there's no interoperable standard that's completed. we all want interoperable standard. if you want to save lives and cut costs to mauro you will vote for this amendment. let me explain why. under the into a kickback a hospital in a big city is prohibited from using their computer software giving that to the providers would it be radiologists or family practitioners or surgeons or obstetricians their purchasing power especially groups of hospitals and chains of costa was tremendous. they have the latest of their. if tomorrow there is no antikickback on just this section where they could share their software with all the doctors that practice after hospital you would automatically bring 50% of the hospital physician practice in this country up to the latest level of interoperable. you also would make them interoperable with their hospital and with another because they would be using the same system. so, instead of waiting two years and i think it is going to be 2012 until it's finished but let's assume and set of waiting two more years we could tamar a 150% of the physici

[laughter] interoperable. do you think that's something you would be willing to work on?>> very much so. my wife and i were not very far from the world trade center on 9/11, most of my family was in either new york or washington. none of us should be satisfied with where we are on public safety. chairman rockefeller, who stepped out, others on this committee have been leaders on this. as one of your colleagues mentioned earlier, 9/11 commission urged the country to do something about public safety interoperability, and we have to do it. it's just not acceptable that firefighters and police officers arrive at the scene of an emergency and can't communicate with each other, and we have a new opportunity now that we need to seize, i think, as quickly as possible around mobile broadband. now that we're through the digital television transition, there's spectrum available for advanced mobile public safety applications for our first responders. i don't think we can move too quickly in tackling that, and it's something that i look forward to working with you on. >> thank you. >>

i did that for years and saw first-hand some of these interoperability issues. when we had a bridge collapse and had done a very good job of interoperability because of our shariff and others and then i have seen difficulties in the past and some of our rural areas with that and it seems to me that is just one of the areas of our nation's information for infrastructure, that may continue to luby's, absent some federal action and federal involvements in terms of making our emergency services more interval. is it in trouble? that is a trick question. interoperable? i think that is something you'd be willing to work on. >> very much so. my wife and i were not very far from the world trade center on 9/11. most of my family was in either new york or washington. none of us should be satisfied with where we are on public safety. chairman rockefeller and others on this committee have been leaders on this, as one of your colleagues mentioned earlier. 9/11 commission urged the country to do something about public safety interoperability and we have to do it. it is just no

some of these interoperable in the issues, -- we had a bridge collapse. they had a very good job of and probability. i have seen difficulties in the past and as some of our rural areas with that. it seems like that is one of the areas of our nation's infrastructure that may continue to elude us absence of federal action and federal involvement in terms of making our emergency services in trouble. -- interoperable? is that something that you could work on? >> my wife and i were not very far from the world trade center on 911 -- 9/11. most of my family was in new york or washington. none of us should be satisfied on where we are with public safety. other members of this committee have been leaders on this. as one of your colleagues mentioned earlier, the 9/11 commission urged the country to do something about public safety and interoperable already. we have to do it. it is not acceptable that firefighters and police cannot communicate with each other on the scene. we need to move as quickly as possible around mobile broadband. now that we're through the dig

interoperability is key because it involves a whole range of different players along the full life cycle of the product and that is one of the great challenges. as we move forward in developing and implementing a trace ability program, we need to work very carefully with industry and with the different components of the food production system. we need to do it in the context of public meetings and open exchange. but that should be our goal, absolutely. >> in the draft legislation that is exactly what we do. we give the fda authority to work with industry and consumer groups to develop the specific types of trees ability technology and the interoperability. correct? in other words, we're not saying, a different sectors of the food industry have different types of trees ability requirements. we're not saying we have a one-size-fits-all, correct? >> do you think there is an economic case to be made for better trace ability? >> absolutely because with the opportunity to really to add acquit trace back we can target what are the components ordeal the products that are causing the problem and

could you talk, admiral, a little bit about some of the interoperability between the agencies. if things are being done in the most efficient manner between the interagency cooperation, some of the challenges you might have faced, what's the best practice and, you know, what are our successes and what challenges are you facing in the meld there? >> yes, sir, we did address that at some level and what i said very quickly is it's better than it will ever been. it will get better. and we are now at the point where the structures that have evolved to provide the venues for these kinds of interactions to occur. now it's a matter of the people getting the knowledge of each each other's organizations and

working in partnership with that office, the national institute for communications interoperability would address the most critical issue facing the first responder -- community today. their ability to command and control emergency resources in response to terrorist acts, natural disasters, and crimes through interagency communication. this project will not only help to make our nation safer by demonstrating how various regional emergency responses can better coordinate, but it will help to ensure that local, state, and federal tax dollars that have already been allocated in previous homeland security measures and in previous budgets throughout the united states are used more wisely. the primary goal of this project is to ensure the best possible use of taxpayer money by public safety officers and first responder organizations. federal, state, and local governments have invested a substantial amount of capital as they should have on first responder equipment, emergency plans, and safety personnel. it makes sense for congress to support a project that will help to coordinate these efforts

doing it on a voluntary basis before requirement but extremely, a complex system of creating that interoperable system that can see lifecycle all the way through of the products. the specific language in the bill, the full pedigree of each product gives us great cause for concern also removed down a path of hundreds of millions of dollars invested in interoperability systems we don't think they may be to the terms of this bill. we was strong reifies fda the mandated to be involved in the technology, pilot test come and learn about each industry and then it right to the regulation. it is premature to tell every industry exactly how we should be done until we have the greater learning. >> one of the stairs we have alluded to is the mexican pepper scare that adversely impacted the tomato industry. we'll ask you again how to reinsure that foreign producers need that kind of standards that we would need would it require a foreign producer verification system of some sort? >> the requirements are appropriate importers will be required to register with the fda and is part of good practices they have t

had our bridge collapse in our area right in the metropolitan area had done a very good job of interoperability because of our sheriff and others and i've seen difficulties in the past in some of our rural areas with that and it seems to me that's one of the areas of our nation's information infrastructure that may continue to elude us absent some federal action and federal involvement in terms of making our emergency services more int intraoperable. do you think that's something you would be willing to work on? >> very much so. my wife and i were not very far from the world trade center on 9/11. most of my family was in either new york or washington. none of us should be satisfied with where we are on public safety. chairman rockefeller, who stepped out, others on the committee who have been leaders on this as one of your colleagues mentioned earlier, 9/11 commission urged the country to do something about public safety interoperability and we have to do it. it's just not acceptable that firefighters and police officers arrive at the scene of an emergency and can't communicate with each other

mitoc provides communication services to disaster sites to make interoperable communications where it did not exist and these -- in these public venues. mitoc has been deployed to areas around the country to help them solve the interoperable need for communications in the disaster scene when no other communications systems were work, including texas in hurricane ike and recently in kentucky in the massive ice storm throughout the entire state. so these are research projects producing results that the department needs and asked this consortium to do and is engaging in the intellectual firepower of these universities and colleges in kentucky and their counterparts throughout the country. and it's one of the best things the department has ever done. i'm happy to say it's in my home state of kentucky. i yield to the gentleman. mr. price: if the gentleman will yield, i want to commend him for his advocacy of these outstanding programs and join him in opposition to this ill-conceived amendment. >> i reserve. mr. flake: may i inquire as to the time remaining? the chair: the gentleman has thr

health care has to be the only industry in the country that hasn't gone to an interconnected, interoperable information technology system. that's part of where the gentlewoman is going. but the other part, and this is a great point, is we have to begin to have our reimbursement system structured in a way that we incentivize the quality of care rather than the volume of care. we should not just talk about how often theatient comes to see the doctor and reimburse based solely on that. we should be reimbursed based on what's the appropriate setting for the patient. where would the patient rather be? and where is the patient going to get the highest quality care? and we don't do that right now in our health care system. and if you have a chronic disease, there are some cases, certainly it would be on an individual basis, in conversation with your physician, where it should be determined based on reimbursement, based on money, what setting you are going to achieve that care, get that care, but it should be what's the best outcome likely based on the setting that you get? if home and community-ba

and $80 million for command, control and interoperability research and development. these important programs will benefit first responders in all of our communities. the bill also includes $887 million for the urban areas security initiative. nearly $50 million more than f.y. 2009 and this is the only program designed to exclusively assist high-risk urban areas such as new york and i thank the chairman for substantially increasing its funding. however, i would be remiss if i did not mention the securing the cities initiative which is not funded in the bill. this program seeks to prevent the smuggling ofs i list nuclear material into man hat -- of illessity nuclear material into manhattan. it is the number-one terror target and i hope the signed into law includes money for securing the cities. i know there are concerns due to the length of the project and unspent funds but i do believe we must do everything we can to prevent what president obama has called the most immediate and extreme threat to global security. this is still a good bill and i thank the gentleman fro

only industry in the country remaining, major industry, that has not gone to an interconnected, interoperable, computerized system. i would ask my colleagues to think about the fact that the gentleman's from connecticut, i'm from pennsylvania if we go to san diego and we put our bank cord in the machine, we can pull up all of our financial records in a safe and secure way, never think about privacy or any type of intrusion, you take for granted that that's going to work. few but if you show up on that same trip at the emergency room in san diego, they don't have any of your records. they don't have your history, your family medical history, they don't have your allergies, they don't have any of your imaging, your x-rays and so forth. they're going to ask you half a dozen times when you're there, what are you allergic to? can you fill out these forms? and most importantly, how are you going to pay? but if we went to a system like every other industry has, where you have an electronic health record that goes with you every where you go and has those records for your family history, your persona

every american with any device, particularly cellular phones. 211s need a system of interoperability with one another. we're in desperate need of congressional help to ensure a level response and meeting everyday needs. fortunately, congress can cure this will ability during this session by passing the 211 act before the next disaster. we are extremely grateful for your steadfast support of this legislation and a co-sponsor ship of the bill and ability to deliver on dedicated federal funding for louisiana this year. thank you for the opportunity, and i welcome the opportunity to answer questions. >> thank you very much. i appreciate the content and thoughtfulness that wanted to your testimony. i would like to start with a question here to you about this chart, the national shelter system. i know this was probably in your testimony, but could you take a minute to explain -- these are the only official red cross shelters, and would you describe most of them as school buildings, or most of them as churches or places where people were shoot? -- were shipped -- worship? how can you descri

industry but we cannot have a one size fits all trace ability system or technology the key is to be interoperable so if you have peppers and tomatoes and mixed in a salsa that is one level of complexity but if this also is incorporated in a process food, that is another layer then put into a restaurant or any place that is another layer. we have two work on that. i am amazed we do have the technology we just need to work on it i hope you work with us to improve the language. thank you for your indulgence mr. chairman. >> i had to take a deep breath because mr. mathisen and chairman dingell, we have tried -- tried to educate the committee with the electronic pedigree with regard to drugs now there is an interest to do something expansive with pedigree with food is so stop and ponder and think about this because as we move to the drug's safety bill it is reason i went right at the fda commissioner you can say hubbell level of interest to make sure they go after tainted food but with regard to drugs that is different we will not send this message to the country that's tainted food bad lettuce is awf

11, shockingly, we still have not made good on the 9/11 commission's recommendation to build an interoperable public safety communications network. so from addressing these challenges and others to maintaining the openness of the internet, which many of us i think you know care about passionately, as well as maintaining a laboratory for invasion, i think you're going to see some of the biggest challenges we face in this field. but i'm confident that this commission is up to the task of implementing the president's technology agenda, so we look forward to a swift confirmation and we particularly look forward to working closely with you. and we hope that you will commit here in the hearings to a strong, candid and, you know, really cooperative relationship with the committee. >> for those of you who may be trying to figure out how to pronounce his name, we've had researchers at work for three days on that. and it's pronounced chow. >> well. we changed our name. it's janikowski. >> all those people are going to be laid off. i hope that you would introduce your family. >> thank you to you for you

equipment, and we look forward to standards for interoperability. and we thank you for the investment in comparative effectiveness research to enhance quality medical care. [applause] in your budget, you used realistic numbers about the cost of treating medicare patients and you charted a course to replace the senseless medicare physician payment formula and you're the first president to do it and we thank you for that. you've recognized that medical liability concerns contribute to rising health care costs and we appreciate your interest in addressing this problem. it is critical to the physicians of this country. friends, i've had the opportunity to meet president obama at the white house and i can attest to his willingness to listen and engage. his focus on health care reform and the flight of the uninsured and the concerns of those involved takes a courageous spirit and wise judgment. and we're grateful for his leadership system of please join me as the american medical association welcomes the president of the united states, barack obama. [appl

etiquette of telecommunications devices particularly cellphones. 211 need a system of national interoperability with each other and other three digit numbers. senator leandro, we are in desperate need of congress helped to ensure boat reliable response to disasters and everyday needs, fortunately congress can cure this vulnerability during this session by passing the calling for 211 act before the next event occurs. chairman landrieu, we are extremely grateful for your steadfast support of this legislation, for your co sponsorship of the bell, and your ability to deliver on dedicated federal funding for louisiana 211 this year. thank you again for this opportunity and i welcome the opportunity to answer questions. >> thank you very much. i really appreciate the contents of all of your testimony and the thoughtfulness that went into its ear and out like to start speech that -- mr. mascelli about this chart, the national shelter system. i know that this was probably in your testimony in some detail, but could you take a minute to explain, these are all in the only official red cross shelters in

the bill also addresses the shortfalls by requiring the fda to establish an electronic interoperable record-keeping systems that manufacturers would be required to use. this measure will allow the agency to quickly trace the source of an outbreak back to its origin and minimize the number of individuals affected by a food-borne illness. by shifting the responsibility on the manufacturers the draft recognizes the crucial role the fda needs to play in this realm. it requires the agency to set standards for food safety and hold the food industry accountable for meeting those standards. it provides the fda with stronger enforcement authorities such as recall authority and access to records. the bill also increases the inspection and frequency for food facilities requiring that the fda inspect facilities at an established minimum frequency. now, we're going to hear today from industry experts about the various provisions in this discussion draft and i look forward to those conversations. i hope that we can all continue to work in this collaborative manner as we move to mark up of food saf

could you talk, admiral, a little bit about the interoperability between the agencies. if things are being done in the most efficient manner between the interagency cooperation, some of the challenges you might have faced, what's the best practice and what are our successes and what challenges are you facing in the meld there? >> we did address that at some level, and what i said very quickly was it's better than it has ever been. it will get better. we are now at the point where the structures have evolved to provide the venues for these kinds of interactions to occur. now it's a matter of the people getting the knowledge of each other's organizations and traditions and frankly languages in order to talk to the efficiency of it. the trend is certainly one in the right direction. we are way ahead of where we thought we might be a couple of years ago. >> this is totally unrelated. but an area of particular interest for me. discuss what you can about our attempts and our movement to the nonlethal field. where we're at on that. whether vehicle stops or personnel stops -- i

really needed as we mentioned earlier the full supply chain to be documented in integrated, interoperability, not just fragments here and it's really key to successful and swift investigation of outbreaks in the ability to control the problem and prevent future exposures to contaminated food product. >> thank-you. just the way we are proceeding, mr. markey is going to go out and he is our last questioner for you, dr. hamburg. we have won the votes, we'll be right back after that and then we will start with the second panel so mr. mark kikkoman thank you mr. chairman very much, congratulations dr. hamburg. you may know that i have a bill that calls for bpa to be banned from being used in food and beverage containers because of the risks that have been identified. we have also recently learned that food and chemical industries have launched a public-relations campaign opposing any efforts to deal with this issue. is the fda concern about bpa? and what does the fda plan to do about those concerns? >> well, we are concerned. certainly i am aware of some of the study is that have raised issues in

those things be interoperable and if you have tomatoes and sauces mixed in a salsa and if you have that salsa incorporated in a processed food that's another layer of complexity and then if you have that put into something at a restaurant or any place that's another layer. we do have the technology and we just need to work on it. i hope you all will work with us next week to work on this. thank you for your indulgence, mr. chairman. >> mr. boyer? >> i had to take a deep breath because mr. matheson and i and i guess now chairman dingell and gene green -- you know, we've taken this -- trying to educate the committee here on electronic pedigree with regard to drugs, yet, now all of a sudden there's this great interest to do something expansive on pedigree with food. so i just want you to stop and ponder and think about this, mr. chairman, because as we move to the drug safety bill you can't say you have this level of interest to go after tainted foods but with regard to drugs, that's different. we're not going to send this message to the country that tainted food, bad lettuce, that's reall

of them being web tech and we're working with all the freight railroads to make sure we have interoperabilitytween them and us. >> i asked the question because it's important in the total accounting of jobs created by this investment. it's important to follow the line, the supply chain back from the job site. because those are jobs that didn't exist either. >> yes, sir. >> before this recovery funding. i recall so well just a month after the president signed the recovery act. a young civil engineer, my home town of chesapeake moved away and got his degree in engineering and found work with a civil engineering company doing highway design work. and he came into the office here to see me and said i want to thank you and the congress, the president, because i'm back at work. i had been working for a year with this company, but was laid off in the recession took hold. but now before any projects were under way, the company called me back, said we know we are going to have a number of projects to bid on and we need to put you to work. it just turned out he had a weeks vacation time coming after be