service center the price is 7985? >> that is the amount the patient pays and the center receives. what do you replace for someone on for medicare or the medicaid are the hospital outpatient visit interesting phenomenon talk about the quality of replace other procedures performed in the inventory service centers with the cms authorize replacement? >>. >> we had studies and risk testimonies that are superior to the hospitals not all outpatients should end up in the surgery center maybe they are too old or there is a lot of reasons why to go to the hospital but a healthy individual especially medicare or medicaid it saves thousands of dollars. >> so not every hip replacement should be performed in the ambulatory service center but that should not bar them so is there any disagreement with that should cms allow hip replacements to be done under certain circumstances? >>. >> yes. as long as we have data. we don't have data right now. >> if they're not allowed to be done then you will not have the data if they are and it sounds like there is data about the quality measures of hip replacements done. >> but they need to be monitored by the independent

centers for medicare and medicaid services estimated twenty seven thousand spending was up four point six climbed nearly three point five trillion and i was going to jump up to five and it gets even worse yes because what they're saying is there's a lot of numbers in between but ultimately what what's coming out is the c.m.s. projected that by twenty twenty six health care spending is projected that it will reach five point seven trillion trillion with a t. wow all right as we go to break court watchers don't forget to let us know what you think of the topics we've covered a big book and twitter see our poll shows at our t.v. dot com coming up sean stone sits down with mark stage the director of studies for the institute of medical studies to discuss the. factor and then texas finally lifted the oppressive bad. swords swords. strange esoteric thought some sword play coming up next stop watching the hawks. in twenty forty you know bloody revolution here to correct the demonstrations going from being relatively peaceful political protests to be creasing the violent revolution is always

and on c-span3, centers for medicare and medicaid services administrator sue ma verma and u.s. comptroller general gene dodaro talked to members of congress about combating medicaid fraud. that's tonight at eight eastern on the c-span networks. ♪ ♪ >> c-span's "washington journal" live every day. coming up tuesday morning, with just over 50 days to go until election day 2018, politico campaigns editor steven shepard will preview key house and senate races. and then rand corporation's senior adviser brian jenkins discusses the state of homeland security 17 years after 9/11. be sure to watch "washington journal" live at seven eastern tuesday morning. join the discussion. ♪ ♪ >> tomorrow is the 17th anniversary of the september 11th terror attacks. on c-span we'll have live coverage of president trump's remarks in shanksville, pennsylvania, scheduled to start at 9:30 a.m. eastern. on c-span2 from new york city, the annual ceremony and reading of the names of those killed at 8:10 a.m. eastern. and on c-span3, we'll take you to me moral service at the pentagon. that starts at nine e

. >> who heads the centers for medicare and medicaid services, testified alongside u.s. comp roller, general tina come about combating medicaid fraud. at a senate homeland security and governmental affairs hearing, the two were also asked about drug pricing, and a newly expanded -- extended period for short-term health plan. this is two hours and 15 minutes. >> this morning, we will come to order. i want to think administrator, verma, and general todaro. okay. i generally get it right and. good. okay. well, we certainly appreciate you coming for us, this is a follow-up hearing to our june 27 hearing, where we explored the report on overpayment, primarily medicaid, and, we have an administrator here, talking about some programming issues, she announced in june, and so we will have you testify, and then we will have the general comment, on how we can make these programs, kind of long-lasting. i would ask, that might written opening remarks be entered in the record, and i just got a couple of charts, that i -- are in front of everybody. i think, to the witnesses have charts

and here on c-span 3, senators for medicare and medicaid services, and u.s. comptroller general talked to members of congress about combating medicaid fraud. that's tonight at 8:00 eastern on the c-span networks. >>> sunday night on q & a, historian richard norton smith discusses his biography of herbert hoover. >> hover said when all is said and done, accomplishment is all that matters. it's an unsentimental -- the sort of thing you would expect an engineer to say. and that's one of the keys to understanding his life. his success in everything but the presidency. >> sunday night at 8:00 eastern on c-span's q & a. >>> up next, a discussion on space based missile defense priorities with pentagon officials, including the head of the missile defense agency. they talk about potential threats and the lat

for example in april, senators from medicare and medicaid services administrator stephen berman announced by january january 29th team, hospitals that participate in medicare, medicaid must list their current standard prices online. in an age when you can compare different prices in check a dozen reviews when shopping for a new barbecue grill, america should be able to know more about the cost of their health care. senator murray. thank you, mr. chairman. thank you for your comments. i will be leaving shortly to get back on the floor to help manage that and appreciate your support for that as well as much of her work here. thank you for witnesses today and looking forward to hearing about her amazing work on amazing organization is the health alliance from her estate. the alliance was an incredible advocate for her value and health care and taking on very impressive projects to increase transparency in employers and health care providers across our state with information that they can use to provide patient care. one report from the alliance details how improvement to our health system co

. >>> centers for medicare and medicaid services administrator seema verma was on capitol hill recently answering senators' questions about medicaid fraud. top democrat on the senate homeland security and governmental affairs committee took the opportunity to ask her about the administration's actions to lower prescription drug prices. here's a portion of what you'll see tonight at 8:00 eastern. >> are you aware of, since april, if there has been any outreach since april regarding the price increase? >> i can't speak specifically. not necessarily from my department, but one of the things we are concerned about is making sure that we have transparency around all of these increases. it's one of the things that we took action on earlier this year. to put out our drug dashboard which provides transparency to the american public about the yea year-over-year increases in drug pricing. we think it's important that people have that information. >> do you agree that the secretary would have the ability to negotiate directly with coleo to reduce part "d" spending if he chose to do so? >> generall

. >> who heads the centers for medicare and medicaid services, testified alongside u.s. comp roller, general tina come about combating medicaid fraud. at a senate homeland security and governmental affairs hearing, the two were also asked about drug pricing, and a newly expanded -- extended period for short-term health plan. this is two hours and 15 minutes.

service providers at local paic centers. there are currently 124 paic organizations in 31 states that serve over 45,000 medicare and medicaid beneficiaries, enabling them to live safely in the community through the fully integrated services and support provided. this allows beneficiaries to live longer, experience better health, and have fewer hospital visits. seniors facing health challenges should have the option to receive high-quality health care while continuing to live at home and programs like st. joseph paic in my district allow them to do just that. in 2016 c.m.s. released a proposed rule to update the original guidelines from 2006. a bipartisan group of members of congress sent letters in november of 2017 and june of 2018 urging c.m.s. to prioritize updating the existing regulatory framework, which is more than a decade old. the agency was unfortunately not take -- had not taken any action. this much-needed update would allow paic programs to customize their interdisciplinary team around the needs of each enrollee, provide more services in the community, and give greater flexibility to partner with community provid

let me start with you, in april, your association commented on the centers for medicare and medicaid servicesproposal to expand the availability of short-term plans. you wrote that you are, quote, concerned that substantially expanding access to short term limited duration insurance will negatively impact conditions in the individual health insurance market, exacerbating problems with access to affordable conference of coverage. one of the reasons you stated was that short-term plans are, quote, offered to consumers only after submitting information about their health status or prior medical conditions. we spent a lot of time focusing on paperwork burdens that providers and insurers deal with in our healthcare system. one of the problems with the trump administration's sabotage of our healthcare system is the paperwork burden it will impose on patients and families. so can you tell us more about the information patients are often required to submit to purchase short-term plans? >> sure. thank you, senator murray, just as a basis -- basic starting point it's important to note we have supported

. >>> centers for medicare and medicaid services administrator was on capitol hill recently answering senators' questions about medicaid fraud. the top democrat on the governmental affairs committee took the opportunity to ask her about the administration's actions to lower prescription drug prices. here's a portion of what you'll see tonight at 8:00 eastern. >> are you aware of since april if there has been any outreach since april regarding the price increase for naloxone? >> i can't speak specifically, not necessarily from my department, but one of the things we are concerned about is making sure we have transparency around all of these increases. it's one of the things we took action on earlier this year, to put out our drug dashboard, which provides transparency to the american public about the year-over-year increases in drug pricing. we think that's important people have that information. >> do you agree that secretary azar would have the ability to negotiate directly to reduce part d spending if he so chooses? >> generally what we want to do and our strategy around drug prices

advocates, with pharmacists about these clauses and asked the c.m.s., the centers for medicare and medicaid services, to prevent this administratively which they could have done but they failed to do so. finally, months ago, this year, i filed two bills as companion legislation to the measures we're considering today by senators collins and stap gnaw and was joined by -- stabenow and was joined by 32 members of the house in supporting and sponsoring those measures. this patient right to know drugs prices act, the house version of it, was endorsed back in june by the national community pharmacist association, by the -- thereafter by the national association of chain drugstores and by the american psychiatric association. madam speaker, i would ask unanimous consent to insert their letters of support into the record. the speaker pro tempore: without objection. mr. doggett: i'm pleased that finally our house republican colleagues have agreed to approve this proposal today. with families nationwide concerned about soaring drug prices, this legislation would end a restrictive anti-competitive, anti-consu

we would direct the centers for medicaid and medicare services to offer an insurance policy on the exchange that anyone could buy if they wanted to. the insurance policy would over the obama pcare essential health benefits. medicare doesn't have to collect a profit. medicare doesn't have to pay taxes medicare doesn't have to pay fancy salaries, doesn't advertise on the evening news. it has a distribution network. if medicare offered this policy it would be significantly less expensive than what private insurance would offer. but they would recover a premium for it. so it's not going to increase the deficit or taxes. if you qualify for an obama care health subsidy you could you th to bring the cost down but we wouldn't force anybody to buy it. it would be available. i think what americans need is more choices and they need lower costs. that's what medicare x would do. >> you were governor during the virginia tech massacre so you have a unique perspective on this. after the shootings in parkland, florida, and a number of other school shootings there's been a lot of passionate debate about tra

new headle there is a of social services and a new medicaid director who has previous private management from other states. and a new actuary has been hired and we have now renegotiated manageds with current organizations and we are looking to add a third next year. we are able to i have talked to a lot of providers in my own senate district who had issues with getting paid by mco's initially. it they are telling me it's getting better. i think we will continue to see that system get better as time goes on. our commitment in the senate republican caucus is to make sure that gets them as quickly as possible. it that is what the governor once as well. as far as getting rid of federal deductibility, we didn't do anything to jeopardize matching funds from the federal government when we got rid of federal deductibility in our tax bill this year. took theid was we the state tax revenue we were going to get, that was more money they were going to have to pay in state tax, and we decided to give that back through an across-the-board income tax cut and we phase of -- the elimination of deductibil

for example, there is a new department of human services director, a new medicaid director who has previous private managed care -- managed care medicaid experience. a new actuary has been hired. now we renegotiate contracts with the current manage organizations. and we look at a third next year. we are able to provide how much care will cost based on actual experience rather than just estimates. i have talked to a lot of providers in my own district who had issues with getting paid by mco's initially, most of them are timely it's getting better. i think we will continue to see that system get better as time goes on. our commitment in the senate republican caucuses to make sure that gets done as quickly as possible. i know that's governor reynolds as well. we don't do anything in my knowledge that jeopardize -- did, the amount of the additional state tax revenue. was's more money than i'll have to pay in state tax. we decided to give that back to taxpayers through an across-the-board income tax cut in your one. then we phase and the elimination of federal deduction ability over the next cou

as an example, in the center for services,nd medicaid only asc report on such adverse excepting. wrong site surgeries and hospital transfers. 2012, asc's have been so consist than that they have proposed to eliminate them, that measured performance rying that meaningful disturbances can no longer be measured. group like the ambulatory surgical center to declare victory and move on. we believe these metrics are so elementary -- elemental, we will ask to keep them. to expande reporting andrequire us to report that other sites do the same. will find, a growing body of academic research shows that we are achieving equal or better outcomes than other outpatient surgical facilities while saving billions for bose patience and public and private sector. patients to empower get the best by you for their health care dollars, both price and quality data must be transparent, meaningful, and comparable. thank you for inviting me to participate. i look forward to answering questions. >> thank you and thank you to each of you for interesting testimony. senator murray. >> thank you. let me start

as example, the centers for medicaid and medicare services alread quality performing progr, only asc's report patients falls, wrong site surgeries, and hospital transfers. soce 2012, asc's has been consistent that cms has suggested eliminating them, " meaningful distinctions can no longer be made." that group usually leads a group like the ambulatory surgery organization, which advocates for the asc's, to move on, however, we think it is so important that we will ask cms to keep them. in fact, we want the recording to expand and require us to report on adverse events for all patients and other sites of service to the same. as you will find in my written testimony, a body of academic asc's arehows that achieving better or equal outcomes saving billions of dollars. if we are to truly empower patients to get the best value for health care dollars, both bece and quality data must transparent, meaningful, and comparable across all settings for thank you again inviting me to appear in today's hearing, and i look forward to answering questions. sen. alexander: thank you, mr. tippets. we will

we proceeded to work on ways that our committee, with its jurisdiction over medicaid, medicare family services and customs could work to improve the lives of the millions of americans who have been devastated by this devastating epidemic. mr. president, there are simply too many pieces of this bill to cover them all in one speech, but i'd like to give some highlights. the bill will make a real difference in medicare, a program in which one in three beneficiaries is prescribed an opioid. it will empower patients through information on paying treatment alternatives, it will expand treatment options for patients suffering from addiction, including through increased access to care via telehealth in a pilot program that will allow medicare to cover methadone and wrap around services to treat addiction for the first time. the bill also increases the ability to track opioid prescriptions to prevent misuse an diversion while making sure that patients get the medication they need. we know many children are in foster care as a result of the opioid epidemic, and this bill supports programs that will help

same working families, you have to pay for it it in interest and in cuts to medicare and medicaid and other services. now, there is another really important point about this to which -- which mr. kind addressed, because just like the bill we will take up tomorrow, just like the bill we're taking up right now, just like this huge republican tax sham, there is much in common. number one thing in common, not one official in any of the departments, in the trump administration, had the guts to come over and face our committee and answer questions about it. they did not bring a single trump administration official to discuss ex-- discuss, explain, justify, see how any of this conforms with all of his campaign promise, none of that, on any of these bills. and they kept their bills in secret until the last minute after having no public hearings, inviting no businesses, no academic experts from around the country, they plop these bills out and rush them through just as quickly as possible so they'll be as little consideration as possible. then they talk about the desire for bipartisan comity after doing this

states to help them reform and strengthen their medicaid programs, whether it be seniors living in the community through the support of personal care services or the respite care that allows a parent to keep their child with a disability living at home. i've seen firsthand the difference that the medicaid program makes in people's lives. i believe that medicaid is more than a safety net. it's a lifeline. one that needs to be preserved and protected for those who truly need and qualify for it. for all of medicaid's recipients, we work to provide for the best quality of life, quality of care, and access to care so that they may live healthier, more fulfilling, and more independent lives. however, i believe that medicaid should be stronger to ensure that no deserving americans fall through the cracks. we must and we can serve them better. the status quo is not acceptable. when the federal government established the medicaid program, it was intended to be a partnership between the federal and state governments to care for society's most vulnerable citizens with both jointly contributing towards the costs. however, that relationship has changed

governor, and the state is still awaiting approval from the federal health and human services to add work requirements for medicaidefi. kentucky, the first state to have its work reirements for medicaid recipients approved, ipwas sued by medicaid recients in the state. a federal judge ruled that the mandate was "arbitrary d capricious" and vacated that approval. that decision could have repercussions fomultiple states that have submitted similar requests for work requirements. for more, i spoke recently with sara rosenbaum, a professor of health law and policy at george washington university milken institute school of public health. sara rosenbaum, thanks for joining us. so let's first talk about kentucky. it was poised to be the first state the country to add wor requirements for some medicaid recipients, but just days bef ee takiect, a judge blocked the new rules. why? >> kensatucky's pro like the proposals in other states, ally boiled down to removing people from medicaid. the state by itsf projected a 15% drop in medicaid beneficiaries, and what the judge said was, you haven't shown us how an experiment on the

that came out that said that state unions can't take medicare funds or medicaid funds from the people who perform home healthcare services. believeit or not, that's a multimillion dollar it to the unions . because they've been taking, they've been getting these home healthcare workers who by the way, often it's for their kids or relatives they work for, that's who they are providing the service to and i don't know whether it's going to be a walkout strike against your child when you're the only employee but they're going to make it so you can't, they're going to change the rule, obama changed it already and they can't use those money for union dues so that will be huge. theyare being arraigned in . >> thank you everybody. [applause] >> andy will be signing books in the hall. >> look up there, just about on time too. i will sign books for anybody who was like one side. >>. [inaudible] >> c-span, where history unfolds daily. in 1979, c-span was created as a public service by america's cable television companies and we continue to bring you unfiltered coverage of congress, the white house, the supreme court and public polic

services that is essential. some of the byzantine rules of medicaid and medicare prevent appropriate care and duration of care for what is a lifelong illness, addiction. there have been new guidelines from cdc which lilly endorses to limit opioid prescribing to seven days or less. the percent of patients after surgery, 99% are discharged on an opioid and one out of 15 becomes addicted. so we have to reduce exposure and reduce use. takeback programs are an important part of that -- as opioids that are unused get recycled and used by addicts. we have got to take them out of the system. maybe from my position, the most important thing we can do is invent pain medications that are nonaddictive. i think ultimately that is what our industry has contributed. we have a robust effort in that area. pain management is one of our core five therapeutic areas. we have several late stage projects now, including one which will ramp up next year, hopefully we submit to the fda and launch in late 2020 which will be indicated for arthritis pain and chronic back pain, the two most common uses of opioids. and perhaps this will presen

documented or seeking to enter if they've ever fallen on hard times and utilized government services like medicaidal policy changes that reflect hostility to immigration among the people and inside the administration themselves like steven miller. their apparent belief that the immigrants are a drain on the welfare system happens to be untrue. undocumented immigrants can't even receive government aid. according to the conservative cato institute, first and second generation immigrants consume 33% fewer welfare benefits than native born people who have been here three generations or more. more "am joy" after the break. take this left. if you listen real hard you can hear the whales. oop. you hear that? (vo) our subaru outback lets us see the world. sometimes in ways we never imagined. you wouldn't accept from any one else. why accept it from your allergy pills? flonase relieves your worst symptoms including nasal congestion, which most pills don't. flonase helps block 6 key inflammatory substances. most pills only block one. flonase. start with 100% cleancheese? ingredients. like vermont white ched

it provides grants to state medicaid programs to help increase the number of substance use disorder providers and services. it increases access to mental health and substance use disorder treatment for children and pregnant women covered by chip. it ensures former foster youth are able to keep their medicaid coverage across state lines up to the age of 26. and it improves the continuity of medicaid coverage for juveniles in the justice system. i'm also pleased that we have been able to improve upon the house-passed i.m.d. policy. this bill adds new safeguards to ensure that states continue to provide an adequate level of outpatient services and offer medication assisted treatment. it does this by making clear that this policy does not impact the more comprehensive efforts to provide care and i.m.d.'s that is ongoing in many states today. h.r. 6 also includes provisions from my legislation, the screen act, that will give the food and drug administration the ability to take action against illicit controlled substances coming in through international mail facilities across the country. f.d.a. will now be abl

medicaid programs. [applause] he has proposed regulations to allow health care providers to refuse to perform services thatt with their religious and moral beliefs. [applause] gardenaid from the rose on the day of the right to life march, in my administration we will defend the very first right in the declaration of independence, and that is the right to life. [applause] anything else? plenty. i realize what i've done here this morning is not the usual let's revert to the script. nearly 3 million jobs have been created. he has restored confidence in the economy. evidence among consumers and businesses has reached a historic high. he has rolled back unnecessary, job-killing regulations, beyond even his expectations and promises. have eachent days marked a record for the dow since he became president. he has kept promises there and elsewhere. as promised, moved the u.s. embassy in israel to jerusalem. [applause] in fact, as promised, ordered an end to united states participation in the atrocious iran deal. [applause] and he has begun the process of ne-imposing sanctions on iran, sanctions that have either be

medicaid programs. he has proposed regulations to allow healthcare providers to refuse to perform services that conflicth the religious and moral beliefs. as he said from the rose garden to marchers on the day of the right for life march, my administration will always defend the very first write in the declaration of independence. that is the right to life. [ applause ] anything else? you bet, plenty. i realize what i have done is not the usual order, so let's reverse. nearly 3 million new jobs have been created since he took office. he has restored confidence in the american economy among consumers and businesses to historic highs. he has rolled back unnecessary job killing regulations beyond even his expectations and promises. 100 different days of each marked a record for the dow. he has kept promises, there and elsewhere. he has kept his promise to move the u.s. embassy in israel to jerusalem. he has ordered an end to united states participation in the atrocious iran deal. he has begun the process of re- imposing sanctions on iran, sanctions that had been lifted away. he has canceled all involvement

new headle there is a of social services and a new medicaid director who has previous private managementrom other states. and a new actuary has been hired and we have now renegotiated manageds with current organizations and we are looking to add a third next year. we are able to i have talked to a lot of providers in my own senate district who had issues with getting paid by mco's initially. it they are telling me it's getting better. i think we will continue to see that system get better as time goes on. our commitment in the senate republican caucus is to make sure that gets them as quickly as possible. it that is what the governor once as well. as far as getting rid of federal deductibility, we didn't do anything to jeopardize matching funds from the federal government when we got rid of federal deductibility in our tax bill this year. took theid was we the state tax revenue we were going to get, that was more money they were going to have to pay in state tax, and we decided to give that back through an across-the-board income tax cut and we phase of -- the elimination of deductibilit

came out of the finance committee to allow, clarify that medicaid reimbursement could be received for telemedicine provision of addiction services. there is a bill called the connect apps that would do the same thing with respect to medicare reimbursements. as we are talking about rural communities, or certain communities, the idea of telemedicine, as a solution, there is no one solution. it is a solution to some people's challenges. it will be a good solution. if we don't have a reimbursement model that accommodates it, we will grapple with transportation, or the challenges of folks work schedules. is not the answer for everybody. when there are applications, we should not be standing in the way, because we have outdated reimbursement models for how healthcare providers provides services. that offers some promise to rural america. i do appreciate all of you for coming. we look forward to taking these ideas. we have had a lot of hearings about diagnoses. i'm getting excited to get to these prescription soon. >> i would be remiss if i did not mention the fact, with the senator asking about prenatal care, uva has a fetal heart rat

and on c-span3, centers for medicare services administrators and comptroller general jane navarro talked to members of congress about combating medicaid fraud. that's tonight at eight eastern on the c-span network . tomorrow marks the 17th anniversary of the september 11 terror attacks. here's a look at our live coverage plans. on c-span, president trump marks the occasion with remarks in shanksville pennsylvania, that's expected at nine: 40 5 am eastern. on c-span2, the annual ceremony and reading of the names of those killed. that's due to start at eight: 10 pm eastern and on c-span3 we take you to the memorial service at the pentagon at nine: 10 am eastern. all services will air tomorrow night onthe c-span networks . c-span2 is in canada for the canadian house of commons citizenship and immigration committee, held a series of hearings during the summer recess examining the response to illegal border crossings and their handling of a surge and asylum-seekers . >> good morning. welcome to this, the 117th meeting of the committee on citizenship and immigration and a reminder that once the meeting begins at the only cameras that will b

finance committee to allow, to clarify cms to clarify that medicaid reimbursement could be received for telemedicine provision of addiction services there's a bill pending now that would do the same thing with respect to medicare reimbursement. underserved communities in general, the idea of telemedicine as a solution, there's no one solution, as a solution to some people's challenges, it's really going to be a good solution. we don't have a reimbursement mod that will accommodates it. then we're going to grapple with the public transportation issue. or the chael engs of folks' work schedules and things like that. telemedicine isn't the answer for everybody, but when there are telemedicine applications we shouldn't be standing in the way because we have outdated reimbursement calls for the way health care providers provide services, i think that offers some promise to rural america. i appreciate all of you for coming and we'll look forward to taking these ideas as part of, we've had a lot of hearings about diagnoses and i'm interested in get moog prescriptions, but thank you, mr. chair for doing this and thank all of you. >> i wou

committee to allow, to clarify cms to clarify that medicaid reimbursement could be received for telemedicine provision of addiction recovery services. there is a a bill pending in te senate called the connect act which would do the same thing with respect to medicare reimbursements. as we're talking about rural communities are underserved communities generally, the id of telemedicine as a solution, there is no one solution, but as a solution to some people challenges, it's really going to be a good solution but if we don't have reimbursement model that accommodates it, then we're going to grapple with the public transportation issue or the challenges of folks work schedules and things like that. telemedicine isn't the answer for everybody but when there are telemedicine applications we shouldn't be scanned in a way because without data reimbursement calls for the way health care providers provide services. i think that offers some promise rural america. i appreciate all of you for coming and we will look for to taking these ideas as part of, we've had a lot of feelings about diagnoses and interested in getting to some prescriptions

medicaid and medic health. thank you so much. on behalf of -- on behalf of the department of aging and adult services, i want to say that you are our employee of the month for august. [cheers and applause] >> good afternoon, everyone. i just wanted to say thank you file for this award. it is an honour to be employee of the month and i want to thank my fellow coworkers, supervisors and the leadership thought by the continued support. thank you. [applause] >> was going before the board of supervisors. we had two site visits. one to the south sunset senior center and also one to the george davis senior center in the bayview. lastly, mrs. karen kinsick reports from the rebuilding reported that they would do a project in the bay view on september 15th. >> any comments or questions? thank you, leon. >> what are your findings on the two site visits? >> the site visits were positive. the one from the sunset -- south sunset senior center, it's a very small site with it being utilized quite a bit. there are issues that mainly a chinese community with 70 lunches per day. the food is brought in by a self-help for the elderly and it's utilized

either insured under medicaid or under insured, so we really are a department that has a bread and butter of serving a population that is low-income, and we need to provide services that are accessibili accessible and very high quality to those populations. another thing i think to just mention is the breadth of services. we have the services that are directly reporting to the health department, and that is a challenge and an opportunity, but even beyond that, the department works under the philosophy of collective action, where we are leveraging not only department of public health resources, but we're partnering with an extremely wide and broad group of non-d.p.h. actors, and that includes our network of c.b.o. partners that we are working with in common cause to advance our health and policy goals. it includes collaborating with institutions such as the other hospitals in the city to work together to improve health in the city. it's working with all of those community partners and community groups that share our mission. so the range of roles that the health director position will play is very broad in encompassing all of those. so with that, just with the pur

medicaid programs. [applause] he has proposed regulations to allow health-care care providers to refuse to provide services that conflict with religious and moral beliefs. [applause] said to the marchers on for the right to life march, we will always defend the first right in the declaration of independence and that is the right to life. [applause] anything else? plenty. i realized what i've done is not the usual order. nearly 3 million new jobs have been created since he took office. he has restore confidence in the economy, confidence among consumers and businesses has reached a historic high. he has rolled back unnecessary job killing regulations beyond his expectations. 100 days have marked a record for the dow since he became president. he has cap promises. -- he has kept promises. he has moved the u.s. embassy to jerusalem. [applause] ordered an end to united irans participation in the deal. [applause] process ofn the re-imposing sanctions in iran, sanctions that have been lifted. he has canceled all involvement in the international criminal court. he has withdrawn from the paris accords on climate c

. >> who heads the centers for medicare and medicaid services, testified alongside u.s. comp roller, general tina come about combating medicaid fraud. at a senate homeland security and governmental affairs hearing, the two were also asked about drug pricing, and a newly expanded -- extended period for short-term health plan. this is two hours and 15 minutes. >> this morning, we will come to order. i want to think administrator, verma,