we want to provide veterans timely access to a community provider of their choice. when we think of care coordination, i really think this is the secret sauce for success here. if we can make care coordination work, then we can make our high performing network work and we can serve as a model for the rest of the industry which is coordinating care through seamless exchange of information. when we think about the community care network, we want to make sure we have a robust network that provides access high quality community providers both inside and outside the v.a., provider payment. it's important for us to be good partners for providers and that means paying timely and accurately. if we cannot be good partners for our docks, why would they work with us and take care of our veterans? for me that's a very important piece to ensure that we provide those services that are needed to our patients. lastly, customer service which is providing quick resolution of questions and inquiries to our various stakeholders. so that's where we started. we started with a veteran at

provider than a community provider. it's important to think about that as we think about moving towards this high performing network. it cannot be the same in every location. it has to vary by that geography and the population density of veterans. i think very important for this group here as well as it varies by specialty. there's certain things we have been partnering for, freestanding dialysis clinic, we we buy a lot of dental care. most or all maternity care is done outside the v.a.'s walls, community nursing homes and home health. there's certain things that are predominantly provided within a v.a. facility such as mental health care service, jerry at tricks, spinal cord injuries and prosthetics. we need to think about the different services not only do they vary by geography, they also vary by what type of care is purchased. so, that's important, because when we think about how do we design the right system, and it's definitely the topic of discussion these days here in d.c., is what's this right proportion of v.a

if you provide the funding we will build infrastructure with the dollars provided. certainly, there's always opportunity for improvement in our programs. and i would allow administrator mclean to elaborate on specific opportunities that we might have to make this program even stronger. >> it's interesting this gentleman that i referenced was outside of fayetteville that you know very, very well. >> i do. >> yes, sir. >> thank you very much, and this year alone, the rural utility service has objeligated $35 million of investments in rural water in the state of arkansas. we are proud of that. very, very innovative municipalitys that are bringing water and sewer systems to their communities. but it's hard. it's tough. our loan and grant programs are focus odd communities of 10,000 or less. and we have to mix that loan and grant combination in order to try to target the grant dollars to those areas that are needed the most. and there's always more demand for resources than we have available. and we just, we work really hard to be able to spend down to the very last penn

we have 190 emergency vehicles around the affected areas providing food and hygienic, also to provide meals and all the kind of thing. 91 cents of every dollar of the 300 million is going to go back to provide all the services, and the rest, the other nine cents are going to go for logistics and management and things like that. >> i distance there was a limit of a computer glitch with people applying for assistance through the red cross. how are you rectify that, and can people who live in the shelters apply for that. >> is yes. thanks for asking that question. the red cross has an immediate financial assistance program. the program started in septembe. we had over 100,000 families apply within the time of 20 hours. so we were able to distribute $45 million, but the system crashed and was not able to take so many people, you know, that were going to us for assistance. the system crashed but it's going to be up and running again on september 21 come which is going to be next thursday. families will receive $400 per household. all they have to do is come on september 21 go to the websit

provide the meals and all of that kind of things.so 91 cents of every dollar will go back for up to provide all of these services and the rest, the other nine cents is going to go for logistics and management and things like that. >> i understand there was a little bit of a computer glitch with people applying for assistance to the red cross. how are you rectifying that and can people who live in the shelter apply for that? >> yes. thanks for asking that question. the red cross has immediate financial assistance program. the program started on september 11th. we had over 100,000 families i ply within the period of 20 hours. we were able to distribute $45 million. testimony problem the system crashed. it was not able to take so many people that were going to us for assistance. so the system crashed, but it is going to be up and running again on september 21st opinion which will be next thursday. families will receive -- based per household they will receive $400. all they have to do on september 21st, go to the website, which was redc

that they aren't acknowledging the services they are providing without the resources to provide some respite care and an opportunity to have a stipend which can be very helpful to have those same benefits of post 9/11. not only the war related wounds but how they have been compounded by the aging process.ngs like now you'll have the advent of parkinsons and als. and those that have happened as you have gotten over you are less mobile with more paid. dealing with all of this without the support that a they deserve. i really do hope this could be passed quickly before the end of the year so we can begin to focus on the kinds of services that they need. the faster we can provide. >> i do know that some care givers and elderly veterans require long term in an old personal care can qualify for the aid and attendants benefit but they have been charging fees are to obtain the benefit even though the application is free. senator rubio and i have a bill that directs the veterans administration to work with other agencies to crack down because it is important and also with one more point i com

provide adoption information and referral. and i urge adoption of this amendment and i reserve. the chair: the gentleman reserves the balance of his time. for what purpose does the gentleman from oklahoma seek recognition? mr. cole: i don't want to oppose and i commend my friend and highlighting its importance. would the gentleman yield? the chair: the gentleman is recognized. mr. cole: we support what he is trying to do and accept the amendment and look forward to working with him through the process to achieve the objectives that he stated. yield back. mr. kelly: i continue to reserve. the chair: for what purpose does the gentlewoman from california seek recognition? ms. lee: i rise time to claim time in opposition to this amendment. the chair: the gentlewoman is recognized. ms. lee: this cuts funds from head start and run away and youth grants among other critical programs and uses it to provide $5 million for the infant adoption awareness training program. this program did not receive funding in fiscal year 2017. women sho

you may still be eligible for coverage and medicaid but perhaps your provider isn't a medicaid provider. >> and i think we heard from senator scott, making sure that child, kaleb, goes to school healthy and being prepared makes him a better student -- >> and hopefully you look at the long road and long picture. and does it make sense where we have programs where families could potentially bounce back and forth from almost month to month. >> talk to me a little bit about the outreach and particularly rural outreach. many families may not feel comfortable going online or going to a library and putting very personal data into a computer without an outreach worker. >> certainly. as you know very well the state, we employ a few outreach workers. and we do try to position them around the commonwealth. but another thing we do in virginia is we use some of our chip admin dollars to help support a foundation of which you're the chairman. and of that program you also get to do the same. and their reach is expensive in trying to help families. and even in this day and age we still get a healthy po

you may lose a provider. you may still be eligible for coverage and medicaid, but perhaps your provider isn't a medicaid provider. >> i think we've heard from senator scott and others that in terms of plain old business, making sure that child, making sure caleb goes to school healthy and it's going to make him a better student. >> i think that's what -- hopefully you look at the long road, the long picture and does it make sense that we have programs where families could potentially bounce back and forth almost month to month. >> talk to me a little bit about the importance of out reach and particularly rural outreach since there are so many communities. i know we've got online sign-ups. but the truth is, many families may not feel comfortable doing on-line or going to a library and putting very important data into a computer without an outreach worker. talk about outreach and more specific lie rural outreach. >> certainly. as you know very well, we -- the state -- we employed a few outreach workers and we d

first is for the rural telecommunications providers that are already in the business of providing broadband or trying to provide broadband across rural expanses, is an effort to stabilize both the forms of revenue sources that rural carriers rely on specifically the universal service fund in the first panel acting administrator mclain referenced the stability of the fund impacts, our ability to make investments, our ability to keep rates affordable, our ability to provide comparable services, our ability to get loan funds from your rural utility services. all of those things cascade into impacting our ability to provide the services in a very difficult economic situation in rural america. the second thing i would briefly say used to ensure we create the proper incentives to focus broadband providers to invest in rural america with the economic challenges. >> okay. mr. olinyk, i know you asked about the rural energy part of the farm bill, and a related question picky talked about how reap five saves money will make it their more stable and profitable. how do you take advantage of the opportu

and we heard a real telecom provider discussed daily challenges that she faces in working to provide high-speed broadband to area in western kansas roughly the size of connecticut. and vermont, the distinguished chairman from vermont, or the senator from vermont has departed. but with 3 million fewer people. i hope today's hearing will continue that conversation and provide our committees opportunities to hear a broader perspective of the needs throughout farm country. on our first battl bill today we pleased to the assistant to the secretary of agriculture for rural development and the three acting administrator for the rural utilities service, rural housing service, and rural business cooperative service. they will discuss secretary perdue use vision for fostering growth and economic prosperity throughout rural america and providing update a program functions within the usda rural development. for our second witnes point is f panels, partly, witnesses come will hear from a broad set of private sector stakeholders including references will cooperatives who work every day to provide

year be provided to cover claims. we believe this can be implement it quickly as it similar to the plan that works successfully in 2014 through 2016. this will not only bring greater stability but also say to the save the federal government billions of dollars through tax credits. as to whether states are federal government should fund the reinsurance program, it would be impossible for most states to implement the program in 2018 or 2019 in many states. most states do not have the existing authority to create such a program under existing revenue to fund it or mechanism to operate. by contrast the federal government can reinstate the program and impact rates in 2018. third, as you heard from several witnesses, the 1332 waiver process is simply too uncertain, too, time-consuming to be a real option for most state. they recommend flexibility, guidance. finally, read urge the senate to also consider extending the moratorium on section on health insurance providers through 2013, thus reducing premiums and to provide u.s.

that was provided in writing on our website last week, provides that on block authority to help managers process amendments which helps move amendments and fewer votes makes a hundred 18 amendments, 57 republican, 57 democrats and four vice partisan and requires a rule to complete consideration of the bill meaning that when we finish with this section we are not going to close the hearing, we will move for the rest of the hearing to begin tomorrow. with that said, is there amendment or discussion? >> i have an amendment. >> mr. chairman, i move the committee make in order to give the necessary waivers for the amendment offers a representatively and myself. six of our colleagues to division g of hr 3354 number 78 which is to strike the bill that prohibits funding for the united nations population fund. it's really is an important issue and i appreciate that we could continue what we been doing in the past and trying to support that. i would ask ray yes vote. >> thank you. miss lee, i think accurately as he has described took time to work through the committee on that. further discussions?

can you provide a brief over view looking at another date for a longer answer, can yo provide what doe plans have there are to ensure that this burdensome permitting program doesn't further impact grid reliability. in other words i'm working on the legislative end. what are you doing on the administrative end? >> we are working diligently to streamline the review and permitting process in the portfolio of the jurisdiction of the department of energy. we're looking at on the transmission side. p preapplication process. i'll be glad to have an in depth conversation on the activities we're working on. >> i do appreciate anything yo provide to the office. i apologize because of hurricanes earlier in the week and now our compressed voting schedule. i can't get a longer answer. those being the two most vital questions. i yield back. >> no further members wishing to ask questions. i'd like to thank our witnesses for being here today. i want to personally apologize for exposing you to a good old fashion texas goat rope because of the floor votes. i appreciate your patience. pursuant to committ

the roll telecom provider in working to provide high speed broadband roughly the size of connecticut. >> i hope today's hearing to provide committee's opportunity to so to have the assessment of agriculture with us at acting administrators in the role business. they will discuss his vision for economic prosperity negative and provide an update on program functions we will hear from private sector stakeholders from the rural cooperatives that work every day to provide essential utilities servicers -- services to whom those all over the country. a university professor leading a state of the art research chemical product and with renewable energy assessment. looking forward to our discussion today with those energy titles of the phone bill. and the recommendations to approve these programs in any other remarks they would like to make?. >> this is such an important hearing to discuss issues with role communities all across the country and want to welcome our witnesses today. and with the rural economy that those who live in rural america are facing tough economic times. but there are many

a change of culture, we are going to have to provide incentives. we are always focused on standardized testing, which is why we are looking at taking the test later in the school year, to give them more instructional time. , byre working with teachers having them work together to focus on the needs of the kids, as focusing on -- as opposed to focusing on that single measure that we have been focused on for far too long. host: you have talked about testing, and i have been trying to come up with the right word to ask this question, but it is -- but is it seductive to teach the test? pedro: i think it is human nature. -- if you tell me you are going to only focus on one aspect of my performance, that's all i am going to focus on areas it is not seduction. that it is absolutely human nature to want to perform as well as you can, on the measurements put in front of you. my team has a saying, we treasure what is measured. as an environment of education, we have only focused on standardized test scores. so as a result, that is all our children have focus

we also provide them with shampoo, toothbrush, everything is brand-new. it's going to be a big challenge, right? >> believe i that as we found it but then also they will think it over and there will be a few conventions coming up soon, but we are going to do our best to find the convention center. [inaudible] they are transported to the new shelter. when people come to the shelter we don't ask their background or whether they are a resident, whether they have a green card or they are citizens, we take anyone regardless of their immigration status and where they are coming from. but mosmost of the people in the shelters have been affected. >> how long will the new shelter stay open? stick it will stay open as long as we are needed. we give them time to think about their permanent recommendation. >> david toothbrush, toothpaste, soap, they have the six showers for male and female and we also have a handicap shower. [inaudible] how much of that funding goes to run the shelters? >> it is going to be back here to the community so we are going to hold that mone

they have a robust and legitimate provider network in your state's. they make no effort to establish a network of doctors and hospitals. >> the company is and can do business in our state. and that would be true for most if not all. >> if you are not going to come in and provide the basic services and networks. they've expressed interest in continuing the bipartisan conversation beyond just market stability going into the areas of cost and quality of care that provide bipartisan opportuniti opportunities. there are five that i've asked people to focus on, patient safety, hot debate co. hospital acquired infections. it's the warfare between insurance companies trying to deny the providers and having to staff up to find their way through the barrier and the whole enterprise contributing zero healthcare value and it's just ridiculous administrative warfare. it's making sure that people's wishes as to what care they will receive at the end of life are properly documented early on so that they can be honored when it is game day and things are going badly.

they have responded by narrowing their provider networks. it turns out you can't always keep your doctor. many other states are facing similar issues. unfortunately, all efforts to repair and amend obamacare have failed. i am encouraged by the trump administration priorities, particularly in a correcting state flexibility and autonomy. in oklahoma, obamacare gives us no other options at this point. oklahoma submitted a 1332 waiver application under the obamacare framework. this focuses on a market stabilization program using federal funding and state used assessments. this will create a regional program for carriers operating in the marketplace. subsequent writers -- waivers will gain state worker -- state control over obamacare requirements. however, i am not convinced obamacare waivers will be the solution to our problem. we need an innovative solution that returns power back to the states, to implement ideas tailored to fit each state's specific needs and health insurance. that's why i have encouraged the proposals out there like the ones

the new grounds of removability provided by? > hr will get criminal gang 3697 members off of our streets. i.c.e.'s recent operation new dawn resulted in almost 1,100 arrests of gang members. had the bill been enacted right or that number would have almost , certainly increased. this bill is only starting the removal process, however. make no mistakes, and there was a lot of of few station today about this immigration , proceedings do not equate to deportation. the government must prove its case and provide evidence to convince an immigration judge that gang-related activity occurred. as a former private immigration attorney, i've seen this process in action and it does work. i.c.e. will not use this new charge as pretext as it won't be sustained by an immigration judge without sufficient evidence. the time for this bill is long overdue, and we cannot afford to be distracted by extreme hypotheticals and issues not germane to what we're discussing today. this bill was introduced to target criminal gangs, as that term is commonly u

it is like any provider patient right. it is time to send the message troopcombining transparency with access to all high-value providers. thank you. encourage the committee to consider these recommendations. >> thank you mr. bragg didn't. mr. tyson, welcome. >> thank you very much to chairman alexander, ranking member murray, members of this committee. it is an honor to be here to speak to about this important issue. fore are two important laws the health and well-being of the american people who are not covered by an employer and/or the personal wealth of their own coverage. i think about this often. i remain optimistic we will succeed in making sure every american has access to the front door of the american health care system. that front door has a key. that key is called coverage. inh the aca that was enacted 2010 and the medicaid exchange, we have now given that key to almost 20 million people if not 21 million people who did not have it before. there are 31 more to go. i'm trying hard to do whatever carekes to make

and we have choice providers out there. i believe as you get further into the implementation plan we discussed in my office you are going to identify other layers of technology to make sure we know how prescriptions are being dispensed and whether there are dangerous interactions and other indicators we can use to make that a more productive experience for the provider and the patient. have you gotten to a point where you are thinking through as you are looking at here implementations priorities and the broader transformation plan the remainder of the clue where are the other custom efforts buying a configuring tools you'll need to flesh out that? >> we have been to essentially the principles that you talked about. a system that worked in the future will have to components that frankly done a good job of outlining. we haven't gotten to binding which specific tools and how we will meet those needs. we talked about the days of va being a software developer are over and we are going to look at technologies. there is going to b

the committee has provided robust wildfire in this bill. fire suppression accounts are fully funded at the den-year average level and the bill increases funding for review reduction. the bill funds the taxes program, pelt, at the fiscal year 2017 enacted level. 42 of the 59 states make up for tax revenue. overall, funding by epa is reduced by 534 million or 6.5 last year. >> they're cleaning up infrastructure and cleaning upland and it will spur economic development in communities across the country. this legislation provides 5 billion worth of investment and water infrastructure through the wifia program and the clean water and drinking water resolving loan funds. this bill provides increases to accelerate the cleanup of contaminated super fund and brown field sites. the bill provides 2.9 billion for the national park service and increases the construction account by 10 million to address long-standing park operations and deferred maintenance needs. we've also addressed a number of concerns with an efficient wild life service accounts, but

but what can be provided by rural development agencies or others that would enable your co-ops to provide broadband to your very widely disbursed customers at competitive rates? >> thank you, senator thune, for the question. the funding sources for any rural telecommunications provider is really kind of a -- i'll say a three-legged mechanism. the revenues we receive from customers. there are the revenues we receive from those who use our network. in other words, other carriers who may desire capacity or need to use our network to transport their services. and then the third item for rural telecommunications providers is the support received from the federal universal service fund. customer revenues and comparable and affordable certainly i think we push the upper bounds of that today for most rural subscribers. paying more for broadband and related telecommunications services than air urban counsel per parts. in terms of being able to generate refer knew, that has been greatly diminished over the last years. and so now you're left with customer revenues and universal service funding. with

this is part of their job, is to provide this training, is to provide the support that's needed. i'm giving you the very brief, abbreviated version of this. but you can get the one to two hour in person training for your local suicide prevention coordinator really anywhere with your local chapters, pva anything. what are some of the signs of suicidal thinking? as i said before, hopelessness. that is really known to be the paramount risk factor for those who are feeling suicidal. most people -- it's a huge percentage of people who have survived suicide attempts, have said that hopelessness was one of their biggest factors, feeling tlifeel ing like there's no way out. other things to watch out for, any change in behavior, any change in terms of anxiety or sleeping, feeling like there's no reason to live, any change in anger, engaging in risky activities without thinking, increasing alcohol or drug use or withdrawing from family and friends. another thing that's really important to recognize is that suicide for anybody tends to happen when people are going through major transitions

care providers out there, choice providers out there. i believe that as you get further into the implementation plan that we discussed in my office, that you're going to identify that you need other layers in the technology stack to make sure that we know how prescriptions are being dispensed, whether there's any dangerous interactions, other indicators you can use to make that a more productive experience for the provider and for the patient. and so have you gotten to a point now where you're thinking through how as you're looking at your implementation priorities and your broader transformation plan, the remainder of the stack, or we used to call it gluwear, or buying and configuring tools you're going to need to flesh out that technology stack? >> we've gotten to essentially the principles that you have talked about, saying a system that's going to work into the future is going to have to have the components that frankly you have done a good job of outlining. we haven't gotten to defining which specific tools they are yet and how we'r

they provide parenting education and other support services. with the goal of helping at-risk families succeed. it's a great program that invests in children and families, helps lift them out of poverty, and increases the chance they will become productive and successful members of society. . in theory, they treat the states and territories equally. in practice, however, puerto rico is treated unfairly. the department of health and human services makes allocations based in part on a u.s. census bureau data product on childhood poverty, but that data does not include information on puerto rico or the other territories. therefore, puerto rico always receives the minimum grants allowed by the law even though the island of 3.4 million has a high rate of childhood poverty. my amendment would simply require h.h.s. when making grants to use the best federal data available for every state and territory and to use an appropriate alternative data source, if necessary, in the case of puerto rico. this will ensure that puerto rico receives its fair share o

if that provider was out of network, you as a patient had a right to go to that provider and the insurance company to treat it as an in-network expense. so it was this combination of giving patients the information and then the power to shop that in state employee plans and other self-insured plans shows that's the way to reduce the cost of health care. senator enzi: thank you. my time's almost expired. i will submit some questions in writing, particularly for ms. tomczyk, to get information on a more actuarial standpoint on what we've been talking about. thanks, panel. senator alexander: thank you, senator enzi. senator murray. senator murray: thank you, again, to all of our panel. it's very helpful. o'toole, in the past couple years i know you took steps to adopt a basic health plan, limit insurers financial risk to keep them in your market and provide premium rebates for enrollees to keep your coverage affordable. and as you mentioned in your opening remarks, you're hopefully within a few days of getting a 1332 waiver. and its purpose is to establish a reinsurance program, correct? ms.

can you provide a brief overview, looking at another date for a longer answer perhaps, but can you provide what doe plans have that there are to ensure this permitting program does not further impact grid reliability. i am working on the legislative end, what are you doing on the administrative end? >> we are working diligently to streamline the review and permitting process that's in the portfolio or jurisdiction of the department of energy. we are looking at on the transmission side, preapplication process. i will be glad to have an in-depth conversation on the list of activities we're working on. >> i appreciate that anything you can provide to our office. i do apologize that, because of hurricanes earlier in the week and now our compressed voting schedule today, that i can't get a lengthier answer. mr. chairman, those being the two most vital of my questions, i yield back. >> the gentleman yields back. seeing no further members wishing to ask questions, i would like to thank all of our witnesses for being here today. and i want to personally apologize for exposing you all to a good old

do you think the russian change of position provides an opening? is there room to get a good peacekeeping force in with the negotiation worth pursuing? >> first and foremost, un peacekeeping missions with access to the noncentral territory of the ukraine and the border between the russian federation and ukraine, possibility to break the stalemate of the minsk agreement. and ukraine has been pushing this on the agenda for quite a while, the un security council and secretary-general by the ukrainian president off of the decision of the ukrainian parliament in early april 2015 and the ukraine is looking for a real objective, and equipped mission, un peacekeeping mission. what we see is the russian reaction. first, probably a positive thing there is an opening in the discussion. my feeling is it is the attempt whether there is an english phrase. >> hybrid means everything to everybody now. >> it is an attempt to twist the idea and present something from the russian federation that is not necessarily corresponding to sorting out -- not necessarily leadi

our bill provides the f.b.i. with $8.8 billion which is a $92 million increase over the budget request. the f.b.i. has done a superb job in protecting this nation against espionage, cybercrime, terrorism and hate crimes. the threats against our security are real and evolving. we have done our best in this bill to make sure that the f.b.i. has the resources it needs to continue to protect this great nation. the commerce, justice bill also provides increases across all other federal law enforcement agencies, mr. chairman, to enhance their capabilities to combat illegal immigration, violent crime and go after human and opioid traffickers. unfortunately, given houston, texas, is the center of human trafficking and our legislation makes sure that all federal agencies have the resources they need to combat these modern human slavers. we've provided funding for 65 new immigration judge teams to reduce the 500,000 case log of immigration case backlog. . we have $88 million increase for u.s. marshals. a $98 million for th

when you get to the high claims side by providing reinsurance what you are doing is providing a stop - a backstop, that has the effect of providing protection but also by providing a backstop keeps insurers in the market that might otherwise make it. isn't one of the reasons many insurers are vacating the individual market because they are worried about the high cost plan? >> if i could respond you are exactly correct. in addition to that, when you have very limited carriers in a market like any of my state if you are the ones riding in that market and you know you have guaranteed renewability and no ability to capitated risks because of no lifetime maximum you have to rate everyone high because you are taking all comers and guaranteed renewability. if you are able to say this is the backstop and ultimate level of risk you would have, it does entice additional insurers to better estimate the risks. >> the backstop ends up having double benefit, encouraging insurers to stay in the market but allow them to do a premium that doesn't account for the super high-cost claims that the premiu

those resources provide a little more wrap around services and the other thing they provide for people is economic influx into the community. if you're staying in a hotel it is pumping money back into the economy. so it is a solution but not for everyone. we have to make a realistic possibility to include space. there's not a ton of places to put those sorts of things. we have to make sure they are not being put back in a floodplain and they have wastewater and all of these other services most homes are not design today handle -- designed to handle right after the bat. right now the state is leading the housing task force. they looking to come up with a solution pretty quickly and make an announcement. there are a lot of options on the table. >> is that a separate -- >> no. it's part of the same process. we ask them what does their living situation look like. if it is something they can remedy pretty quickly we may look towards the hotel program. if it will be a longer term solution then probably rental solution is a lot like that. >> fema offers other types of assistance. >> yeah. thr

to provide that kind of education. i think the second thing is that privacy standards can really vary country to country. they can vary depending on the sector of the financial services provider. so it might be different if you're in telecom and it might be different if you're in banking and then different again if you're in fin tech. so there has to be some way of har mondayizing that and bringing those up to global standards. and i think there it's really important for regulators to conduct meetings where they are not only talking to providers, but they're talking to, you know, consumer advocacy groups. they're also talking to other regulators about how you do that kind of coordination. and particularly in areas like sub sa harian africa and south asia, i think it's very, very important to have a regional approach to that, because there's a lot of people movement for jobs, for economic opportunity, and so i think it's extremely important to have a harmonize the approach not only within the country and within various

people are losing providers. and the providers are not leaving because of staying in the same way for the next two year, they're leaving because it's staying there so yes, i look fwrd to continuing this conversation. because we cannot allow this harm to continue to go through this country. i yield back. mr. hoyer: mr. speaker, we could go on all day. and the fact of the matter is, this is a critically important issue to our country. and when he talks about providers, the providers said they didn't like any of these bills. they have had three opportunities, one that we passed, by one that was offered, but not put on the floor. then one that came to the floor and passed this house and then went to the senate. and the majority of the senate has not agreed with any of the three alternatives. plus the alternative that senator graham brought forward along with senator from louisiana. the majority of the senate has not depreed. and mr. speaker, what that has done is provided with the insurance industry, providers, docto

lastly, providing resources. the proposed agreement would provide fda with the resources required to clear out the fda's review backlog, address safety concerns for product currents on the market, in review future applications for innovative products in a more timely manner. what it supports to it strikes a sensible balance of reflexive couple compromise between stakeholders. the current monograph system has had detrimental effects on consumers in theaters fda's ability to ensure that the effectiveness of the over-the-counter products. we applaud the subcommittee for the bipartisan proposal and urged congress to capitalize on this momentum and pass this legislation as soon as possible. thank you. >> thank you. mr. warner, your recognized for five minutes. opening statement. [inaudible] >> thank you for inviting me to testify today regarding efforts to improve and strengthen the approval process for over-the-counter otc products, including sunscreen ingredient. the past coalition is a multi- stakeholder coalition

the misalignment of centives it createdhen the coensate providers bed on the volume of care ty provide. rather than on efficiency. in tennessee, are working to chge the way we pay for and deliver health care so that providers are compensated bad on value. congress should ma a clear commitnt to this type of payment innovation. publicans, democrats, independents should agree our current path is not sustainable. theng all this debate about aca, the has been a lot said about how immoral it would be to have millions of people lose health insurance coverage. i understand. republican goveor who proposed a conservative plan to increase medicaid coverage in our state. itan't we all in knowledge is just as morally questionable to cover everyone with health insurance and put the bill on credit cards to be paid by her granhildren, rather than do everything we can to makhealth careffordable now? thank you to the entire committee. to strengthen the individual market and our entire health care system. >> thankou welcome. chairman alexander, and members of the committee, ank you. governorsr inviting ,

fema provides assistance in the form of grants. we can provide $33,300. a lot of people won't come close to that maximum grant. we want to provide as much assistance as we can. so when you look at the damage for most people, even if they did hit the maximum grant, they are not talking about it being enough for their recovery. the small business administration despite it being business can do a lot of assistance and they can provide low interest disaster loans that will bridge the gap for a lot of people. regardless of whether people want to take the loan, we need them to fill out the application and they can make a decision afterwards with what they want to do with whatever they've been approved for. but we need that information to continue with the loan process. it is part of why we partner to make sure they are providing those services and answering those questions and helping people figure out the application process. gl when you say low interest rate, how low is that rate? >> you'd have to ask for the exact examples, but i think we're talking 1.75%, t

technical experts to essentially provide a set of menu options, to enhance cyber security and provide technical assistance for implementing those solutions. so moving forward, we look forward to hearing from all of you regarding this year's report and scorecard as well as the 2015 and 2016 reports and we will continue our efforts to facilitate dialogue regarding important financial inclusion dwe dw developments and the outcome of the scorecard. we haven't addressed that up here. we welcome your feedback. and now thank you for listening to the presentation and i would like to invite our moderator john villasenor as well as our panelists. >>> thank you very much to darrell west and robin lewis for setting the stage here and thanks to all of you for taking time out of what i'm sure is a very busy schedule to help us with the dialogue on this really important topic. so the organization for the remaining portion of the program is i will introduce our two panelists and i will ask a series of questions and we'll hear their perspectives until approximately 11:00 and then we'll open it up to q

providing assistance in the form of grants, provide a maximum $33,000 piccola people won't come close to the maximum grant but we want to make sure providing as much assistance as we can. you look at the damage for most people even if they did hit the maximum grant they are not talking about it being enough for the recovery. the small business of section despite the deed being business can we do are a lot of assistance of people in terms of low interest disaster loans that will help bridge the gap for people. regardless whether not people want to take the loan, we need them to thought the application and they can make a decision afterwards what the want to do but we need that information to continue the loan process. it's part of why we partner with the sba to make sure they're providing the services and answering those questions helping figure forgot the application process. >> when you say low interest, how low is the right of? >> you have asked the sba for exact examples but 1.75, 2% range. we're we're talking very low interest rates. that depends on the credit score and that appli

it is brought to you today by today's son of -- your satellite provider. today, north korea's foreign minister spoke with the united nations general assembly, and responded to president trump's threat to totally destroyed north korea. his whole speech is just under 20 minutes. give the floor to his go -- readrihanna young ho. >> mr. president, first of all allow me to congratulate you on your election as president of the 72nd section of the united nation's general assembly. i look forward to the fiscal out some of the decision of able guidance. before going into the main point in my debate, i feel forced to make comments on the speech just four days ago i someone called the u.s. president that renders this sacred u.n. arena tainted. since trump uttered such reckless and violent words, provoking the supreme dignity of the democratic people's republic of korea at this very platform, i think it is fair enough to me to make a response in the corresponding tone. during his eight months in power, he has turned the white ofse into a noisy place full crackling sou

government for who could provide this.this case it was the department of defense that have this equipment, so we asked the department of defense to provide this equipment. a couple of these purification units are being delivered immediately with more on the way. what we are also doing it his clear that this is in the early stages of the disaster response, so our teams are on the ground conducting assessments and looking for gaps in ways to respond in the future. not only do we do response but you for a number of questions about preparedness. that is an essential part of any disaster response is what you can do ahead of time. and this is a big part of what usaid does is help communities become more resilient disasters around the world and i have a personal saying that how we honor the people that have been affected by disasters, learning lessons for response and preparedness we can put in place, and again that is how we honor those that have been affected by disasters. .. >> >> the money is spent at the community level. >>