of them have long term illnesses and some cases it's easier to try to medicate your way out of the illnesses than to talk with the family and get to the heart of what is going on: are there relationships between, for example, assisted care facilities nursing homes that are particularly problematic in this area that lead to this kind of abuse? >> i don't know i can directly answer the question, but with regards to the vulnerable population, the elderly being in nursing homes and some of these drugs being very powerful, we did do a random review of antipsychotic drugs used in the nursing home setting, and found that 88% of them were prescribed against the black box warning, clearly raising health concerns, and based on the medical record review we found 51% of the claims

dr. coburn? get you on the record a little firmer. cms supports the modification of part d program to establish a lock in? >> what i can say is that we but no official position, i believe it is time for congress to consider this change. >> semesters not have a position? it is time for the congress to consider it. it is not part of the president's 2014 budget mission, but advocate is time for congress to make the change. >> with your recommendation back up the change -- the chain at cms that would go along with congress writing the bill that would do that? >> yes, we are happy to support the committee. >> would cms go back up the lifting ofupport a the rules so insurers can protect patients and their long- term well-being by allowing them to transfer data on drug seeking behavior patients? principles that cms believes is we have to have greater data sharing to spot outliers, beneficiaries, pharmacies, and physicians. >> if i wrote a bill that would allow a little hole for the insurance industry that are managing this to share the data

dr. coburn said we don't have more money for uscis officers. we do. $3.6 billion more. and finally, dr. coburn talks about the trigger. look, let's face it. for many on the other side, the number one priority is securing the border. for many on our side, the number one priority is achieving a path to citizenship. the amendment proposed -- the bill proposed by the gang of eight we believe did both, but certainly there were many on the other side who thought that the amount we were putting into the border security wasn't enough, wasn't adequate, so we're willing to augment that in the corker-hoeven amendment which i'm going to talk about in a minute. but certainly what we don't want to do is choose one in place of the other, and the problem with the 90% which senator cornyn proposed was that under many different types of status quos and circumstances, an act of god, an administration that was decidedly against a path to citizenship and counted things differently or held up the count, you could envision no path to citizenship. that was out of the question for us. and so what we tried to do

dr. coburn and myself. in the cigarette will we can do. i appreciate what you are trying to do on your own authority. but what we can do to enhance your authority to facilitate what you are trying to do. i do not want to be here six years from now and say, we still have thousands of surplus properties that we should sell. i won us to have dealt with this issue in a smart way. thank you. have dealt with this issue in a smart way. >> thank you, mr. tangherlini, for being here. thank your family as well. i want to ask about the recent june i.g. report, that senator coburn referenced in his opening statement that is troubling. the conclusion that the management improperly intervened an -- award extension of of a contract and resulted in the contract being inflated. if you look at it, to have the gsa contacting officers tell that theythe oig feared for their jobs because they were trying to protect taxpayer interests and companies were able to go above their head and gets a more favorable officer to change a decision that was in the best intere

dr. coburn was raising. whether or not federal agencies have the flexibility to hire the talent that they need. we had a tough time in state government in delaware. retaining i.t. personnel. we took them out of the merit system and said, hey people what you need to pay them to retain good talent. on tom'sualify question, is that a problem or not with the federal government? it sounds like it is not as much as i might find. >> at the top ranks, it is not much of a problem. we have a turnover rate of about 18-24 months, which is pretty average. we havelow that that some of the issues. if you look at cybersecurity in particular, the private sector is able to attract talent at a rate that is much higher than the federal government. we are doing things to mitigate that, working on federal security to train the people that are on staff and to drive that forward. with technology jobs and the economy growing in the other category, it is putting a strain on the ability for us to retain talented people. andw into that

dr. coburn said we don't