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tv   Key Capitol Hill Hearings  CSPAN  September 8, 2016 7:00pm-12:01am EDT

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educate and plug into meaningful careers. and if you're in the world that most of us live in you will be able to super charge what'si happening in the classroom. you're going to have resources that allow yous to get your core skills at your own time and place, you're going to have labs, create portfolio. allowing more people to enter the top of the pyramid. >> i was going to add two things. one of the amazing leverageable aspects of khan is you can free up the class time to freely engage. i see a direct corollary to our business. we're trying to take the
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administration out of our colleagues' hands so that they're not stuck sitting there doing administrative tests in front of a guest but actually provide them with resources so they can engage authentically and in an empathetic way with our guests. same thing happens in the classroom but you need to tools to be able to do that. in our case we're building a platform to take all of the administrative burden off of their plate so that they can authentically engage in the khan academy case, you can learn a lot of these things on your own, core skills and when you get to class it can be more project based, active and engaged. i think that's super powerful in a work context and a school context. the other thing is you talked about it earlier today, agency. just being able to take more control over your own path and your own growth and your own learning. which i mean it's got obvious
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benefits but it's also, it's -- there's something deeply respectful of the human spirit when you do that, when you put that in someone's hands. and it often, it bolsters your self confidence and i just think it makes a big difference from an emotional perspective in terms of how you experience learning and how you build confidence over time. so i think that's the special gift embedded in what he's built because that's really an emotional connection that those people -- those kids will carry with them forever. and i think that really enables amazing things in the future. >> we just have a couple of minutes left. let me maybe have you both comment in closing on how important the public/private partnership is going forward especially. and then where you see learnstorm going. you mentioned ireland. what are the longer term goals? >> ireland is interesting because to some degree the presur core of learnstorm
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started there, one of our board members is a reality tv show in ireland. he said that's a good idea. yeah we're in the works right now of figuring out how to get this into more regions, how to go nationwide. we want to work with districts, teachers and corporate partner to make this -- literally, can you imagine, a nationwide growth mind-set organization. change culture around learning. that's key to us. and you know, the public, private, ngo, for profit, corporate, partnership is key. we're not for profit. we're funded by philanthropy and partnerships like this. and it isn't just the financial resources that allows to build khan academy and do things like that, it's the expertise, the know-how. if we can connect you learning on khan academy to authentic career paths and industry and things like that, then that really starts to take us to where the future needs to go. >> mark?
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>> yeah, i would just say it's been -- this whole experience with sal and his team has been inspirational and it's been a very personal one for me personally but also so many members of my team. and i think one of the reasons we found so much meaning in it is because we as an organization with very purpose driven. our purpose is to care for people so they can be their best. and we felt that our support of learnstorm and sal's organization helps care for people in a very explicit way and it certainly propels them and enabled them to be their best. it was a fulfillment of purpose. but i do think that the sense of perspective, what sal described earlier and the reality on the ground of what's going on with workforce and with young people who are disenfranchised at this point is certainly a huge motivator. and i think it's necessary for employers and enablers and tool
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providers but also institution to actually align around what is the design principle that we're going to align around and what's the impact that you really want to have. the one thing that sal has demonstrated is you can scale impact e formousily and the impact has been super deep. it's a great model. >> sal, mark, great. thank you so much. appreciate it. thank you, everybody. [ applause ] this weekend on american history tv, we look back 15 years to the september 11 terrorists attacks through stories of americans who are at the white house, the u.s. capitol, pentagon and in the skies above washington, d.c. on saturday at noon eastern we'll here from if former chief
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of staff to senator edward kennedy and mary madeleine, former aid to dick cheney. >> even before the second plane hit i went down to the vice president office, a floor below mine, took the stairs down to check my gut. and it was -- i was there when the second plane hit and we knew instantly that this is not -- this is not an accident. it was some kind of act of terror. >> and on sunday, u.s. navy rear admiral david thomas, former senator majority leader tom daschle, garry walters and major heather penny, former f-16 pilot at the district of columbia air national guard. >> not in the near vicinity and able to prosecute and attack at that point in time. we need to get back and make sure we can play the short goalie game now that we cleared out the air space. so when we returned back to
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d.c., that was when things began to -- i mean on one hand settle down because we never -- you know, flight 93 wasn't there. and as we discovered later, the passengers on that flight were truly heroes. >> and sunday evening at 6:00 on american artifacts we'll tour the visitor's center of the flight 93 national memorial, the final resting place of 40 passengers and crew whose actions prevented four al qaeda hijackers from crashing its plane into its likely target, the u.s. capitol building. >> the flight 93 national memorial represents a lot about what makes america a fantastic country, in that on september 11th, 2001 the people that were on board flight 93 were every day ordinary people, citizens of
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the globe even. and it shows that you can make a difference no matter how big or how small. and no matter where you're at. >> for your complete american history tv schedule, go to this sunday night on q&a, author and columnist david k. johnson discusses his book "the making of donald trump" which takes a critical look at the republican presidential nominee. >> he's p.t. barnum. e's selling you ticket to the amazing two-headed woman. and then i started -- because he was the dominant force in atlantic city i started asking about him, and his competitors, people who worked for him and some big gamblers all said to me, donltd doesn't know anything about the casino business. >> sunday night at 8:00 eastern
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and pacific on c-span's q&a. at the national press club today, connecticut senator chris murphy talked about gun laws and the sandy hook school shooting. senator murphy led a filibuster in june to force congressional action on gun regulations. this is 50 minutes. welcome to the national press club. my name is thomas burr, the washington correspondent for the salt lake tribune. our guest today is senator chris murphy of connecticut. i would like to welcome our public radio and c-span audiences and like to remind you that you can follow the action on twitter using the #npclive. now it's time to introduce our
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head table guest. stand as your name is announced, please hold your applause until i finish announcing the entire table. tammy, former press club president, john welch, will lester, an ed toitor at the associated press, mary cyprus, director of affairs, dan freidman of the hurst newspapers washington bureau, clay lasher-summers a fellow engagement leader for every town new hampshire, mark chef senior reporter at investment news, skipping over the speaker for just a moment, jonathan so launt, a former press club member, kate ran sick, national
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spokesperson more mom's demand action, jason dick, deputy editor, peter irvine, freelance journalist, and key da lucky, commander of the american legion post here at the national press club. thank you all. [ applause ] take as moment of personal privilege, i would also like to welcome in our audience, andy and barbara parker. they're the parents of a reporter who was shot and killed a little over a year ago during a live shot. mr. and mrs. parker are now members. would you please stand and be recognized. [ applause ] thank you for being here. a senator filibuster is usually designed to block a vote on a
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piece of legislation. the connecticut detective chris murphy had a different goal when he orchestrated a 15-hour filibuster in june. murphy's objection was to get senate republicans to allow votes on measures to prevent people from buyi ining guns. weapons buyser can avoid background checks. eventually the republicans agreed. while he lost the votes murphy made his point. in philadelphia he spoke on gun control at the democratic national con vepgs and he's promised to raise the issue again and again this fall with the white house and congress at stake. murphy has emerged a was op the most vocal supporters of gun control. he hadn't taken his senate seat when a gunman started shooting at sandy hook in 2012 killing 20 children and 6 adults. murphy served in the state
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legislature. when joe leiberman retired in 2012, murphy won the seat. let's welcome to the national press club, senator chris murphy. [ applause ] >> thank you, thomas. thank you, everyone. thank you very much. thank you. thank you. thank you. thank you, mr. president, thank you to the national press club for hosting this really wonderfwonder ful lunch here today. as i wrote in the guest book i feel like i finally made it, my first trip to the national press club. i want to join in your acknowledgment of the parkers, want to add an acknowledgment to
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mark barden of sandy hook, a greet friend and leader on this issue. i want to thank those that are part of this head table today, clay and kate and marry for all of the work that they have done with me and others to try to move forward this issue of gun violence. and i want to ask your forgiveness as i delve into some prepared remarks that i think are important and then really look forward to answering your questions here today. so december 14th, 2012, a day that everybody recognizes, it's a day for me that forced my political career, which at that point was 14 years old, to change course. that morning i was standing on a train platform in bridgeport, connecticut getting ready to take my 4-year-old and 1-year-old boys down to new york city to see the rockefeller
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christmas tree and i got a call that there had been a shooting at the sandy hook elementary school. then i got another call telling me that there had been kids involved. and a few hours later i was there at the fire house adjacent to the school as 20 sets of parents, including the bardens were told that their children were laying dead on the floor of their first grade classrooms. sometimes in this business you get to pick the issues that you work on. and then there are other times when the issues pick you. now before that date quite frankly working on this issue of gun violence just was not at the top of my political priority list. as a congressman i didn't represent any of the cities in connecticut with epidemic rates of gun violence. but it's become my singular focus now on a united states senator. in the wake of sandy hook my eyes have been opened to the catastrophe of gun violence in america. and the inability to explain our
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exceptionally high levels of gun homicide with any data points but our gun ownership rates and our lax gun laws. in the four years since sandy hook the carnage in our streets has not abate pd. the mass shootings from san bernardino to orlando, they've continued, gun homicides remain as regular as rain drops and they now see the assault weapon rrt than the hijacked airplane or the explosive devices, their primary opportunity for mass slaughter in america. stopping dangerous style military assault weapons from flooding our streets is now one of the most effective tools we have to combat terrorism. that's what drove me to make the decision to stand on the floor of the united states senate to demand change. i'm still furious that in three years since sandy hook, three years of almost daily bloods shed in our cities congress has
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done absolutely nothing to prevent the next massacre. think about this. as our air waves are flooded with news of horrific waste of gun violence in chicago, mass shootings, congress hasn't done a single thing. but i also understand the my furry or the furry of others over this inaction, it's not going to make progress. we need passion but we also need to understand the reasons why the two sides on this debate are talking past each other. and that's really what i want to spend time talking about here today. here's the essential problem. from the center to left of the political spectrum, the conversation about guns in america is largely about the mechanics of how guns are regulated, how they fall into the hands of the law abiding citizens, what the data tells us
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about the best rules to reduce the number of crimes that are used to prevent guns. our debate starts and ends with the concrete details of gun laws on the left. the dysfunction in our dialogue over guns largely results from this conversation being totally foreign to those that inhabit the center to right half of the political spectrum. they're having a completely different conversation that has nothing to do with gun laws and everything to do with abstract concepts. of liberty and freedom and revolution. and how the discussion over guns is simply a prism through which to discuss these founding principles of our nation. on the right the debate starts and ends in the abstract of these big ideas. put another way, the debate within the right is in the clouds. the debate in the left is down in the weeds. so it's no wonder the demeanors and republicans have a really hard time finding common ground.
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if we're starting on different planets, it's hard to find a room that we can all sit down together in. and so i break this problem when it comes to how the right thinks about the guns into two modern realities. i want to spend some time talking about both. one is the increasingly anti-government i would call it neoanarchist bent of the republican party and the second is the new economic model of the gun industry in america where a smaller number of people are buying guns but in larger quantities. let's take the first. since the election of america's first african-american president, barack obama, it's become increasingly hostile to government. not hostile to inefficient government or overreaching government, just government. and you can see why frankly because in an era where cable news covers politics as soap opera, there's a lot not to like
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about politics. bashing government is big money these days. and the republicans are ready, just picking up the dominant media nair tiff. second in an era of unprecedented economic anxiety, many americans are looking if are somebody to blame for their plate. republicans not excited to blame the private sector offer government up. this culmination of the media covering the dysfunctional story lines out of washington and the national tendency of economic hard times to flow towards scapegoats it pushes the right further toward hard rhetoric. as kids in school we were taught that no one hated the government, at least their government more than the founding fathers. they hated their government so much that they took up arms against it. they were willing to die for their anti-government beliefs and then after casting off their 0 pressers, they carried their
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anti-government believes into the drafting room of the founding document of the new nation. the story line goes they wrote a section of this document that they would assume that the oppression would return and the guarantor of people's rights to cast off that second coming was the private right of gun ownership. that's not an unfamiliar story line to a lot of americans. so if you want to prove your be that fieds, then enacting people to take up guns against their government is the coin of the realm. in a realm where this is the hallmark of the modern right, it shouldn't surprise anyone that increasingly republicans are absolutists in their views of the right of citizens to own guns. they want to preserve the right of revolution as a means of showing how much they truly hate the current government ad
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ministered by president barack obama. and of course to be honest, guns are in many ways at the core of american mythology, beginning with that story of faye tree yots running through romanticizing freedoms of the wild wild west. it does have a seductive ring to many americans who may not endorse the idea of armed insurrection against government but nonetheless find this appeal to our finding ethos compelling. and to be clear, the founders of the republic, they were concerned with defending against tear any and enshrining the right to bare arms. but perhaps more given its pride of place is its first amendment with its protections of free speech and freedom of the prez and freedom of assembly. but to show you how far our second amendment debate has drifted from the rest of our rights talk, there's no movement
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among first amendment purists insisting that laws banning child pornography or yelling fire in a crowded theater are a slippery slope to tear any. and whether it's journalists being ordered to reveal anonymous sources, our understanding of first amendment guarantees, it continues to evolve amid new technology and changing social norms. or take the fourth amendment's protection against unlawful senl and seizure and the tension between privacy and security that played out in the struggle between the fbi and apple. these are important questions that have tremendous reach into our lives. and the members can and often do come down on either side of this question. but that's not true of the debate over the second amendment. i did five town halls on guns in connecticut in early 2013, after
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sandy hook. and at each one i heard my constituents talk about gun rights as god given, parroting the recent words of a conservative writer who wrote we don't have the right to keep and bare arms because the bill of rights says so. the bill of rights says so because the right to bare arms is intrinsic to our very being. it's a right we're endowed by our creator. unquote. my point is that there is a reason for this mystical brook no treatment of the second amendment. it fits naturally into their need to become more an more extreme in their campaign to undermine the legitimacy of the government. but the second cause for the hardening position of the right i think is the changing economic model of the gun industry. only one third of americans today is buying guns and that number is dropping every single month. that's opposed to half of americans who used to own guns
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30 years ago. meaning that the gun industry is relying on a smaller group of gun owners buying large kachs. how do you do this? you convince people that there are really only a few needs to buy weapons, but one of them, in addition to being able to hunt or shoot for sport, is to protect yourself. you can also make guns a collectible in the dizzying array of models offered by gun makers, certainly turned gun collecting into a hobby. but something else is going on within the gun industry marketing. the other motivation that they feed for the stockpile of firearms is that same revolution nair theory that became over time so attractive to the republican party.
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the gun industry in cahoots with the gun lobby, the nra and the gun owners of america, they've created a fantasy construct of a world in which citizens need to arm themselves against an out of control government. instead of one gun, you need 10 or 20 or 40. so that you can arm yourself and your neighborhood when the black helicopters start landing in your back yards. and you better also stockpile a year's worth of ammunition just in case. now further, the industry figured out that in the wake of this increasing fear of domestic terror attack, gun ownership can be marketsed as a way of protecting average americans from the blast radius of violent extremism. nra says that every american needs a quote security plan which means owning one or perhaps many expensive firearms. and the reason that americans need a security plan is because as the gun industry tells us, no
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laws can keep us safe. this is another essential element of the gun industry's new positioning. the ill legitimacy of law or government as a means to protect us all from arm. the gun industry's hope is that if americans lose faith in the law's ability to protect the public safety, then the natural turn will be to a massive private firearms ownership. thus the gun lobby opposes every single law designed to keep america safe from gun violence because to acknowledge the efficacy of any law would be to undermine the importance of guns. now how else can you explain the transformation of the nra's positioning of background checks. in 1999 the nra was pressing for an expansion of background checks. a similar law that they fought tooth and nail to defeat.
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it's not coincidental that the industry which provides a sizable chunk of the gun lobby's financing change. and to perpetuate itself, it needed if are the gun lobby to help create a new motivation for large sales of gun purchases. this is the new reality in the right today. an absolutism, a complete refusal to engage in a conversation because to do so would compromise the notion at the heart of american freedom and american liberty as the unrestricted right to stockpile arms is used in case of emergency against a government. which is regrettable. even if you think the supreme court got it wrong in the heller decision when it held that the second amendment protects a responsible law abiding citizen's right to bare a firearm, the court confirmed that the amendment protects only a limited right. justice scalia said, quote, nothing in our opinion should be
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taken to cast doubt on long standing prohibitions on the possession of firearms or the mentally ill or laws for bidding carrying the firearms in places on the commercial sale of arms. as clear as the law is today, the data is just as clear. and to me this is maybe the most tragic part of this story. because the right so cap occurred, so imprisoned by this conversation about god given rights that we all miss the fact that there are some pretty minor changes in our law supported by the vast majority of americans that would unquestionably reduce gun deaths . in connecticut we passed a strict gun licensing law in 1995 that result the -- this is a johns hopkins survey -- in a 40% reduction in our firearms related homicide rate. at the same time missouri repealed a similar law which johns hob kins showed resulted
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in a 25% increase in firearms homicide rates. 46% fewer women are shot to death in states with universal background checks. 48% fewer off-duty police officers are shot and killed in states with universal background checks. two out of three gun deaths, they're suicide related and states with gun purchase waiting periods have a gun suicide rate that is 51% lower than states without waiting periods. gun safety measures are constitution constitutional, they work and they're popular. and get they go nowhere in congress time after time because the two sides within the political system are living on different planets when it comes to this issue. so what do we do? or more accurately what do i do as someone who has committed my senate career to this issue. and i'll lay out three things and then i'll close. first i remind myself that all politics still is local. if the political force around
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anti-gun violence measures becomes strong enough, its will cannot be resisted. so we keep building up our grass roots organizations, pushing more voters to elevate this issue on their priority list and we work toward a day when the voters will force the right to moderate its stance on guns in order to win elections. and that political transformation right now is playing out before our eyes. anti-gun violence groups are getting stronger, numbers are growing all over the country. for 20 years, though, from 1994 to 2012 the gun movement was dormant in this country. it's had a very short period of time to catch up. but let's look at two competitive senate race to tell the story of how things have changed so quickly. in pennsylvania incumbent senator path too my is running n
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his support. when he originally ran in 2010, there was no mention of his position on guns. six years later, it is a central part of his campaign. in new hampshire with oun f the nation's highest rates of gun ownership, kelly ayotte's first ad of the campaign was in defense of our position on guns. of all of the issues she could have led with on the air, she chose guns because she knows what an important issue it's going to be to swing the voters in new hampshire. and also one of the grass roots organizations that i was talking about is strong enough that they raised the money to run two ads criticizing her position on guns early in the campaign. in ayotte's first race when the exact opposite dynamic was in effect. her democratic opponent that year was bending over backwards trying to get to ayotte's right
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on guns, trumting his a rating from the nra. not this year. not a single democrat this year is running for the senate trying to cozy to the done lobby. times and voters have both changed. second we have to take on the gun lobby head on and unmask it for what it has become. a spokesman for the gun maker, not for gun owners. 80% of gun owners support universal background checks. a higher percentage of gun owners than nongun owners some polls show support closing the loophole. more need to call out the gun lobby's double game and make their endorsement a little less meaningful. at the top of the ticket hillary clinton is doing just that. don't under estimate a major party presidential candidate calling out the reforms. some of her biggest lines is when she pledges to take on the
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gun lobby. and she's not afraid to talk about this. and further we're getting unlikely allies during the republican party. during the debate that followed the filibuster, jeff flake and lindsey graham were very critical of those that argued for the status quo. quote, every right has boundaries on it, unquote. that's what lindsey graham said earlier this year about the second amendment. i'm sure he would not have conceded that point two or four or six years ago. and lastly, this is the hardest part, we need to resist trying to remake the modern right. if they're moving toward a place with everything that the government touches is sullied ground, then we cannot alone stop this marge. the solution lies on the democrats moving away from our
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own safe space and recognizing that the right slide away from defending the legitimacy of government isn't going to magically abate, especially if a democrat continues to occupy the white house. have to be ready to meet the republicans in their space in the sense that we should be thinking of another outlet other than tau drawing a line in the sand on gun laws. many republicans that i talked to want to be more reasonable on the issue of guns but they're stuck on a party in which their position on guns is a litmus test for how much you hate government. there have got to be other proxies to demonstrate etiological purity in this respect. and we should be working hard with the sympathetic republicans to find another path forward, not simply yelling at them for refusing to work with us. following sandy hook, former supreme court justice john paul stephens said the law should
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encourage intelligence discussion for possible recommeremedies of what every american can reck nigh as an ongoing tragedy. that is not happening now. rather than simply continuing to occupy our separate planets, time is now for those of us leading the charge to take on gun violence. to try to force us to stop talking past each other and to fix the bugs in the system that create that reality. i'm mad that even in the wake of orlando, the deadliest mass shooting in the nation's history, coming on the back of san bernardino and rosenberg that we couldn't get a background checks bill passed or even a bill stopping those on the terrorist watch list from buying guns. but the filibuster and the sit-in that followed it changed things. it helped grow this political movement. it did cause republicans and democrats to talk past each other a little more.
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in the senate is compromise was reached that if you're too dangerous to fly you shouldn't be able to own a gun. and maybe the democrats are beginning to poke their heads up above the weeds of policy and republicans are willing to ascend from the cloud. the political anti-structure of the gun violence movement and the two sides of congress finding new ways to work together, then maybe it's just a matter of time before the laws of this country finally catch up to the will of 90% of americans. thank you very much for having me today. [ applause ] >> thank you, senator. just a reminder to those watching on c-span or listening in, the public is invited the our luncheons here at the national press club. the applause you hear is not necessarily from the journalists covering the event. let me ask you first off are you planning any dramatic strategy
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to put the gun issue on the front this fall. for example are you going to try to top your record? >> yeah. i'm very pleased that in the wake of the filibuster and the sit-in the momentum has seemed to have shifted. and i use pennsylvania and new hampshire as examples. but i think we have to be in the business over the next two months of the basic blocking and tackling of winning elections. there are some key elections out there that pundits and political progress nost caters are going to look at when they decide whether or not guns were on the ballot in 2016 and which side won. so i'm going to be spending much of my time between now and the election traveling to states in which we have a clear difference between candidates for the senate and the house on is the issue of guns. i'll be spending time in the states that have referendums, i point to nevada and maine, two
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important states, swing states on this issue. we have referendums on the ballot. i don't think we're going to need to do anything extraordinary or noteworthy from a public relations standpoint right now. we just have to go out and win some elections. >> let's talk about pennsylvania for a second. because we have a question here about the pointing out that gabby bigiffords and mike bloomberg are supporting pat toomy. his race is very important. will you campaign for his opponent? >> so if you are working on the issue of protecting americans from gun violence, you have a lot of reason to think pat toomy. pat toomy, you know, did something that was exceptional in reaching out and working with democrats on this issue. i don't just work on this issue. i work on lots of other issues as well. i'm supporting katie ma againty and i'll be supporting here from
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now until election day because though i appreciate what pat toomy did on the u issue of background checks there are a lot of issues which i deeply disagree with pat toomy. and so long as republicans are in charge of the united states senate, good luck getting these votes on the floor of the senate in the absence of extraordinary measures like the filibuster. that being said, i don't think we are going to make progress on this issue if all we do is try to elect democrats. i do think that we have to be honest about republicans who have stuck their neck out. and some of my friends get upset when i acknowledge that pat toomy did something that was mildly heroic when he worked with democrats on background checks. but that's the truth. he did. and we should congratulate and applaud republicans when they do work with us. i think we would be fools to
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ignore the fact that ultimately we will get a quicker root to success by finding republicans who are willing to work with us. >> you're pretty good at this filibuster stuff so i'm going to start asking rapid fire. which do you think is more effect fif, that all gun violence prevention organizations have their own area to work or should we all work together for one objective at the same time? >> so a lot has been made of the fact that we have a bunch of anti-gun violence groups today that are all very strong. i think that's a great thing. i think it's great to have a number of gun anti-violence groups that sometimes have different priorities or different areas of focus. i think that brings more, not less people into our ranks because they don't have to fit themselves into one policy agenda that they can take a look at the brady campaign, at america's responsible solutions, moms demand action, every town, sandy hook promise and decide
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which one fits their model or advocacy the best. i don't think this is anything that hurts us. i think it makes us stronger. >> you alluded to this during your speech but do you think there should be an i don't have lap between the gun violence prevention movement and the black lives matter movement where they can work together since gun violence does affect people in communities of color? >> i struggle with what happened earlier this year that provided this psychological tipping point for the country. why are you seeing in polls today that the disapproval rating of the nra in swing districts is twice what it was a year ago? why are senate republican candidates all of the sudden running to talk about how strong they are on background checks? i think that the combination in a short period of time of orlando, dallas, and the high profile shooting of black men in a few american cities became a
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tipping point. people just were consumed with this ongoing coverage of tragedy. and there was one thing that all of it had in common. guns. and so the idea that there should be no change in america's gun laws, when all of the bad news that you saw on tv had one thing in common, firearms, became unacceptable to people. and so yes, i think you've got to marry the black lives matter movement into the anti-gun violence movement because ultimately this isn't just about plifs shooting unarmed black men. this is also about this country making a decision to allow for the flow of illegal weapons into the cities which result in the assassination and slaughter of young black men by others in the cities, not just by law enforcement. >> question from the audience on that point. doesn't the breakdown in law and order in some of the towns and
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cities, ferguson, baltimore, contribute to the promotion of gun sales? >> there's no doubt that every time there's a mass shooting there's a spike in gun sales. again as i laid out, the nra as effectively proffered the argument that the only way to protect yourself is to buy more weapons which is why it's incumbent upon us in the wake of the mass shootings when people are thinking about going out and buying a weapon for protection to remind americans that there's one cold hard true statistic. if you have a weapon in your house it is much more likely to be used to kill you than it is to kill someone trying to do harm to you. and people just don't believe that. they either don't know it or they don't believe it. so there's no doubt that the nra capitalizes and the gun agency capitalizes on these tragedies to sell more weapons. but every time you buy a weapon statistically it's making you
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less safe not more safe. that's something that the americans don't know. >> can you respond to the quote up quote consequences to house democrats for their sit-in on gun violence protection -- prevention. >>? >> in terms of breaking the rules. >> they were threatened with consequences for breaking the rules, some kind of sanctions or something? >> they did break the rules. i don't know the details of house protocols and house rules and sanctions, but they did break the rules. and i assume that there's some sanction that comes with that. but you know everyone that's engaged in civil disobedience since the founding of the nation knows that there are often consequences that come with it. so i don't -- i'm not one that's going to make a stink if there's some sanction against house democrats for sitting in. you know, sanctions and consequences are in the best traditions of civil disobedience. >> this is the most important question i can ask you and the
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base question i think of all of our conversation. what would it take to get gun control passed in congress if sandy hook wasn't enough, in orlando wasn't enough? what is the impetus do you think that will take congress to actually act on this? >> this is the question that gets asked most often and there's a famous tweet that got retweeted a million times, says something like, you know, america decided that the current rates of gun violence are acceptable the day that we did nothing in the wake of sandy hook. don't buy that for a couple of reasons. one, i think in the wake of sandy hook, this country was not ready to have a thoughtful debate on policy change. why? because that tragedy was so psychologically disruptive to this country that all of our energy in the wake of sandy hook was spent just trying to reconcile how you square sandy hook with a just world in which at our essence we are still good. and i think it took a long time
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for americans to figure out how to emotionally and psychologically reconcile sandy hook with their lives. i understand why it has take an few years for americans to become ready to plug into this conversation. i also know that it has taken a long time to get the political movement right size so we can change elections. we can actually change policy debates. the gun lobby had 20 years of run from 1994 to 2012. we've had three years to build this movement. so yo buy the idea that sandy hook should have just automatically flipped the political paradigm on guns. i think for a lot of issues connected to psychology and a lot of reasons connected to pure la gis ticks of organizations, it's understandable that it's taken us three years and it might take us a few more years to get this done. but the momentum in heading in
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one direction and one direction only. that's what you pay attention to. >> let me follow on that. you said a couple more years. in some ways this is almost generational. isn't it going to take longer than two to three years to get something passed and for attitudes to change in. >> i don't think so. if you take a look at the number of republicans that voted for the background checks bill versus the number who were willing to break with the nra on the background checks bill in 2013, about double that number were willing to break with the nra to support the compromise on closing the terror gap. again, you're seeing a sea change in some of these elections. i mentioned the flip on gun politics that's happening in a state like new hampshire. i think this is not moving fast enough for many of us. but it's moving fast enough that we're not talking about a generational change. we're talking about a change that is going to take months or years, not decades. >> we have this in some degree with michael bloomberg involved,
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but do you foresee any super pac level funders willing to fund gun control as an issue, sort of like tom stier did with the environmental movement? >> i think that bloomberg and every town have made a commitment on this issue. and i think bloomberg will continue to spend a lot of money here. i don't know of any other individual funders who are willing to spend that kind of money. but as i mentioned, americans for responsible solutions have made major ad buys in states already. i'm not sure that we can rely on that strategy. i think we're better off building our numbers across the country rather than trying to go out and find one or two more white knights athat are going t spend millions of dollars. >> why don't democrats just focus on banning military style weapons and the sale of ammunition for such weapons, none of which the questioner says are needed for hunting? >> i think there's a long
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laundry list of policies that need to change. right? we went backwards for nearly two decades. so i would add to that list the liability of gun industry enjoy other industry. i would add to that list the prohibition on research and development into the causes of gun violence that are currently in effect. i mean, we have a long list of policy changes that we need to make in order to make this country safer. so i hate it when people say well, why aren't you focusing on banning assault weapons? well, of course i am. but you've got to sort of pick the battles that you can win first and order them in a way that is logically sequenced. i think our best chance right now is to get bills passed that increase the number of background checks in this country and a bill passed that stop people on terrorist watch list from getting guns. i'm not going to stop talking about the need to ban
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assault-style weapons. in sandy hook, you don't need to tell us what it would have meant if those weapons weren't legal and on the streets. it's just that we've got to put some priority on the things we fight for. >> do you think the gop will be more willing to accept gun control or gun control at all if donald trump loses badly against hillary clinton this november? >> yes in this respect. hillary clinton is running proudly on the issue of changing our nation's gun laws. and there were a lot of skeptics who said that she was only talk about guns as a means of differentiating herself from bernie sanders, that this was just an issue she was using to get through the primary. well, that has not proved to be the case. she has continued to make this a part of every speech she gives, including one at the democratic national convention. she is the first candidate in modern times running very publicly on a promise to make changing gun laws a priority as
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president. so there is no question that people will have to take a signal from her election. i think what is more important is that in legislative races, there are a few signals sent that there are consequences for being on the other side of 90% of your constituents. so i'll frankly be looking more closely to the new hampshire senate race than i am to the presidential race when i'm deciding whether my colleagues on the republican side have gotten the message that they can't oppose changes in our gun laws without some political consequence. >> so i hear you're an expert in this filibuster stuff. but if democrats take over the senate, with the party would you be willing to modify the filibuster rules to ease the passage of gun laws? >> absolutely. absolutely. i have no plans nor do i want to ever do that again. so if the laws made it harder for me -- if the laws made it harder for me to flirt
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withstanding on my feet for 15 hours, i would gladly accept that fate. no, i am separate and aside from my decision to mount a filibuster, a supporter of changing the rules of the senate. we have a rule now that says you have to effectively get 60 senators in order to pass any bill. i think our founding fathers are turning over in their grave seeing how difficult we have made it to pass a piece of legislation on top of a system that they intentionally built as being very difficult to pass a piece of legislation. they debated this issue of super ma jorts. and in the constitution they specifically told us when it would be necessary. constitutional amendment, treaty ratification. so it stands to reason that they thought about whether or not you should have super majority for ordinary pieces of legislation, and instead built a bicameral legislative system with a strong
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presidential veto as a means of making change hard instead of imposing super majority. and listen, i, even as a member of the minority, have fought for the end of the filibuster. so i'm not going to be hypocritical about this and only advocate for it when i'm in the majority. >> still a few minutes left. let me switch to another subject before i ask the final question. the 15th anniversary of september 11th was upon us which has had to direct impact on a lot of connecticut families who lost loved ones who commuted to the world trade center. where were you at the time? and what lessons have we learned since 9/11? >> i was in a high school in southern connecticut when i was a state representative when i saw the initial coverage on a tv screen in the library there, and then went home to watch the rest of it. i was a state legislator at the time. we've learned a lot. one of the things we've learned
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is that good laws protect us from attack. what we learned in september 11th was that our airports were vulnerable, and that terrorists had figured that out. and so they were able to penetrate our relatively lack security at our airports at the time with box cutters and do great harm to americans. so what did we do? we hardened our defenses. we banned certain things from being brought on airplanes. we constructed tsa. and though they have attempted since then to penetrate our airlines, to attack americans, they have not been successful. and so why aren't we learning the same thing now when al qaeda operatives are stating clearly that lone wolf attackers should go to gun shows and take advantage of loose american gun laws in order to buy assault weapons to shoot civilians. that's what recruiters are
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saying. i can show you the video of one of the most prominent al qaeda recruiters, saying here is what you do. you go to a gun show. you buy one of these weapons, and you start shooting. why aren't we doing the same thing today that we did after september 11th? today terrorists are using assault weapons. they're not making improvised explosive devices. they're not trying to board airplanes. and yet we refuse to change our laws. so i think we learned in the wake of september 11th that good policy is good protection. and we unfortunately are not using that when it comes to this new tactic of terrorist groups to take advantage of our gun laws. >> thank you, senator. before i asked the final question, a quick reminder. the national press club is the world's leading professional organization for journalists. and we fight for a free press worldwide. for more information about the club, please visit our website at i would also like to remind you
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about upcoming programs. on september five 15 ash carter will speak here at the press club. on september 3rd, tom vilsack will speak. a reminder to our audience, please remain seated until the senator has departed. he needs to make that vote and we don't want to make him late. i also would like to present our guest with the national press club mug. >> oh, thank you very much. thank you. that's very nice. [ applause ] if you come back and do our spelling bee, i'll give you another mug. last question, we typically do our last question is something a little more fun. so the movie "a haunting in connecticut" was apparently based on a house you once lived in. >> wow. >> do you believe in ghosts? and eerie things might have happened while you lived in the house? >> that is good research. so i moved into my first rental house when i was 22 years old with two friends from high
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school. and the second day we had a plummer to come do work, and he walked very tentatively up the stairs. and when he entered, we asked him what was wrong. and he told us that we were living in the haunted out of southington. i won't tell you the full story because you can find it online. but it was an old funeral home. and the story was that the ghosts of the deceased had come back to haunt the house. but as we watched the old videos of, you know, every crew from "entertainment tonight" to "inside edition" who came to do a story on our house, we found it was only the first floor that was haunted, not the second floor. so i never experienced anything -- anything out of the ordinary in that house. but it was a wonderful welcome to southington, connecticut. and it's been a great story to
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tell ever since. interestingly, some of the other houses in the neighborhood when we moved in we thought it was odd were painted purple and pink. and apparently some people in the neighborhood took it very seriously. and went to these gaethe hunters to get advice. and they were told that ghosts don't like certain colors. and that's why some of the louis painted strange colors. but that is deep, deep in my biography. so congratulations for finding that out. >> thank you, senator. thank you to the staff at the national press club and the national press club journalism institute, and we are adjourned. [ applause ]
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tonight on c-span3, a house hearing on the civil war in south sudan. the house veterans affairs committee looks at the health care system for veterans, and later, a panel of law professors on the state of free speech on college campuses. u.s. diplomats update members of congress on the violence and humanitarian situation in the south sudanese civil war. they look at actions the international community can take to address the crisis, including a potential arms embargo and the deployment of a regional protection force. this hearing of the house foreign affairs subcommittee on africa is about two hours.
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>> so if we can come to order. thank you for being here. on april 27 of this year our subcommittee held a hearing on south sudan's prospects for peace. an accord that finally ended the civil war that broke out in december of 2013 was reluctantly signed by both the government of south sudan and the people's liberation movement in opposition in august of 2015. we were cautioned by ambassador booth at the time. and i remember your testimony on april 27th, mr. ambassador, when you said these are the most significant advancements yet in implementing the peace agreement, but you also cautioned and said it is only a
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first step towards lasting peace, the most difficult work still lies ahead. those words were prophetic and certainly very, very true, especially given what happened in july. peace was never fully established in south sudan as a result of the august agreement. in fact, as we all know, fighting spread to areas that had not previously seen armed conflict. an estimated 50,000 south sudanese have been killed since december of 2013. more than 2.5 million have been displaced and 4.8 million face severe hunger. according to the u.n. mission in the republic of south sudan, quote, gross violations of human rights and serious violations of humanitarian law have occurred on a massive scale. south sudanese women have long reported cases of sexual assault by armed force throughout the country, sometimes in sight of unmas bases. this past july between 80 to 100
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armed soldiers broke into the tehran apartment compound which houses aid workers and international organization staff. and for several hours, they sexually assaulted women, beat residents, murdered one south sudanese journalist, and looted the facility. unms did not respond to the desperate calls for help from residents, even though their own personnel lived in the tehran compound and u.n. mission officials say the various components didn't respond to orders to mobilize within the organization. u.n. peace keepers were just minutes away but refused to intervene despite being asked. and having a robust legal mandate to do so. a contingent of south sudanese military ultimately rescued the victims from other rampaging troops. the investigation by the south sudanese government is scheduled to be completed within days. and just over the weekend, our ambassador samantha power has asked that there be an
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independent panel to look into what happened there. and there must be consequences for those who are found guilty. the rapidly deteriorating security and the increasingly dire humanitarian situation made nato undertake an emergency mission to south sudan two weeks ago along with staff director greg simpkins. i have known since he first became vice president in the government of the republic of sudan in 2005. i met him only weeks after he assumed that office. i hoped my visit might convey to him the outrage over the murder, rape, sexual assault, attack on aid workers and the precarious situation that his government faces. south sudan is at a tipping point. the united nations will likely take up a measure to impose an arms embargo if they do not see implementation of what looks like was an agreement over the weekend to deploy some 4,000 peacekeepers. the international monetary fund
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has strongly recommended a mechanism for financial transparence circumstances and that meets next month, likely expecting a response from south sudan. meanwhile, the house and senate both had measures that had arms embargo embedded in it, as well. in juba we met with president keyer, other members of his cabinet and his defense minister kual manyang juk, including his defense minister. the rape by soldiers must stop. and the poemps these despicable crimes must be prosecuted in response to president keyer and agree to produce a zero tolerance presidential decree against rape and sexual
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against rape and sexual exploitation by armed forces. kier, other members of the cabinet and his defense minister sup suchsuch such a decre perpetrators that may they be punished for their actions, but it places the government on the lip line line to enforce s. tthe u.n. commissioner for hum abusabuses accountable as quotw and inadequate. and that of course must change. president keir also gave a copy to a presidential order to investigate the incident at the compound. the results of that is due any day now. there are however four military officers and one civilian in custody for looting the tehran compound, but no one has been arrested for sexual assaults, beatings, or the public murder of a south sudanese journalist. one of the victims of sexual assauassault at tehran is from congressional district. aftafter relaying horrible det of the assault by two soldiers, she gave us the name of the soldip soldier whsoldier wh
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ap and wand who might be abe informati information that coul to prosecute those who attacked hp her her at the tehran c. aand p andand i convey thar and the defense minister. p as you know, mr. ambassa there were about 20,000 humanitarianpsoutsouth sudan, from the united states and other foreign countries. pif therrif there is not gr security, vital assistance will diminidiminish at a time that needed most. the exploitation of children as chichil child soldiers must st well. according to unicef, 16,000 chirchild soldiers have been recruited by all sides since the civil war began in december of 2013. moreover, this year the u.s. state departmerstate st persons report gave south sudan p a failina failing grade,t because of child soldiers. south sudan faces the possibility again of a u.n. arms embarembargo agai embargo agai
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implement the deployment of the 4,000 regional protection force. thethere i there is yet time f sudsudan to make its pivot to e and good governance by faithfulp faithfully implfa accord and including especially the establishment of a hybrid coucourt signed one year ago, time is rung out. it is a very, very fluid and unfortunately volatile situation. the governments of the three gordgordon the governments of the three gordgordo or thes of south sud peace, the united states, and norway all have discussed their disgust with the government and ip iits arme its armed oppo adhering to the peacep and for security and well-being of its people. however, expressions of the state are not enough. tp tthe tp tth syrians not only ino examine culpability but also to try to find solutions that will safeguard the future of one of tthe world's newest nation and its citizens.
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t r asas p as a guarantee united states can and should do no less. i would like to yield to my friend and colleague. >> thank you for your trip that yp you and mr. simpkins ma. i know it was on very short notice but a very important delegation. i'm glad that you did that and also that we are having this hearing so quickly. i also want to thank ambassador boobooth and ambassador limon. ip i'm glad thi'm glad thatg your testimony today. i was in south sudan in november and i went there with a small delegation to look at the u.n. peacekeeping mission at the time. ap and that was before mach returned. and the big concern then was wip will he return, and wil nation hold to the agreement. it was shortly after president kier had divided up the nation and expanded the provinces. we were very concerned about how you could possibly since that was done after the peace agreement, how can you hold to
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the power sharing that had been agreed to in the peace agreement if you have reconfigured the entire geography of the nation. at the time we were concerned about what is happening then. bp but nbut now what's goin encompassed and victimized yet again south sudanese citizens, and especially the ones that are least abr least able to protect themselvthemselves -- women, g youth. in response to the crisis i joined several of my colleagues in a letter to president obama outlining the severity of the deteriorating situation in south sudan and calling on the u.s. to lead the way and calling for an arms embargo on south sudan to stop the needless killing, endless brutality. the unsc august 12th decision to renew unms, the proposed
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revision and inclusion of an additional 4,000 strong regional protection force must be applauded, but there must also be clarification regarding the specific rules of engagement governing the troops. i understand that the government agreed to the additional regional protection force as recently as sunday. i look to ambassador booth to outline the next steps which must be taken to bring an end to the nightmare of violence not only by the long-term suffering citizens of south sudan but also by the foreign nationals who with total disregard for personal welfare seek to assist these citizens. several of the questions that i have we'll get into in the dialogue but i want to propose those in the beginning. and obviously, the central question is what more can we do. an arms embargo, will it be effective? it seems as though there needs to be a whole international effort that is beyond and i want to know what your thoughts are au's capacity.
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and also, in terms of unms, what will their role be? will they be able to intervene will they be able to be aggressive? or will they be in a position where they will watch something happening. i just think that this situation has reached -- and we all know this -- has reached dire proportions. i was in nigeria a couple of weeks ago. it was a staff member from the state department actually had just been evacuated from south sudan and sent to nigeria. so i really want to be as specific as possible. it's important to understand the situation but i really want to get down to the brass tacks of okay, now what? what can we do? what can we do as a nation and what should the world do? because otherwise i just don't see the situation getting particularly better. with that, i yield. >> thank you.
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chair recognizes mr. donem. >> i will yield my time so we give the witness more time to testify. >> i want to thank all of our and ranking member bass for calling this hearing on the crisis in south sudan and thank our witness and ambassador booth for being here today. i look forward to hearing from you on the deteriorating situation in south sudan and as congresswoman bass said what we can do to be effective in responding. in 2011 as an independent country. however, the civil war that has ravaged south sudan since 2013 has escalated alarmingly since the subcommittee's last hearing on south sudan in april. the impact is devastating and the potential for an even deeper crisis is greatly disturbing. not only does south sudan face another post conflict reconciliation process, high civilian needs and widespread
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displacement of its population, but increasing human rights abuse, including recruiting child soldiers, which is extremely distressing. u.n. officials have asserted that targeted attacks against civil civilians and personnel in south sudan may cute war crimes or crimes against humanity. a u.n. commission in south sudan reports civilians have been targeted along ethnic lines. forces on both sides have committed violence. including an attack on a residence for aid workers in juba in july, which resulted in assaults on several americans and the killing of a local journalist. the dangers faced by foreign workers could have a devastating effect on aid workers. if the current crisis cannot be brought under control, the situation will likery deteriorate further and could spin into complete chaos. i hope that the sudanese government's decision to allow the force to deplay will enable the beginning of real
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improvement in this very dire situation. i look forward to hearing from our witnesses on what else we can do to support the stability in that part of the world. and i thank our witnesses again for being here and yield back. >> thank you. we're joined by full committee chairman ed royce of california. >> mr. chairman, thank you very much. i would just start by commending you, chairman, for your sustained focus on the crisis in south sudan. as all of you know chairman smith just travelled to south sudan to engage with our embassy there, and to engage with our other partners. and that is the fifth i think south sudan specific hearing that the committee has held since this crisis began. what's unfortunately and frankly maddening is the underlying problems haven't changed in the past three years. it is still a man-made crisis. it is still a crisis political in nature. and what does change, what changes every day is the number
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of innocent south sudanese killed, the number displaced. tens of thousands have been killed. millions have been now been displaced. and i very much appreciate the recent senior level engagement of the administration including secretary kerry's trip to the region and ambassador samantha powers' leading of a security council delegation to south sudan. i was on the phone a few hours ago with secretary susan rice on this issue. it is really unclear whether this high level diplomacy can have an impact on the ground. one of the oddities here is that the anti-american sentiment is growing in juba as of late. there is reporting today of an incident in which the presidential guard deliberately opened fire on a u.s. diplomatic convoy traveling through the city.
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i understand command and control of armed forces in south sudan is practically nonexistent in this situation, practically nonexistent. but there should never be an instance in which american diplomats are specifically targeted, ever after lengthy security council negotiation, the security council approved of the deployment of a regional protection force. i met with the secretary general recently of the u.n. on this issue. and i shared that we welcome the establishment of force, but i know how difficult it is going to be moving this from concept to reality. it's going to be far from easy.
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especially envoy booth in your prepared testimony you explained that if the secretary general reports that the government of south sudan is impeding the new forces deployment, the administration would be prepared to support an arms embargo. we've made similar threats in other resolutions, and i'm not sure anyone in south sudan takes that threat of an embargo seriously anymore. i hope that we will be serious in terms of implementation of it. interestingly in your prepared testimony you made no mention of the existing executive order that would allow the sanction of individuals who threaten peace in south sudan. i think that is worth contemplating. i look forward to hearing from you why no one has been added to the u.s. sanctions list in over a year. there are surely people who deserve to be on that list.
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if we fail to hold south sudan's political leaders on both sides accountable for the atrocities committed, we cannot expect anything to change. so i thank you, mr. chairman, and i yield back. >> thank you very much, chairman rice. mr. rooney? >> thank you, mr. chairman. again, thank you for letting me sit in on your hearing. mr. ambassador, since the signing of the peace agreement in august of 2015, and since the violence in july, the u.n. security council and the u.s. have both failed to implement an arms embargo, as you know, in south sudan. the u.n. and the u.s. have failed to sanction additional individuals that we have proof have been involved in the attacks against civilians and that continue to procure weapons and military equipment. secretary kerry in february in state foreign ops subcommittee that i sit on as well as yourt
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in april both told me that the u.s. is committed to holding senior officials accountable for continued ceasefire violations and human rights violations that undermine the terms of the peace agreement in south sudan. you both said that the administration would be willing to implement sanctions on such individuals. but secretary kerry stopped short of endorsing an arms embargo. also in august during a trip to africa, secretary kerry threatened to withhold humanitarian assistance to south sudan if leaders there continue to violate the peace agreement. so i'm curious to hear your testimony why the u.s. is threatening to with hold assistance to the people of south sudan rather than holding the leaders who perpetuated the violence accountable through an arms embargo. i would like to know who in the administration is preventing additional individuals from being sanctioned and who do not want to implement an arms embargo. thank you, mr. chairman. i yield back.
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>> thank you very much. i would like to now welcome in ambassador booth. donald booth was appointed special envoy to sudan and south sudan on august 28th, 2013. he previously served as ambassador to ethiopia, zambia and liberia. prior to that he was director of office of technical and specialized agencies. ambassador booth also has served as director of the office of west african affairs. deputy director of office of southern african affairs, economic counselor in athens, division chief of bilateral affairs. your full resume will be made part of the record. ambassador booth, the floor is yours. >> thank you very much, chairman smith, ranking member bass, other members of the committee, the subcommittee. thank you for the opportunity to speak before you today. i want to discuss some of the tragic events that occurred over the past two months without ignoring the bitter reality on
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the grown, i also want to focus most of my remarks today on the possibilities for way forward. chairman smith, as you know from your visit south sudan is in a dire state. the most recent outbreak of violence in early july created perilous security situation in many parts of the country. the humanitarian situation as many of you have noted is one of the most extreme in the world with 4.8 million people, over 40% of the population facing life threatening hunger, 2.5 million displaced and the economy in free fall. serious crime is now a part of daily life for south sudanese, and aid workers and their supplies are targets as well. the violence in early july came about because neither president salva kiir nor vice president was willing to work with the other to implement the peace
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agreement, or to set up the security arrangements that were designed to prevent a return to fighting in juba. we saw the moment of greatest optimism since the signing of the august 2015 peace agreement. the establishment in late april of the transitional government, we saw it shattered by the irresponsibility and ruthlessness of south sudan's leaders. both leaders lost control of their forces during a moment of tremendous political fragility and government soldiers engaged in sexual violence including attacks on both south sudanese and foreigners at tehran camp. i would be remised not to pause here and praise the work of ambassador malifi and her team at the embassy in juba. they have faced enormous hardships and real danger in doing their jobs and their work has been extraordinary. they have against long odds reserved the engagement needed to help the people of south sudan. they have done so despite two events that i know are on your
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minds. first on the night of july 7 just a few hours after a deadly encounter between government and opposition security forces in the same area, two vehicles carrying several diplomats were fired upon by government soldiers. fortunately, because they were both armored vehicles the occupants were not injured. ambassador fi confronted president kiir the following day and received an apology as well as assurance there's would be a thorough investigation. that day, however, was also the same day that major fighting broke out between the government and opposition. the second event was much more tragic. the attack by scores of uniformed government security forces against the terrain camp where 12 americans and other third country and other south sudanese nationals were located. the attack involved hours of looting, beatings, rapes and murder of a prominent south
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sudanese journalist, john gadlak. i would like to express at this point my personal condolences to john's family and to all survivors of the attack. that attack occurred towards the end of two days of heavy fighting in juba which saw government force drive out nashar's security contingent. even as shooting raged near the embassy compounds, as soon as the embassy was alerted to the attack, ambassador fi contacted security officials whom she believed still had command of their forces. and she convinced them to intervene to rescue those under assault at the camp. i want to stress that she did everything in her power and resources in those circumstances to assist those who were under assault at the terrain camp. in the after math of the attack our priority was the care and evacuation of the victims and then to protect their privacy and to demand justice for them. my written testimony contains a thorough account of what we know
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of the awful events at terrain camp that day as well as what we're doing to ensure safety of our personnel. i would like to focus the rest of my statement on what i see as the way forward or at least a way forward. or at least a way forward. first, in the wake of the fighting in juba in july, a political accommodation to avoid further fighting and suffering remains as important as ever. but given that neither president kiir nor the former vice president nashar could prevent their security entourages from fighting, we do not believe it would be wise for nashar to return to his previous position in juba. that said, this cannot serve as a justification for president kiir to monopolize power. what is most urgently needed is creation of a secure space for inclusive political process to forestall further violence. that is why we strongly support intergovernmental authority for
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on development's call for deployment of a regional protection force to juba to provide for free and safe movement throughout the capital. the rpf should proactively contribute to stability and thereby allow for the demilitarization of juba. we must be clear that the government will allow rpf to do its job once it's in juba. no political process can take place as long as large numbers of armed men and heavy weaponry remain in the capital. stabilizing the security situation in juba is only the first step. any political process to be credible and viable must be inclusive. i believe what is needed for south sudan's political and military leaders in and out of government to meet together to figure out how to jointly shoulder responsibility for preventing further bloodshed. however, this can only succeed if those currently in power are willing to accommodate the legitimate interests of others. the violence in early july drove out significant factions of
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splm and opposition of the former detainees and other political parties. these groups must be deterred from supporting any further violence. thus they must see a path for peaceful engagement. south sudan's leaders must look ahead to the creation of a professional inclusive national army and other security institutions. they need to be able to articulate an agreed end state of security sector reform. as any international support for contonement or ddr activities will depend among other things of the credibility of envisioned security sector end state. the transitional government should prioritize legislation establishing an open process for drafting and ratifying a new constitution under which elections will be held at the end of a transitional period. in addition the transitional government should prioritize legislation regarding african
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union led hybrid court for south sudan. a recent opinion survey showed 93% of south sudanese believe there can be no enduring peace without accountability. we agree. what i have described is a sequence of interdependent events. i'm describing them as a way forward not because it will be easy to implement them, but because it is difficult to see any other path that does not lead to a future of oppressive one party rule, renewed conflict or most likely both. i am not naive about the chances of these things happening. our ability to influence events in south sudan and steer its leaders towards more constructive behavior is limited. the security council's permanent representatives just returned from a trip to south sudan. we were pleased that the council was able to come to agreement with transitional government on several key issues including the government's consent to
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deployment of the regional protection force and to work with u.n. mission that is already there. however, we now need to see those words turned into action. if the secretary general's report finds the government is obstructing deployment of regional protection force or continuing to prevent unmis from fulfilling its mandate, we are prepared to support an arms embargo in the security council. beyond an arms embargo we stand prepared to impose restrictions on individuals involved in public corruption as official corruption has a long history in south sudan and has played a direct role in ferret rans of conflict in the country. mr. chairman, i would have liked to come before this subcommittee today with better news. unfortunately, we now face a difficult and uncertain path for south sudan. it is a frustrating and disheartening situation particularly of course for south sudanese.
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it's their future that grows bleaker by the day. with them in our minds, i believe we must continue to press south sudan's leaders to give peace a chance. thank you for inviting me to speak today. and i look forward the answering your quirks mr. ambassador, thank you so very much for your statement and your work, your fine work. without objection your full statement will be made a part of the record. just a few opening questions. and i do want to add migrations and thanks to ambassador, u.s. ambassador to south sudan molly fi and her staff who under unbelievably trying circumstances have been working around the clock to try to secure the peace, provide for access of humanitarian aid workers, which is one of the biggest impediments, and why so many people are dying of malnutrition, and why so many young people, especially children and babies are succumbing to starvation. they are working hard. i want to thank her for her leadership as well. let me ask you about the zero
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tolerance policy that the defense minister when i asked him said they would do against rape and sexual assault. he made it very clear that he was going to call the president to try to get him to do it, as well. we did meet with salva kiir. and i raised it with him and he said he would do it. we called back since then, a little over a week. it hasn't been promulgated yet. of course, the mere issuance of a statement without implementation is not worth the paper it is printed on. we are hoping that the two will go hand in hand. good strong statement, hold the service members, armed forces to account and police and put them behind bars when they sexually assault and rape and kill and maim. your thoughts on that. secondly, ambassador limen who as you know will be testifying
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on the second panel, who performed your job admirably and with great distinction dtinctio was special envoy makes a point in his testimony that the new rapid protection force should not be under unms, the u.n. mission there. greg simpkins and i met with the head of the united nations mission and she said they tried to get commanders to make the trip, which was only less than a mile away to try to save people who were under assault at tehran. and they wouldn't go. this isn't the first time it has happened. several times. they have the right rules of engagement. this isn't sarajevo all over again or the former yugoslavia and elsewhere. they have a robust rules of engagement in charter 7 powers. he suggested it be under a separate authority or mission. your thoughts on that on whether it would be an improvement and
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provide additional help. and then the access issue. it seems to me that if we -- as i said, people will do if there is not humanitarian access. the huge majority of humanitarian workers are south sudanese who in a way are in a special category of risk. your thoughts on what we can do there. and then security sector reform. when you testified last time, you put the agreement under four basic baskets, which are mutually inclusive of each other. security sector reform and justice and reconciliation. i think as you pointed out the hybrid court ought to be set up. it ought to be done yesterday to hold people to account for acts of impunity and crimes against humanity. but security sector reform seems like the most daunting challenge with all the militias and all the lack of chain of command that appears to be the situation there. your thoughts on the prospects
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of meaningful systemic reform of the military. >> thank you very much, mr. chairman. let me go through those. first of all, i want to thank you for being such a strong advocate for the zero tolerance policy on gender-based violence for rape and other such crimes and raising that at the highest levels during your visit in juba. it is certainly something that we are following up on. unfortunately, like many commitments that are made when we meet with senior officials in south sudan, the promises are not always turned into reality. but it is something that certainly is important and we will continue to push on that. we will let you know what success or lack of success we may have in that regard. secondly, as regards to the regional protection force, there are a number of reasons why egad
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proposed and we have supported putting a regional protection force as part of the u.n. mission in south sudan. first of all, there is the issue of funding it. and a separate stand alone force under an african union or egad flag would have faced problems of being funded and would have severely delayed the ability to be deployed. doing it under the u.n. may not be always the fastest, but that's one of the things that i've been engaging on in my many trips to the region in talking with chiefs of defense and foreign ministry officials as well as other senior leaders to ensure the three countries that have pledged troops to this regional protection force, east openia, kenya and rwanda would be indeed prepared to move their forces very quickly. and we would be prepared to help them move them quickly to do that.
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also, this force was designed in a way that it would be under one commander and that commander and that commander would report to the force commander of unms, but would have the authority and the mandate from the troop contributing countries to use that force for the very specific tasks of the mandate in u.n. security council resolution 2304, which is to ensure the free movement of people in juba, to protect critical infrastructure, including the airport and keeping it open, and in intervening should anyone be planning or engaging in attacks on the u.n., on civilians, on idps, a very broad mandate. again, in our discussions with troop contributing countries they have assured us that troops they would deploy to do the mission would have the political backing in their capitals to indeed enforce those tasks. so i understand the skepticism
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that many may have, having looked at other u.n. missions, but this seemed to be the most practical and expedient way of getting troops on the ground who could actually provide a security umbrella in juba. but as i said in my testimony just putting those forces on the ground will not solve the problem. they need the cooperation of the south sudanese government, and in the peace agreement and particularly in the security arrangements that followed it that were negotiated after the signing of the agreement in august 2015. there was a limitation of number of forces that both salva kiir, the government, and the opposition could have in juba. and all other forces were to be at least 25 kilometers outside of the city. so that is at least the starting point for taking the heavy weapons and many of the security forces that are currently in juba and getting them out and we would hope that the government
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would cooperate in further reducing the military footprints so that the citizens of juba can feel more secure and so that there is the room for the political dialogue that i have talked about. on humanitarian assistance, this is indeed a terrible situation. since the outbreak of this conflict 59 humanitarian aid workers have been killed making south sudan the most dangerous place for humanitarian aid workers, more dangerous than syria i am told. so this is a serious problem. it's something we have engaged repeatedly on in my visits, many visits to juba i have engaged with president kiir, defense minister and others on this. we keep receiving assurances that this issue will be addressed, that orders are issued, that they simply need to have a specific example so they can go after individuals who might have been harassing aid
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workers or stealing aid. but frankly, this has become a systemic problem. shortly after the fighting in july there was looting of many different stores in juba. one was the world food program warehouse. it was very organized. a truck came with a crane not only to loot the food but to take the generator from the wfp compound. so this indeed does need to be investigated and people need to be held accountable. i think that is the only way that the message will get out that the government is truly serious, that humanitarian aid workers and their supplies are meant for the people of south sudan and should not be interfered with. this is going to be a continued engagement and a hard slog i'm sure with the government in juba. on security sector reform, the
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peace agreement and in particular the security arrangements negotiated after it called for a security and defense sector review board to outline sort of the end state of the security arrangements of south sudan, what the army would look like, the security services, the police, et cetera. that board had just begun meeting when things fell apart in july this year. but even under the peace agreement it was foreseen it would not come to conclusion for p about 18 months into the transitional period whereas the idea of contoning forces and beginning a ddr process was to start prior to that. what i am proposing and i have said in my testimony is that we really need to have an idea of what the end state is. south sudan has suffered for too long as a heavily militarized state. probably understandable and it was the product of a long liberation struggle against the
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government in khartoum. so almost 50 years of struggle. it is time that south sudan in order to be able to be at peace and to prosper needs to be a less demilitarized state. so can we get south sudanese to agree on what the end state is, and if we agree that it is a sustainable and reasonable end state, that's something we can look to support. really our leverage on getting a meaningful security sector reform is that we will not fund things if it isn't a reasonable outcome that we are driving towards. and then on the hybrid court, again, we share frustration that this is moving more slowly than we would like. i have engaged numerous times and we had our legal experts engage with the african union. we are at the verge of giving them $3.3 million to actually
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begin some of the work. we have encouraged them to move forward on at least establishing an officer of the prosecutor so that testimonies and evidence can begin to be collected even before the court is established and judges can decide on who would be indicted or who would be looked at by the court. so that is something we want to push forward. i have discussed that with the african union special representative for south sudan, the honorable president konori, former president of mali who has been deeply engaged as well for the past year in trying to sort out the problems of south sudan. thank you. >> thank you. ms. bass? >> thank you again, mr. ambassador. i wanted to know if you could tell me the status of the former president of botswana, festus
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moai, and if you can, one, review the role he is playing, and then the status of that. we have talked about humanitarian aid. and i know no one wants to see that end, but how can humanitarian aid get to the population? you mentioned the world food program and the theft, the organized theft that took place. i wanted to know if that was the government or the opposition. you talk about -- we have talked about an arms embargo. i mention that in my opening. i wanted to know what is the position of the administration on arms embargo and where are the south -- south sudanese getting arms from now? i also wanted to mention a couple other items. >> thank you, congresswoman. let me start with the question about the joint monitoring and evaluation commission, which is
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headed by botswana former president festus mohai. he was appointed by egad to fulfill the role as chair of jmek. now jmec is a committee that is made up of south sudanese parties as well as the members of e gad plus, who are both guaranteetors as well as members of egad plus. and he chairs monthly meetings of that group. his function is to oversee the implementation of the agreement and where the parties get stuck in implementing it, he is to recommend ways forward. if the parties are blocking implementation his recourse is to report to egad, to the african you know peace and security council and to the u.n. security council. he has done a number of reports to those various bodies. he has tackled issues such as the problem of the 28 states, the impasse in seating of
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members of the transitional legislature and other elements of the agreement that the parties were unable to find a way to implement because they were not working in good faith with each other. after the events of july 8-11 it jmec temporarily moved its operations to addis ababa. they have now gone back to juba. and one of the tasks that the security council asked jmec to undertake is to hold a security workshop to determine the level and arming of forces that should remain in juba. i understand that president mohai has convened a meeting held on the 22nd and 23 order this month to look at that. those are the types of activities that jmec is doing. we are one of the major supporters of jmec. we have contributed over $3 million to the operation of it.
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we believe it is a critical component for successful implementation of any part of the peace agreement. it has been criticized by the government in particular for being a usurping government authorities. we do not see it that way at all. we see it as neutral -- president mohai in particular as the neutral arbiter of the agreement. on humanitarian access, i just really would like to clarify one thing on what secretary kerry was expressing in the press conference. in nairobi. i really think what he was expressing there was not a plan to cut off humanitarian assistance from the united states but rather a frustration with the continued interference with the humanitarian assistance that we are providing. and really trying to put south sudan's leaders on notice that they have to get serious about dealing with this. that was the message.
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>> i wasn't referencing secretary kerry, really. i mean i know there are concerns about that here. >> so, again, how do we get the humanitarian assistance delivered? it's a systemic problem and it's partly related to the criminality of the wfp warehouse incident, for example, occurred after opposition forces were driven from the capital. so it would have to have been government forces that were doing that looting. and again, that's the type of thing that needs to be investigated and some examples need to be made of people who are involved in that type of activity. of the people that the government claims it has arrested for looting in the aftermath of the fighting in july, it's not clear to us that any individuals -- of those individuals are particularly involved or being looked at for involvement in this attack. and then the arms embargo. what we have tried to do with the arms embargo, as it is a
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major tool, is to achieve progress toward peace by threatening it, and we have used that on a number of occasions, and we think it's one of the reasons that the government is seriously looking at allowing the deployment of the regional protection force. because they know that if there is impediments to that, and they know that many other members of the security council are already on record of supporting the arms embargo. but i think most importantly, what they heard when the security council permanent representatives went to juba this past weekend was a unanimous security council that was saying, when we pass a resolution, even though some may have abstained on it, it is the security council that is speaking. and so, you have to take that seriously. and as i mentioned in my testimony, if the secretary-general reports that there is continued obstruction
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of this force, we are prepared to move ahead. and as we said in security council resolution 2304, which we have the pen on, that there is an appended resolution to be is an appended resolution to be voted on, an arms embargo resolution, and we are also prepared to look at other tools, such as sanctions. i must say, though, our record in getting additional people sanctioned in the security council has not been good. we had what we thought was a very good case back about a year ago when fighting flared up in the area right after the signing of the peace agreement. and the two generals responsible for this, paul malong on the government side and johnson maloney on the opposition side, we've put their names forward for sanctioning. and the council, certain several members of the council blocked that effort. so, even when you think you have
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a clear case, it's not easy to get the council to agree on that. and to be effective, travel and financial sanctions really do need to have the backing of a broader community than just in the united states. >> did you mention who's the primary -- or where is the primary place that they get the arms from? who's selling them the arms? >> they seem to have mainly come from the former soviet union area. but i think most of them come in through the gray or black arms market. i don't have specific countries that i can attach to specific arms platforms because, obviously, the government goes to some lengths to keep that information to itself. but clearly, it has access still to arms --
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>> which is why i wonder about the effectiveness of an arms embargo, but anyway. >> well, that's why if an arms embargo is voted, it has to be something that is done by the security council so that it will have the impermature of that body and the weight of the international community behind it. >> so, mr. chair, before i yield, i just wanted to bring attention to someone who's in the audience who was a former intern with me, david akuth who was part of the lost boys and lost girls that has been living very successfully in the united states and is leading an effort with other lost boys and lost girls -- i should say lost men and lost women, because they're all grown. but we actually plan to next week introduce legislation calling for a program that would be run by us, by the state department, to allow some of the former lost boys and lost girls to return to south sudan.
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those individuals who have come here, who have gotten their education, who have been successful and want to go back and give back to their country. obviously, no one would suggest that they go back right now, but given the length of time it takes to do legislation, we certainly would hope if a program like that was instituted -- it was one suggested many years ago by one of your former colleagues -- that it is something that we might consider. so, i just want to mention that, and i'll save my other questions for the next witness. >> mr. donovan? >> thank you, mr. chair and thank you, ambassador, for your service to our country. many of the things you spoke about are troubling. two things i'd like you to address is, one, the recruitment of children to fight in these battles, and the other is the u.n.'s mission in south sudan's instability to protect the workers that are going there on humanitarian missions. and the last thing, if you have
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a moment, is you spoke about the path of peaceful engagement. i was just curious about how you think we get there. >> thank you, congressman. on child soldiers, i think the number was already read out, about 16,000 supposedly have been recruited during the course of this conflict since december 2013. child soldiers had been a problem in south sudan before this current conflict. it's something that we had actually engaged very robustly with the ministry of defense prior to december 2013 on, and which we were making actually some real progress in getting child soldiers out of the spla and even addressing those who were in many of the militias throughout the country. >> what ages are we speaking about, if you know?
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>> i've heard of children as young as 10, 12 being involved. it could be even younger in some cases. but this is, you know, something that we have been constantly engaging them on. now, during the height of the conflict, they were recruiting both sides, opposition and government, and they were utilizing militias. and many of these militias are sort of traditional youth organizations that go on traditional cattle raids, and there's sort of no distinction there in terms of age of majority, if you will. and so, they ended up being i think swept into the fighting. so that's part of the problem. but clearly, as we look, and i talked about a security sector end state. clearly, we want to see a security sector end state that the government would support. they would have no place at all for child soldiers. and we will continue to engage
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on that. the state department last week, i think, issued a very direct statement condemning the use of child soldiers in south sudan and the continued practice of that there. on the problems protecting humanitarian workers, i'd like to just give a little bit of context. the u.n. mission in south sudan on december 14th, 2013, the day after the trouble started in juba, they had camps in juba and in other towns, their own bases that became the sanctuary of tens of thousands of south sudanese who were fleeing ethnically based killing. and this was sort of a new move, if you will, for the u.n. to actually let people on to their bases in such numbers. but we think it was the right thing to do at the time and that it saved thousands of lives to have that happen.
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but what has resulted is the u.n. is now saddled with somewhere between 150,000 or so people that are actually now in, if you will, their own facilities, their own camps, that they have to provide static protection to. and in many instances, they don't control much of a perimeter around where their camps were. and so, it takes a fair number of troops to be able to provide that static protection. so this means that there are fewer troops available for moving out into the city, into the countryside, but we have had numerous successes. for example, back in april of this year, ambassador phee worked diligently with the government in juba, the regional governor in unity state and the u.n. mission to put in a forward base in lear, which is in unity
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state, so it was a hotspot for humanitarian needs. and the humanitarian community was demanding protection there. and so, the u.n. did go and establish a forward base there, and that enabled humanitarians to access an area that they had not been able to get to for almost two years of the conflict. so, we've had successes like that in some specific cases. but the ability of the u.n. to be able to move about the country as well as in juba has been erestricted by the government. unmiss has had two helicopters shot down by government forces over the years, one before the conflict, one since. and when they need to fly, they need government permission to fly to make sure it's safe. and the government does not always give that.
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so, again, i would go back to the problem is partly unmiss, but it's also the government which has not allowed unmiss to do all that it could do to facilitate humanitarian assistance delivery, and that function, humanitarian assistance delivery and supporting that is one of the four key functions the security council has given to them, so they clearly understand that as part of their mandate. >> if you could spend a moment, as my time has expired, about your vision of how we get to this path of peaceful engagement. >> first step i would say is getting juba secured so there is space for a political engagement. now, why would those that are sitting in juba now who feel that they can implement the agreement where they are, why would they go forward on that? i think the answer to that is that they have to ensure that these people that have been driven out over the past two months and others that felt
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already excluded from the peace process, if they're not given a peaceful path forward, a political path forward, is going to result in more widespread fighting throughout the country, and can this government afford that? is that what it wants its legacy to be, is a south sudan that goes down with more and more fighting in more and more parts of the country? so, there's going to have to be pressure on the leaders, for sure, but frankly, it's the only way forward that is going to lead to peace, is to have this open up some political space and have this discussion with others. >> thank you very much, sir. >> thank you. >> mr. meadows? >> thank you, mr. chairman. mr. ambassador, let me come back to a question that my colleague, ms. bass, asked you, because your response was a little troubling with regards to arms and where they're coming from and where they are not coming from.
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are you suggesting in your testimony that we don't know? because you said it was a gray market, but we have unbelievable intelligence, even in that region. so, are you suggesting that we don't know or that you can't say? >> well, congressman, what we do know i would have to address in a different setting than this. >> all right. that's fair enough. i just wanted to make sure we clarified, because here's my concern, ambassador. i have followed sudan and south sudan before there was a south sudan. and it has been a passion for my family from a humanitarian standpoint. the stories, the true stories that have been told will break anyone's heart on what so much has not only been done but has not been done. and so, i appreciate you being the special envoy, your work
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there in a very complex and difficult situation. but what i've also come to find out is that from both sides, those who would be supportive of sudan and those who would be supportive of south sudan in a particular position, they believe that the united states has failed to live up to the promises that we have made and that we make threats that we don't follow through on. and even some of your testimony here today would seem to underscore that, that when we talk about arms embargo or sanctions, does it not have a chilling effect if we ask for sanctions and they don't get passed by the u.n., that there's no consequences, that life is going to be like it always has
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been? >> well, first of all on the threats, and in particular, the example that i gave of the two generals. even then, while we were trying to get them on the list, we were using that as leverage to get them to stop the fighting. and they were both told directly that we were going to sanction them, we were proceeding in new york to do so, and the only way they could get out of this would be if they stopped the fighting. well, while the sanctions committee did not approve adding them to the list, it also did have the beneficial effect of the fighting dying down in the same time frame. so, cause or effect. you know, i can't prove it, but -- >> but the results speak for themselves. here's the concern i have.
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if we make too many idle threats that are not backed up by action, what ultimately happens is the threats become irrelevant. and ambassador, do you believe that our country, indeed the state department, is using all its leverage points to accomplish the task at hand on dealing with the issue in south sudan? are we using every leverage point that we have? >> congressman, i think we are using all the leverage points that we have. some take some time to develop. sanctions cannot be imposed, even bilaterally, under u.s. law without a rather extensive package that could hold up in a court of law. >> right. >> so, oftentimes when you find you need to move against someone, you find that the actual evidentiary requirements are not there. this is, as you mentioned the idea of idle threats, this is one reason why we don't just
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take names up to the security council, if we don't think we can get them through. it's also why we, as we've often done with the arms embargo, we will say we will move on this and we will put the full weight of the united states behind trying to achieve this if you don't do "x" or "y." >> well, the reason i ask is because it sounds like you walked back a little bit secretary kerry's comments here today. and i guess, why would you walk those back? >> well, i'm certainly not trying to walk back what the secretary said, but our humanitarian -- >> that's what it sounded like. but you go ahead and clarify. that's why i'm asking. >> humanitarian assistance is something that we provide on the basis of need. it's not something we provide on the basis of political -- >> but it is something that we must prioritize. and so, if some groups are using it inappropriately, there is more need than there is ability, even for a very prosperous nation like the united states. and so, do they understand that there is a priority for humanitarian relief? >> that is something that i
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think -- >> well, if they don't understand it, please let them understand it based on this hearing. >> i think it came across from what the secretary said. it certainly is something that i've made very directly to them, that they are not the only place in the world that needs humanitarian assistance, that there are many -- >> and this comes from someone who is, my kids collected money in tennis cans to give to them to support. so i mean, it's not out of a noncompassionate heart. let me ask you one other question. i think there's a new law about ngos. and 80% of those ngos having to be south sudanese citizens in order -- is that correct? order -- is that correct? are my notes correct on that? >> yes. >> so, tell me about the implications. if that's indeed correct, would that not have a chilling effect on some of the work that the ngos have done and could do in the future?
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>> this ngo law is something that's been in the making for a long time, something that i've engaged on several occasions directly with president kiir on. yes, there is a provision that says the percentage of workers of ngos needing to be south sudanese. this is something that many countries do to try to ensure that aid workers or aid organizations are also hiring local staff. there are a number of problems with the bill that we've pointed out. a lot of them have to do, frankly, with things like excessive registration requirements and also very vague references to sort of what is allowed and what is not allowed that allows the government to interpret whether an ngo is doing the right thing or not. >> all right, so, let me ask and be specific, then. this new law, do you see it having the potential of providing less humanitarian relief to some of the most needy
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in the country, the potential? >> we certainly see this law as having a potential impact on the ability of ngos, both international and local, to operate. >> so, does the president -- their president not see that? >> well, i'm sure that they do see that. >> but they think that we're just going to go ahead and just go along and fund it and create a jobs program? >> well, i wouldn't see this as a jobs program. i think most ngos probably do hire more than 80% of their staff being local. i don't think that's -- >> so why the need for the law, then? >> well, that's a good question, and these are some of the issues that we've raised repeatedly over three years when this has been under consideration. >> well, if you could -- >> it is a problematic law and we've made that very clear --
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>> okay, if you could, as the special envoy, take to their very highest government officials a sincere concern from members of congress on this new law that potentially the humanitarian relief that needs to get to needy families and citizens could be stopped because of the unintended consequences of a new law and that we would ask them to reconsider. and with that, i'll yield back, mr. chairman. >> thank you, mr. meadows. mr. rooney. >> thank you, mr. chairman. ambassador, you know, you paint a very bleak picture in what we've talked about here today and the testimony you've given. i mean, we talk about a government that has lost control of its military from time to time, an opposition that's gone, a government that's raided humanitarian and food aid from this country of which i sit on the committee which helps appropriate that money, which is why it's concerning to me.
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but as a catholic, it's also concerning to me that, you know, that this would happen in this day in age, that we as americans won't be able to do anything about it. and the other thing it seems like you've said that we have leverage to use is this arms embargo. and we keep threatening to use it, but we never really get there. and then i just notice that maybe it might be a political thing to say, if we use an arms embargo, then we're admitting some kind of failure as a government. i hope that's not the case. i hope that it's a sincere ploy or a sincere intention of this government to use an arms embargo, because guess what, what can it hurt if we actually do it? if this guy controls the government, there is no opposition. he's used the term overmilitarization. you used that term. if that's true and the only thing that we can control is how much militarization that's in
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that country, then what can it hurt if the united states does take the lead to say enough is enough? we've got diplomatic envoys being shot at, we've got all kinds of crimes that we've talked about against its own citizenry, we've got humanitarian aid and food being seized upon, we've got the opposition has fled, we've got a government that's lost control of its own military, and we keep threatening to use this arms embargo as if it's something that, well, you know, maybe, maybe if we say this one more time, we'll put this security force in there of 4,000 people, which i've got to be quite honest with you, i don't think they're going to do anything. i think that this is just going to keep going on and on and we're going to be right back here again at the next hearing talking about how this has failed but we might use an arms embargo again. i just want to know, what will it hurt if we do it?
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i mean, is it an admission by the administration that we failed in south sudan? is that the problem? >> well, congressman, as i've said, it's a major tool, and to be effective, it has to be done multilaterally, not -- >> why? just do it. just use the united states as the leader of the free world and do it and other people will follow. who cares if it's unilateral? that doesn't make any sense! we build coalitions all the time and people follow us because we're the number one country in the world. we're the sole superpower. >> right. and because it is such an important tool, we have used it effectively, and we think we're using it effectively now to leverage a way forward for south sudan to get it back to a path of peace and political dialogue. >> do you believe that? do you believe that we're going to create this space in juba, like you say, and there's going to be elections and a political process and a constitution and all that? do you really believe that,
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unless we do something affirmative? >> well, the something firmive we're trying to do is trying to get this force on the ground and get juba to be demilitarized. and this is the leverage we're using to try to get there. now, the south sudanese may well not cooperate with this, and in which case we're prepared to move forward with that, as well as potentially other sanctions, so -- >> okay. i hope you do. >> the frustration level, we hear it -- >> hey, you're on the front lines, so i appreciate your service. i'm not -- i just don't believe that any of this stuff is going to work anymore, and i don't think that the security force is going to work. i think that we need to move forward with an arms embargo now and stop as much bloodshed and killing as we can and protect the food and the humanitarian aid that mr. meadows talked about getting in there by however means we need to figure out how to do that. because i think that's the only thing that's left to do is to help the people that are starving and being oppressed. but you know, trying to talk about elections and that kind of stuff, i don't buy it. i yield back. >> thank you, mr. rooney.
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mr. cicilline. >> thank you, mr. chairman. thank you, mr. ambassador. mr. ambassador, what is your best assessment of the anticipated timeline for the regional protection forces, both troops and deployment? and how long do you expect that negotiations with the government will continue on the composition of the rpf? how long will that delay the deployment? and have any countries outside of the immediate subregion, besides rwanda, indicated that they might consider providing troops to the rpf? >> okay, on the timeline. what i have been told by the military leaders in the region is that they are prepared to deploy the troops very quickly, within a matter of weeks, after there is permission from the government to go in. they've made it clear they're not fighting their way in to
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juba. the u.n. does not send missions to fight their way into countries. but if the government in juba accepts this force and provides land for it to be bivouaced on, what i've been told is they're prepared to move the troops very quickly. moving the equipment will take a little bit longer, and that's something that they've indicated that they might need some help with. >> maybe i wasn't clear with my question. i recognize that the troops are prepared to -- i guess my question is what's the length of time the government is likely to engage in negotiations? that's really the unknown. >> well -- >> piece, i think. >> there's also questions about how fast countries can actually mobilize their troops. >> right. >> but in terms of that, this is
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what the secretary-general's report, which should come out and will be discussed next week in the council, will be about -- is the government really moving forward to accept this force? and the message that was given by the security council visit that secretary kerry gave with regional leaders, including to the south sudanese who met in nairobi on the 22nd of august, was a clear message that we expect this force is going to be deployed, it's going to be deployed as envisioned by igad, which is with the troops from those three countries who are committed to this mission of actually the ensuring freedom of movement around juba, protecting the critical infrastructure, including the airport, and preventing violent actions, so protecting civilians in a more robust, not a static, manner. those troop-contributing countries have agreed to that mission. so, we don't want to enter into a negotiation with south sudan on who the troop contributors will be, what arms they will need, how many of them can deploy. that is foreseen -- and what
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their mission will be. that's all in the resolution. and so, that's where we get to this idea of using the threat of the moving on an arms embargo and potentially other sanctions, if, indeed, the government tries to delay this. so far, their actions have been on the one day to say, yes, the next day to say maybe, the next day to say no and then to say, well, probably yes again. so, this isn't something that we are not going to have patience with to drag on. >> so that leads to my second question, mr. ambassador, and that is, what influence does the united states have with the government of south sudan to encourage them to develop a more inclusive, transparent and accountable approach to governance? and what other things might we do to accelerate that process? >> when i was here in april and we were actually looking at trying to help a transitional government to succeed, one of the pillars of the peace agreement that i mentioned was this idea of the economic
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reform, and particularly strengthening the transparency of public financial management. and that's something that we believe needs to happen in south sudan. the kleptocracy of the past must end. as i mentioned, we are continuing to look and utilize information to utilize sanctions that are available, particularly travel sanctions, for corrupt practices, to send the signal that being in charge in south sudan, it's not about just enriching yourself. trying to change a little bit of the mentality of those who might lead the country going forward. so, a very important component. how do we get them to do it? again, i think our main leverage is, you know, what is it they want from us? at that point, they were clearly looking for support for their budget, for their economy, and they've recently come out again
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and said to the international community, we need $300 million from you this year. that's not going to be forthcoming, unless these types of reforms occur. >> and my final question, mr. ambassador. the director of the african center for strategic studies has suggested that it may be time to put south sudan on life support by establishing executive mandate for the u.n. and the au to administer the country until institutions exist to manage politics nonvaliant and to break up patriots networks underlying the conflict. this were to be considered, how do you think it would be executed given the sensitivity of the current government to foreign intervention and apparent reticence of some of the security council toward u.n. actions perceived to threaten south sudan's sovereignty? it seems like that would be a very difficult initiative to
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move forward, but i'd love your assessment of it. >> i've seen that proposal. we've looked at that idea. frankly, the u.n. cannot impose this on a member state. the african union i think certainly has absolutely no appetite for putting one of its member countries under an international trusteeship or guardianship, whatever you want to dress it up and call it. that is something that i don't see that we would have any support for. it's impractical, and i don't see how the south sudanese would ever accept it. the visceral reaction they've had, even to the role of jmec in overseeing implementation of the agreement as an extra sovereign force, the reaction that they've had were the initial reaction to the regional protection force
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was, you know, not one more foreign soldier. we will fight them. this is a matter of sovereignty. i think we get the idea of how that would be received in south sudan. >> thank you. i thank you, mr. chairman. i yield back. >> thank you. before we go it our next panel, i would like to just ask. you know, i make it a point to always meet with the bishops, the faith community, the protestants, whatever the denominations might be, and even country. greg simkins and i met with archbishop marino akudu loro, had a very good exchange on the reconciliation aspects of what the church can provide and also the humanitarian assistance. are we fully utilizing the faith community in south sudan? secondly, there's a foreign policy article, september 6th, very disturbing. i was briefed on it when i was in south sudan about the gunning of -- the bullets that were sent in to two of our vehicles as they passed by salva kiir's compound by his troops. thank god nobody was hurt, but
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the state department says we don't believe our troops or personnel were specifically targeted, but the article's author, kallum lynch, points out that 50 to 100 rounds were pumped into the two vehicles. the armored suvs held laminated cards with the american flag on it and also the diplomatic plate number 11. are we investigating this? do we believe it was by design or by mistake? even by mistake is bad enough, but if it was by design. and finally on the sanctions. we've had sanctions for two years, ofac sanctions, the office of foreign assets control. they are well laid out, child soldiering sanctions against persons contributing to the conflict in south sudan. there are only six people on it, and i wonder if you're looking at that to expand it and make it more robust in terms of those
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who meet the criteria laid out, so well laid out two years ago in this sanctions regime. >> well, mr. chairman, on your question about engaging with the faith-based community, yes, we do engage with them, both within south sudan and also the vatican. we've been in touch with them on numerous occasions and comparing notes on south sudan, and they have also engaged i think one of the senior cardinals who recently went there as an emissary for the pope. and a number of the religious leaders spoke out during the visit of the u.n. security council perm reps this past weekend in favor of the regional protection force being deployed and moving forward on a political process. so, i think the faith-based community is finding its voice. we've also through usaid given it a $6 million grant to the
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south sudan council of churches to work on community-based reconciliation efforts. so we are engaging the faith-based community, i think. i think in the many meetings that i've had with religious leaders in south sudan, after the outbreak of fighting in december of 2013, they showed a lot of frustration, and the leaders seemed to have turned a deaf ear to them. and i think they are beginning now to, as i say, find their voice in unison, and it may become harder going forward. on the july 7th firing on two u.s. vehicles that contained several u.s. diplomats. this occurred, as i mentioned, very shortly after a similar looking vehicles that were driven by the opposition forces, who had come into town on some mission, and they were going
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back to mashar's compound area, and they were driving in this -- it's always an intense area right by the president's compound -- and they tried to stop that vehicle. the opposition people refused to get out of the vehicles and they sped off, and the soldiers fired at those vehicles. the opposition security officials in the vehicles fired back and killed i believe five government soldiers right in that very vicinity. so, it was a very tense environment. there were a lot more soldiers out on the street after that incident. and our cars came along, and they were -- it wasn't a formal checkpoint. it was a lot of soldiers on the streets sort of waving them down.
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it was very dark, and our vehicles have tinted glass. so, even though for the brief time that they stopped and tried to show identification, it is not at all clear that these soldiers would have been able to see it or, frankly, even understand the license plates. you're dealing with, don't forget, with an army that's primarily illiterate. and so, when our vehicles, according to standard operating procedures, when they tried to open the doors of our cars, also sped off. the soldiers opened fire, just as they had when it had happened with opposition vehicles. and again, shortly, again, in the same area shortly after that incident, the country rep for unesco, an egyptian national, was driving in the area and encountered a similar problem, and because he was not in an armored vehicle, he was seriously wounded. so again, to say that this was targeting americans, i'm not -- we did not deduce that from the circumstances, and the regional security officer working with
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diplomatic security back here in washington conducted an internal investigation of the events. and the review of that report is still ongoing. and we were very thankful, of course, that our people had the resources, that we had the fully armored vehicles there for them to ride around juba. it's why our security protocols call for them to be riding in armored vehicles in most parts of town and particularly after dark. and in response to that incident, the embassy's emergency action committee met the next morning and changed the curfew to a dawn to dusk. so, took appropriate actions to try to mitigate that. in terms of sanctions, let me just say, yes, we share the frustration. i mentioned some of the difficulties of actually putting together packages that meet all the legal criteria, but we certainly will look at taking
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actions against those who continue to impede the peace process, are hindering humanitarian delivery and the like. >> yes, i just wanted to take a moment to acknowledge that there are several people here from gabon, who are expressing their concern about the elections that took place. i just want you to know that we see you. we read your posters. i know you were asked to put them down, but we did see what they said. and we also are concerned. and i just want to acknowledge that your presence has not gone unnoticed. >> and i fully concur with the ranking member. thank you for being here. i would like to now yield to mr. meadows. >> ambassador, let me come back with very, very quick points. i mentioned the ngos, and technology's a great thing, so i
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got some information that would suggest that even within the last few hours or few days that there has been potentially the shutdown of 40 ngos and the threat, if not the reality, of seizing their assets. are you aware of that report? >> we've received reports over the past several hours of harassment of a number of ngo civil society organizations -- >> so, you're saying that report could be accurate? you're getting the same -- >> it could be. we have to look into that and try to verify it. >> so would you get back to this committee right away on whether that is accurate or not? and i guess the second follow-up question to that is, if it is accurate, will you be resolute in your condemnation, of saying that we will not tolerate that behavior if our humanitarian aid is going to continue? >> i can assure you, congressman, that we will be very direct and very strong in a condemnation of any harassment of --
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>> but it's seizing of assets and it's more than just harassment. so, that's my concern. so, will you commit to get back to this committee within the next seven business days to let us know what is happening on that? >> let me say, we'll get back to you as soon as we can confirm what's actually going on. >> what's a reasonable time? if seven days is not reasonable, what's reasonable time? >> again -- >> 14 days? >> not on the ground. 14 days? give us 14 days, yes, please. >> all right, 14 days. we'll do that. and the last thing is this, is you talked about a political environment which is open and inclusive. and yet, we're hearing reports that potentially someone took a letter to the u.n. security council and might have been murdered after that. would you care to comment on what's happening since the u.n. security council's visit? >> well, some of this harassment of civil society that -- >> well, murder is more than harassment. >> -- that we've been hearing about as been subsequent to the
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visit by the security council. but it's something that has gone on in the past as well. we have long been engaged -- >> so, how much of that are we going to tolerate? >> -- suppressed movement and freedom of movement for the ngos and the like. >> how much of that are we going to tolerate? >> well, it's a matter of what can we actually do to affect that behavior? >> well, i'll yield back. we have many leverage points. thank you, mr. chairman, for your flexibility. >> thank you, ambassador booth, for your leadership and for spending your time today with us at the subcommittee. thank you. i'd like to now invite to the witness table ambassador princeton lyman, senior adviser to the president of the united states institute for peace. he served as u.s. special envoy for sudan and south sudan from march 2011 to march of 2013. as special envoy, he led u.s. policy in helping in the implementation of the 2005 comprehensive peace agreement.
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ambassador lyman's career included deputy assistance secretary of state for african affairs, u.s. ambassador to both nigeria and south africa, and assistant secretary of state for international organizations. he also is a member of the african advisory committee to u.s. trade representative who began his career at usaid and served as its director in ethiopia. we will then hear from mr. brian adeba, a journalist by training, previously an associate of the security governance group think tank that focused on security sector reform in fragile countries. over the last few years, his research interests have focused on interlinkages of media conflict human rights and security. he supervised the coverage of the conflict zones in darfur, blue nile and eastern sudan for the boston-based education development centers radio project in nairobi, kenya. prior to this, he served as project and public
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communications coordinator at the think tank, the center for governance innovation in waterloo, canada. again, he is representing the enough project. ambassador, please proceed. >> thank you very much, mr. chairman. and let me begin thanking you personally for all the support you and the committee provided when i was special envoy and you and congresswoman bass and the members of the committee continuing to focus attention on these set of issues. it's very important and it's very much appreciated. i'm not going to go over the background to the situation. i want to address some of the key questions that you've raised and have been raised in the previous exchange. let me start with the peace plan itself, around which the various activities are organized. the igad peace plan, which was
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signed in 2015, on paper is a very comprehensive agreement, but it has a fatal flaw to it, and that is it rests very largely on the willingness and ability and commitment of the very antagonists who brought the country into civil war to carry out a fundamental political transformation. it is not in their interests to do so. and what we've seen over the last year or so is that instead of carrying that forward, they fell back into conflict, and now machar has been driven out of the country. without a strong international oversight and administrative oversight of this program, it was not likely to succeed. the second problem that we now face is that it would be a
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mistake to assume that with the succession of taban deng gai to the vice presidency, we have a government of unity. he does not demand the loyalty of all of the various forces that were fighting this government, and to assume that it's capable of carrying out a comprehensive and being inclusive would be wrong. it's not. now we have the humanitarian crisis which people have addressed. it's an outrageous situation that the international community and the united states alone spending over $1 billion a year, that over 50 aid workers have been killed trying to carry out a humanitarian program, that they've been attacked, and again, most recently in the terrain hotel. and both sides have impeded this activity that the international community seems to care more for the people of south sudan than the leaders on both sides. that's an outrageous situation.
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and what it does is really call into question whether the government has the -- can claim to the rights and responsibility of sovereignty, which goes with the claim of sovereignty. recently, kate holmquist, as congressman cicilline mentioned, and myself, did an op ed saying that there should be an international oversight administration of south sudan. without that, we do not see how this peace plan could go forward. ambassador booth described the role of jmac under the peace plan and the role of festus mogae. the fact is that mechanism has no real authority over the parties. festus mogae himself has said on several reports that almost no
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progress has been made on implementing the peace process. now, the proposal we made, of course it would be extraordinarily difficult to do, and ambassador booth indicated that. but here's the fundamental question and the fundamental challenge. the peace process is in the hands of igad and the african union, primarily. and if they are not prepared to amend the current peace process and create a true oversight authority, which they will back up, back up politically, back up by enforcing an arms embargo, by taking other measures, then that peace plan won't work. now, if they're prepared to do that, then no one needs trusteeship or anything else. but the problem is that igad is badly divided. they are not in agreement.
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they have threatened an arms embargo many times but never followed through. and for the u.n. security council, we have an adage that guides your practicality. when the africans are divided, the security council is divided. you're not going to get sanctions through russia and china unless the africans are united and say this is what we want. and the africans are divided. the igad is divided. so, even if the u.n. security council wanted to pass an arms embargo, those surrounding countries would have to implement it, make sure that arms weren't sneaking through, weren't being violated. so, the primary attention effort, seems to me, for the africa union and for igad to decide exactly if they are in control of this process how to strengthen it. now, let me just come to this question of the 4,000 troops that are being added. as you pointed out, it's a
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question of putting these under unmiss and whether they will act differently. it's very difficult to contemplate a u.n. peacekeeping force confronting in an armed way the forces of the host government. i don't think very many u.n. peacekeeping forces are prepared for that. i'm not sure the security council is even prepared for it. so, the question is, is this force really going to have the mandate to confront not just outliers, but an attack like the terrain hotel complex and go up against government forces? that is a very difficult thing to do, and it has to be backed solidly by the troop-contributing countries and by igad and by the u.n. and if they're not prepared for that, then this force may secure the airport, but they won't be able to protect civilians.
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now, the other question is the political context. putting more forces into juba without changing the nature of the peace process and the way it's enforced seems to me is going to have a continuation of the situation we now have. so, i think it is critical that the u.s., the international community, the united nations call upon africa union and igad to strengthen that process so there is a real oversight and enforcement of the peace process with sanctions and punishment for those who get in the way of it. otherwise, we won't get the transformation we need. and i think that's the great dilemma that we now face in south sudan. thank you very much. >> ambassador lyman, thank you so very much, and again, thank you for your prior service as special envoy. mr. adeba.
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>> chairman smith, ranking member bass, members of the subcommittee, i want to thank you for your continued focus on south sudan and for inviting me to testify. impunity is entrenched in the system of rule in south sudan. the horrific terrain hotel incident is an example of that impunity. the country's leaders commit horrific crimes and treat state resources like their personal property. the country's money is captured by a few and used to wage war. with financial leverage on these leaders and your continued leadership and support, it is possible to counter this system and the perverse inclinations of its leaders. it is possible to disrupt access to the process of corruption that fund war and to shift the incentives of south sudan's leaders toward peace. congress can do the following four things to have an immediate impact.
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first, congress can make sure the u.s. treasury department has the funds it needs to use more antimoney laundering measures. the measures can be used to target and freeze the assets of elite politicians and leaders in south sudan who perpetuate violence, loot public coffers, and use the international system, including u.s. institutions, to process their ill-gotten wealth. second, you can ensure the administration sanctions assets on top leaders and others who take these measures. we've had discussion about how the threat of sanctions alone is not inducing the change that is needed in south sudan, so when we look at this recommendation, this is a call to action.
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third, you can push for stronger enforcement of existing sanctions and asset freezes in the united states and internationally on the south sudanese political elite. fourth, you can pass the global human rights accountability act. this act authorizes the u.s. president, like those in south sudan who misappropriate state assets. and attack anticorruption crusaders. i believe these four steps can strike directly at the wallets of the people suffering in south sudan, the people that commit crimes and enrich themselves because they believe they would not face consequences for their actions. these leaders are more likely to support peace when they pay a price for war. the institutional challenges in south sudan require your long-term support, as well.
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i analyze this very issue. epu was a man full of hope, the first vice president and opposition leader had returned to town, people believed that the fighting would stop and the two leaders would work together to govern. there was hope that the critical governance institutions could begin to function properly, as well. i focus my research on three key institutions. the anticorruption commission, the national audit chamber and the public accounts committee in the national legislative assembly. i found that all three were severely undercut, intentionally. top-level politicians deprive them of the money they need to function. conflicting laws prevent prosecutions of officials that have been investigated and cronyism undermines the effort to fight the corrupt.
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the mechanisms and institutions that could promote accountability do not have what they need to be effective. but there are several things congress can do to help south sudanese people address their institutional and systemic challenges. first, continue to support the people in south sudan who fight for transparency and accountability. listen to them, stand with them and help their raise their voices. second, ensure there is strict budget oversight for assistance to south sudan. those who command or commit atrocities and seek personal enrichment should not be able to misappropriate public funds, especially those given by americans who support the south sudanese people. third, support and strengthen the institutions in south sudan that can build an open and accountable government. these institutions could work much more effectively than they do today, but they need political, technical and financial support.
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most of all they need the space to operate without undue political interference. an institution that meets these things is the hybrid court for south sudan established in the august 2015 peace agreement to ensure accountability for war crimes. next week on september 12th, the century on the initiative of the enough project will publicly present the results of a two-year investigation into corruption in south sudan. they have documented the connection between high-level, grand corruption and violence in south sudan, and we encourage u.s. policy makers to take immediate action on the findings we release. your support is critical. the stakes are very high in south sudan. if south sudanese leaders face no prize, no deterrent for their crimes from anyone, south sudan will disintegrate. with your help, that can be prevented.
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thank you very much for your efforts on south sudan and for your tireless commitment to the south sudanese people. >> mr. adeba, thank you very much for your personal work, your trip which really uncovered, and you got to see those three institutions in particular. thank you for relaying it to us. so, without objection, your full statement, both of your full statements, will be made a part of the record. and unfortunately, we do have a series of votes, well over an hour we expect of voting. so we will conclude here, but i want you to know how deeply appreciative we all are on the subcommittee for your leadership, for your guidance, and we will stay in touch going forward. in a week i look forward, or so, to that new report, which the committee will digest, and i'm sure utilize as we have in the past with enough projects. and ambassador lyman, thank you, because you did extraordinary service under very difficult situations. so, thank you for that leadership all those years, and
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your entire foreign service career. the hearing is adjourned. i would have liked to have asked some questions. i will submit a few for the records, if you could get back to us in a timely fashion that would be greatly appreciated. hearing is adjourned.
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friday on c-span3, senators tim scott and james langford at the value voters summit. live coverage from washington begins at 8:45 a.m. eastern time. coverage continues on c-span2 at 2:05 when donald trump is scheduled to appear, along with rnc chair reince priebus. former senator rick santorum and actor john voigt. watch our coverage of the conference on c-span networks and >> c-span's "washington journal" live every day with news and policy issues that impact you. coming up friday morning, new york republican congressman tom
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reed will join us to talk about his endorsement of donald trump and the statements that congressmans made on the record saying mr. trump needs to be reined in if he wants to win the . . . . . then i started because he was the dominance force, i
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started asking about him and his competitors including steve nguyen and people who work for him and some big gamblers. donald does not know anything about the casino business. >> sunday night on q and a c-span. this committee meeting begins with a debate on a subpoena after the vote members of testimony of veterans. this is two and a half hours.
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good morning everybody, thank you for being here today. before we begin, i want to take care of one item of committee business right here, i am hearing a motion of an issue on a subpoena to the secretary of veteran affairs of work as well as evidence here associated with the denver construction project with the aie report. i want to say it is unfortunate that va continues to lack of transparency has led us to this decision. we have not done so ample jurisdiction. i made the original request for art contracts at the time
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related to the palo pinto health system. i think most of you remember that. what follow was a yearlong back and forth between myself and the va of their approvals and procedures and practices for purchasing and nationwide as well as an accounting of art work aor ornamental furnishing. the va made any attempt to respond to my request for their spending. however, true reform what they gave us is holy incomplete. for example, va claims who have spent approximately $4.7 million on our nationwide from january of 2010 to july 206. yet, the committee has already substantiated over $6.4 million
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segment during this period for the palo alto system alone. spending data that the va finally did provide even of art purchases in the palo pinto system that the committee had already substantiated. both the eclipse which i will ask the clerks and you have a copy of this slide with you on your desk purchased for $250,000 and the sculpture also pictured on the screen was purchased for $220,000 were omitted. of the va's total figure that's divided. va took it on itself to admit
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amounts spent on-site preparations for art work and installations which amounts to millions of dollars in palo alto. do remember the art work that's a rock? it was supposed to cost $250, 0 $250,000. by the time it was purchased, it was $500,000 and sit cost costs -- this was not included because the cost is $1 million to put the rock up. that was omitted from the number that the va provided us recently. when taken into account, the va provided no data at all and quote negative responses and from vision, 27, 9, 16 and 20. i am confidence that we are not receiving the whole picture from the department.
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this is compounded by the fact that va compile the data by searching for all contracts under the budget operating code, 31-26 which indicates art work. by definition, art work purposes that were not categorized by our work and not made by bona fide contract. the committee has seen too many instances in the past. all miss categorized. as for the denver construction, the committee received a similar lack of information. we have seen -- va claims they
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provided thousands of pages in the aiv and august 19th letter to this committee highlights that is simply not the case. in this letter, va -- documents that it has provided and most either congressionally mandated or required for some other purpose or in one case, an advertising contract that was totally unrelated to our request about the aiv. the va out right stated in the letter that they did not intend to release documentary information that is entirely within the authority of this committee to accept or reject. we'll not accept va trying to pull it over the eyes of this committee or the american people, important decisions making or made on the part of the department. as such, today we are going to
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vote to issue a subpoena which will demand complete answers on both of these issues. the subpoena will cover of the spending of art work of fiscal year 2010 to present. and medical center construction project and registration report. are there any members having any questions to ask on this issue? >> mr. kaufman. thank you for your leadership on this two very important over sight matters. everyone on the committee is painfulfully aware that it is b a long struggle to get straight answers from the department of the aurora project. as late as april 2014, at a field here in colorado, despite the findings are numerous and a
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scaling gao review. officials continued to tell congress that the va hospital in aurora could be billed with funds already on hand. keep in mind, that as far back as 2010, va officials were internally discussing how the va project was broken and at least that five separate committee hearings were held detailing to evidence. it was not until december 2014, when the va lost its case on all counts that it was forced to publicly admit that it had a construction problem. a full three months later in march 2015, weeks after the project was shut down could be required, the va told congress that as much as a billion dollars, and additional funding was needed, still mr. chairman,
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it is the department's effort to hide the problem in aurora sounds bad, the department's effort to avoid sub accountability had been worse. deputy told members at the colorado delegation after the aip completed and following numerous congressional requests, the committee was provided of a 31 page summary. one va official collected over $60,000 in bonuses while over e overseeing a project that's spiraling out of control. i believe this committee and the american people are entitled to review all the documents associated with the aurora aib
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and to draw their own conclusion as to what went wrong and whocc. i believe there is an understandable lack of trust in the va's explanation. i urge all my colleagues to support this motion and i yield back. >> thank you mr. coffman. >> thank you mr. chairman, i want to remind my friend and my colleague from colorado that congress and of the morning hours, approved over a billion dollars to augment and there were projects over concerns of minorities that more conditions sort of have been attached and that the funding should have been sunlightbmitted careful.
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i am engaged in this how we should hold the va accountable for. again, i find it a bit rich that congress approved that funding in the middle of the night over, i think the concerns of the minority. today i am concerned that you are asking us to exercise our subpoena power when it maybe unnecessary. you have denied my request for witness for violating committee rules. how can we as a committee to work together to make the right
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decisionings f decisions for veterans. i am requesting today that we hold a full committee hearing on the report so we, veterans and the taxpayers know who's responsible for this waste and management ties to the colorado department. va employees before both the administrative board and the ig provided information critical to the investigation. now, you are asking us to subpoena unredacted documents, exposing those employees to retaliation and maybie making i difficult for va and the ig to conduct a thorough procedure.
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in the same subpoena, you are asking us the subpoena on all documents related to the purchase of art at the va hospitals. this subpoena is not only unrelated to the va investigation, it also seems to be unnecessary if as i understand correctly. va is working to provide you answers on the amount it spends on art. i think it is porimportant that work together to resolve this issue together and use our subpoena power only when necessary. now, if we cannot protect, whistle blowers by afemending t subpoena before we vote today, i am prepared to support the subpoena. but, only if we the minority is assured and the subpoena will be amended and i would like to see the language change in the subpoena, actual subpoena before
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we actually vote. >> mi want to echo this committee. it has worked in a bipartisan way. i want to give a little back and forth because you used the word "rich," it seems too little and too late. we have been looking at this situation ever since i joined the committee. i am ranking on the over sight investigation committee. i was delighted to come out mr. coffman's district in april and assuming that the topic would be asking american taxpayers to build the taj mahal. the topic was opiate which is fine, that's an issue that i care deeply about. i appreciate the opportunity but it was not until we were on the third round of questioning and i said to mr. coffman, i got one more question that i want to ask
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about aurora. so why didn't we ask for these documents before we took this vote in the middle of the night? this is a lot of money where i come from, $1.6 billion on one hospital. so, you know, i am prepared and i support the amendment with the redaction. i want to protect whistle blowers. i don't want to lose the moment here, what are we 60 days out from the election and we are worried about documents, why have we been working with these documents the entire time and is that the role of your over sight investigation subcommittees? that's just my comment. any other members wish to spout off? >> i want to spout off. >> and i concur of what you said. the question is why in the world did the va bring these documents up here. why are we having to do this. i have been here now almost
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eight years and you hear this over and over again from these people. they should be up here bringing it up and we should not have to ask. they should be saying how do we make this better. we mess this up. the fact we are having to do this annoys me to no end and it is time for this to stop. >> no, but with all due respect, why are we asking for this information at that point in time. i don't disagree with you. >> i can answer that question as a chairman of the full committee. we have been asking for the document, we did not have to go to aurora to ask for the do you means. we have been asking them for over a year. i am surprised at this point to hear anybody on the neither side talks about the vote oss of the dark of the night. the fact that i was not wanting
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to approve the add discussiitio dollars for aurora. mr. couffman was aware of how w debated that particular issue. i want to a couple of thing things -- just, i think i have earned the trust on the minority side. i think i earned the trust on the majority side. when i say that va has not provided us the documents in a timely fashion, i am not talking about writing them a letter on monday and asking for a response on friday in issuing a subpoena on monday. i have 176 outstanding deliverables at va right now. some going back years and the oldest is december 4th of 2012. i have not received a response. average response time now is 80
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days to get a response. i would ask any person in this room to tell me if that hanging light switcher, is it a light or is it art work? if they have claiming it is a light fixture, why in the world are they spending that kind of money for a light fixture that's exactly what the va did. they called it a light fixture instead of art work. it was half a million dollars on two things. number two, the member said i denied his request for a witness at this hearing. i want to set the record straight, that is not true. we have two witnesses, and i offered and it was declined to substitute, misinflicting for the person that the ranking
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member requested. i was very happy to allow that to be done. i also said that if a majority of the minority per our rules voted to want another witness that i would accept that as well. according to a rule at a place of choosing at my time. as what's the rule says. i was told it was not necessary. we are not talking about an office of report that's coming. we are talking about the ai aiv -- we had people talked about the and the ranking member said we are going to out certain people. i will tell you, this committee has never allowed personal identifiable information out to
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anybody. period. nobody has ever been identified. to say that and insinuate that this committee is prepared to do that is a red head. to talk about the overly broad language, this is the language that we use for phoenix and an exactly the language that we use for philadelphia. it is not overly broad. again to insinuate, we are suddenly concerned, i will remind some of the members who are new to this committee that until i became chairman of the department of veterans affairs have never had a subpoena served on it. never by this committee. that's ludicrous. we need to be doing our job. and, so the question of
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identifiable information as it relates to the aib, i get it. i don't intend to release it and i have never released anything like that. i am willing to have that discussion. mr. woalts and i had a discussin on the floor yesterday afternoon. whether or not it is necessary in the actual language of the subpoena or what i am asking is that again, you trust me enough as the chairman of the committee not to release that information. it is not going anywhere. the problem is we don't know what we don't know about what's going on. we think we know who the folks are that should be held accountable. we protect whistle blowers every single day.
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we have hundreds of them across the country that we meet with and talk with and trying to gather information. again, i understand the concern. i really do as far as releasing of the information and how we go about getting the assurance that the minority wants. i think we should be sufficient in this process and i think we are potentially hurting our committee investigation by allowing the va to reduty to act what they wanted to reduty to act and verses giving to us and allowing us to control the information which is what we should be doing. any other comments? >> i would like to yield to mr. hofm hofman. >> i just like to address an issue raised by mr. patrick.
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we did do -- that was done prior to you, member kuster i have a letter here came from both of us requesting both documents. it was dated october 9th of 2015 that you signed and it has a mandate on it for friday, october 23rd, 2015. they have not turned over the very documents that you will be voting on today in the subpoena that you requested last year. so, i just want to set the record straight on it. i yield back. >> mr. chairman. the with regards to the issue of the witnesses for the commission
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on care report, i see no harm and with sorting with the minorities would like us to see, additional witnesses. you only had two witnesses and your concern is the hearing is too long. i think that the main key points of contention which our witness have decented on that report. y i see no harm and actually to the contrary of a great benefit to the crewing to a full range of views being presented on what the commissioner has to say. >> but i would like to move on.
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i continue to wait for a request by a vote of the majority or the minority for that particular witness wish that we have not receive. at that time, if you get that vote, i will schedule another hearing at the place in time of the chairs' choosing. >> i thank you for that. our concern is replace in time and we hope that we can get a satisfactory in time. >> how about october? >> i am just kidding. [ laughs ] >> i do want to comment on the issues of the va response. how are these things individually involved. this is not a matter of speculation about or not -- the
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thousands of pages related to the construction project. it states the -- i can go on and on and it is a huge long list that the chairman has that the va has been responsive, too. he further goes onto say that the va does not intend to release the under lying of the employees' transcript. he's to ensure that the future efficacy of executive branch finding processes like the aiv.
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in order to get to ground truths, those charged of the department must be able to count on employee witnesses to be completely forthcoming and candid and not just with the facts but opinions and exceptions on theories of what's happening and why. the best way to ensure complete candor is to remove any fear that witnesses may suffer for spee speaking up. to expect an opinion of insight concerns, they provide through a consecutive branch that's provided to and potentially judged and second guess by the legislative branch will chill our ability to get relevant information regarding to the root causes of our process and risk creating the appearance of politicizing of functions.
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i submit to you that the minorities request is very reasonable. therefore, we are prepared to support the subpoena if you will amend this and take references to unredacted documents. hang on just a minute. let me see if i can figure out how to make it happen. i do want to satisfy, yours and the va. we are talking about whether we can insert a sentence that satis satisfies you and protect the whistle blowers. we might suggest is just take
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out any reference of unredacted. >> no, we cannot do that. what you are talking about is one particular area. we need to move onto the hearing. i don't know if we can do this but i would like to do this. can we take a vote? we are going to take a vote subject to on agreement. i want this done today and if not, we are going to go ahead and push and if it falls into a partisan vote, it will fall into a partisan vote. >> i request that we'll push this to next week until we get
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it to a satisfactory. >> what i am asking is for you to trust me and the ranking member to work on a solution that is sufficient and if so, if we do then the vote that's taken right now, if it is procedurely approved and i think we can do this then this subpoena would be issued. if not, i am going to go ahead and take a vote. if the ranking member does not want to do that then say no. >> i just said that. >> we can work together as far as language. >> no. right now. >> it is going today. >> now? >> it is either going today with your votes on our side or going
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today with the majority as it is. your choice. >> okay, here is what we are going to do. we are going to go ahead -- i am going to take a motion of subpoena. we got a lot of work here. >> we have to rule 2 m 1 b and rule 3 clause g of this committee. i will hear a motion for mr. lamborn of this issue. the department to produce all documents indicating the amount that's spent and the process of spending on art work and furnishing from fiscal year 2010 to present. as well as the entire investigative files and all
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interviewed transcripts and tachmetac attachments and pertaining to the administrative and inve investigative board or aip. do i hear a second? >> we are moving forward. >> we are done. i gave that opportunity to the rank of members that i did not get. all those in favor will say aye. >> aye. >> and no. >> no. >> the opinion of the chairs, the ayes have it. i am signing the subpoena for the production of documents here by directed this issue of support of this. this concludes our business hearing fo
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. i want to thank everybody from joining us on today's hearing on the commission of care and the future of the va's health care system. you remember that the commission on care was established two years ago by the veterans' access choice of accountablea e accountableableaccountableable
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act -- the commission's final report was delivered at the end of june. and with us today to discuss it, and the 18 recommendations that includes our commission on chair, chairperson, miss nancy and vice chairperson, doctor toby grosse. i want to thank them for being here today and i truly want to ex per express by gratitude with them of them putting in the important work of the commission. i want to thank many organizations and other stake holders that provided statements for the record for today's hearing. the advise and councils and support offered by our va's parters par partners as we work everyday. impersonally grateful for the
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input that they have provided me as chairman and will, i am sure continue to provide this committee as congress moves forward to strengthen the va health care system for future generations of america's viewers. like me, the vso's and by and large, we are supportive of many of the recommendations that the commission has made. the commission recognizes of the health care system has made strengths as well as weaknesses. moving forward, it is important to ensure any -- va under goes preserve those strengths which includes provision of care equal and equality that's outside the department's walls. va's weaknesses which includes persistence and access failures of non compliance and a lack of accountability and billions of
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taxpayers' dollars lost to financial mismanagement of construction projects to it program and poor performance employees and more are growing. this is evidence not only by the commission of 300 page final report but by the thousand of pages made up last year independent of assessment. the years of work performed by this committee, the gao, the va inspector and most importantly by the daily experiences of the millions of veterans who we lie on va for care are all too often left disappointed. i only agree with the commissions calling for an integrated va community care system, modernizing va's out dated system and better managing va's vast capitol assets and reorganizing the veterans health
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administration central office and reviewing eligibility for care and light of the modern health care landscape and much, much more. >> however, i disagree as the administration and many of the commission of a commission called for a establishment to provide governance and long-term direct and reforms. our nation's second largest bureaucracy care and challenges that are deserving of our detailed consideration. given the crisis that seems to erupt on a daily bases where va is concerned and any efforts to shield the va health care system and executive and legislative branch over site is a non start.
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not to mention unconstitutional. the debt that our nation knows is a debt that we all share representing a combination of a unique moment in history. for va and veterans that va exists to serve. there has been a likely will be other commissions to vote in examining the va. that is providing assessable and high quality care to our nation's veterans. it is incumbent on all of us, not to let this fall by the waste side like so many have. this is not one that'll sit on the shelves that'll gather dusts. ignoring this opportunity is a dare election of our duties. the scandal of the va's have
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opened doors to changing this systematic culture and deeply entrenched problems facing the va and he will care systems. translating that into lasting and meaningful reform will require a commitment to having uncomfortable conversations about how as a nation we can begin to pay the debt, we owe the men and women of our arm forces and taking risk that are necessary to challenge the status quo that have let them wanting and waiting. whoever sit in this chair after me will be responsible for and i am sure will be more than capable of moving the balfour ward and i am hopeful that today's hearing will help set the phone for that. with that, i will yield to the ranking member, mr. takano for an opening statement. >> thank you mr. chairman for calling today's hearing.
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since we first learn of the wait time controversies in phoenix. this commit knee htee has been path of veterans' affairs. this gave us a good view of the va health care delivery systems and manage ing the process. a year later of the enactment and the veterans health care improvement act of 2015 requiring the va to come up with a plan to consolidate all care and programs. now the commission on care has released its recommendations for transforming veterans health care over the next 20 years. now, i am pleased to receive this recommendation but i am disappointed of the va -- and the legislation, the va has 60
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day to comment on these recommendations and provided a response late to us last week. i have already gave my disappointment of commissioner michael buck lwere not able to . it needs to be apart of the discussion as this committee weighs it forward for the va. >> no objections. with all the reports and studies that we have seen over the past two years and it is clear to me that the status quo. the va that we know is unacceptable. there is an important balance between transforming the va, well maintaining the services and support that millions of veterans rely on.
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now, i am concerned that some of the commissions may in fact fact, -- much like i have seen happening with charter schools and proposals to funding of private contractors and private care will take resources away from our veterans and should be immediately rejected. shifting resources is the pay for care will have impact for our veterans. in addition to reducing quality, it could deprive the va of cutting edge medical research and it innovation. topnotch clinician training and stifling va's visit ccritical r. we cannot view expanded choice or the private sector as the panacia for solving challenges. long wait times impact private
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care, too. care the community should be locally targeted to augment and not to replace the va. instead of stripping additional resources from veterans' health care, our first priority is making sure the va has the st f staffs and resources they need. downsizing, with unique health conditions and urgent mental health needs to navigate a private sector is bad policy. lastly, another big concern that i have is the cost associated not just the recommendations made in the report, but with whatever solutions we agreed on that makes the va efficient and capable of providing more timely health care to our veterans. it is incumbent pond upon us to our veterans.
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to defend the rights and workplace protections of the 114,000 veterans who work at the va and their co-workers who served everyday. again, i appreciate the work on the commissioner care and the commissioner care work that's done. i am looking forward to hearing your testimony today and thank you, i yield back my time. >> thank you very much. members, as i mentioned earlier, joining us as our first panel this morning is miss nancy and the chief executive officer and the henry ford health system and better known to many of you as toby, the vice chairperson of commission on care and the executive on care, i appreciate with all the hard work that you put into the work of the commission, i understand that you will be presenting oral
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testimony this morning, just as you both provided written testimony. with that, i'm begin with you, you're recognized for four or five minutes. if you do go over and your red lights are blinking, we'll not gavel you down because we are interested in hearing your remarks. you are recognized. [ inaudible [ inaudible ] thank you for the invitation to discuss the report of the submission commission on care for the support of the commission over these months and extension of time to complete our work. it is truly a privilege and an honor to share the commission of the road map to improve veterans' health care for the next 20 years.
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i am pleased to be here today with my colleague, toby, who also presents after my testimony. >> for 35 years, i have served in senior leadership roles at large hospitals, i have been in detroit at henry affordable healthcare 13 years. henry ford is an integrated health system with $5,020,000 employees that owns a large system as well as insurance company. and making capitol investments in our community and won the quality work have prepared me very well for the demands and complexities of the commission's
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work. i am proud to be here with one of our veterans, spencer hoover. he served as an airborne infant infantry with two combat tours with one in afghanistan and one in iraq. he's honored with six medals and 70% disabled. spenc spencer, if you would recognize yourself. [ applause ] with me today are susan -- three staffs. john and ralph are also veterans. our commission was composed of diverse leaders and two-thirds of whom are veterans and five have served in significant house leadership roles and three have served in the va and four have
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been leaders ander v service organizations. we developed several principles to guide our work and creating consensus and being data driven and creating actionable and recommendations and focusing on veterans receiving health care that provides optimal quality and access and choice. the independent assessment report that the commission is in valuable as a foundation for our work. a comprehensive system focus details report revealing of troubling weaknesses in the vha performance of capabilities. our work took place over ten months with twelve public meetings over 26 days. we sought to have the input possible and we had intense debate over the issues. our unified focus throughout the process is what is best for our veterans. i believe we produce a really
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good report of transformative. the vha requires transformation which is the focus of our recommendations. there are many blairiglaring pr including staffing and facilities and information technology and supply chain and help despairty that threatened the long-term of our system. transformation is not simple or easy. it requires stable leadership and major and strategic investments and a capacity to reengineer and drive
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high performance. they believe that government cannot run. veterans should have the same choice of a medicare beneficiary should have. empl we believe that vha should be invested in for several reasons. one is the model of integrated care. the clinical quality that is comparable or in some cases better than the private sector. the history of veterans focus research and medical education and emergency capacity especially rehabilitation. the role is providing for millions of complex and low income veterans that could not
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be filled by many markets. kna in fact, as we have seen the implementation of affordable care acts, the shortages of primary care physicians and mental health providers of many markets across the country. our recommendation falls in four major categories. first, creating a system that integrate vha and private sectors and other providers. vha will continue to provide and fully vet the provider network to ensure that veterans receiving care from the individuals who understood and the need for access and transparency of performance and many other critical criteria. we included the fact that veterans should have a choice of primary care providers within those networks to ensure the ease of access and meeting their needs. the second category is leadership system and governance
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focusing on con annuitinuity to implement these recommendations. we recommended a board of directors providing over sight and expertise that's critically needed. in the third category focusing on information technology and facility management and performance management and human resources and work force and supply chain and diversities and health care. we have a category of eligibility and focusing on the need of discharge veterans who have health care needs and retrospect and eligibility design. the objective of every commissioner throughout this process has been that our report did not and did not sit on a
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she shelf. we ask that you provide va needed authority to establish integrated care networks. we are asking to address the fundamental weaknesses and providing more flexiblilitiefle. waving or suspending the -- and medical facility leases and lifting the statutory threshold and facility project and reinsta reinstating -- easing for a time limit. and establishing a line item for
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vhi it funding. also, creating a single personnel system for all vha employees to meet the staffing needs of our health care system. i would like to amplify one very key point which other commissioners view as foundational. the commission saw vha as equipped to carry out successfully of the kind of long-term transformation required to invigorate health care. continuity leadership cannot be assured under governance framework marked by senior leadership. the commission believed that two fundamental governance changes were needed. establishment of board of directors of authorities and set long-term strategies and change in the process of official designated of the secretary health. we work with health economists in modelling different options.
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in our discussions that's been the question, should the nation invest further in va health care system. our report answer that question affirmative and it under scores for the need of a sweeping change in the system. we do not suggest that at all that congress made a substantial investment in the system. rather we call this strategic investment in a much more streamline system that aligns va care if the community. in my judgment of the central challenge that's identified in 2014 approved access to care and improve care quality and contribute to improve patient well being. it is a vision that puts veteran first. my experience tells me that while strengthen the system while providing strengths and accountableab
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accountability. i would be pleased to be a continued resource of this community as you continue on your work and i will be happy to answer any questions since i know toby will after his presentation. thank you. >> thank you very much. >> doctor cosgrove. >> as a member of my va advisor committee, for the course of my work for the va, i have become well acquainted with the department and understanding its contributions as well as challenges and meeting our veterans' needs. as ceo of the clinic and an $8 billion health care system serving our community and aware of the magnitude of the challenges facing va health care
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system leaders. mr. chairman, the veterans health care system must make fans formati transfo transform transformative changes. the final report contains 18 different recommendations. today, i am going to address specific areas that includes the establishment of an integrated community based health system. >> solve metrics and information technology specifically electronic he will health records and supply change. given the commission's charge and access to care, it was concluded earlier on of reliance on and closer immigration of the private sector of the
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greatest -- not only improviini access but greater choice. the commission considered and debated options of different choices. the recommended options in the final report reflects a consensus -- a private sector of pr providers. the commission agrees that the vha must establish hi high performance and community health care networks providing timely care for our veterans. as was said, if the challenges are the opportunity to describe in the final report are left unaddressed. we are concerned that our veterans are not receiving the care that they deserve. the commission recommends that
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the vha adopting a methodology to engage staffs and improve the culture. this will help, but it will take significant time, effort, and resources to modernize and streamline such essential functions as human capital management, capital asset management, and leasing, business processes and information technology. the commission recommended that the vha should implement core metrics that are identical to those used in the private sector. veterans deserve to know that the health care they're receiving either for the vha or from the community provider is of high quality. that these metrics are put in place, it will be easier to evaluate the system's performance. and congress will have a benchmark from the private sector to compare both its progress and the improvement over time.
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congress and the american people deserve to know that vha is getting value for their investment. years ago, the vha was a leader in the field of electronic health records. unfortunately, this is no longer the case. therefore, the commission believes that vha should transition to the same type of commercial off the shelf electronic health records as other providers. by using a proven product, many of the scheduling and billing problems would be resolved. further, these systems could help the v.a. identify areas of opportunity and utilization to promote better access to care for our veterans and promote interoperability which is critical as our veterans move to different care sites. finally, the commercial electronic health record would also allow vha to link financial and clinical information. a critical functionality for running a modern health care
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delivery system. the best and most prevalent commercial electronic health record programs allow staff and patients to schedule patients' care easily and provide legitimate performance measures for wait times, unit costs, clinical care outcomes and productivity that conform to those of the rest of the health care industry. many of our country's best hospital systems have converted home-grown information systems to commercially-based systems. vha must do the same to remain in the current and engage the rest of the health care delivery system. it must also have its own leadership, specifically a chief information officer for the vha information system that allows vha to adjust its information needs as the health care industry evolves. as a vha contractor, cleveland clinic has experienced firsthand
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the burdensome, antiquated system that is currently in place to receive payments. we are required to provide documentation and hard copy of forms sent via the postal services as they cannot accept fax, e-mail, or other electronic submissions. if a request results in more than 100 pages, we must burn the records to a disc because we do not have any mechanism to track whether the documentation has been received, we have heard on many occasions they never received the paper records and we have no recourse other than to send them again. the independent assessment that congress commissioned found that the vha should keep claims adjudication and payment separate from its care delivery. the health care system that the commission envisions for the vha will continue to expect exceptional performance from its network of providers and
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providers should expect timely and accurate payment in return. supply chain is another area ripe for vha streamlining. the commission's report stated that purchasing processes are cumbersome, which has driven v.a. staff to work arounds and exacerbates the variation in process the v.a. pays for products. the v.a. should consolidate and reorganize procurement and logistics for medical and surgical supplies under one leader. vha has enough market share to leverage prices that could result in savings of hundreds of millions of dollars. at the cleveland clinic, we constantly evaluate and review our supply chain products and processes. today, our supply chain is working with teams of clinicians led by a physical champions to justify purchases by engaging clinical staff and the value based sourcing effort that illustrates that cost and quality do not have to be
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mutually exclusive. clinicians are made aware of the cost and outcomes are associated with different brands. once the clinical staff has to justify the higher cost and understands whether it will add value to the care, outcomes based on empirical evidence, they make purchasing decisions based on value. such efforts are then integrated into patient management and inventory management to insure the appropriate use of our resources. a clinician engaged value based supply chain management practice model has allowed us to save $247 million over the last several years. we are continuing to reform our process by entering into purchasing consortium with other providers and are continually searching for improvements and cost management.
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leadership is the key to transformational change. the commission speaks to the need to create a pipeline of internal leaders and to make it easier for private sector and military clinical and administrative leaders to serve in the vha. market-based pay is critical to bringing in leaders capable of taking vha to the next level. the commission also proposes that congress provide vha governance board to provide a long-term strategic vision and successfully drive the transformation process. both the chair person and i would be happy to talk more about this aspect of the report. mr. chairman, transforming a system as large and as complex as vha will require streamlining multiple services, redesigning care delivery and more. this report offers a road map to success. realizing the vision the report proposes will require new investments, both financial and in expertise, enactment of legislation and strong leadership.
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thank you for your attention, and i'm happy to address questions. >> thank you very much, doctor. we appreciate you both being here. for either of you that would want to answer this question, do you agree with the president and the secretaries who have both stated that many of the commission's recommendations are already being implemented via the my v.a. initiative? >> i think that it's difficult for us to really evaluate that because we're not within that structure at this point. but i think in terms of strategies and direction, there are many areas that are aligned. but it's hard to understand within that, do they have all of the plans that will allow that to be executed? those are the questions i would have. >> dr. cosgrove? >> i don't think we can know exactly. example, electronic medical record, we don't know if they purchased an off the shelf record or not, which is imperative.
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>> neither do we. we're still trying to find out the answer to that question also. this is something that probably other members won't touch but i will since i'm retiring at the end of this term, but what do you think the biggest benefit of a brack-like process within the v.a. would be for vha and also what do you think the big impediment would be? >> just a couple of comments on the facility challenge i think that v.a. has. when we looked at the breadth and depth of all the vha facilities across the country, the average age of physical plant is 50 years. to give a comparison, at henry ford, that's nine years, and across the country, it's around ten. so the issues that v.a. will face over the time in terms of
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their facilities and also the fact that they're very in-patient oriented today as opposed to out-patient are really significant. we think it could provide some objective view and input on how exactly the vha facility networks are performing today, where the problems are, and where change needs to occur. it also could provide much as it did during the military closures, you know, the opportunity for some objectivity and protection from the political challenges. closing hospitals is a very hard thing to do. i have closed three in my career, and i don't wish it on anyone. it is a very challenging thing to do. and particularly for members of congress who are concerned about job loss in communities that might happen. the opportunity, though, in health care is different than the military closures. there's no substitute. so the opportunity for jobs to be preserved in communities through more partnership with the private sector exists, and also the evaluation of other capacity within that community could serve veterans better with lower cost long term, so i think
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it's with that in mind that we really believe this would help the process. >> i would just add to that that i also have closed two hospitals and realize how difficult that is and how politically entangled this is a decision making process. also, i think there are over 220 facilities right now that are not in use and have not been either sold or abandoned or begun to be taken down because it's been unable to get that accomplished through the current system. >> one final thing. there was a statement made in va's letter to the president regarding the final report that indicated v.a. is not in favor of eliminating the current choice program restrictions by mileage criteria and the time restriction of 30 days.
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because they don't -- they desire not to sacrifice v.a.'s four statutory missions. i know the report called for a total elimination of the mileage and time requirement. i would like to ask if you could address why you went further. >> well, as you know, choice was a very difficult discussion among the commissioners because we had wide ranging views around choice. i think we felt that we had to find a balance because we understood the fact that there was the danger of weakening the current vha system if in fact choice was too broad. but what we did do is believe that those limitations in many cases were causing really undue problems for veterans, and oftentimes, the timing involved of even being able to assess some of those limitations caused access issues. we felt that we were erring on the side of choice of primary care provider and also strengthening the v.a.'s control of those networks.
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because if v.a. could set up those networks in a way that really created the right capacity, the right access, without endangering the ability of vha to continue their important mission, that was what we were trying to find. we were trying to find that sweet spot between choice and also the issues of maintaining a system that is critically important. >> go ahead and yield to mr. takano for his questions. >> thank you, mr. chairman. many of the national veterans service organizations are very troubled by recommendation number one. they are concerned that instituting choice as a core policy could lead to a large percentage of veterans to pursue more conveniently located community care. this could end up jeopardizing the viability of unique v.a. services. your own economist projected a steep migration to community care. i have one question for you both. what analysis did you conduct to
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test how this concern may play out, and second, the follow-up would be, and why did you not recommend pilot testing such a radical change as this? >> well, we did actually talk a lot about how do you roll this out, and felt that probably a phased approach to really test some of the assumptions was important. there were many commissioners that spoke to that issue. the execution implementation is very complex, and it will take time. i think it will require, much as any major change does, some testing and refining and continuing to tweak this. but i think on the choice issue, it's important to balance this question of choice and making sure access is really available within every market across the country with the issue of how we're trying to also control frankly those networks to better serve veterans. so it's really finding that balance that i think is very important. >> okay, well, the commission's guiding principles called for
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recommendations to be data driven. what specific data did the commission rely on in recommending that it should be organized on the principle veterans should choose to receive care from a community provider even when the v.a. can provide the veteran timely care in reasonable proximity to the veteran's home. >> if you think about the v.a. system in the way we did, it's not a question of v.a. versus the provider in the community. it's one system that should be operating in a much more integrated way, and every provider that is within that vha care system then would be able to provide access for veterans. so it's a different mindset than today. and i also think it should be balanced against all of the investments in improving operations we're recommending within the vha. >> okay, let me ask you this. as you know, the v.a. health care system is necessarily very transparent when it comes to wait times and health outcomes. how does the ford health care
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system and the cleveland clinic measure wait times? do those health care systems or for that matter, any private health care system, post wait times publicly, and if not, why not? >> we actually do. we have an electronic system where people can call in to clinics and find out wait times for that day, for same-day access. the other thing we have really changed is the whole notion of access. we now believe that same-day access not only for primary care but specialty care is a standard we're setting for our health system. >> ten years ago, we instigated same day access. we now see 1.1 million same-day. and the waiting time from door to doctor is ten minutes. >> would you expect for private providers participating in this system in an integrated network to be held to the same wait time rules and requirements as the v.a.? >> yes. >> yes. >> so i'm also concerned about
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your recommendations to expand veterans choice to all veterans regardless of the day's waiting or distance, i'm concerned that it's financially unsupportable and may weaken the v.a.'s health care system and increase the share of veterans care provided outside of the v.a. did the commission look at the cost of these recommendations and how this might affect the vital research and education missions that the v.a. conducts for the good of the nation? >> we did look at cost, and we have included estimates in our report around what we think that would mean. it is hard to know, though, i will tell you, there are certain assumptions as you go into the cost estimates that are based on certain assumptions that may or may not actually come true. and part of the question is how rapidly can some of the improvements in operations to improve access within v.a. be put in place. because it's quite conceivable that more patients would gravitate to v.a. for many
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reasons as opposed to always assuming that they're going to go in the private sector. it's not as clear as some people would like it to seem. >> a point on the last point, there are a number of veterans who currently do not get their care from the v.a. since the v.a. improved their access and improved their ability to take care of them that they would migrate to. there's 22 million veterans across the united states, only 6 million get some care from the v.a. so the assumptions are very difficult to project. >> okay, thank you. mr. chairman, my time is up. >> thank you very much. mr. lamborn, you're recognized for five minutes. >> thank you, mr. chairman, for having this important hearing. i want to thank the chair and vice chair of the commission for appearing before us today and for the time and effort they put into this report. we have two main challenges today as i see it. first, how do we at least insure that we take what's good in the report and make it a reality?
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137 previous reports on v.a. health care have already been presented and are sitting on the shelf gathering dust. second, and this is the -- maybe an even harder challenge, to evaluate whether the proposed recommendations go far enough. we like to use words like transformation and reform, but how willing are we really to challenge the status quo and consider bold reform? we all recommend the managerial failures of 2014 that came to light, the inconsistent care, the manipulated data and other manifestations of dysfunction. and we also remember the words of the independent assessment in 2015 which found that the vha systematic problems demanded, quote, far reaching and complex changes that when taken together amount to no less than a system-wide reworking of vha, end quote. so when will we have a system-wide reworking of the vha?
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i have 100,000 veterans in my congressional district, and i'll say that the calls they're giving complaining about v.a. service haven't diminished and are about the same as it was a couple years ago before we tried to make and the v.a. tried to make some changes. they don't believe that things have substantially changed for the better. with that, mr. chairman, i ask unanimous consent that the commission report dissent from commissioner hickey and commissioner selnick be entered into the record. >> without objection. >> that's one perspective i think we should look at on an opportunity for transformation. dr. cosgrove, i would like to ask you a question about the quality of v.a. health care. according to the report, quote, care delivered by v.a. is in many ways comparable or better in quality to that generally available in the private sector, end quote. however, the independent
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assessment found, quote, on most major veteran reported experience of care in veteran hospitals were worse than patient-reported experiences in non-v.a. hospitals, unquote. is v.a. care better than the private sector, the same, or worse? i know it's very broad, but it's very critical. >> it's difficult to answer that. there's only a handful of comparative studies published comparing the two care. some suggested it's better. some of them suggested it's not equal or not as good as. and i think part of the problem is that they have not been reporting the same as is reported in the private sector. and one of the suggestions that we made so that you can begin to compare the quality is to have exactly the same metrics as reported in the private sector. for example, the society of thoracic surgeons reports the
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mortality rates and morbidity rates of cardiac surgical cases across the country. vha is not a member of that and does not report. that's not to say it's better or worse. they just don't report. >> okay. i mentioned earlier that commissioners hickey and selnick signed a dissenting letter. what accommodations were made to their views, if any? >> well, both of them participated in all of our discussions and had the same opportunity as everyone to put their ideas forward, which they did. and at the end of the day, we built a consensus around the report recommendations which 12 of the commissioners approved, and their dissent opinions were included on the website as well. you know, with all due respect, neither stewart hickey nor darin selnick have ever run a complex health system, and to say what
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we're proposing is not transformative, i think is a complete -- it's just untrue. the integration process of creating vha care system is a significant transformative process that will take many, many years to complete. recognizing the complexities of both facilities and staffing issues and leadership and all of the components that we included in our report as well as i.t. interoperability to allow that to take place is very transformative. neither of those individuals have ever implemented a major change in a health system, as dr. cosgrove and i have, and i think we recognize the transformative aspects of what we're proposing. >> thank you, mr. chairman. >> mrs. brownley, you're recognized. >> thank you, mr. chairman. i want to thank both of you for your time and commitment on putting this road map together. i know it's an inordinate amount of time you have put in, and quite frankly, all the commissioners.
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i just want to thank you for it. there's much to it that i like very much, and i think it's critically important that we have a clear road map by which we can base a discussion. i think this is really the most important discussion this committee needs to undertake, we need to figure out what the transformation is and what it's going to look like for now and into the future. i clearly believe that community partnership with the v.a. is part of the solution. i just -- particularly for primary care and some specialty care, i think that partnership is critically important. i think there are some services that the v.a. provides that the community can't provide. and so that partnership, i think, is really important. and it is, i think as we talk about this, you know, to me, i see it sort of in a sliding scale and where is exactly, you
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know, the sweet spot in terms of what that partnership really means going forward. so i really, really do appreciate the report very much, and mr. chairman, i hope that we'll spend a great deal of time having future discussions on this until we can all come to, i think, a consensus in terms of moving forward. i wanted to ask, you know, a very specific question relative to the report because it certainly affects my district. in my county that i'm very close to the l.a. medical facility, west l.a. medical facility, which is a huge facility, and thank you, mr. chairman, for your leadership on moving forward with the west l.a. facility, but my veterans also are by mileage, are close enough to the facility but by traffic and getting there, you know, it can take a day to have a visit.
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and so we're working hard to try to expand our v.a. facility within the district. it's been authorized and so forth, but the way the v.a. does their leasing arrangement, and you're probably aware of this, is the way the cbo accounts for it, makes it very difficult for us or anyone to approve the resources when you're counting a 20-year lease or a 30-year lease all up front. so i'm just wondering, i actually have a bill that is called bill of the better v.a. act, but what my bill would do is to sort of harmonize the way the v.a. does this, the way general services does this for other federal facilities so that we can break down this barrier the way cbo is scoring it. do you have any comments relative to that or did you discuss that at all? >> probably not specifically, but i will say around the facility questions, there was a tremendous desire on the part of
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our commission to simplify and make things more agile for people leading these health care facilities today. as you know, health care is changing dramatically. there's probably as much change taking place today in the delivery of care as we have seen in 50 years. rapid changes in terms of technology and where care can be delivered safely and effectively and the ability to really create those access points from an outpatient facility standpoint. you know, we're at henry ford, we continue to built more outpatient care all the time. i mean, it's a constant effort to keep up with the access needs. for the reasons you mentioned, that's one of the reasons we took out the time limit and the distance, mainly to create -- because every market is different. sometimes you're having huge barriers that are unintentional just because of the way that market might function. >> i think that's also really important as we look at this that we have to really look at
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each sort of area and community and region because everybody is going to have very different needs. what about in terms of this vision and road map, where does telemedicine fall into all of this? >> i think telemedicine is an integral part of it, and v.a. has taken a lead in many aspects. we think this is going to be something that will be ubiquitous across the country, and will greatly eliminate the need for traveling great distances. as you stop and think about the health care system in the united states, it was developed in a time where there was not a lot you could do for people in the hospital and very poor transportation. now there's a lot that you can do for people and great transportation and added on top of that is virtual visits, which are going to reduce the travel and the access and improve the access enormously, particularly in areas of chronic disease.
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so we're moving ahead very, very fast on that, and the v.a. has taken a nice lead there. >> one thing i would add on that point is there's also a lot of digital health development going on today, where patients themselves can self-monitor and report information, communicate differently, and that is, i think, a great frontier as well. >> thank you very much, and i yield back. >> can i just add one thing? you know, going back to the electronic medical record. you know, once you have a commercially available electronic medical record, it allows you to make your appointments yourself on your electronic medical record, and that electronic medical record should be available to all patients. and so you have to begin to engage the patients, and one of the ways to do that is through electronic medical record. >> and i do want to salute the v.a. with the new person in charge of i.t. i think she gets what's
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necessary, and i hope that that progression will continue. mr. bilirakis, you're recognized. >> thank you, mr. chairman. i appreciate it. and i thank the panel for their testimony. thank you for all these great suggestions. what do you think is a realistic timeframe for the large-scale transformations that the commission's report calls for, assuming the v.a. is already implementing some of the recommendations that claim they are making? when do you think veterans should expect to see meaningful change in the care they are receiving in terms of quality and access? >> i think realistically, we're looking at a five to ten-year transformation process, but i also think any time you go through that, you're looking for those early wins, those things that veterans can see quickly that improve their patient care experience. so there are some things, particularly in the area of technology and certainly just customer service aspects that can be improved very quickly to
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help veterans feel more confident in that change process. >> very good. >> can i just add that i had an experience with changing the culture of the cleveland clinic, and it took me five years, and the organization was only 80,000 individuals. and something that is as large as the v.a., i think it's going to take even longer. >> thank you. again, we're building on that. what benchmarks should we be looking for as the v.a. implements these recommendations and do you blink the v.a. has the capability and foresight to track these relative data? >> much like dr. cosgrove does at the clinic and we do at henry ford, we have balanced scorecard, if you will, that provides data on a frequent basis that scores on patient engagement, all of the metrics that dr. cosgrove referenced that are comparable to the private sector should be available, i think, in a transparent way for people to assess the quality as well as the service provided in each
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v.a. facility. i think that level of transparency and having a scorecard that focuses on regular accountable results is very critical in this process. >> for example, we report almost 100 quality metrics to the federal government on an annual basis, and in fact, we have quarterly scorecard meetings with all of our department heads going over all of these metrics, and i think you have to be completely data-driven, metric organization in order to achieve these transformations. >> thank you. understanding that not just one solution will solve all of the agency's shortfalls, how, or if you had to identify the single biggest problem, the biggest problem, what would that be effecting the v.a. health system, and what is the solution to that problem?
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>> you know -- >> single biggest problem. >> i think all of us felt this truly is a systems-oriented approach that many of the recommendations are interdependent. but if i were to put one on the table, i would talk about leadership sustainability. because it is virtually impossible, i mean, toby has been at the cleveland clinic how many years? >> 13. >> yeah, and both of us have served in ceo roles, 13 years in our organizations. when you have turnover in the undersecretary position every couple of years, it's very difficult to sustain change. and i think that really is holding back the kind of transformative work that potentially could happen and obviously needs to happen. >> i think -- do you agree, doctor? >> i would say that it's one thing you can do rapidly that will change the organization, and that's the electronic medical record. that can be done in a short
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period of time. the rest of the transformation is going to be much longer. >> thank you very much. i yield back, mr. chairman. >> ms. kuster, you're recognized. >> thank you, mr. chairman, and thank you for being with us today. this is a critically important report and certainly at the heart of what our role is, so we appreciate the time that you both have put in and your wisdom. i want to dive right in. i spent a great deal of time with my veterans and visiting our clinics and hospitals during the august district period. and you talk about data driven, and i agree with you. i just want to point out one example of an unintended consequence that we face, many of us around our districts. and that's with regard to the heroin epidemic that's threatening the country. what we discovered, and this is broader than the v.a., but that
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the use of quality metrics with regard to bringing down the pain surveys, bringing down the numbers inadvertently incentivized physicians to push opiate medication which then led to high rates of addiction. we have a wonderful project that the white river junction v.a., dr. julie franklin, getting out in front of this with our veterans. i met with a number of them using alternative remedies for pain maintenance, pain medication, including acupuncture, yoga, all these different criteria. and i just wanted to see if you would comment both on the risk of being so data driven that you have unintended consequences, but also your view on alternative remedies within the v.a. system.
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>> much like dr. cosgrove does at the clinic and we do at henry ford, we have balanced scorecard, if you will, that provides data on a frequent basis that scores on patient engagement, all of the metrics that dr. cosgrove referenced that are comparable to the private sector should be available, i think, in a transparent way for people to assess the quality as well as the service provided in each v.a. facility. i think that level of transparency and having a scorecard that focuses on regular accountable results is very critical in this process. i think certainly other alternatives are going to be part of it. also i think education, expectations of patients is going to be an important aspect of beginning to change that. but this is an epidemic. in ohio, it is a huge epidemic. >> you've been very hard hit. we have a bill we are hoping to get attached as an amendment that would provide a pilot
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project for vas to do this type of alternative remedies for pain management, try to -- we've had a reduction at this one hospital. 50% on opiate prescriptions. i got to tell you, the one-on-one conversations i had and the quality of life for people whose lives have been turned around. so i just want to bring that one up. >> congratulations. i think that's a great piece of work. >> good. thank you. the other one is you talked about the safety net provider. i think that's an important consideration that we can't lose sight of. many times as i visit our veterans facilities, it is the lower income veterans who don't have access to private care can be don't have access to private insurance. this is their provider of choice. you mentioned about a shortage of primary care and mental health professionals. my colleague mr. o'rourke in el paso will discuss that. we also have a bill about physician assistance coming out of our military. i just welcome your thoughts on
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that approach where we can sort of grow our own and use the skill set of veterans coming out of our military. great experience. and how we could put that to work to reduce the shortage of providers. >> i would say that the military providers are tremendous workforce for health care. we've hired over 1,000 veterans in the last five years because we recognize they are highly trained, experience and a great culture. >> great work ethic. >> great work ethic. we're delighted to have them. we actually recruit both nurses and physicians assistants coming out of the military and go to the bases to do that. >> great. >> i would just add the concept of growing your own is very important within the va system. the dedication of the veteran workforce is incredible and an opportunity to really leverage that makes a lot of sense. we are looking at similar issues
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of growing our own in areas that we simply can't find the talent that we need. thank you for your good work and thank you, mr. chair, for indulging the shameless promotion of my two bills left to be attached as amendments going forward. thank you. >> i understand you did a field hearing in aurora, colorado -- [ laughter ] >> and it was excellent. it was great work. i want to thank my chair. >> dr. rowe, you are recognized. >> thank you. i want to start out by thanking the committee that put this together. it was a remarkable piece of work. thank you for taking the time away from your shops. all the committee members. this is probably the most important piece of work i've seen in my almost eight years here in the congress to really make a difference if we can implement this. during the convention, instead of spending most of my time politicking, i spent afternoons at cleveland clinic.
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and certainly i want to talk about brak in a minute. the way you evaluate your needs is you build the needs to the entire health care system and the entire health care system is undergoing radical changes in the u.s. right now. shifting from the big concrete silos to outpatient, more and more surgery. 100-bed hospital today can do what a 500-bed hospital did 30 years ago. i think the va's still stuck at the 500-bed. a couple things. let me just summarize what i've heard so far. one, i believe to move this system forward we need an integrated care model that involves the private sector and the va sector in primary care. two, dr. cosgrove, you pointed out to have an electronic health system that's 20th century -- remember this, three years ago where dod and va tried to make these two antiquated systems interact and they could not. i've been all over the place trying to see how these experiments failed.
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a modern system solves a lot of the scheduling problems, payment problems, data problems that you talk about right now. they've done a remarkable job of working around these problems. but there's new technology out there. the dod made that decision. the va set there right and tried to convince the dod to put in a 20 or 30-year-old system andthy didn't do it. they took it off the shelves. i think that would be something they need to do. that solves your supply chain. all those things -- helps -- that doesn't totally solve it but helps solve it. lastly i think is the brak. it may be my last term, too. you can vote for the brak and brass tax and maybe you won't be here again. i think we have to sit down and evaluate what those assets are and where -- look, where you can get the best care. the best heart surgery is at cleveland clinic. it is about providing the best care for veterans. i think that's what this is all about. not sustaining a bureaucracy but providing the best care and where that care can be given
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most cost-effectively. i admire what you have done. to say our committee has not provided the resources for the va. when i came here in 2009 we spent $95 billion, $97 billion on all va care, cemeteries, disability and health care. today it is $165 billion without choice. i would say that congress has done a job. it's just -- we've gone from 250,000 employees to 330,000. in the private sector, you've had to figure out how to do it more efficiently with less people because your revenue, i promise you, has not been going up like it did. you've had for better manage. i commend you for that. my last question. do you think if we can come to the consensus -- those four things i pointed out. and it won't be easy. if we pass it, do you think the va can carry it out? and i know that you said -- i hate to put you on the spot, but you pointed out that leadership is the key for transformational change. is that leadership there?
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>> you know, i think leaders get better over time, also. the current leadership has been in place a very short amount of time, actually. and i have, i think, made some progress in key areas and have set the right tone for improving access. but i also think they need some time. it's hard to judge whether that can happen unless there's sustainable leaders in place which is why we recommended the idea of five-year terms for the under secretary and having that individual actually selected by the board of directors so that that process can move forward and that individual feels the support of a group of people that are really trying to move transformation forward. i recognize that that may be unconstitutional. there may be ways around that that can help with oversight. but -- >> that hasn't stopped us from doing a lot of the consultation. so -- the question is do you think we can? because i think this is a remarkable document.
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i think it has a chance to put veterans and doctors back in charge of their care and not a system. i just wonder if you think we can do it. because if you could, i think you would truly transform the health care system that veterans receive. >> i think it is going to take time. this is not going to be quick. this is going to be incremental. and it is going to take continuing change of a very big system. >> i think the key one is making a decision on vhr. i think that one is one that begins to solve a lot of these other problems. you are trying to do with different software systems that now don't work well together. >> i would just say one other point to move to that. we have -- and many people around the country have learned that you can't maintain a electronic medical record in an individual facility. it is moving too fast. that's why the commercial aspect of this has kept up with the
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changes and made them uniform across the country. so i think it's absolutely imperative. >> thank you, mr. chairman. i yield back. >> mr. o'rourke, you're recognized. >> thank you, mr. chairman. i'd also like to thank the chair and vice chair for their work and sacrifice of their time and, frankly, their commitment to their day jobs in order to be able to fulfill this commitment to the veterans in this country and to the american people. really appreciate the way in which you conducted the review and made the recommendations. so just want to add my thanks to all my colleagues. i'd like you to discuss what i think is the most pressing crisis facing our veterans and the va. the single greatest unmet need right now in the system, and that is the tragic number of veterans who are taking their lives every day in this country.
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the new data from all 50 states is that it is 20 veterans a day who are taking their lives. think that's the single greatest opportunity to stop these preventable deaths. if we take this seriously, confront it, and organize to provide far better care that's being delivered to veterans right now, as i hope you remember from our discussion. in el paso, because of the high number of veterans suicide, the inability for too many veterans to be able to see a mental health care provider. never mind the wait time, originally estimated at 14 days. we now know it is over two months on average. but one-third of veterans in el paso couldn't get in at all. that has prompted us to propose a solution in el paso that we're trying to pilot right now to focus va care specifically -- that care that's delivered in house -- on those conditions
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that are unique to service or combat. ptsd, traumatic brain injury, traumatic amputations. military sexual trauma. there is a lot of list of these that i believe we want someone who knows how to treat veterans, perhaps only treats veterans and active duty service members, knows things to look for, questions to ask, the treatments to prescribe. is there a way to resolve that idea with this idea of a network where you do leverage capacity in the community? and for those conditions perhaps that are not connected to combat or service, we prioritize community care. but for those conditions that are unique to that experience of being a veteran, we make the va the center of excellence for treatment of those conditions. love to get your take on that idea. >> actually, we agree with that. the recommendation that we put
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forward really focuses on those unique capabilities of vha absolutely being supported, invested in, continue to grow and develop. because it is -- it has been shown -- my understanding is that it's been shown that those veterans that actually seek care within the system end up with much lower suicide rate because they're being managed, their care's being managed and they are in touch with health professionals who provide that kind of support on a daily basis which is really critical for those types of needs. but, unfortunately, it's how do you embrace and get people in to the system who otherwise may not be willing to go there. i think that's one of the challenges. you're right about the fact that in the private sector, doesn't mean that people are well equipped to handle the complex mental health needs of veterans. in fact, in many cases we have the same problems, if not more acute problems, of having enough mental health providers in our community today. >> i would just say, think there
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are a couple things we have begun to recognize. one is the shortage of mental health providers. increasingly i think you will see virtual visits begin to augment the shortage and help the shortage of mental health providers. similarly, group visits and group therapy for those individuals. we've found both of those to be very useful. >> i think as long as we can prioritize that excellent in care around those conditions, especially those that could potentially lead to veteran suicide, and are able to reduce the number of veterans who take their own lives, improve outcomes, improve access, i think the system that you're proposing makes all the sense in the world. we learned this summer that the vha has 43,000 positions that are authorized, have the funds appropriated for, but are unhired today. and we're fools to believe that we will ever hire all 43,000 of those. so let's prioritize within the va on those areas where we can
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do the most good, make the greatest positive difference for those veterans. for me that's clearly mental health in reducing the number of veteran suicide. and then we face another issue which you raised which is how do we produce enough countries -- enough doctors in the country generally to ensure that we have capacity for veterans in the community. but i think if we can leverage the two, what we should do really well in the va, with what exists in the community today, and follow our ranking member's lead in creating more graduate medical education positions, then i think we are going to be on the path to fixing this. my time is up. but again, thank you for your work on this. really grateful for the effort. >> mr. chairman, thank you so much for the great work you did. i don't know exactly where to begin with all the things that have come up today. which strikes me about many
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answers to the questions is your comment about the leadership and how critical that is to transforming the va. having not so much political appointee at the head, but like a regular hospital, a regular system that people are on the board. i was on the board. and a continuity of care over a period of time so that these things can be developed. i think it behooves us to make that happen. i see that as a challenge to this committee to take the bold step necessary to basically implement your plan. i don't say i agree with everything, but if we don't do this, we're going to be faced with 30 more years of the same thing we've been doing now. i think that's the critical take-away from this very important commission's work.
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and the thing that you said, dr. cosgrove, the other think i take away, is the critical need for an i.t. system that makes sense. to me, that's your testimony of the two of you. is leadership, and the immediate action on an i.t. system which really can't be changed. i just want to bring up a question that always bugs me. and that is, when you estimate the cost of implementing these things, how did you estimate the cost of the va care? because when we try to figure out what the va is actually -- what it actually costs the va to see a patient, in the private sector we know what it costs to see a patient. all right? the va doesn't do that. how did you estimate that? because we haven't been able to get a figure on that. >> let me just say that one of the things i think that probably struck all of us that are in the health care industry was how little focus on cost va has. that was sort of shocking because we live in a world where we have to constantly focus on
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cost per unit of service, cost for a full episode of care over time, creating population health management techniques so that we in fact can understand cost and whether we're contributing to value and improvements in quality. and that doesn't exist today within a budget oriented va system. i think that's one of the challenges as we looked at this cost question of how we move forward. i think one thing that probably should have been in the report that wasn't was this notion of getting more cost oriented in terms of some of the -- >> my frustration here is, what does is cost for the va to see a patient? there is like no clue. >> and in fact, if you look at the model and what's changing in health care today, we're getting away from the volume oriented kind of measures. we're trying to focus on outcomes of care, clinical results, as well as are we making a difference in terms of
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the efficiency of care that we provide. so i think this is part of the transformatio transformation. how do we get metrics that are more comparable so that in fact we can determine the effectiveness of the va system over time. but i would add that i think -- if you view this in phases, there are ways to test some of these assumptions and begin to look at those cost elements that could be projected out over time so that you can really see. the other thing is this issue around facilities. if all the facilities had to be replaced versus creating this integrated model, there is a lot of potential cost savings around cost mitigation over time that i think would help. >> the only thing further i want to bring up, it is related to the way -- the status quo of the va, now one of my big complaints is that working there, i have very little input as to how things worked in my clinic or in
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making sure that things ran efficiently. it seems like others who weren't really involved in the patient care were making the decisions as to how many staff to have, how to make the staff flow. patient flow and all that. i think that would come with the leadership changes. but is there any other comments you would like to make on that? >> yeah. i just think that you need to bring physicians more into every aspect of delivering care and running the organization. i gave the example of purchasing. previously physicians were not involved in that. we found tremendous efficiencies by bringing them in. and without involving physicians in leadership of the organization, i think you're missing an intellect and a set of knowledge that is necessary to have high-quality organization. >> thank you very much for your work and it is up to us to get this show on the road. >> thank you, doctor.
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>> mrs. rice, you're recognized. >> thank you, chairman. would either one of you want to be secretary of the va, by any chance? just out of curiosity. [ laughter ]. >> i had that opportunity. thank you. >> so i just want to echo some of the comments that mr. o'rourke made. we recently had a veteran take his own life in the parking lot of the north port va which is so disturbing. so i couldn't agree more with mr. o'rourke about this being such a top priority for the va to handle. i also totally agree that the two issues in terms of accountability and the electronic health system, records system, are critically important. i mean every single hearing that we have, the number one issue that we talk about is accountability, whether it is for treatment of -- how whistle blowers are treated by higher-ups, wait times, the enormous cost overruns for construction projects.
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the list goes on and on. if you could just address the whole issue of how you would create a more effective hierarchy. the board of directors, how would they be chosen? why do you say that the undersecretary of health position should be one that has a fixed time limit versus the secretary, someone similar to the head of the cia and the fbi. if you could just talk more about that. because to me i -- i mean i don't know if that will get to changing the underlying culture of the thousands of employees who are under the secretary and the undersecretary. but if you could just talk a little bit more about that. >> sure. well, first of all, culture starts at the top and there is absolutely no doubt in any organization that the tone that is set and the way it's deliberately carried out every single day in decisions in how
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leaders respond appropriately to the needs of an organization. i think that is very, very important. as we look at the va and you have again someone who is really running the health system, at least the way we understood it, it run by the undersecretary of health from an operational standpoint. and yet that position has turned over repeatedly. so the ability to set that tone and follow through on a whole host of strategic initiatives and making decisions on a daily basis gets cut off. then the next person comes in. and it is very hard for an organization other than to hunker down and sort of wait for the next leader. very hard for an organization to embrace those kinds of changes. the board is, in our view, very important, first of all, a board stands behind that individual and helps them be better.
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they are there for a broad base of input, expertise, again that level of accountability which happens on a more regular, routine and organized basis. so that board is sitting there saying, we thought this was your strategic plan. it is not to usurp congress but it is to get that performance up. congress is ultimately responsible as the power of the purse and all of the other suspects of your authority. but the idea is to bring some health care expertise in and other leadership to engage that ceo on a regular basis to make the kind of changes that are necessary. >> thank you. dr. cosgrove, the electronic health records, just what has been the problem within the va in terms of addressing that issue? >> the va started out by developing one of the first and best electronic medical records. and over time, i think they suffered from the same problem
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that massachusetts general hospital did, johns hopkins, mayo clinic, henry ford, that they could not keep up with the changes that were needed across the organization. so they -- there was -- there are now 130 versions of that electronic medical record across the system. and that has fallen behind in its capabilities and also has not added the sort of capabilities that you now see commercially available. this is -- it is time to do the same thing that many other organizations have done and abandon the homemade project simply because there's not enough i.t. expertise within the organization to keep updating it. >> right. well, i want to just echo what every member of this committee has said, which is to thank both of you for really your herculean
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efforts. my hope is that all of us here are going to be able to see the wisdom of your report and begin to implement it in a way that is not partisan at all because the bottom line is, giving the kind of health care to men and women who serve this country that they deserve. thank you very much. thank you, mr. chairman. >> thank you very much, mr. kaufman, you are recognized. >> thank you, mr. chairman, and thank you both for your tremendous work on this. just incredibly important. i'm looking at recommendation 10 when you talk about changing the culture of the va. it is such a corrosive culture. if we look at the appointment wait time scandal, manipulated to bring them down, by denying veterans care and maintaining a secret waiting list so people could get cash bonuses. number one, nobody was ever prosecuted for that and there was systemic. number two, nobody was even asked to give back their bonus.
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and so when you have a system where it literally takes an act of god to fire somebody, and where it seems like the only people who are disciplined and fired are the whistle blowers who bring these problems forward. i mean it would seem that the root of the problems at the va are -- lie in the culture of the va. i just wonder if you could respond to that and some of the internal discussions maybe you had that aren't necessarily in this report in terms of the range of views on your commission. >> well, there's no question the independent assessment report commented significantly on the problems of the culture of the va. i think we felt very strongly that in order to change culture you have to make sure, again, sustainable leadership has to be in place and leadership that people have confidence in that are going to make those tough calls and those decisions that
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are appropriate. >> but if the leaders -- it become so difficult to get rid of subordinates -- >> i'm not sure i believe that. >> then over time people just don't even try. >> well, that's the problem. people, frankly -- i've seen it in our own organization. people say, well, we can't fire people. i say oh, yes, you can. you have to work at it. you have to make sure that you're going through the appropriate discipline process, that people are given due process, which is important. but that you have to do it. that's about leadership development at all levels. that's not just at the top. that's front line supervisors, that's managers, and people that really are going to make those decisions on a daily basis about the quality of their workforce and their decisions and getting it done. >> also seems like the leadership of the va, that leaders when they are responsible don't take responsibility when wrongdoing occurs and are never held accountable. so we're talking about not just the rank and file but we're talking about -- >> but my sense was that a
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secretary was fired over that. and when that did happen, that's when secretary mcdonald came in. so i think clearly there was a decision made that reflected the seriousness of the problem in phoenix. but i also think people need time to change that culture. >> i think you also have to invest in leadership training and bringing people along. i think it goes into couple categories. i think it goes into the category of experience with feedback, which is difficult and painful sometimes to get and to give. and the second thing is they have to have a certain amount of intellectual training that goes with that. and it may fall into the 80-20 or 90-10 leadership. nonetheless, you need an active leadership and training and education program which is not available now. >> i don't know how we ever really have a full discussion
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about transforming the veterans health care administration when we don't know what their costs are for any given specific procedure. and we have -- as a committee we've requested that. and it is stunning that they either know it and don't want to give it to us, or they don't know it themselves. what do you think the case is? do you think they just don't know it or do you think they don't want to give it to us? >> my sense is that that needs to change. and, frankly, i think it's been based on a focus on a year by year budget process as opposed to, in our world we rely on revenues to set the level of expense so we have a very strong focus on cost. this is a very different model. i think, frankly, it would be helpful to think about how to get that cost focused more directly built into the process of the budget and how they justify expenses. >> i also think there is a matter of collecting the data.
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and if you don't have the data, you can't understand it. that data includes the severity of the illness, all of that that goes in to determining how much cost per veteran to take care of them. >> thank you, mr. chairman. i yield back. >> thank you, mr. chairman. i, too, want to echo my thanks to both of you. you did exactly what we were hoping would happen in that conference committee when we created the commission of care and the request for it, that you would come up with specific recommendations to improve veterans care but you would also help facilitate a national dialogue that was sorely missing in a transformational type of way. i represent the mayo clinic in rochester, minnesota, too. they're, like many of you, will say there are different models. but there are certain fundamentals that are true throughout all these organizations and how they deliver that, educational
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clinical practice, and that focus on leadership. the one thing that i think is so refreshing about what you came up with, i hit on a couple of those points you brought up, i remember ten years ago asking why we did a quadrennial defense review with an understanding that the world of 1986 looks entirely different than the world of 2016 from a resource allocation perspective to how we would defend this nation and all of that. but never done on the va. so we plodded on year to year, year to year budgets. we actually did something i thought was somewhat innovative and it took a stretch from this congress to do advanced appropriations to give a little more continuity to that, to make some decisions like your organizations make decisions. but it challenges us in ways that we haven't been. i also want to thank you. i think you are doing a very good job of stressing this, trying to remove this simplistic argument of public versus private sector or the idea that va health care can be discussed in a vacuum outside of health care in general. this gives us an opportunity to wholistically change the entire system and we know that there
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are going to be assumptions that maybe don't pan out the way we want. lo and behold we find in the aca a lot of people didn't have health care insurance before like to go to the doctor now and some were sicker than we assumed in some cases. those things have an impact. instead of just fretting or pointing fingers, let's come back and find a workable solution. that's going to challenge all of us. i want to hit on the first one, this one just has me tied in knots, the board of director issue. i absolutely hear where you are coming from. if i go to the mayo clinic, they will say, this is a great suggestion. i can guarantee just like you're saying. because they may be saying, tim, you may have some expertise in geography, china, artillery, but have you ever run a large health operation? as a member of congress it is our job to try to gather an learn as much information and we are ultimately responsible for oversight. there is a real hesitanciy to give away what feels like giving away that authority but the need to put that in there. this has been challenged on the constitutional issue and challenged for all kinds of
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reasons. how important, if i could ask you, do you believe that mechanism is for transformation? how -- if we're going to fight this fight, it is going to be big. and it is going to be transformational with the big "t." how do you see it, if i asked you, if we do this and you answered a little earlier, do some of these recommendations separately but you really need to look at wholistically, how important prioritized is this board of directors? >> i will tell you that probably of all of the recommendations, this had unanimity among our commissioners and i think it was felt to be, if not the most important, one of a very small number of the most important recommendations that we came up with. >> i completely agree. it is a fact that you have over 500 people trying to run the va seems a little more. >> this may be on the achilles heel of democracy that we're responsible to the taxpayers, we ultimately have to do that,
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giving away that authority even to a secretary is very, very hard to do. then giving it to another layer in there. but i am with you on this that i am certainly willing to have this discussion. behind you there is a whole room full of folks who have spent decades supporting veterans. they're not in opposition to this. they are there to ask these hard questions about this recommendation, how is it going to impact. but my question to you, too -- i could not agree more, sustainable leadership. i've seen it at the macro level and i've seen it at the and i've seen it at the micro level. in the va and outside of this. it is absolutely critical. we have is to restore some trust that people want to go to work there, that it is not this assault on the integrity of everyone's there and to see a unified commitment to getting this. how many of these things do you think should be implemented even if they could be through internal rule making on the executive side? i always make the argument on this that i think we're bet egg off if we do it, we keep
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responsibility, we have ownership and we have the american people behind us. it takes a while, but do you see that we should just enact some of these and get moving or should we have this national debate and fix it through this way? but i think that our staff really identified in the report those areas where congress really does need to take action, and those areas we felt could be done within the executive branch. but the truth is i think everyone in this room acknowledges, this is a bipartisan issue. these are our veterans. it's critically important that we find a way to deliver better health care and we felt strongly that in the area of leadership and governance that new structures were needed in order to provide that oversight, whether it's the i.t. project. i will tell you, at henry ford, we had a special committee of our board to oversee the implementation of the epic


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