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tv   Politics and Public Policy Today  CSPAN  February 11, 2016 11:00am-1:01pm EST

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not emphasize the importance of some of the help and what we're trying to do is make sure that americans in puerto rico have equitable care with regard to medicaid in terms of those rates and that's what the proposal and the budget at the same time we will do everything we can from an administrative perspective. i also thing the issue that was just raised about zika is particularly important. when one things about the cost that senator nelson was mentioning, cdc estimates for children born with some of these severe birth defects depending on the severity that the cost is 1 million to 10 million per child. so making sure we're doing everything we can right now to help and assist and support puerto rico in preventing cases of zika in pregnant women that could lead to these additional uses is a place that it's a priority focus. i've spoken to that in the past several days. in terms of the urgency of the
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need of the financial assistance to us. >> i appreciate your answers. we are ready and willing to do whatever we can from the side of the capital to be helpful in your efforts there. >> thank you. >> thank you, senator menend. how much i appreciate your accessibility, your willingness to work to solve problems. appreciate everything you've done for us. you're on the moon shot task force for cancer cures. >> i am. >> i've got a homework assignment. the surgeon general in 2014 said skin cancer was the fastest killing cancer of all cancers. as one who survived two melanomas in my life, i took that on as a call to action. and found out there was a 13 year backlog of ingredients
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submitted to fda approval in sunscreen that had been delayed. so we passed the sunscreen innovation act out of the health education labor committee. 14 months later, none of those ingredients have been approved. nothing has moved forward. as one -- to quote the president, he's asked you to identify and address any unnecessary barriers. would you please make the first item in getting those items approved? >> one of the things in terms of those ingredients is we actually need the data and information from the actual manufacturing companies. we're working with them, being very clear about here is what we need to meet the standard of approval. that is part of what the act did in terms of the new act is making sure we meet the
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standards. now we put them on every day. what you said is a true thing. on our children, every day in the summer, those sunscreens are going on. the question of what that sunscreen does in terms of absorption in the skin and causes other issues, that's what we want to make sure. we want to get to a base level of safety. we've been very clear. we heard you when you talked to us last year about this issue. we're trying to work with the companies to be very clear about this is the data we need and for us saying it was approved, can we just see the data, to make sure we know what we're putting on children is safe. we want to make progress on it too. we want to make sure we're making it as simple as possible to get the information we need to make it safe. >> i'll do you a favor. expedite getting to you what you need.
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if, i've just been handed this, i take no responsibility for the accuracy of this, but i've got great staff. it says fda has moved the goal post and is now requiring a new test that no one has ever heard of. so i'll check on what that is. if you'll check on that too. we'll see if we can get the barrier removed. think it's important to get this done as fast as possible. on the zika virus, i know tom freeden and i talked last week. i think the estimated request is 1.8 billion, is that correct? >> 1.48. >> 1.48. in another meeting, i heard there was money left in the ebola fund that has not been spent yet. some suggest using that. that would be fine. please do one thing for me. there were private hospitals that assisted the administration in responding to ebola. they were told they would be reimbursed for their cost. make sure they've been reimbursed before you spend that
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on something else. >> one of the things we want to make sure is we finish the job on ebola. that's a very important thing for us to do. we know that just this last week, a new case in sierra leone has occurred. the good news is, they were swabbing dead bodies to continue watching for it. that's how we found it. we're able to do the contact tracing. we need to make sure we finish the job on ebola including making sure we pay those communities like hospitals like emory and others that help with the issue. >> cdc did a marvelous job in responding. i just want to make sure everybody that was going to get reimbursed gets re reimbursed. finally, make sure ya'll are utilizing those people and they're not the only provider. i know we have a lot of things
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fall through the cracks and things are paid that shouldn't have been paid because people weren't eligible when they claim they were and i understand there's an underutilization of those resources. if you would follow up on that. to make sure those eligible for medicaid are eligible in getting the benefits. thank you very much. >> thank you. >> senator casey, i haven't asked my questions yet, nor have i even graded our distinguished secretary. if i can just greet her. then i'll ask my questions. welcome. >> thank you, mr. chairman. >> bill bill on the floor is mine. i've been running back and forth. i had a bill in the judiciary committee as well. i just want to welcome you to the committee. sorry it's belated. but i'm very pleased with the hard work that you're doing. it's a tough job. but i think you're doing about as straight forward and good a way as i could expect.
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i just want to let you know i'm proud of you and want to keep working with you. so listen to our side too. and we may be able to get a lot done here if we do. but we're happy to have you here. i'll have some questions for you after senator casey. >> thank you. >> mr. chairman, thank you very much. secretary burwell, thank you for your stellar service. i hate to pass up the opportunity to report some good news. we need that around here once in a while. someone's got to talk about good news. just some numbers. you don't have to respond. but i was struck by some of these. between 2010 and 2014, 87,000 fewer patients died in hospitals due to hospital acquired infections. that's a good number. 150,000 fewer readmissions which is good for the individual and good for saving money. but in the budget presentation,
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i was happy to see a lot of things, but i'll just do some highlights in this. this won't be fair to every priority. but a couple things. requiring coverage of epsdt program for children inpatient psychiatric facilities. extending the children's health insurance fund being through 2019. and the new initiative or i should say the new dollars for an existing initiative. the maternal infant and early childhood home visiting, $15 billion investment over 10 years. it is voluntary and it is evidence based home visiting which is good for the new baby and good for the mom and the family. so all that by way of good news in addition to the 17.6 million is it covered by, newly covered by aca since the enactment. on the bad news side, you've been asked i know several times
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about the opoid problem. terribly significant problem in our state. we have the ranking now in pennsylvania being third highest in heroin deaths. the coroners association, either one of our 67 counties has a coroner reporting on how people die. that number has gone up from about 47 a few years ago to hundreds of deaths every year. thousands if you look at it over several years. a huge issue, a huge problem. i know you've been working on it. the administration's new initiative is welcome. one subset of this is i've heard anecdotically that child welfare agencies are reporting an increase in foster care placements. prescription opoid abuse epidemic. how is hhs taking into account
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the needs of the child welfare population as it coordinates its response to this epidemic? >> i think in a number of ways, one of the most important ways is actually making sure that the mother gets into coverage and health care before she has the baby. because this is also about the health of the baby. and making sure we do everything we can for an addicted mother and actually in colorado i did visit one of the successful programs and so making sure we have that coverage, the coverage that has occurred through the aca in terms of people coming in through the marketplace but in your own state, with the expansion of medicaid, we believe we're going to reach more women. step one is making sure they have the coverage. step two is making sure they are willing to come in. i hope that the conversations we're all having publicly destigmatize women coming in because that's the other problem that's a barrier. you don't have health insurance so you can't pay for it as a
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barrier. then the question, you're stigmatized if you come in. these are some of the issues we're working to do to make sure we start at the beginning of the child's life in terms of healthy birth and a mother that feels connected to that child and is willing to care for it in an appropriate way. >> appreciate your work on this. and my last question is on the complex rehab issue that came up at the end of the year. where we legislated but now we're in a situation for the first six months of the year, providers will face the same payment difficulties they would have faced if we had not passed legislation. cms as you know better than i performed these quarterly updates. we had some discussion with dr. wakefield when she was here. just asking that your work -- that you work with cms to ensure the congressionally mandated
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payment change for complex rehab is included in the april update. >> we will work to implement as quickly as possible. i think acting administrator slavette is planning on combing up and having a conversation directly with you about it so we will follow up in that way. >> thank you very much, appreciate your work. >> i think i'll take time now to ask my questions because i may have to leave again. i've got so many things i'm doing today that it's hard for me to keep up with it all. but welcome again. i appreciate the work that you're doing down there. it's very meaningful and very difficult. it's almost an impossible agency to run so you're doing good. i have great concern on the topic of executive overreach of medicare part d program. there have been rumblings the president may issue an executive order that would allow the federal government to negotiate prescription drug prices in the medicare part d program. such an executive order would be in violation of the law.
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as the statute specifically prohibits such interference in private negotiations. despite this fact, i take the possibility of an executive order very seriously. i'm a strong supporter of the bio pharmaceutical industry as a source of innovation and intellectual property that produces life saving drugs and therapies. the part d program gets these needed drugs to medicare beneficiaries. we need to keep the program as it was originally structured because it works. everybody knows that part d is one of the most important things that really works. beneficiaries have choice of prescription drug plans, private entities negotiate to keep costs down. overall spending is significantly less than originally projected. beneficiary satisfaction is very high. in fact, it's been a tremendous success. moreover, allowing the government to, quote, negotiate, end quote, prices is not a new
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idea. congress has considered this policy and chosen against it. the president's budget proposal states it has no budgetary impact. the congressional budget office doesn't see it as a big saver. my question is, secretary burwell, is anyone working with the white house on an executive order that would allow the government to negotiate prices? >> i think you know we are focused on both sides of the issue of drugs. it's about innovation. which is why we actually brought everyone in for a conversation about both of those issues at the end of last year so we could hear from industry as well as consumers on the issue. as we think about it and the steps we have taken, we're focused on both that innovation as well as that affordability. deficits and entitlement in mandatory spending. we take that very seriously.
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and are looking for the opportunities we can do in terms of drug prices. because it's becoming an increasing percentage of our overall health costs. the most we've seen in many, many years in terms of prices. the steps we have taken to date include the session that we did include closing the med -- closing the doughnut hole which was a part of the aca which at this point has saved seniors $20 billion. the third step we've taken to date is on the issue of trying to provide transparency. because we do believe that puts downward pressure and created a medicare -- >> let me interrupt you. i'm very concerned about this. i think they fouled it up on da data with regard to -- should i say tpp -- >> negotiation -- >> and frankly if you don't have
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a data exclusivity time. kennedy and i negotiated that. because we know we've got enough data exclusivity time for the companies to recoup their costs. on bio and the tpp which we can actually get cure ecures, it ta about 15 years and $2 billion. and so you need some time to be able to recoup that money or if you have the five years that they have in that provision, the costs are going to be so high that everyone will be screaming and the bio industry will go down the drain and that's where we're going to find some that might really save health care costs in the long run. in the case of pharma suit calls, i'm sure if they get that figured, they'll do that to pharma ceuticals.
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in the case of bio therapies. so i'm concerned about it. i hope you'll weigh in, because we've got to have some economic sense on these things or we'll lose the whole pharmaceutical and certainly the whole bioindustry because of what i consider to be a stupid provision in the ttp. my time is up. let me -- i think senator kacarn is next. >> thank you for your service. we appreciate your career of service to the public. let me just point out how the extension of access to psychiatric emergency care which was extended in the omnibus is a ho logical extension of the program through june through september but allows you to extend it through 2019.
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it's revenue neutral. 4 i know you're working on it. it's very important particularly for those from 18 to 64 years of age. we think it is critically important for access to psychiatric care. i also thank you for being willing to look at the pediatric oral health care issues. we've provided coverage under the affordable care act. the oig report indicates far too many americans are not getting access, children are not getting access to dental care. so we need to figure out a strategy to get beyond coverage and make sure coverage is adequate and make sure there is access to qualified dental services. i want to follow up on the psychiatric care act but deal with the community mental health needs. this past week i had a
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roundtable discussion. in baltimore with experts on mental health and addition services. we've talked about this several times in the committee, the need for greater community access to mental health and addiction services. what came out at this meeting was a couple very interesting facts, but the number one priority still is the reimbursement structure. that does not take into consideration care managers. so if you're a hospital trying to be able to deal with psychiatric care, someone comes in to your emergency room, do you really know how to triage that person into the most effective least expensive care setting. do you have that capability. if you're a qualified health center, can you be able to deal with walk-ins and referrals, and do you have 24/7 capacity to do this. and the reimbursement structure is not terribly friendly towards
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those who understand that they must have those types of capacities in their facilities. i know that you invited comment last july on how we can make the reimbursement structure more effective. i know congress has taken some actions in regards to programs in several states. can you just update us as to how we are moving forward to encourage community based models for integrated collaborative care for mental health services? >> section 223 in terms of the implementation of an approach where we are trying to experiment both with different payment models and build on the backs of the behavioral health centers that are already in communities as well as our federally qualified health centers. that's a step we took and certainly senators stab now and blunt and on the house side have been very engaged on this issue. we are ahead of our schedule with regard to implementation in
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terms of doing the demonstrations. the budget that came up on tuesday, we'd like to extend those demonstrations so more of those can start doing the types of things your talking about. our budget proposal and i think miss stabenow are strongly for this. >> my colleagues have been incredible. i would just suggest that we need systemwide changes in the reimbursement structure so that we can deal with mental health. and i know you're looking at that. it was part of i believe your july inquiry. we should take what we've learned. we know that for every dollar we spend in these settings, we're going to save $6. yet the reimbursement structure doesn't allow creative ways of using managers in communities
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that may not be part of this program. i urge us to think broader as to how we can make the system work for mental health because historically it has not and today it's still not. >> in terms of the changes that will do it, the other way what you're talking about is through accountable care organizations. seeing the progress they make with integrated behavioral health care. we are funding those through accountable care. it's through both 223 as well as our accountable care organizations. >> i know i have one of the real champions on this issue. >> yes, we were just -- >> thank you, mr. chairman. >> thank you, sir. morning, madam secretary. good to see you again. just a couple questions. i know that on the -- happen to
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be the co-chair of the prescription drug abuse caucus. i know there's a lot of funding throughout the budget for opoid abuse. there's one account that was zeroed out. i assume the access to recovery account was zeroed out by the administration. other resources, other parts of the budget. more people are dying from overdose than from auto accidents or gun violence. will you talk to that so that would help some of the folks i'm hearing from and their concerns? >> yes, i think this gets to one of the topics. making sure there's not overlap in programs and we are doing that in the proposal and the money we've asked for. in the opoid space, there is specifically money around norcan and even last year with existing funding we have moved those moneys out. we're trying to work on this on two fronts. and that is through our funding and helping communities. but we're also working with the private sector to make sure that
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it's taking steps to be able to access it. i think you probably know in a number of states we see pharmacies like cvs and walgreens working with the state. so that access can occur not just for first responders but sadly sometimes family members need to. the other thing we're doing across the department in this space is fda has approved the first nasal naloxon making it easier for regular people to be able to give it to their loved one if they need to so they don't need to do a jab. >> very good, thank you. next question for you. i know you spent some time in south -- you should come back more often. each state was provided with the cms liaison to contact with questions and issues. these were removed recently and replaced with the generic e-mail account and causing some challenges in south carolina seems to be nearly impossible
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according to the department of insurance in some states like south carolina to get qualitienses. especially answers that are necessary from a timely perspective. what i've been told wby the doi is the respondent many times they're talking to doesn't list their names. it's signed basically by the fm response team. when they do identify themselves, it almost never e-mail or contact information. it's very difficult to have an actual conversation via e-mail or by phone with a specific person that leads to immediate response. >> i will follow up on that. the responsiveness of customer service in the space is something our riches with the doi -- i need to find out exactly which part and does it have to do with the fmm, the federal marketplace?
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>> yes. >> i'll follow up. this does get to the issue of resources for cms. i think you probably know the question of funding for these things and this particular type of service, we can't do the things. in our budget this year, fees that are coming in from the ffm will far exceed what we're asking for in appropriationings. there are certain services the fees can't pay for some of these. if you'll look at that, let me follow up specifically on have we changed something and do we need to figure out who to contact. >> right. >> i hear very clearly we need to be able to follow up with someone. >> exactly. as opposed to a department to a specific person to get a more immediate response. i assume in your budget there's some flexibility to shuffle some of the resources around. >> we do and we have done but i'm sure you probably know the funding for cms over the past few years has certainly been an issue. i'm hopeful we're at a different
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place this year. >> i know you've answered a couple questions about the challenges around the co-ops. the federal government has distributed loans to 23 co-ops around the country. however, recently, including in my home state of south carolina, we have seen co-ops closures which will likely result in lost coverage, higher premiums and perhaps even higher deductibles. in my state alone, about 67,000 south carolinians could lose their insurance. sadly, we've heard so far this morning, co-ops in 22 to 23 states where they operate are suffering large losses according to last year's results. and they are very -- there are very few signs these co-ops will actually be successful into the future. what's your next steps? >> with regard to the co-ops in terms of our next steps. the consumer's at the center of our strategy and our approach to
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making sure those %0vconsumers. that's why a number of those came out prior to enrollment. most recently, one of the steps we've taken is make clarity for our guidance so the co-ops can seek a broader range of capital for them to have inflows as they try and work through any issues they have. we support the states and we continue to monitor them closely. so we understand there are changes in the facts they have given us. >> yes, thank you. my time is up. thank you very much. >> thank you, senator scott. senator schumer. >> thank you, secretary. i think you're a superlative secretary. i've seen a lot of them in the many years i've been around here. nobody has more -- has a greater grip on what's going on, understands the policies, understands the practicalities and is able to get things done, so kudos and accolades, at least from this senator. and i know from many more.
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so what i wanted to talk to you about is two things. one is the zika virus. i don't know if that's come up so far. your administration, our administration, has sent us $1.8 billion in emergency suppleme supplemental requests in funding to address the zika virus. we have a window here. we have time. because the mosquitos that carry. even the one in new york the tiger virus is not going to come for several months yet. we're good if we get a handle on intercepting mosquito borne diseases. so i'm glad you've asked for these moneys. and again our republican colleagues, i am going to plead with them not to just talk the talk but walk the walk. you cannot combat these crises, whether it's zika or opoids or
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mental health or security in our country without a lean effective government. the private sector is not going to fight zika if we don't have, you know, cutting cdc, cutting all the agencies, fda, makes no sense. what they're trying to do right now or some are trying to do is say that we should not have any new moneys, will use the moneys that were set aside for ebola which haven't been spent yet. which seems to me like robbing peter to pay paul. will you please explain to me why we shouldn't do that. what the money's for, ebola being used for, why they're still needed, even though the ebola crisis for the moment has subsided both here and in africa. >> with regard to our ebola moneys, there are three main pots. one, as a budget person, the reports we send to the congress are fully obligated.
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as many of you know, much of the money we're in the middle of negotiating contracts and using. the biggest part of the money that is left is about $500 million. that has to do with the global health security agenda. the congress gave us that money. we have committed to 17 countries to help and invest over a five-year period so we spend it wisely. our moneys go down as their moneys go up. we are negotiating plans so we have implementation is what we're working on together. those moneys were set over five years to do this. the reason that is so important in terms of why would you take that money is one of the conversations we didn't have this year was middle east respiratory syndrome. last year, we had more cases outside of saudi arabia than we have ever had in history. we didn't talk about it because korea was able to handle it. we have to get these countries ready. actually zika started in africa and we didn't know. there was no ability to prevent,
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detect and respond. >> some of the money goes to stop ebola from spreading to other countries. we all know it will come here if it's there. >> that's another portion of the money. we know just recently in sierra leone, a case came back. we were able to detect the case. because they were still swabbing. we are still supporting them. so dead bodies, they swab and tet. that's how it was fund. so it didn't spread more. we need to get the job done in the three west african countries. continue our commitment to prevention of not just zika or ebola but mers and other -- >> vaccine or some kind of preventive measure. >> that is the other piece of it and barta and bio shield and efforts there. >> so we'd be robbing peter to pay paul. less safe against ebola and make us safer against zika. if we use the ebola money for
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that. you think that would be a serious health mistake is that fair to say? >> it would be a mistake. >> yep, okay. next, quickly, because i'm running out of time here. puerto rico. we've been talking about puerto rico and the dire situation. as you know, i've sponsored, along with many of my colleagues, some of whom are here. senator cantwell's played a leading role in this. to deal with the problems of puerto rico. we need bankruptcy as number one. but senator hatch has been very, very -- trying to be very, very helpful on this. we appreciate it. but in addition to bankruptcy and bankruptcy, no money should be a substitute for allowing a territory to declare bankruptcy. we need other moneys to help and those would be additional. my question is how long do you estimate puerto rico's current medicaid allotment to last. and what would happen if congress did -- fails to provide
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additional money to their medicaid program. or as we both propose, to grant them with state-like treatment? >> we continue to analyze. we worry things in terms of that allotment or that cab and using could happen as soon as this year. that's part of why the proposal we currently have in the budget to make sure we treat puerto rico equitably inner it er i te other americans are treated in regard to medicaid. >> i thank you for that extra minute. >> could you wait just a second? hold that time. put the time back up. let me just -- i have to leave. so let me just thank secretary burwell for being here as well as all of our colleagues who have participated in this hearing. my hope is the issues we've
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discussed here today. and to ensure the taxpayer dollars are used efficiently and effectively. dedicated taxpayers and citizens of this great country. i would also ask that any written questions for the record be submitted by thursday, february 25th, 2016. and if we can do that, you can answer them as quickly as you can, we'd appreciate it. sorry to interrupt you. >> no, no, no. thank you. madam secretary, welcome. it's great to see you. great to talk to you this week. your dad, my mom, spent some time in nursing home care. my mom for dementia and i think your dad as well. i shared with you the other day on monday i visited a presbyterian village nursing home just outside of dover, delaware. lovely facility. they are doing something that i thought was very encouraging. they have stopped prescribing
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antipsychotic medication. i'm used to going in nursing homes and seeing particular dementia patients drugged out. they don't know who they are where they are. not very response iive. a lot of people in these nursing home 90s, 100s. they had a fitness center there, doing yoga. they don't take those medicines. and they reported to me on, like, a number of falls. a number of falls now as compared to what it used to be, dramatically reduced. i think we have currently over the long-term residence zero percent of them on antipsychotic drugs. on a personal level, professional level, i just want to know if the department of health and human services you do, if this is in your -- if this is something that you're thinking about. we've worked on this issue with respect to trying to stop --
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reduce their -- reduce the prescribing of these mind altering drugs for like foster kids. an important issue. this is something like grandparents or great grandparents. i think they're on to something at westminster village. any thoughts? >> i think it aligns on what we're trying to do to get an engaged consumer at the center of their care. when we pay people for actually the outcome instead of pay for fee for service and the transaction, that's i think when we get to that. that's when in a place like that on a regular basis there is a meeting of the caregivers with the family to have the conversations about these things, to talk about them. so you can reduce those. so i think it's all part of the delivery system reform we're doing and shifting the payment system. i think the other place that we will be pushing on this kind of specific issue is as we try through our innovation center to
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do our experiments in home based care which mr. wyden certainly has spent a lot of time promoting. those are the ways i think it is a lot about payment incentives as well as, you know, certainly opoids are a separate category but the type of drugs you're talking about i think have a lot to do with how we pay physicians to care for people. it's about the quality of their care. defining that and defining the outcome is value not volume. not how many pills you describe but what the situation is for the individual. >> good, thank you. this is personal. i very much appreciate what you just said. during the last session, in the last congress, i work with dr. coburn and with some of your colleagues in the administration on issues including improper payments and something called the prime act. preventing, reducing medicaid
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expenditures. over the last two congresses, we passed bits and pieces. which was a wonderful thing -- and i'm going to ask you for the record to talk about the -- implementation of the new law which has been implemented in pieces and how we're doing in this effort to curb waste and fraud but not here at this forum. we just don't have time. i would ask though on the reducing opoid and painkiller addictions. we as i understand it folks that are in some casespractitioners, are able to prescribe medication for opoid addition to help increase the number of health care5szs providers who can help address this epidemic. could could you just talk about there -- i think there's a pilot, confused on this -- i think there's a pilot program that would focus on this area
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allowing them not throughout the country to prescribe medicines for opoid addition but do it on a pilot and the question is that something we ought to do on a pilot or is this something we should allow them to do nationwide? do we need the pilot i guess is my question. >> with regard to the issue of medication assisted treatment and broadening the number of prescribers that can do it. i think there are two separate issues. there is the issue of broader medication assisted treatment. there are different categories of it. one particular issue, buponophrene. right now we're in the middle of reviewing that and using our administrative authorities to use those caps. there are concerns it may have greater diversion. and so we want to make sure as we're creating access to it, we do it in ways we don't have diversion. i think there are two different categories.
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where we have the evidence. in the cases where we need some evidence. >> thanks so much. >> thank you very much. mr. chairman, i'd like that. secretary burwell, obviously we thank you for all your wonderful leadership. i do want to follow up on behavioral health, mental health substance abuse. before doing that, i want to thank you for all of the efforts of your department and the administration in helping us with the incredible public health energy in flint and the person you have put on the ground, dr. nicole lori, is really tremendous and the work going on there. i know you'll be going next week to flint. we have a community of 100,000
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people who, no fault of their own, have seen their water system poisoned and basically many parts of it destroyed because of lack of corrosion treatment before switching to the poor quality flint water and 9,000, up to 9,000 of those are children under the age of 6 who are now exposed and some of the houses have lead levels as high as a toxic waste dump so this is extremely serious. we're still hopeful. we've had difficulty coming together and getting bipartisan support to help rebuild the pipes and so on. we're still working and still hopeful we can still do something. thank you for that, your help. i do want to talk about, as you know, another passion of mine. we spent a lot of time on. that is implementing what senator blunt and i were able to get passed in a new law to create this structure so we're not just funding mental health
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and substance abuse services for grants that ebb and flow up and down but a structure change on payments that recognizes when a behavioral health specialist, psychiatrist, psychologist, social -- does work that meets quality standards, that they will be reimbursed like we reimburse other health professionals under aer er ia qualified health center. we've known actually since senator kennedy passed the community mental health act over 50 years that we needed a structure in place so we were providing comprehensive health care in the community. that's the final gap, mental pa. we now have qualified community behavioral health clinics. definitions of what quality is. like we do for fqhcs.
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the question is how do we get that available in every community in every state. the congress is willing to provide enough funding for eight states with planning grants for states interested to see how they could meet those qualifications in order to apply to be one of the eight states. under your direction and samsung and all of the wonderful folks that have been involved in your whole team, hms, cms, everyone, you've built a program ready to go. 24 states have gotten planning grants. 24 governors, 24 states have said we want to do this. we're planning how we meet those quality standards and we currently only can accommodate eight states. even though to do anything else we want to do, opoids, mental health and so on it all comes back in the end to having community services so people aren't going to jail or the
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emergency room, the hospital, they're getting service in the community. i wanted first -- i noticed in the president's budget, you expand the number of states from the eight we're talking about to 14. there are 24 states that are getting ready to go. i wonder if you might speak to joint efforts, bipartisan effort, to actually allow every state that's working to be ready to go to have the opportunity to provide the resources so we really have mental health substance services in the community. >> moving forward on that establishment of the quality standards and then that implementation because it is about the infrastructure to implement. that's why it's so important in these communities across the country that lack access. so many communities across our nation actually lack basic access to psychologists,
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psychiatrists or other behavioral health professionals and we do have an infrastructure in place. so now what we need to do is take those quality standards and make sure we pay. that's what we believe the demonstrations we're doing are going to do. so we believe it is taking that step. and our budget is proposing that we do more. because we think that's the right thing to do, to build on this, to get that transition to where we finally treat behavioral health issues on par. it's not just about saying we're going to do it, it's about having providers to do it and quality measures to pay for. this is a direction we're push being hard. i think you know we're meeting our statutory deadlines in terms of some of this work because we believe in it strongly. >> i want to thank you. just take another minute to thank you for doing that because you are working hard to meet those standards. hopefully you've proposed expanding that. we want to take it to every state that's interested and
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frankly listen to the sheriffs across the country who are tired of having people in jail who ought to be receiving mental health or substance abuse services. or hospital administrators who are treating people. i'll never forget, whose director of his jail is a psychiatrist. when we say why, it's because over a third of the people in his jail need psychiatric help. over the quality standards we've now put in place, 24 hour emergency psychiatric help would be required as part of this certification. hopefully congress this year will decide to give the 24 states who step forward the opportunity to put services in place. >> we look forward to working with you on it. >> thank you, mr. chairman. thank you, secretary burwell. thank you for your responsiveness. if i can get my questions out quickly, you may be done for the day. i've got a three piece.
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want to thank you. secondly, a concern. third, a question. on the thank you, you know, an issue we've talked about a number of times is the gabriella miller kids first act which deals with pediatric cancer and celebrates the life story of an extraordinary young woman from leesburg, virginia, who passed but advocating for research pediatric cancer. i was very glad to see that it was fully funded and the president's budget proposal. i know we had to work through to get that done and i'm grateful for that. i was also glad that the president's cancer moon shot included elements targeted pediatric cancer since pediatric cancer is so different than adult cancer so thank you on the front end of that. on the concern issue, that's just to put it on your radar screen, we're working with cms. we know that due to budgetary constraints, a number of the community based care transition programs that initially folks
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thought might last for five years but cut to four years, we have a successful program in virginia that does this coordinator transition care. unfortunately, they were cut back without being able to make the full transition to sustainability. we were working with cms. this is a concern. asking you to one off here. they've been cooperative. when we see successful programs that can and should make them the transition to economic viability, i think we've got one here. i again will just appreciate the collaboration, cms, to try to make this successful program, make this transition. finally, a subject again we've talked about at times and it's one that i think, candidly, that the american public is ahead of most of our elected officials and that's around care planning and end of life issues.
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i think that, you know, we still remain the only industrial nation in the world that hasn't had this kind of adult conversation about, you know, care planning, about trying try sure that issues around end of life are dealt with respectfully but also recognize that this is not about limiting choices but about expanding choices. and i was pleased to see that cms introduced a payment form for physicians to have those kind of conversations. and these conversations should include family members, loved ones. senator isakson have been working on this and we're gaining broader based bipartisan support and there's not a member of the senate that i haven't talked to that doesn't have a personal story.
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mine was my mom had alzheimer's for 11 years, nine years of which she didn't speak and i was relatively well-informed citizen yet we didn't have all of those conversations before it was too late. we're working -- i guess i would like to assure that a commitment that we'll continue to work with your staff on the care planning codes, how we look at more wrap around services. we're trying to work to make sure that these type of advanced directives can actually travel across state lines because so many loved ones, even if you move forward with this documentation, i know this is something that senator wyden has been engaged in as well. mom and dad and aunts and uncles move. trying to make sure that those documents travel with you built into your emr. i would like your comments in this space and again acknowledging that we have, i think for the most part, elected
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officials have to move beyond some of the horrific language that may have been used six or seven years ago. this is a part of everyone's life and it needs to be dealt with and dealt with appropriately. my hope is that the care planning act we actually may get this done. if you would like to make a few comments on that. >> thank you for your leadership. because your leadership and senator isakson and others, it helped create the space where we could go forward and make the changes that we've made. we think that's a first step but we know it's a first step. how now to implement this so it's useful to the people and meets the goals and objectives that i know we share. we're going to continue to work in that space. we welcome the comments and welcome continuing to work with you on the issue. we did this because we believe it's an important change and a change about quality of care for people across this country and their families. we take seriously the next step that we need to do and we look
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forward to working with you on that. i think being able to pay makes a very big difference. >> and not only being able to pay to have that conversation but also to recognize that people's wishes ought to be respected. we've talked about and you've been a leader on this for many years. my sense is that is a place with the american people are candidly ahead of their elected officials. there's not a single member in this body that hasn't had some experience either with a family member or friend. and it just breaks your heart sometimes when you see, i recall one virginiian had to go twice as a daughter to make sure that her mother's wishes at 102 in terms of being resuscitated when she had chosen not to have those
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wishes honored. and i again appreciate the secretary's sensitivity in this issue. it is a hard issue to talk about but it is one that i think in america we need to address and it is not about limiting choices. it's about expanding choices. thank you. >> thank you, senator warner. it's striking. i was going to talk to secretary burwell for a few minutes about the future and how appropriate that senator warner, who along with senator isakson, have really been in the vanguard of laying out some new policies to expand choices for end of life care. one of the areas that i'm very proud of took years is now as a result of the secretary's good work we have finally put in place what's called medicare care choices. so for the first time older people would not have to give up the prospect of curative care in order to get the hospice benefit. and i have been hearing about
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that since the days when i had a full head of hair and rugged good looks and was director of the gray panthers. >> mr. chairman, is that back in the early part of the 20th century? >> it's impossible to calculate. but the point, the point is, what senator warner has been talking about is creating more choices. this is not about washington, d.c. producing another federal cookie cutter program where you're going to have to do a, b, c and d. what senator warner is talking about is the center piece of end of life care should be about empowering patient and their families. it is high time. senator warner you and i and senator isakson have been prosecuting the case. medicare care choices starts is down the path. but senator warner is absolutely right about several of the next steps and i'm with you. secretary burwell, your last
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hearing. and one of the assessments i would make as we wrap up is that because of the good work that you've been doing, you and your colleagues, america is not going to turn back the clock. america is not going to turn back the clock on the affordable care act. you've talked about the increased enrollments. i'm particularly pleased that you're making this point that the heart of the aca, right at the center of it, is making sure that people don't get discriminated against for preexisting conditions. i always thought that as long as you allowed that, which was the history of american health care for just' ons that you basically had health care in america for the healthy and the wealthy. because if you add a preexisting condition and you were wealthy, you could pay for it. if you don't have one at all, you're in clovers. so you all have, i think, now made it clear that the affordable care act is not going
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to be repealed. we're not going to go back to the days when you could beat the stuffing out of people who had preexisting condition. and i think it's appropriate to talk about the future. i'm going to spend just a couple of minutes doing that. one of the first areas that i would like to mention is newt gingrich and tom dash l wrote an op-ed piece here a few days ago. i don't think you see that happen every single day, the past republican speaker, pst democratic leader writing an op-ed piece and they said, let's have a bigger role for the states. let's have a bigger role for the states in the affordable care act. they had a variety of ideas. pulling the governors together to look at approaches. making sure that the various funding sources were more integrated, i guess, in the lingo of your agency. those are funding streams but to me it's taking the various funds
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and trying to find a way to coordinate them. what do you think about that? what are our opportunities for -- and as i ask the question i want to be clear. this is not talking about anybody trying to duck the coverage requirements and the consumer protections and the law. this is about whether people across the political spectrum can figure out how to test various approaches at the state level. what are the possibilities? >> i think there are possibilities across a number of different places, in terms of where the authorities lie for us to work with states to do the thing they want. we actually earlier spoke with ms. cantwell about the basic steps that new york took in terms of how they wanted to approach. as you mentioned at the end, one of the things that's f fundamental, there's a basic guideline in terms of what the benefits need to look like, in terms of making sure that the access gained is not lost.
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so when we think about that, there are ways like the basic health plan where progress has been made and there are different alternative approach to that. ams i would highlight that the governor of alabama this week announced that he is working with us and has come to closure on a waiver that will do regional care organizations like accountable care organizations. he's created an approach in his state that is innovative open working towards the kind of care that we were just talking about at end of life, educated and empowered consumer ethics centers care throughout their entire life. those are the kinds of things we want to work with. the constraints in terms of where the boundaries are have to do with affordability and access. we look forward to working. with regard to 1332 we've put out the gloins that articulate the standards that have been met. we have not put further constraints because we want to hear innovations and ideas. >> the second question i want to
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touch on is a committee project. i'm appreciative of chairman hatch's interest in this. he knows that i have been interested in this for years. medicare of 2016 is not the medicare of 1965. medicare of 1965 is people stayed in hospitals a lot longer and if you hurt your ankle and it wasn't really serious, you know, injury, it was part b of medicare. if it was serious, you were in the hospital for a few days. that is not medicare today. medicare today is cancer, do e diabetes, heart disease and stroke. that's most of the spending. we have a task force led by senator isakson and senator warner with their interests in these issues and it is stunning what you come up with when you look at this, is after seniors, particularly in areas where you don't have medicare advantage, after seniors get that free
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physical, thank you affordable care act, so often their care or kind of the nonsystem that exists just sort of leads them off the rails and they end up in a hospital emergency room. and when they're about to be discharged, nobody knows who to send a record to because the care is so fragmented and splintered. and you, in putting together hhs budget, obviously has take an look at the chronic illness. what is ahead there. >> chronic care in terms of quality and cost, we know 08% of the total care costs come with the chronic situations. and so both from a quality of life perspective and a cost perspective, taking these issues on is important. i think the other thing is we think through the strategic approach that then guides all of the tools and levers that we had from a policy and payment
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perspective, is that the center of that is more integrated care. we need to change the way that we deliver care in the country. and we're on a path way to do that. and whether that's in prevention, as you highlighted, the importance of the preventive care services that are required without additional costs throughout the affordable care act to making sure that you have a primary care home. where that person is responsible for making sure that the pieces and parts of your care are connected in a way that serves you. and i think that connects to a point we discussed earlier, which is making sure that we are paying for value, not volume. we're paying for the outcome of your health. whether that's the prevention up front or when you do have something making sure we get the outcome you want. connecting those things together and that's why the payment system is a very important part of the tools that we have at hand to drive this change in terms of care that is something integrated and focused on the individual with them engaged as part of that care in terms of the choices we were discussing at the end of life, but well
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before then in terms of your everyday care. >> i can tell you that of course the popular wisdom is that this is an election year and nothing is going to get done and the like. but i have been very appreciative of chairman hatch's interest in this. and he is telling us we are supposed to pull out all of the stops to pull together a bipartisan bill. he has set what i think are reasonable kind of principles we ought to work around. so buckle up for that one. we're going to push very hard to advance that this year. let me turn briefly to some questions with respect to some of the other issues that are within your jurisdiction. first, i want to make sure that we formally acknowledge the improvements to the tanif program, again outside of washington is public assistance. i think we've made some real
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progress most recently in the tax bill in december with respect to the earned income, you know, tax credit. that's a very substantial victory. we've got more to do to help struggling parents find work and i think you all have some promising proposals in that regard. so that is as much a reflection on your good work as a question. with respect to foster care, i thought that -- and i just heard about it from the staff. senator casey made a good point with respect to the new spike in foster care and certainly a factor in that is the opioid epidemic. chairman hatch and i have spent the better part of the last year working on a proposal called family first that would allow states to use their foster care dollars on programs that we know to be effective, you know, drug treatment or mental health, and help prevent the need for foster care by keeping families
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together. and i think the premise is these types of programs not only save money for the overall system but they also approve the health and well-being of vulnerable youngsters. now you all have a similar proposal as i understand it. perhaps not with the same role for substance abuse treatment programs as a foster care prevention tool. now, you pointed out there is certainly a role here for medicaid and that is important. chairman hatch and i feel strongly that child welfare and foster care dollars can also be used more efficiently in this space. and i would be interested in whether you share that view. >> i think you know that we do share the view that trying to make sure we are doing the things so that children can say in their home setting as much as possible, as long as that is
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safe and appropriate. but that there are ways to encourage that. and many of our proposals are around that. we welcome to opportunity to talk about what are the key ways that you do that in terms of supporting a parent so they are able, or parents able to care for the child appropriately. and then the question of where the funding streams. we welcome that conversation. >> we started a vote on a bill that's in this committee's jurisdiction, the trade enforcement act. and i'm just going to leave you with one last thought. we are going to be relying on your council and your expertise a whole lot during this remaining year. and what i have always sensed about your agency and handling the responsibilities there is that doing your job well is a contact sport. and i admit that i went to school on a basketball scholarship. so that's kind of my world. but i see you constantly
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reaching out to legislators, to state officials, to the advocates, people that often don't have the power and clout. and i want you to know i really appreciate that. because i think you're kind of writing a sort of manual for how you ought to do this job at this incredibly important agency, which is sort of the people's agency for kids and seep yours and the disabled. and i wish there were more time to get into some additional issues, but we're going to be back at you on some big questions, because i know you and i have talked briefly about the 18-month investigation into the hepatitis c drugs. there's a piece out this morning that indicates that the states are rationing hepatitis c drugs. that they cannot afford to take care of people. and by the way, when you ration rep tights c drugs, people get sicker and sicker and have very
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serious liver illnesses that cost more money. so we're having problems today handling just a small percentage of those who have hepatitis c. and we're likely to end up with bigger expenses as a result of care being rationed. and i think -- it's a question we're going to tart examining here, is we are on the cusp in the united states of having a policy that says we are going to have spectacular cures for illnesses. and the hepatitis c drugs are cures. and we're going to have spectacular cures i suspect for diabetes and cancers and the like. and the question will be, will americans be able to afford to get those cures. and that is certainly going to be a debate that wouldn't be for the faint hearted. i'm really glad that we're going to get to have you for close to
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an additional year. and i so appreciate particularly the way you constantly come back to pulling people, you know together. you don't get, you know, this job done well and come up with policies that pick up bipartisan support by osmosis. you get it done because you're constantly reaching out to people saying, look, bipartisanship is not about accepting each other's bad ideas. bipartisanship is about taking good ideas. i think you've handled that very well. i think chairman hatch indicated we have some colleagues who may ask additional questions for the record. and with that the finance committee is adjourned.
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homeland security secretary jeh johnson is speaking today on the state of the nation's security and his agency's achievements and expected challenges for the new year. he'll take questions from people. you can see his comments tonight at 8:00 eastern on c-span. then at 9:00 eastern on c-span the house foreign affairs committee hearing on implementation of the iran nuclear agreement. witnesses include the state department's lead coordinator
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for implementation of the deal and the treasury department's head of sanctions oversight. every weak end on c-span 3 we feature programs that tell the american story. here are some of the highlights for this president's day weekend. saturday afternoon 5:00 p.m. eastern, the we talk about this book. her unusual life including a second marriage to former vice president aaron burr. >> what brought these two celebrities together. on burr's side of the alter, the undoubted attraction was his mon -- her money. a marriage to her would give him a big pot of money to spend. she had her own motivations for the marriage.
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on the one hand she would soon have to begin settling her first husband's estate. burr, with his knowledge of the law, could help her protect her assets. but the main attraction of the marriage for her was the opportunity to enter social circles that had been previously closed to her. >> at 6:00 on the civil war, historian dennis frye on the reactions of southerners and northerners to the 1859 raid on the armory. his subs subsequent execution and the nation's divided sentiments. sunday afternoon at 2:00, historians explore the history of the death penalty in america, including the 1976 greg v. georgia u.s. sprkt case that affirmed the constitutionality of capital punishment. monday at 3:30 eastern, an our author compares the
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assassinations of abraham lincoln an john f. kennedy. their personal similarities and differences, the state of the country at the time. he also talks about the experience and reactions of the two widows. >> jackie was very conscious of history. jfk was very interested in ieb ham lincoln, knowledgeable about lincoln. so jackie did have v much in time the lincoln president for the funeral. >> for the complete schedule go to c-span.org. roads to the white house began in iowa, the caucuses which date back to 1972. and then we move to new hampshire, that quintessential first in the nation primary, a listening open rich history. now we begin to test the candidates and their message. we move south to south carolina the first southern primary and then to the party caucuses in
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nevada for the democrats and republicans. more than likely we'll see a number of candidates probably drop out of the race so the field will narrow and then we move into early march. super tuesday, the start of winner take all primaries which means that the delicate count will be critical. as we watch the count continue, we'll get a better sense of whose message is resonating and who is on the path to the nomination. president obama recently spoke at an israeli embassy ceremony honoring four people, including americans who were risking their lives to protect jews during the holocaust. it's the first time an american president has participated. this is about an hour and 20 minutes. >> mr. president, honored guests, it's a great honor for
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me to be here this evening with all of you. i'm deen that tottenburg. some of you may recognize me from television. but most of you probably recognize my vis and not my face from national public video. we're assembled here at the assembly of israel in washington, d.c. to award medal es and certificates of honor of the righteous among the nations, to the late master sergeant roddy edmonds and the late lois venn den of the united states and the late soldier of poland who risked their lives to rescue youed during the holocaust. the holocaust remembrance authority was created by the state of israel in order to gather all information about the holocaust, to commemorate,
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document, preserve, research and educate. when it was established, the jewish people did not forget the nonjews who stood by their side in the darkest hour of history. struggling with the enormity of the loss and grappling with the impact of the total abandonment and betrayal of europe's juice. the state of israel made a point of remembering the rescuers. thus, the law establishing this added yet another mission to pay tribute to the nonjuice who risked their lives to rescue jews during the holocaust. since 1963 a public commission headed by an israeli supreme court justice -- i would say maybe that's why i'm here but i don't think so -- has been responsible to making the decision as to who will be recognized as righteous among
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the nations. this title is the highest honor that the start of israel bestows on nonjews in the name of the jewish people. our ceremony here today is unprecedented in that this is the vsh first time that american citizens are receiving righteous honors on american soil. i'm honored to invite to the stage, our host, ron dur mer, ambassador of israel to the united states. [ applause ] >> on behalf of the state of israel, my wife roda and i want to welcome all of you here to the israeli embassy in
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washington. i want to extend my profound thanks to you, mr. president, for being here tonight. your pence here on international holocaust remembrance day is a powerful tribute to the memory of the victims as well as a testament to the unique nature of this ceremony which we've come together to honor two americans and two poles who risked their lives to say you during the holocaust. your presence is also a testament to the unique relationship between israel and the united states. it is not every day, nor every year or nor even every decade that a sitting american president speaks at a foreign embassy. in fact, this is the first time that is sitting president has ever spoken in our embassy in washington. [ applause ]
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so, mr. president, i deeply appreciate the message of friendship that you are conveying by being here with us tonight. i want to welcome the chairman. as a child, he survived the concentration camp. he would eventually become the chief rabbi of the state of israel. i can think of few individuals who better per son fied the indomitable spirit of the jewish people. i also want to welcome the chairman of the american society, leonard vilf who is a child of survivors. i want to thank you and thank the entire vilf family for everything you have done to support the mission here. i want to recognize someone else who is here tonight who has done so much to preserve the memory
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of the holocaust and that is steven spielberg. mr. spielberg, thank you for using your talent to spread awareness of the holocaust across the world and across the generations. and thank you for your remarkable work to preserve the memory of tens of thousands of survivors. some of those survivors are here with us tonight and i would like to ask them to stand for a moment and be recognized. [ applause ] finally i want to say something to the nearly 60 members of the families who are here. you know, the jewish people are
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an ancient people with a very long memory. we forget neither our most wicked enemies nor our most righteous friends. tonight the names of your four esteemed relatives join the names of oskar schindler and other righteous among the nations to become a permanent part of our nation's heritage to be remembered by our people for generations and generations to come. ladies and gentlemen, 71 years after the liberation of auschwitz we still try to make some sense of the hholocaust. we still try to learn some lesson that will shine light in the darkness. for some the holocaust represents man's inhumanity to man. and its primary lesson is to be ever vigilant against racism,
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xenophobia and intolerance. for others the holocaust shows what can happen when extremist ideologies come to power. and its primary lesson is to always safeguard the corner stones of a free society to protect the rights of all. for me, the holocaust was the attempt to wipe out the jewish people. and its primary lesson is for the jewish people to never be powerless against our enemies. that is why like many jews, i take great comfort in the rebirth of a sovereign jewish state in our homeland. and the jewish people once again having a voice, a refuge, and most important the power to defend ourselves. but regardless of its meaning and its lessons, the holocaust
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poses two difficult questions for all of us. questions that challenge both our faith in god and our faith in man. first, how could a compassionate god allow the holocaust to happen. second, how could seeminglymn 8% civilized societies produce so many individuals who could purpose trait such horrific crimes? in trying to grapple with these two questions, perhaps we should consider two other questions. two much older questions. they are two questions recorded in the bible. they are the first question asked by god and the first question asked by man. after adam and eve disobey god in the garden of eden, we read that they hide in shame as they hear god's voice.
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i echo, where are you, god asks? the stages of the jewish people teaches that where are you is not a question god is asking for his same, it's a question god is asking for our sake. it is a question meant to spur introspection to instill in us an appreciation that we are moral agents in the world, that we are responsible for the moral choices we make. ladies and gentlemen, the 6 million jews killed in the holocaust were not the victims of an earthquake, a hurricane or some other random natural disaster that would understandably turn our eyes to the heavens for answers. the 6 million jews killed in the holocaust were murdered by other human beings. by human beings who had a
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choice. so perhaps the question where are you, i echo, a question that so many asked god during the holocaust, and which so many of us have been asking god ever since is not a question for us to ask god, but a question for god to ask us. where was man during the holocaust? where was the moral compass of the millions who simply looked the other way as the nazis and their army of willing executioners perpetrated such monstrous evil. rather than honestly confront this damning question, people instead tried to excuse their inaction. too often they justified their failure to accept our moral obligations to one another by hiding behind another question. they answered the first question
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asked by god in the bible with the first question asked by man in the bible. it was the question asked by cain after murdering abel. [ speaking jewish ]. >> am i my brother's keeper. am i my brother's keeper. ladies and gentlemen, we're all here tonight to honor four people who were their brother's keeper. they're here to honor four brave individuals who saw their actions not as an act of courage but as their fundamental moral obligation to their fellow man and that is precisely what makes them true heroes. they are heroes, not simply because they had an answer to cain's question, they are heroes because they had an answer to god's question, to the question i echo, where are you.
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these four had an answer. and in an age of so much indifference, they acted. in an age of so much cowardice, they were courageous. in a age of darkness, they were a source of light. so in honoring these four soul to night, let us not only recognize their remarkable heroism, let us hope that their light will inspire us to live our lives so that we too will be able to give the right answers to those timeless questions. and in so doing build a better future for all humanity. thank you. [ applause ]
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>> it's now my honor to call upon the chairman of the council and holocaust survivor. president barack obama, we will never forget the friday morning you visited, signed by the president, prime minister netanyahu, your remarks is unforgettable for us. thank you for joining us tonight. our host, ambassador of israel, ron durman and his wife, thank you for hosting. the honorees of righteousness. all what we will say about you
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is nothing. it is zero. what you deserve for your families, knowing that your fathers or grandfathers did not only for the jewish people or man kind at all, would assemble so that a man can be good even in an evil period time. we were in that dark tunnel six years. i was in the city where i was born. the first getto located in poland was in our city. why? don't ask. the first. october '39 started the misery,
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the sufferings, the separating of families. in those six tunnels, six years, we thought that we conquered the whole world. being later, every day a new transport came. from where? from hungary, from romania, from bulgaria, from greece, from tunisia, from paris, belgium, poland. so we disconnected from media six years, didn't see a newspaper, didn't hear a voice of a radio, whatever. what did we feel. that we conquered the whole world. and in this dark tunnel there were some stars, the righteous among the nations. stars. many of us owe their lives,
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their survival to those stars. the professor in the university, kenneth walsh, he found an archive of the guess that po peer berlin a document. there is a prisoner of war, a russian. he is risking his life in barrack number eight to rescue the life of a jewish child. that's me. you have to investigate. maybe some jewish blood is in him. why is he doing it? four months rescued his life to save me. risked his life. he was a star.
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and how many like this. from the whole world we have about 26,000 names. after all of the investigations, we found them, that they end right there. medal of righteous among the nations. 26,000 from a continent of so many millions of people. a our doctors, our educators, our merchants, industrialists, whatever. 26,000, including from japan, sweden, germany, poland. no more than 26,000 after 70
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years. mr. president, we have a long history speaking about righteous among the nations. because as ambassador durman mentioned, we have a good memory. 3,300 years ago we didn't have bread. there was no time to wait for bread. we at matzos. t over 3,300 years, the same menu. [ laughter ] four glasses of wine. everything. memory. 2,200 years, about, found some oil in the temple. happy hanukkah. you face us. happy hanukkah.
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on the same date. earlier to these two events we had already a righteous among the nation. order was given by king pharaoh of egypt, all of the boys born to the jewish people, throw into the nile. the girls survive. right and left, boys and girls. it's kind of a final solution. there was a baby of three months put in a box on the nile. his mother couldn't hide him anymore. and the daughter, not the jewish daughter, opened the box and said, this must be a jewish child. a jewish baby. she took him from the river, from the nile and he was brought up at the knee of her father.
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he was the first child survivor in man kind's history. and the daughter of pharaoh is the first righteous among the nations. the daughter of the king who made the final solution. she saved him. we will never forget. and i want to say one word. as far as we are unable and not authorized to forget the horror, we are commanded to remember people rescue their lives -- risked their lives to save us. we will never forget anyone with
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assistance and helps for the mortality and the eternity of the jewish people. thank you. [ applause ] >> let me call to the stage now leonard wilf who is chairman of the american society. >> good evening with, friends. it is a pleasure and honor to address you on this occasion. mr. president, you truly honor the state of israel and our courageous heros with your presence. your participation, along with that of ambassador dermer and
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mr. spielberg underscores the cingularty of the event that will take place tonight. for that we deeply thank you. in the first years after the holocaust when the jewish people were still grappling with the aftermath of the horrors that that endured, there was an understanding that along with memorializing and documenting the mass murders and destruction, the jewish people would honor and remember the unknown and silent heroes. these were the rarest of men and women who did not go along or stand silently by as their neighbors web friends and countrymen were rounded up and targeted for death. at risk to their own and their family's lives, master sergeant roddy edmonds and others were guided by a strong sense of morality to save jewish children and adults whose descend dents open families are here tonight.
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they're identified by the state of israel as righteous among the nations. true exemplars of courage and heroism for us and our children. many element os f this ceremony make it distinctive. this is the first time in history that an american president has joined us to honor united states citizened as righteous among the nations. also the first time that american citizens are being recognized on american soil. it is the first time that a u.s. soldier has been so recognize ds and only the fourth and fifth time that americans are being recognized as righteous among the nation. that's a son of two hall loi cost survivors, this event, with its bond to american citizens who demonstrated enormous acts of bravery to a polish couple who saved their child who would go on to build a life in america gives me a strong sense of pride. my family and i have dedicated u ourselves to furthering holocaust research and education
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in israel and the united states. and chairman of the american society, i am humbled by the great task to which we commit ourselves, to ensure that the world never forgets. tonight not only do we give honor to these incredible men and women, we also proclaim that despite the years that have passed, these stories carry timeless lessons for us all gathered here tonight and indeed for all humanity. thank you again. [ applause ] >> now if you would turn your attention to the video monitors on each side of the room for a video greeting from prime minister benjamin netanyahu. >> president obama, ambassador der mer, roda, former chief lou and all of the family members who have being honored tonight, today marks the 71st anniversary of the liberation of auschwitz.
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today we remember the 6 million jews murdered in the holocaust. we remember the 1.5 million jewish children who never had a chance to grow up. today is also a day when we can be especially grateful for the establishment of the state of israel. the jewish people were once powerless and stateless. now we are again a sovereign independent nation with a capacity to defend ourselves. but as we defend ourselves, we know that we do not stand alone. while israel counts other nations as friends, we know we have no better friend that the united states of america. on behalf of the people of israel, i want to thank you, president obama, for coming to our embassy to mark this important occasion. and i thank you for your commitment to continue to work with us to bolster israel's security over the coming decade. your being here reflects the
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unbreakable bond of friendship between america and the jewish state. and it's a worthy tribute to the four brave individuals whom we honor tonight. the jewish people owe a profound debt of gratitude to valley, to lewis and to master sargent edmonds. we're forever indebted to them because of the jewish children and the jewish soldiers who were saved thanks to their bravery. their courage was a special courage. not only did they risk their own lives but the loifs of their families. and the life of their soldiers. their is no greater courage. god bless you all. [ applause ] >> so as we turn to the presentation of the righteous among the nations honors ceremony, i would like to invite ambassador dermer and rabbi
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israel mayor lowe to the stage. yes? you're coming to the stage? [ laughter ] i think they have chairs for you. it is my honor as a cousin of holocaust survivor elizabeth willing to read the story of her rescue by righteous among the nations. on july 22nd, 1942, the germans began the mass deportations from the getto. by september 21st, some 260,000 inhabitants of the getto had been deported to the extermination camp where they were murdered. they managed to flee from the getto and to go into hiding.
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i'm actually named after my aunt yanina because my father thought by the end of the war when i was born that she was dead. my aunt and her daughter stayed for two months at the home of acquaintanc acquaintances. my aunt then brought her daughter to the home of valley and maria until my aunt was able to rent and apartment under a false name and take her daughter back. despite the enormous danger, the germans publicly announced that helping jews would be punished by death. they cared for my cousin until her mother was able to take for her. at this time i would like to
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call upon the doctor of johns hopkins medical school grandson of the late maria and valerie. righteous among the nations from poland to receive the medal and certificate of honor. [ applause ] so now let me introduce my cousin aka elizabeth wilk who was rescued in poland.
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[ applause ] >> i am here today because of acts of tolerance, kindness and heroism. when the war started i was not even three years old. during the time of the nazi occupation of poland, fear, menace and terror. when crews were ordered to move, my parents and i did so in spite of urging my friends with offers of help. my father said that he will go where his people go. he died there at the age of 41.
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my mother and i were covered by polish underground to escape from the getto. once outside we didn't know where to go. my mother knocked at the apartment door of friends from before the war who took us in without hesitation. we stayed with them until bombardment destroyed their house. we did not have a place to live and my mother slept one night here and one night there. she feared for my safety. she turned to these friends from before the war. they took me into their home and i stayed there for some time with them and their children and i do not know how my mother managed during this time. on posts everywhere there were
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notices by occupiers that anyone who fed a you, knew about the you in hiding and did not report, written report it or hid a you would be executed together with their entire family. there was always a possibility that someone might notice something or a child might say one word. this family who helped were in peril. we survived the war because of people like them and others some of whose names i cannot know. in time of an unspeakable horror, they all showed heroism and humanity in the highest sense of the word. history repeats itself and i'm frightened by aggression, hatred
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and a lack of tolerance. we cannot forget our humanity and the lessons of the past. thank you. [ applause ] i now invite to the stage mark kay lish, son of holocaust survivorer trucker kalish who is here to read the story of her rescue by righteous among the nations from the united states of america, lois gunden. [ applause ] >> 1941, lois gundun, a 26-year-old teacher of french from indiana volunteered to work
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for the men no night central committee in southern france. she established children's home which became a safe haven for a number of children, including jews whom she out of the nearby internment camp. there lois pleaded with the parents to give up their children and give them to her in order to save them from deportation and almost certain death. my mother, who is with us tonight, is one -- is just one of the several children saved by lois. my mother told yad vesham at the time i was 12 years old and certainly scared, but lois was kind and passionately determined to take me and other jewish children to protect us from harm. gundunfearlessly sheltered the children when gunmen arrived.
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and she ran the childrens home even after the united states entered the war and she herself became an enemy alien. she continued her work until january 1943 when she was detained by the germans fortunately to be released in 1944 in a prisoner exchange. i, my sister elizabeth and janet's grandson eric are all here today representing the scores of jewish descendants of the children lois saved. through lois we are bound in gratitude to the gundunfather and mother -- family, thank you. [ applause ] >> i'm honored now to call upon ms. mary jean gundun, righteous among the nations from the united states of america to receive the medal and certificate of honor and to offer some remarks.
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[ applause ] >> on behalf of my late aunt, lois mary gunden, her family, friends and her broader mennonite community, i express our deep gratitude to yad vesham and the people of israel for this great honor. our family was blessed to have lois among us. she possessed an inspiring spiritual dignity and grace. humble about her many achievements, we knew little
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about her wartime activities. her fluency in french allowed her to communicate with the 60 children in the home and their parents. lois was grateful for every doesn't to in her words adjust another ray of love to the lives of these youngsters who have already experienced so much of the misery of life. from contact with other relief workers from organizations such as the american friends service committee, or aafsc, and the jewish organization, lois knew the dangers her children faced. after a visit from her colleague from the aafc on august 9th, 1942, she wrote, mary elms informed me of the return of polish and german jews to poland where death by starvation awaits them. learning that three children sought by police had been saved from deportation on september
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3rd, 1942, she wrote, when i heard of how the children were finally snatched from the fate hanging over them, i felt as if god must have had a hand in preventing anyone from coming after them during these two days. had they been taken to camp, all efforts to save them would have arrived too late for any good. marking a year on october 31st, 1942 she wrote, but my year's experience in relief work has taught me more than ever that one has to live one day at a time. god's faithfulness towards those who put their trust in him can be counted upon throughout the particular problems of the day. without the assurance of his abiding presence and his sustaining help, i would feel lost in an impossible tangle of circumstances.
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lois refused an offer by the resistance to leave france and avoid german detention. she, a pacifist, would not risk physical danger to those helping her nor others that might be harmed in retaliation. this young woman not much older than the children she strove to save is truly an american hero. [ applause ] >> i'm honored now to call upon lester tanner who will tell the story of how he and his fellow p p.o.w.s were rescued by righteous among the nations from the united states of americap
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[ applause ] >> good evening. i am honored tonight to present this narrative of my commander and my friend. master sergeant roddie edmonds, of knoxville, tennessee, participated in the landing of the american forces in europe and was taken prisoner by the germans. in january 1945, the germans ordered all jewish inmates in the p.o.w. camp to report the following morning.
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understanding the imminent danger in which this would place his fellow jewish prisoners, like myself, master sergeant ed monds ordered all the p.o.w.s, jews and non-jews alike, to report together. when the german officer in charge saw that all camp's inmates standing in front of the bare ra barracks he said they cannot all be jews. i remember standing by his side when edmonds retorted, we are all jews.
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edmonds did not waver even when the german took out his pistol and threatened to shoot him. according to the geneva convention, said edmonds, we have to give you only our name, rank and serial number. if you shoot me, you'll have to shoot all of us because we know who you are. and after the war, you will be tried for war crimes. the german finally gave up and left the scene. and the jewish p.o.w.s were saved from certain death. roddie could no more have turned
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200 of his men over to nazi persecution than he could stop breathing. my fellow p.o.w. who is with us tonight, paul stern, raise your hand, paul. [ applause ] >> paul was one of the jewish p.o.w.s saved by roddie edmonds. and he recalled, although 71 years have passed, i can still hear the words he said to the german camp commander, according to edmonds diary, these events took place on january 27, 1945.
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71 years ago today. and tonight my comrade paul stern is celebrating his 92nd birthday. [ applause ] i would also like you to meet one of my other comrades, he's actually the kid among us. he celebrated his 90th birthday last august. sergeant irwin fox. would you stand up? [ applause ] sonny's actually a tv star.

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