with providing fewer services. and there's no significant difference in hospital provision, a safety net, or in patient care for low income groups or in mortality among the low income residents of the hospital. if you will, it's an indictment. because theoretically, this is supposed to -- i worked in a 340b hospital. some of them are fantastic. and there are patients at the hospital where i worked that only got medicine because of this program. but it seems as if there are issues with how it's currently being done. i noticed consumer groups are advocating for it. i'll point out something else. last week, memorial sloan- kettering's drub pricing lab reported research -- or made the suggestion that should 340b hospitals be required to provide charity care totaling just 1% of their patient revenue, 9% of 340b hospitals would no longer be eligible for 340b. that's if they provided just 1% of their revenue for charity care. secondly, i'll point out, that if you say that the way the business model works is that the more

service providers. a clear set of rules. they couldn't violate anti- trade policies are violate the basic rules of commerce. it was a clear set of rules. two years ago, the fcc -- the ftc regulates the internet for two decades. the fcc decided they wanted to regulate, not the content and the internet service providers, just the internet service providers. so, the fcc in an unprecedented ruling that had already gone to court multiple times and failed, they grabbed the regulatory control from the ftc and said we will take the internet service providers and manage them and you keep the content. that is the fight we are in. it's funny to be in a conversation about net neutrality. the implication is the internet will not be free if the government is not regulated with this particular entity, the fcc. when i asked people if it would be okay if they regulated with the ftc they said that would be fine. good, that's what has been for 20 years. >> for 20 years there has been one set of rules on the superhighway o

the integration of the health care provider. senator wyden: that is so important and chairman roberts is the co-chair of this rural health caucus. and we talked about this constantly. not a week goes by. i say this whole committee of the co-mingling rules that ms. martin is talking about, this ooks like a bureaucratic la-la land. >> strengthening the support to nurse practitioners and p.a.'s and extenders that many times are working in very isolated areas to give them the support, the education the retraining and access. senator wyden: giving them a bigger role. we had it in our bipartisan bill with eight democrats and eight republicans, you ought to practice the top of your license and particularly in these rural areas. why you wouldn't let people practice at the top of their license in a rural area? that is common sense. yes, ma'am. indiscernible] senator wyden: you all have been terrific and been at it for close to 2 1/2 hours. and to me, without rural health care, you cannot sustain rural life. this is not rocket science. th

that is one of the reasons it passed. >> it does provide for -- it does allow for a provider to object or file a motion to object in certain circumstances. describe what are the circumstances or what's -- how does that happen? >> there is this larger question of cop flickeds of -- con flikts of law. ukts of law -- conflicts of law. there's a foreign law which bars them from disclosing that legislation. this is the idea that he was referring to respects to abandoning records. how do we resolve that question. here the conflicts of law question is raised in the -- in the -- legislation and created is a new section that -- addresses -- a fairly narrow set of situations. but never the less is the -- is clearly set out in the legislation. its sometimes called an analysis because its evaluating the a -- that one count are you offerings to another. in a narrow set of cases where there is an executive agreement between the united states and that foreign country whose law might be violated, where that other country offers rights to for the provider to challenge and where there is an actual confl

care is being provided by practitioners. the albuquerque system even has shortages and high turnover including nurse practitioners. i've been fortunate to work with andy and address these as problems arise but now he has been reassigned to loma linda to fill a vacancy over there. this needs to be addressed more forcefully. they need a long wait time and the va continues to lose administrators, doctors and nurses. last month it had nearly doubled to ten days. the problem is national. my question to all of you is what additional authorities or resources do you need to get doctors to come and stay in va facilities? medical school debt forgiveness, waivers? salary increases? as many others. please tell me what we need to do to get them in place. >> it's a very interesting question. want to say were hoping to keep the reassignment as short and brief as possible. where you could help us right now is giving us some relief for the three rs of relocation, retention and recruiting incentives. to make the budget fit, we had caps instit

we also provide job coaching. so for individuals who once we help them find the job if they have difficulties learning the job or need more assistance in what their manager can provide them in training we have someone that comes in and work with them either on site or off site so they can keep their jobs. we also provide assisted technology as people need that to go to work or to participate in schools. there's several services. this is a small list. everything is individualized in terms of what the individual needs to go to work. any questions? >> yeah. how closely do you work with our city's ace program? it's just a great overlap of who you are serving. >> so we're in partnership with them. i have a staff person who does the certification and trains all my staff to do certification. also, when we have openings, every week we get openings for the ace program. we get it out to all of our staff as well as to our community partners to seek qualified applicants and we have to certified that they have a disability so

we also provide hiv screening we provide hiv treatment for people living with hiv and are uninsured and then we hope them health benefits and rage into conference of primary care. we also provide both pre-nd post exposure prophylactics for hiv prevention we also provide a range of women's reproductive health services including contraception, emergency contraception. sometimes known as plan b. pap smears and [inaudible]. we are was entirely [inaudible]people will come as soon as were open even a little before opening. weight buries a lip it could be the first person here at your in and out within a few minutes. there are some days we do have a pretty considerable weight. in general, people can just walk right in and register with her front desk seen that day. >> my name is yvonne piper on the nurse practitioner here at sf city clinic. he was the first time i came to city clinic was a little intimidated. the first time i got treated for [inaudible]. i walked up to the redline and was greeted with a warm welcome i'm chad redden and anna client of city clinic >> even has had an std clinic s

they will call out for sexual assault provider to come and provide services. the survivor will meet with the provider and during office hours, we will also have a mental health provider come from the trauma recovery center to support the client. the next thing that happens is that the survivor is given informed concept. so they are told about what rights they have. to get a sense of whether or not they want to get the police involved. to give them an idea of what's going to happen and to prepare them for the next steps. if they decide they want to have a rape kit, those services will be provided and then we will discharge them to either a home or some safe location. and then they are invited, we give an appointment for a follow-up appointment for them to have medical follow-up and also for them to receive some mental health services. i should mention that when they are being seen during the day and we have our mental health support there, we do have mental health assessment. they have a follow-up appointment, they come to the trauma recovery center. and at tha

i'd like this morning to add a little more details and provide us update. the second issue that i want to your role l be across the u.s. government particularly with regard to some of our near pier nation state adversaries, russia, china, their whole society approaches. i believe particularly the challenge posed by china in terms of its acquisition of our technology secrets and their penetration starting at early stage companies. penetration of universities. and some of the companies this committee has highlighted in the past. we're going to need to up our game on that so i look forward to your testimony on that subject as well. thank you, mr. chairman. i look forward to the witness' testimony. senator burr: bill, do you solemnly give the committee the whole truth, nothing but the truth so help you god? lease be seated. director, before we move to your statement, i'll ask you five standard questions that each nominee, they require a answer.es or no if confirmed, do you agree to send officials from your office to appear before the committee and designate sta

it will provide assistance for our communities and provide the resources necessary to help individualsho are coming off the streets. most importantly, and most substantially connect this budget package will include $50 million for new navigation centres. helping support our new facilities here. we will provide a million dollars for programs for transitional eyes use. a population that has been dramatically affected with homelessness in san francisco. we are specifically wanting to address this. we are providing new access points to provide resources, supports and services for families and residents juggling with homelessness on the streets. this is a comprehensive package. this is about making sure we create new exits off the streets through temporary shelters and permanent supportive housing. it's also making sure we provide the resources necessary to stem the tide of new people becoming homeless in san francisco. we will not solve homelessness overnight in our city. but in san francisco we are investing for the future click as mayor, it has been one of my biggest priority since week

the program requires drug manufacturers to provide outpatient drugs to qualified health care providers that serve low income patients. this is just over an hour and ten minutes. >> good morning, the senate committee on health education labor and pension. please come to order. last friday president trump and secretary azar announced a blueprint on drug pricing. seemed to me it was sweeping comprehensive, sophisticated, and appeared to be patients and taxpayers first. the administration is beginning to tell us more about what they have in mind. some are asking in some cases, they're asking for input from the public about some of their objectives. so it may take some time before we know what the specifics of all the proposals are. many of the proposals appear to be in the jurisdiction of other committees, but some of the more important piece wills be in the jurisdiction of this commit -- pieces will be in the jurisdiction of this committee, including over-the-counter drugs, which this committee already has taken some steps on such as legislation we approved last month to make it easier to

providers. your scenario where what if the data stored in russia by microsoft, in that situation it's the first of those two things. the executive agreement doesn't get involved. we serve our legal process on microsoft and they comply because now the law is clear that they must if it's within their possession, custody and control. >> the russian courts just required telegram to turn over the encryption keys for that particular service. do you see a situation where a foreign government would be able to use the cloud act to perhaps require a u.s. company to turn over private keys or any hardware encryption in connection with that service? >> the answer is the cloud act does nothing to change the situation with respect to foreign legal process. there's an explicit provision that says these agreements may not enhance the authority or detract, it's neutral and that was made explicit. it's important to understand these executive agreements are designed to lower u.s. blocking statutes in a -- that rare

residential care will provide the a.p.s. program with two temporary emergency placement beds as well as meals and supportive personal care services. we have been working with merced residential care for approximately two years and we have found that this facility provides the clients that we refer with excellent and compassionate care. thank you. i'm happy to answer your questions. [please stand by] we have about 191 days out of 272, like, seven out of nine months from the fiscal year to date. and you could say that another way we have had one bed occupied for the entire time and they keep two beds for us that we can use at any given point. >> and are we -- like in general do we exceed the two beds that are available at any given time? is there -- are we meeting -- are we consistently having beds available or are we -- or are people having to wait in terms of the overall -- >> we have the beds available and there's been some occasion on which, you know, people may be occupying the beds but we have alternatives. >> in 12 indi

that is 26% of the provider pool. and we have about -- of those, 2,200 people are age 65 or older which is about 11% of the pool. so it's not unsubstantial this amount of older adults working in this program. and then just briefly, because i am not super knowledgeable about the department of human services side, but i do want to mention they have several workforce programs as well. and these are primarily tied to and funded in connection with other benefit programs and specifically calworks and the welfare to work. and given this connection, these workforce programs send to serve younger and more able bodies populations or what they call able-bodied populations. we are exploring opportunities to collaborate and we had a meeting last week and agency wide meeting last week and will be meeting with supervisor yee to talk about maybe explore some of the ideas. and we do know that there are about 1,100 new job placements through the jobs now program. of those, only a small, small percentage, one%, were older adults. howeve

what would you do by provider policy? >> rural healthcare create an environment that is unique in this country. the community cares for each other. the opportunities that are before us that have been demonstrated in some of our aco models create not only an integration of hospitals and physicians, but in all components of healthcare across the continuum. this kind of an environment is motivating. it is inspiring and could create a platform for transforming health care for the country. >> i want to give ms. murphy the chance to wrap up this round. i would like to keep the record open for you all to give us as many concrete ideas for getting more providers to rural america. this is enormously important. we have tried this and that and we all understand that year after year we are faced with this question of whether there's going to be and want to keep the lights on. in other words we have buildings and lights but you have to have people who can run them. ms. murphy your priority for medicare as we use this. where we have fi

we operate two of which provider base and this past year we provided a 500 hospital visits and 58000 out patient services and over 65000 clinic visits. we are a level three trauma center and the only facility that delivers babies and provide surgery or has any type of specialty care for hundred miles in any direction. we serve veterans, farmworkers, college students, tourists, and her own friends and family. we are resilient and crated team apopka providers. we are the largest employer in the region the staff of over 800. many of them have lived in the community their entire life and the families for generations. as for me i moved to the valley in 1985 and i began my gear career and an entry-level it position back when the personal computer was new technology. i have worked my way into the current ceo role. our staff struggles with the co of meeting regulatory requirements which are often different and sometimes conflicting across payers. our system must report on dozens of measures for the medicare quality and pay-for-performance graham however are private insurers asked us to repor

it holds internet service providers accountable for providing the internet access consumers expect while protecting innovation and competition. it's also one reason the internet has become one of the great american success stories, transforming not only how we kphaoebgt -- communicate with family and friends, but also how consumers buy goods, how we educate our kids. it's an equalizing force because it means kids on tribal lands in minnesota orchids that are in extreme rural areas are going to be able to access the same classes as people in urban areas. it means that a small business in ada, minnesota, is going to be able to sell their goods on the internet just like one of our big companies in the twin cities, like target or best buy. it is an equalizing force. earlier this year the f.c.c. approved chairman pai's plan, unfortunately, to eliminate net neutrality protections despite the millions of comments from the american people asking the f.c.c. to protect a fair and open internet, not to mention a half million comments from russian e-mails, the f.c.c. voted in december to move forwar

and who also provide opportunities for current youth to do job shadowing and provide mentorship to those folks. the program was founded in 1993. >> thank you. next speaker please. >> sandra davis, john, william, patrick, eva gomez, jackson. tiffany jackson, jacqueline jones. >> i am spencer with boys and girls club. i would like to read a letter. deer chair. i write to urge the committee to support increased fund egfor the services in the 2018-19 budget. one of our cities largest and most influential youth organizations. the city's funding is far too low based on need and high cost of doing business in our city. as you know, the department of children youth and families recently competed competitive process for funding for services over the next five years. it is flawed in three main ways. one, not enough money allocated to out of school time funding. this is for both poor and working class families. two, the funding in several categories with no relationship with families especially public housing. three, too little money to teenagers. the dollars targeted at teens are exclusively for y

unless additional funds are provided. we anticipate how extremely supportive the committees have been of va and we urge congress to pass the va mission act. i have seen firsthand how important flexibility and collaboration between va and community partners is to our veterans. last year on august 23rd 2017, i was on my way to join president trump and leaders of our veteran service organizations in reno for the signing of the appeals modernization acted of 2017. when i received a call from mrs. capielis. i served as the director of veterans affairs for the great state of mississippi. her son was in need of a liver transplant. i called va. and the memphis va center contacted the ellis family. and took the hand off for his care and provided treatment to get him healthy enough to receive a transplant. he was able to receive a liver at vanderbilt and now gets essential follow up care at the memphis va. va saved matt ellis' life because of its ability to coordinate the right care between va and the community at the right time. v

to exercise proper oversight of community care providers it contracts with in order to provide informed compassion that's earned sex specific health care to women when its facilities to not have the equipment or specialists necessary to care for them. e latest study by the rand corporation confirms that v.a. delivers superior health care to veterans when compared to the private sector. brief independent studies confirm this. for this reason v.a. should orporation confirms that better monitor the quality of care received by women in the community. this bill would require that careful monitoring so that women veterans receive high quality care. v.a. should always remain at the center of managing veterans health care and managing the care veterans receive in the community by only contracting with high quality providers with the competence to provide the treatment to veterans better monitor the quality that's a major part of ensuring they receive the highest quality care. i reserve the balance of my time. the speaker pro tempore: the gentleman reserves. the gentleman from tennessee is recog

sidel, many community services are provided through large, third party service providers. talk about the economies of scale that community banks by using large service providers. >> well, it's a matter of brown.e, senator the larger organizations can afford to staff and recruit the kind of talent that you need in a department and the focus that they can provide. they have the resources to technologies and install and implement those that a smaller organization wouldn't have so if a smaller bank were to use those services, they have access to cybersecurity kind of resources that they wouldn't have if they tried to do that in an in-house or own.eir >> okay, thank you. president obama in 2009 ofablished the position white house cybersecurity withinator to work cybersecurity efforts across all agencies. trump recently eliminated that position. that's the position mr. daniel held in the obama administration. will that help or harm government's efforts to make the country and especially financial system more resilient and stronger cybersecurity threats? are you concerned about t

is being provided. in some cases, we found a contributor listed with a supporting documentation being a voter i.d. we looked at that voter i.d. and found that, for example, the person associated with that voter i.d. on the city records was born in 1993. the contributor listed was in law practice much, much prior to that. so there were a couple of inconsistencies where the voter i.d. did not match the contributor, so those are another examples of where voter i.d. is important. >> commissioner kopp: wait. what's the voter i.d.? >> the voter i.d. is the number registered to the individual registered to vote in the city and county of san francisco. >> commissioner kopp: and we have those. okay. am, you wanted to say something? >> yeah. commissioner kopp, honorable, i wanted to say this was not a residential address, this was a business address that was the same as the one on my check. so i just wanted to make that clear. thank you for your time. >> good afternoon, honorable commission. my name is jeffrey wo

so the first slide provides some information about what the department has done so far to provide informationabout remote accessible vote-by-mail system. the presentation contains the same material we share at outreach events and will address the following topics. what is remote accessible vote-by-mail system? who is eligible to use the system? when can voters access their ballots through the system? what are the steps to access, mark, print and return the ballots? and how does the system ensure voters' privacy of selections? what is remote accessible vote-by-mail system? it is a new option that allows voters with disabilities to access and mark their ballots in a screen readable format from any computer with internet access. the service provides an opportunity for accessible voting without having to go to a polling place on election day. the department provides accessible voting equipment. it's important to note voters must have access to a compute tory print the ballot. only voters with disabilities and those in the military are eligible to use the system. to be able to access the ballot th

program provides grants to over 100 nonprofit organizations across the country to provide socially and economically disadvantaged women with technical and managerial training design to meet the needs of women entrepreneurs. many of women's business centers offer training at night and in multiple languages to make sure all women have the small business knowledge, tools they need when creating or sustaining a business. last year, w.b.c.'s trained over 114,000 clients and advised over 26,000 individuals. this training and counseling contributed to the creation of more than 17,000 new small businesses in the united states. clearly, the women's business center program has a profound impact, not only in our local communities, but also on our nation's economy overall. h.r. 1680 authorizes the w.b.c. program, requiring specific conditions for participation and application criteria for organizations seeking a w.b.c. grant. while many of these requirements have been met in practice, the inclusion of these standards in statute allows for increased congressional oversight and program confidence. h

they provide postoperative care. the sobering center provides a clean safe place for intoxicated people to rest, sober up and also be introduced to other health services. both programs are largely nurse ran and staffed. units will provide compassionate patient centered services to high risk individuals. with the effective collaboration with an investment community partners, the mrsc successfully expanded into a new adjoining building this year and is now functioning at maximum capacity which is 75 respite and 11 sobering beds. with a vision of home care for people without a home, medical respite was founded as a place for homeless people to recuperate after surgery or hospit hospitalization. nutrition and compassionate care are needed in order to make a full recovery. suck duker burg san francisco compassionate hospital is over 30% homeless, having a safe place to which homeless people can be discharged is essential to patient flow at csfg, especially to minimize the number of patients who remain in hospital care but

so first i'll go through each one and provide data and graphs for them. since fiscal year 2015 and now in fiscal year 2016 charity care in san francisco has declined with the continued implementation of the aca. the first figure, the one on the left, provides unduplicated patients for the last five years and you'll notice from starting in fiscal year 2014 into 2015 and now again into 2016 we are seeing significant declines in charity care patients for the city. in fiscal year 2015 we had about 60,671 and now in fiscal year 2016 we reported 51,569 or 15% decline. the next rate provides an over view of charity care service utilization by type, so emergency services, out patient and in patient services. you'll notice the inpatient, out patient services have declined from fiscal year 2014, 2015 and now 2016. emergency services from fiscal 2015 to 2016 have remained stable. there's a slight increase in about 3% and i'll get into that later when we talk about traditional charity care as well. so continuing with the first city wide trend charity care expenditure

looking to maximize profits should not restrict access to information if they are unable to provide more particularly during a natural disaster. during the flooding on the island and the ongoing volcanic activity local providers have been a critical lifeline for timely and accurate with understandable information so the hawaii tribune herald as well as other news sources and big island video news to provide the essential service to the public the websites and social media channels they have provided o details about the precise location of hazardous conditions and where evacuees can find shelter and e essential services and where the public can make donations of clothing in nonperishable food. television stations have also used social media platform to live stream that has been a critical lifeline for residents and for their families and friends. internationalri journalists have also drawn on the work of the local chairman through national and international audience. but to be seen by people across the country or around the world or cnn among others. the response to natural disaster

speeds for providers unable to pay more particularly during a natural disaster or other emergency. during the flooding on kauai the end a wahoo and the ongoing volcanic hippity on the hawaiian islands local newss providers said it was a criticaloc timelie for critical accurate and understandable information. the garden island in the hawaii tribune herald as well as on line sources such as big island now and big island video news have provided an essential service to the public. and social media channels these new sources have provided detailed reporting about the precise location of hazardous conditions , where evacuees can find shelter and essential services and where the public can make donations of clothing and nonperishable foods. television stations like hawaii newsne now hank k. hon have oftn use their web sites as social media platforms to livestream news reports that have been a critical lifeline for local residents and for their families and friends. national and international journalists have also drawn on the works of local hawaii and journalist to report their stories t

these transmission lines are critical to providing reliable electricity. conspicuousy large, transmission -- infrastructure project, transmission lines are free from controversy. allocating space for new infrastructure is often a challenge. the electricity sector is going through tremendous change and at the same time, demand for power remains relatively flat. there are new challenges from the weather and security threats as long as making sure the grid is more responsive. this requires us to evaluate the policy tools for is using. we hear opinions about the degree to which for orders are helping or hindering investments and electric transmissions. it is a challenge to get this right. stakeholders will have diverse opinions on how to improve these policies. if you look at the map of existing transmission lines across the country, it is hard for me to believe we need new transmission. this is a mature network. but it is also a good debt that it needs to be upgraded and modernized. something companies must consider when pursuing transmission project. a proje

content on theon left fighting with the internet service providers that actually provided the fiber to connect content they are fighting over their business in the way the content providers have wordedd it we want the internet to be neutral. h we don't want to have customers pay more for certain content we don't want the isp to charge more based on that. the whole time the content people are charging people they are literally saying we don't want them to do what we do every single day what google does everyday or facebook does every day we don't want to filter the content that facebook puts out every week a new release how they are filtering content and what they don't like. here is what we really want, a fair playing field for everyone. everyone that wants to do free speech can do free speech on theu internet if you want to start a new business start a website you don't have to worry about somebody filtering you out. a place with a will filter or decide if you can consent to get your content out everybody wants their content to go out and not have somebody judge that. that is what we

can use to provide veterans quality of life. one of the witnesses today, mr. john worden is collaborating with the texas a&m university professor on a wearable device to help veterans suffering from posttraumatic stress disorder. and, we welcome dr. -- assistant professor of the department of industrial and systems engineering at a&m. thank you and your team in texas for your hard work and efforts to support our veterans. >> i would also like to thank mr. chris meek and miss martha maccallum for their respective efforts on behalf of soldiers strong. in january, soldier strong donated a robotic exoskeleton to the road l murphy memorial va hospital in san antonio, which i represent. destination will help the facility provide state-of-the- art rehabilitative care to veterans. one of the benefits of hearing from the experts today, is that the fruits of their labor are not limited to helping veterans. although, they do that so well. they can be applied to people all over the country, and the world, who suffer from similar ailments an

>> no, they did not provide that explanation. i do know that on the 25th, when they were asked to submit their additional information by noon, we did confirm and received confirmation from the committee that they had submitted everything to us and that their submission on april 25th was the complete record, so they may have further comment on that, but we can confi -- did confirm that they had submitted a complete record, and that's what they told us. >> commissioner renne: okay. thank you. >> with regard to the software from netfile, in reading the letter from the alioto campaign and also your memo, but also the -- that was received today, public comment from the ceo of netfile, my understanding is that on april 13th, netfile communicated with the commission about a problem with another candidate's filing and went into the system to fix that problem, but that problem related to software that was maintained or sold by netfile for subscription service and not with the commission's filing system; is that correct? >> yes. >> and so

relief to rural providers. i'm sure the access is absolutely vital. not doing so can be pennywise and pound-foolish. >> have you established a rate? for most of the rest of this year what to expect to happen after that? >> we want to take -- we have been on track for 2019 but we put a pause on that to make sure we take the learnings from this experience and what we have seen in terms of what happens to rural durable equipment and of course in the ruba came out yesterday we have come up with if it de-50 blended rate that will provide a a lot of relief to these providers. we have also the budget us for two changes in how competitive bidding can work and i hope it gets support from congress on this. the first is what we pay winning bidders, rather the lowest bid there has been bottom feeding behavior that was going on that was make it unsustainable to rural communities to be a supplier even if you won the bid and the second is to expand competitive knitting to all areas so are rural provider is paid on community b

to provide at the veteran'sy, provider provide that -- at the veteran's choice, provide that care at the veteran's facility. having said that, it was never clear whether a veteran would qualify or not. that 30-day, 40-mile criteria empowered the v.a. to make decisions that often left a veteran who seemingly should be eligible uneligible for care in the community, and this legislation indicates that the -- it removes the 30-day, 409-mile requirement -- the 40-mile requirement and it replaces it with the criteria, the eligibility that is what's in the best interest of the veteran? that's pretty important and pretty basic. one would expect that always to be the circumstance, but the criteria is changed now to what is in the best interest of the veteran? and the v.a. must meet clearly defined, routinely reviewed records -- excuse me, criteria as to whether or not that is eligible, whether or not that veteran's desire to have community care, whether he or she is eligible. so we're reducing the discretion, the decision is still made between the veteran and the v.a., but the v.a. has -- we

if the provider says -- and are your preferred providers fee for service based or just a monthly stipend per enrollee. the fee for service benefit. >> right. so, to answer your question, this is -- this is going to be added possibly based on this recommendation just to your active p.p.o., self-funded plan, so your p.p.o., in-network p.p.o., contracted dentist, not your delta care plan. >> not for retirees? >> no, it's not. >> ok, all right. just want to be sure. commissioner sass. >> commissioner sass: we started out talking about how there's been a build-up in the stablization reserves, but reading it correctly, smile way, estimate benefit, all these are reflected in a claim in a premium increase on the very next slide, is that in fact what's happening, so that it actually, although you are increasing benefits, it's also increasing the premium costs. is that correct, therefore, it's not actually having any, necessarily having any impact at all upon the, you know, the build-up of stablization reserves or anything else. when i'm looking at slide ten, it's important to look at that in conj

director evanina has provided substantive written questions -- responses to over 55 questions provided by the committee. and today, of course, committee members will be able to ask additional questions and to hear from him in open session. director evanina graduated from wilks university and earned a master's degree in educational leadership from arcadia university, served in government for over 23 years, including service as a supervisory special agent and assistant section chief with the federal bureau of investigation. and prior to joining ncsc, served as chief of counter espionage at the central intelligence agency. director evanina, you're being asked to lead this agency during a period of significant and wide-ranging counterintelligence threats against our nation. i'm hopeful that moving forward, you'll be an influential and forceful advocate for those foreign intelligence tools you believe are necessary to keep our citizens safe while protecting americans' privacy. as i've mentioned to others during this nomination hearing, i can assure you that this committee will faithfully fo

, edge providers not internet service providers? >> that would be on both. >> both? terrific. i want to drill down that a little bit. i want to recognize senator coons to keep going but i want to come back and follow up on that as well. >> thank you, chairman lankford. let me follow up on that if i might. chairman simons, would you agree prioritization, blocking throttling practices by isps that may advantage or disadvantage access to particular parts of the internet could be seen as unfair practices? >> under the right circumstance, yes. >> so are you confident that the ftc, should you end up in the place where you're the principle provider of free and open internet you feel you have the authorities you need to do that, if not you will come back to us and seek legislation that would clarify exactly what the regulatory framework need to be. >> yes, absolutely, sir. >> given the hearing we had yesterday on judiciary committee on cambridge analytica and facebook i'm increasingly concerned that the average consumer doesn't really under

internet service providers, known as i.s.p.'s are basically utility companies that provide internet service to our constituents, to our businesses, and to america. without the protection for net neutrality, these utilities have the ability to block or throttle content in the internet, charging what is known as being in the fast lane, charging more. so this is a debate between whether we are on the side of the big utility-type companies that provide internet service, their special interest, or the individuals and small businesses of america to guarantee them equal access to this critical service. let me just give you one example, and there are many that can be given. i'm sure that in every one of our communities we have a lot of small businesses, and they recognize that they can now do business on the internet, and they have an opportunity to compete with the large companies that do most of their business through the internet. so in baltimore, in maryland, i have small shop owners. one that i am particularly familiar with sells b

it will provide wifi to an extent. it has its limitations but it will be serving as a way to connect, devices in your home, retail, construction and all of those devices will need the back haul services of a very robust fiber infrastructure. we also need to look forward to new business services and opportunities as we have mentioned the technology is transforming, the digital landscape and i just came back from a conference where u.p.s. talked about how they have transformed their business with the internet of things and it is a remarkable story of savings, resiliency, redundancy, reliability and resiliency that i think we need in the city and will be coming if we have the infrastructure to support it. so what are the policy goals for the fiber sf project? first deliver fiber to the premise. close the digital divide. one gig speed as a baseline service to all residents. create an open access network of choice and i will talk about how the technology works and how we are able to support multiples of providers and give t