Skip to main content

tv   Public Affairs  CSPAN  July 2, 2013 1:00pm-5:01pm EDT

1:00 pm
about health care and think about ac telephones and the new structures that meet -- are needed to do what needs to be done. that will affect how we deliver services and local communities and the other thing is the liberation of information. there's a great piece in this great"new york magazine" by frank rich talking about how people believe are not very excited about this breach of their private information or about government listening in to their phone calls. they think about privacy very differently than we do. i think we have to think about that as we plan services and talk about the future. for specialty mental health that delivers services now for people with serious mental illnesses, there are some real issues and barriers. one is that small businesses with small margins lack human capital. there's a work-force crisis in
1:01 pm
health care generally. it is even more acute for behavioral health were not for profits cannot compete for salaries that hospitals and other big players can do. i think that parity in this safety net is something that we, at the national council, think is vital anti told the organizers that i was going to take a few minutes at the end to plug some legislation since we hope people on that hill and excellence in mental health act. it was introduced in the house and that would create capacity. we are talking about taking mental health out of the shadows. you need tothat, have treatment capacity. mental health and addictions need to be treated by it -- like the rest of health care in the safety net and this bill does that. the other thing we have and we
1:02 pm
support is a mental health first andill that billbegich representative barber in the house introduced. both of these bills have a wide bipartisan support. this is really mental health first aid designed to help answer and teach americans about mental illnesses and addictions and what to do when a crisis. next, we will have another bill that will be introduced by senator white house of rhode island in the senate and house, congressman murphy and that is toally to bring hit behavioral health. we cannot use their skills are adequately if we're not part of health information exchanges and for't have the wherewithal ha the hand-held technology that will bring treatment to people around this country. finally, we have a hill day
1:03 pm
coming up september 16-17 and i will invite you to our policy institute on the 16th and we will see you in some of your congressional offices on the 17th, thank you. >> thank you very much the views expressed by the panel about legislation are not necessarily those of the foundation or the alliance. except in the case of legislation co-sponsored by senator rockefeller and senator blount. >> terrific. was remiss in not noting that for those of you who are if youf the twitter-verse want to let people know what is going on, it is hashtag *mental health *. speaking of letting people know what you think and what you want to talk about coming in now have the chance to get involved in this conversation.
1:04 pm
there are microphones at either side. the ansar 8 -- you do not have the opportunity to yet to be part of this conversation. our panelists have actually referred to our final panelist several times. carl wilson is a clinical psychologist who was a community psychologists and was the first president and ceo of krieger center in missouri which he led for 33 years, just retiring last year. community andt mental health services -- service four missouri counties. is a model for the country. he has taught at washington university in st. louis for 37 years in psychology and social worker if he has been in the leadership of both missouri and national mental health organizations. he is now consulting in missouri on -- to help us integrate behavior and health care and
1:05 pm
we are very pleased, despite my lack of memory, to have you with us. >> thank you so much. i would like to start by saying a few things about this community health center. it has been referred to before that we have over 1500 safety net behavioral healthcare organizations in the united states. there is a lot of variability between them but we all have an essential goal and a mission in terms of our most vulnerable citizens. is the safetyter net and mental health center has been doing this for 34 years in missouri. seven years ago, given a lot of the data that has been described and with some leadership from wonderful individuals, we came to the realization that we need also to provide primary health care of services and integrate
1:06 pm
those services. the national council, in working hsa has done an awful lot around the country to promote that. fq8-c 6 years ago. we do more than just what the state can't afford to support. that includes primary prevention work, anti-bleeding in the schools, resiliency promotion, problem-solving skills, 51,000 kids go through those courses in our 21 school districts. we also have been able to take advantage of some of the leadership from the federal government in terms of some demonstration grants. were part of the first system of use grant which has helped working with schools and home-
1:07 pm
based interventions to keep kids in school and out of trouble. and safely at home. you have heard a lot about bolts and the evolution and development of better alternatives that are community- based, more active approach is that help people thrive in the community. we do a lot of that and a lot of housing because that is essential in all of that. we also do an awful lot of work in terms of employment-oriented work. we found that we would help people to get a life by the time they're 50 and get back and have sought -- strong social networks and, at some point, they were dying because they were obese were at the consequences of un tree to diabetes so it the wish to take some responsibility for that. generalave three clinics that include primary
1:08 pm
health care, psychiatry, and pediatrics, dentistry, access to gynecology and we have 18,000 people, adults and kids, every --or going through those receiving those direct services. we have been confronted by some general issues that we needed to address as a center, and a state, and that the national level. people with limited income generally do not access preventive care as often as they should. they over use the emergency and specialty care. this is complicated by illness and significant lower rates of primary health care and routine testing. one thing that is not talked about a lot is poor dental care and that impacts over all health-care profoundly.
1:09 pm
there is little integration of primary care and psychiatry which beginning to change. an important federal study known for the comparison of psychotropic medications, the caton study, also found that a small minority of individuals were receiving care who had high cholesterol or high blood pressure and somewhere around 1/3 who had diabetes that were receiving the treatment. this is a death sentence. that's certainly goes a long way to explain some of those outcomes we have been seeing in terms of the mortality and morbidity of people with serious mental illness physical health care is a core service and behavioral health care systems
1:10 pm
have a basic responsibility to provide access to health care both for disease management but also for wellness aec you cannot lose that was recovery focus. management and integration of medical care for people with serious bill must should be part of our basic missions. showed you a slide earlier that helped us persuade our state in missouri why we should be the first out of the block. we were able to achieve the status under the affordable care act of establishing health care homes. one was the primary care health care home, for people with chronic conditions. the community mental health center helps their homes. i will refer to that as a behavioral health care home. the community health care's and our affiliates in missouri have
1:11 pm
all become part of the homes. we have a number of functions that i will not gro detail. we have these slides. we take a whole person approaches. what is beautiful in missouri is that we found that we can help centers that have not been able to have primary care within their walls. to be able to coordinate care. and to achieve good outcomes. across the spectrum of different type of centers with different assets, i think we have been able to achieve the kind of outcomes that we need. the way we have done this is we have taken our existing services. the behavior program is not separated. the centers as the most successful if integrated into their over all day-to-day functions as a center. the difficulty is that we get
1:12 pm
funded for a minority of the people we are serving in terms of behavioral outcome. in essence, we have to transform our entire system to impact our overall populations in terms of cordoning care. this includes the addition of additional measures care physicians may be a consultant to can go over treatment plants and make sure we fell in the gaps and people are getting the services they need. need where weong have to have good information technology. behavioral health has lagged in this. this is one of the critical areas in terms of what were doing in terms of being able to status and better integrate care and compassion and the help of this population. all the people,
1:13 pm
the 17,000 individuals across the state receiving the behavioral health care home services are having metabolic screens on a routine basis which means that we're looking at their blood pressure and their cholesterol counts. we are looking at the waist size. we are beginning to integrate that into their over all planning. data analytics is critical and can only be done successfully because we have individuals who have all their health care paid for by one source, medicaid. we can see if people are picking up their medications, if there are other physicians for duplicating agitations. we have problems in that arena more frequently than people
1:14 pm
realize. we have nurse care matters as consultants who are on a routine basis looking at that. the we are utilizing extensive experience we have in terms of developing and covering networks. of the individuals are pierce specialists and community support specialist and coordinators' and clinical case managers. we're turning those individuals into community health and wellness coaches. in disease management first and moving toward wellness which life spouseues of changes. we are using strength tests based promotions and are promoting human big help be a years. this slide is actually one that
1:15 pm
was a key in missouri to be able to persuade our medicaid office and the governor's office and the legislature that we should become -- that the health care home should exist. two yearsne is the prior to individuals receiving services for our safety net service. you can see the dramatic rise. this goes back to -- we need to find a system where we can make people eligible for care back two years earlier. to bee people have eligible for disability services, many times they have to deteriorate to this point to receive services. demonstrates that this is when treatment began and you can see a real rise, the jump in overall costs.
1:16 pm
the costs are going up rapidly. then they come down rapidly after a few months. bans the cost curve, we reverse it almost back to what it was what two years prior to the beginning. this is a four-year slide. it demonstrates the cost savings we can have thurgood care management. there was some reference to the reports from missouri as to what are outcomes were. we had managed to have cost savings even let you deduct the the overall cost of a behavioral health care home. we have some real challenges. i think it has been mentioned that april health care organizations are behind the curve, by and large, in terms of i.ti. we could not find a medical
1:17 pm
record that would do the whole thing in terms of primary care and behavioral health care. i think products are developing more now. the cost of those products is high for these marginal, not-for-profit community health centers around the country. help and we were left out of the earlier hit be enhancements that the federal government provided. a number of us have taken advantage on the medical services side and we can get our psychiatrists covered but we have many other individuals we need to invest capital in, the capital for most organizations is not there. exchanges aretion advancing rapidly. behavioralwithout health being added. get said. their funding issues in terms of
1:18 pm
sustainable funding for early intervention, limits of funding sources for the uninsured we have talked about and silo funding. we made these changes in missouri because we showed that the single funding source in medicaid was saving money. when we save money for schools and when we work with drug corpsa and picked on recessive -- recidivism, we're not getting paid for that. that is a major problem. we have work force recruitment issues and a lot of that is within states in terms of restrictions on who can do what in terms of state statutes that protect professional organizations. we need to expend within teams can do and made to show our outcomes by benchmarking them and agree with those outcomes are across the country and between states.
1:19 pm
we need to work on our culture changes we had tickets to work on in terms of developing a recovery model. we have to develop a wellness model within a few years. terms on some basic principles, we have to remain close to the people we're working with even as these clinics become more important, is real important with the target populations to go where they are like in schools and homes. thomas and recovery need to be integrated. these centers are uniquely positioned. we are working toward a person- centered system of care. it is within sight but we do need to deal with these barriers in order to make sure we don't have often as practices but rather the stage route to
1:20 pm
run the country. this,anizations develop what is our role of community health centers and behavioral health centers -- be a hero help homes. the answer to that will be critical. thank you very much. >> that's terrific, thank you very much. i apologize for getting the that other analysts pointed toward. you canas interrupted, now join this conversation. there are green question cards that you can fill out and hold up and someone will bring them forward. there are microphones that you can go to to ask a question in person. if you do that, please identify yourself and your institutional
1:21 pm
affiliation and to keep your question as brief as you can. this is so we get as many -- this is so we can get to as many questions as we can. co-moderator to charge -- chime in with questions and answers. go ahead to. >> i'm at the office of the national coordinator of health technologies. thank you for a great presentation. dr. wilson just referred to it but i would like to hear perspective from other panelists about the work that still needs to be done in terms of quality measurement, the creation and validation and then the specification of quality measures for behavioral health.
1:22 pm
>> from the cms perspective, we have a number of quality measurements, activities in place that i would like to refer to but i did not have the time. it was our adult quality measures and our children's quality measures. out there forare public consumption. we are encouraging providers and system to use that. them actually include mental health and qualitye abuse measures, we are hoping we can include some substance measures. they are open each year for comment. pay attention to the notifications you get because we want to know whether the
1:23 pm
measures we have make sense or whether we should think about new measures and whether some of the measures we have should be replaced with new measures. are other if there folks on the panel -- >> the quality measurement is a big issue. state mental health agencies are struggling and trying to support this and we have a quality measurement system for hospitals that we run. we're also hearing questions from states. a lot of the measures cut across boundaries of different systems. if you're trying to look at reducing use of hospitals, you are looking at medicaid and medicare and different datasets. it gets into the importance of starting to use information exchanges or ways to be able to access data from different services. from the state's perspective, we hear that a number of states are
1:24 pm
putting in electronic health records but they are being left at the back of the queue would changed data electronically. it is an area we are hearing that consumers and found and the state and community progress all want to have more consistent say in quality measures. aco, there is one mental health screening measure barry will work -- we were in proposal that would be indicators around psychotherapy, an area that needs attention. i think what you'll see is the iom tackling that in the next few months and that will begin to contribute to the need for measures. just as we're behind in the use of hand-held technology and other things, i think we are behind in this but fast in terms
1:25 pm
of a desire to catchp and attention to it. korfmy question is about evidence-based practice. thank you all for your great work. i'm wondering we could expect an extent where we could see differential incentives for providers offering evidence- based practices. side, i amcaid wondering what your thoughts are about that. i would start there. right now, states have the opportunity to be able to do
1:26 pm
that. in some places i know, whether they are doing it through their own volition or fee-for-service is or managed care, they have been implementing rate differentials based on different types of evidence-based practices. should there be more of it? probably, but there are few things that would prohibit a state medicaid agency to be able to develop that rate differential or begin to think moving towards payment for outcome. some of what we have been trying to do true air bulletins around quality and care for a nation is to try to get states -- and they have been -- changing individual services. >> this is a struggle not just in mental health but in health care generally. there are guidelines about what
1:27 pm
you should do. ityou have chest pains, involves aspirin but it is spotty in some places. i think this is a struggle around really taking research and then changing practice. lot of people do what you pay them to do but you have to make sure the differentials are worth that. this requires an investment. take critical number of people know the new practice can teach it, can supervise it, so when you talk about investments and differentials, you've got to make sure it supports what you want. aboute a question
1:28 pm
mental-health services that are privately finance. the discussion is about serious mental illness and a population publicly financed. it seems to me the pros another population that could fall into withgroup if not cared for some of these approaches you have described, combining the clinical services for mental and physical health. what are your thoughts of the importance of this group? we sometimes think of teenagers in this group. that relates to the issue of gun violence. other populations as well. how important is this group and what the social benefits of aiming at this group and how do
1:29 pm
you emmett them? tell private aca insurance -- insurers to do in the way of parity. after running a private not- for-profit where we worked hard foret insurance to pay different things, we had a of individuals in working with the schools who have fairly good coverage. in the past, there were covered by traditional services that were not the one that could make a big difference. we need to go into the home and renewed to work directly with school. it never seemed to work out. the parit legislationy hold a
1:30 pm
lot of promise but the issue, in terms of the temple -- implication, john and others are much more expert at this. that is where we will see the difference in terms of whether or not this continues to fall into the safety net when people need more than office-based care. when the real evidence-based practices show that we need to use approaches that bring together systems ofthe care, thy have not been supported in the past in the private sector. >> with respect to private payers, it will focus of the affordable care act is on private financing of health care including mental health. half of the coverage expansion and allies in medicaid and in of marketplaces and
1:31 pm
requires the provision of central health benefits for qualified help plants. that pertains to private health insurance. the other piece are reforms to our health care system. -- its targetng our private health plans. but now have to comply with the same rules that help plants sponsored employer- insurance. private health insurance is really a chief of this. of the reforms in the affordable care act. pick up a couple of questions from the cards -- there is one for john and probably one for linda. but aestion asks --
1:32 pm
second witness trade and so long or read the rules for mental illness and parity. what have been the consequences of that long delay. and those of mckelway newspapers don't count of a hearing in the legislature yesterday in which the insurance commissioner was lamenting his lack of tools for orying to enforce the parity requirementskk with some of the private insurance firms. john had mentioned that the states flexibility of was covered in the essential benefits package. i wonder if the behavioral health community is worried about that flexibility. go first?want to >> bashoor, well, i am sure there are a variety of reasons why it has taken a while to get
1:33 pm
where we are at today. the good news is that we have a commitment to have those regulations finalize this year. i think there are certain places where we have seen issues with commercial plants not implementing parity as we intended to it -- to be. sinceeen lots of land 2010 have taken some significant strides to make sure it did comply with the parody. issues, youll have bet. the plans like the department of blog -- labor and hhs has been doing is to understand the power to block an
1:34 pm
enacted on the commercial side and that has been effected. we have been working pretty closely with our state partners who are moving forward. it is important for them to understand parity and plan for what that will look like as part of their essential health benefit. cases, we'ret going to probably not here one lewd good left to did to the right thing. again, is of the more and the again, we are- worried about state flexibility. we understand the need to give states flexibility at a time when there is this expectation that they implement lots of
1:35 pm
changes including, hopefully, and i expect they will buy into the medicare expansion, but then, in turn, we are a country that feels very again, stronglyt states' rights. it is a fine line. in terms of giving them flexibility. the good news is that stakeholders in those , all the groups including the managed-care companies, i think in some i have a stake in ensuring that the state does the right thing. i think there is a lot of organizing going on in states to make sure that happens.
1:36 pm
what are the mental health -- >> what are the mental health services that can be provided? i was wondering if linda wanted to cover this. the national council has terrific experience around the country. the instituteut which is working towards helping a lot of different types of areas around the country in terms of integration. my experience with that is that there are some real challenges in lower density areas. we have some rural areas that but at the same time, in some of those areas, you get more flexibility because the competition is less. you're able to accomplish an
1:37 pm
awful lot more more quickly. that we reallyls need and we need to address restrictions on includetele madison. telemedecine and other procedures. none of the most successful homes in missouri is in northern area with nine counties. they have a part-time position consultant. they really don't work very well with primary-care providers throughout of their area. they have had real successes on the clinical basis in terms of controlling the blood sugar levels and bringing down blood pressure and using everything they have together and they have
1:38 pm
gotten very good support across the board. in urban areas, it gets more complex and there could be more problems. i am a medical students. my question pertains to the third alkalizing goal of thecmcs would integrating behavior health and i was wondering what is the model of care that has been identified or if it has not, what are the plot around the model of care that will be used to integrate primary care and mental health care? if it is similar to that of the behavioral health home, how was the behavior of help from defrank from the model of care of the patients center medical
1:39 pm
home? >> terrific question. thell defer to some of other folks on the panel for more detail but we don't have a prescribed model. part of what we want to do with the health home and state plan opportunity as well as our innovation grants was for the states and even the providers to come back to us and say we would like to try this. some of it is based on research and some of it is yet to be research. we felt it was really important that was not just one model and we really wanted to reinforce that it was bidirectional and sometimes it was behavior health embedded in primary care and other times it was primary-care embedded in behavioral health and other times it was our rural and frontier communities and we will have to be creative about what we do.
1:40 pm
we are fascinated to see what the next year or two of help homes will be to be able -- to be able to inform of where we might go more permanently with that program. >> when you talk about embedding mental health and primary care, wouldling an imh they save the model is a collaborative care of and if you look at the impact work of a few years ago, that is the work that has the research. i would suggest that to you. >> here is a question about young people who have an opportunity for coverage under the aca. a big problem is the 18-25 age group. some may be covered by their
1:41 pm
parents' insurance but seeking treatment is difficult. activities are you pursuing to help reach out to this age group? i would say this is obviously beyond the group of people eligible under their parents' insurance. there is coverage opportunities for all age groups and average and enrollment will be a critical element to the success of the affordable care act. people with mental illness and others might be -- might find it difficult to get into coverage. what can we do in the field to help reach out and the ball people into coverage? anybody want to take that on? >> others probably have some
1:42 pm
ideas that i will take that on. part of what we know we need to do was to have a fairly impressive enrollment effort. what we have done today in terms of the chip programs is primarily focused on children but also an older children as well. some of those efforts that states have to do some average and a moment to get people eligible will be important. even if we get people eligible, they will not always seek services. some of the national think tanks have been looking at how to use technology to engage individuals. it is not only in the enrollment process but the treatment process. maill say this like i'm old nifty smart, some applications. you might want to say a few things about this. >> i think of two things when i
1:43 pm
think about that question. i'm not sure which one director man's greed can get help the young people to enroll so that our premiums can stay under control? that is a very big issue because they think they are invincible. the penalty for not and rolling is not that big. when we said earlier that people do to pay them for, they -- punishment does work and this is not much punishment. i think that is a problem around healthy people. in terms of enrollment, one thing we tell our members and we will talk more about is their capacity to enroll people on site. and to begin to help people get to that computer and medicaid will be simple with a simplified process application and people who deliver services will have to take this bond. particularly for people who have
1:44 pm
ellis says, i think what they found in massachusetts is people will often come to the front door without coverage even though they are eligible. i think there'll be a wonderful effort using technology as well as in knocking on doors to enroll people bought providers and practitioners have to also have the capacity. from theing we hear states like states that are doing this exchange and during the medicaid expansion is the mental health agency is working with their providers to get consumers trained to be held navigators and tell people enroll in services and make sure that when anybody comes to the door that they are found to be eligible and can get whatever services they need. that cost as al major reason people don't access services for a 18-25 is the year that is the onset for
1:45 pm
schizophrenia and a major mental illnesses. mental health first aid and recognizing, we can get people into service as much quicker and as a potential to break some of that cost curve. right now, people have to get really ill and become severely disabled before you qualify for benefits to get into the public system. if people have basic service -- coverage and don't have to wait until they are really -- in really poor health, that is what some of the studies suggest where there could be positive outcomes. >> can i ask a follow-up to that? this is one area where we have had some experience. the law has been of an effect for two years? i'm wondering about the experience that local and state level in terms of who has the --
1:46 pm
who has taken advantage of this change and a lot to maintain coverage under their parents' insurance. are millions of nearly ensured young people but have we detected anything in terms of people who have mental illness? >> we have not. we have not heard from our member organizations that they have. i think this goes to your early people do nottudy come to the attention of organizations until they have been ill for a number of years. and they are ready to go on medicaid. there is a barrier. it has developed in states in order to control access to these highly specialized services. when that begins to change in tandem with the insurance changing, i think you will see insurance companies want to do some of these more inventive
1:47 pm
constellation of community services rather than what they do now with young people developing schizophrenia which is to pay heavily for people going in and out of the hospital, basically. i think it is the combination that we can see some action. >> if i can add to that -- i completely agree with that. one of the major problems we have had and i have seen that over the past three decades is the transition from children to where and the barriers they receive services and the good work that happens when kids are being lost in this canyon before individuals become available for adults services. we were really looking forward to, at some point, when missouri gets medicare expansion, that individuals who had to wait until they were at
1:48 pm
rock bottom because they had to be able to qualify as being disabled, that we would be able becausel them earlier of their income status under havingd or in terms of subsidies in terms of the insurance exchange. hopefully, we can then change our state rules with federal support in order to be able to mobilize these more intensive services and sports. this is an order to help them earlier. we know we get out people earlier that the outcomes will be much greater down the line in terms of their overall health. it is also in terms of their employment status. >> we have several folks waiting to ask questions. wasme dispose of one that
1:49 pm
directed to dr. wilson. [ara-asking about p professional definitions. i suggest you take this offline after the briefing. it is a very good question but very narrowly drawn. wilsonee to approach dr. . go right ahead. >> i am with the united health group. i have a more social-cultural question about health utilization. i'm interested in the correlation between utilization of children and teenagers in particular and household income. i am wondering if you have noticed any trend where children or teenagers from families with higher incomes have high medical need rates.
1:50 pm
>> i don't have data on that but i was just reading on the plane here this morning, a piece about over-diagnosis and kids. it spoke to the issue that people who have insurance coverage, there is a higher diagnosis of adhd in that population. i don't know if that is what you're getting at but there are statistics about that. i am not an expert. our data recovers people who get into the public system. i can't answer that either. i'm with the national real health association and i wonder about this status of dual eligibles and the efforts to integrate primary care and mental health services.
1:51 pm
we have an office that specifically focus is on medicare and medicaid coordination. we have gone through a series of activities that have solicited states that are interested in moving forward with developing a dual program. it has been slow, at best, and some is really helping states think through the right model. around integration and some of it is around changes the states have to make in their policies in order to be able to implement the program. but got a couple states now we have memorandums of understanding between us and the states. and medicare and they're just beginning to move forward with implementation. it is getting there. is probably not as fast as folks would like but it is getting there. >> thank you.
1:52 pm
we have time for only a few more questions. we will get to yours. we hope we take this opportunity to fill out the evaluation form that is in your packets. >> i am with the american society of consultant pharmacists. i know what you mentioned that we don't to a good juba of dealing with the mental health issues and the elderly population. i'm wondering if anybody could comment on your thoughts about that given the large proportion of baby boomers that will be age 20 in the next few years. the utilization in the public mental health system drops off the older people get. within the national association of state mental health directors, there has been concerned for years about the
1:53 pm
lack of geriatrics psychiatrists and psychologists who have expertise in treating their needs as well as the capacity. there is a lot of discussion about the coming beijing -- baby boom aging into that group and how will overwhelm the work force capacity that now exists. that is being talked about but i don't have a good solution. it is a group that is recognized as under-utilizing services. an iom paper that deals with this issue. start which is expensive as medicare which pays quite handsomely for inpatient psychiatric care for elderly people but as a very limited benefit, a very traditional, not evidence-based for elderly people.
1:54 pm
when paper are ready to take them on, we might see some more attention. i think that as a barrier right now. >> thank you. have a question for dr. wilson. what influence your organization to become a federally qualified health center? didit difficult to do and jury decisionmarked change in medicaid reimbursement when you became an fq8-c. >> yes, we did. incentive wonderful for us to take that step. the severity of the -- difficult step. fquses or different and the work very hard so had to
1:55 pm
work quickly. when we were looking around for models in the country, we found that there are many places that had spun off fqh as opposed to becoming one but a few like cherokee in tennessee had done a wonderful job in terms of making that transition. we wanted to retain a lot of the community-based behavioral health care components and the recovery model. putting those all together was the major challenge. when we look at our
1:56 pm
board as being an organization politicallyelp us and could help us in terms of our legitimacy a local basis and where it was to have bush of the dollar rebounded we had to debate how to go about doing that. i think that struggle has paid off well. in terms of making that transition. and wek it works well would recommend it where it is possible. i think it is only possible probably in areas that don't already have an existing fq8-c and we have great models of partnerships in missouri between community health centers and existing fq8-c's around the states of their many ways to make this all work. the organizational structure depends largely on what is and with the
1:57 pm
overall mission is. otherd recommend onenizations will meet this of our colleges already done this. c has merged into its so we have that model in missouri and that is expanding. this will be the last question that we have time for. it brings us back to what several of the speakers of reference. how will you create an environment, the questioner asks, where people from -- suffering from mental illnesses will look for coverage woman up
1:58 pm
there. iwas officer of the others have a point of view that not be popular. i think is happening. i think is about younger people who are blogging -- and talking and chat rooms and other social media. these are vehicles that i can of brunei's and deny use. i mention cantor and al is changing and i think in your packet is a piece for people who have mental illness or disservice is, they did not list this as a barrier. it was much more money and confusion about where to go that was more an issue for them. i think what happens is, the general public, at this point who are older and have trouble
1:59 pm
interacting with people with serious mental illness is one of the reasons that we abraded metal -- mental health, to enable people to have those conversations. generational the, there's a difference. i think some of it is coming out of the shadows just as people like me die away. [laughter] i hope brought -- i hope not right now. >> we need your leadership. a few years back in the greater st. louis area, a number of us came together and with the help of a wonderful health foundation, the was the missouri foundation for help. we started working and how we can better integrate our services. there were a number of forms that occur at that point.
2:00 pm
the responses of many people, many times they would say i love the services i am getting and i love my provider but it was hell getting here and we had to swim shark-filled moats for to get from one spot to another and we were given the runaround and sometimes it was like having to learn a secret mock and a door in order to get in. and we need to greatly address that and we can certainly do that through more integrated systems, which have good pathways, and where there is no longer the war. door.g and that is easier to say that is to do. sometimes we need to help these people through these past -- pathways to navigate them. part of the affordable care act
2:01 pm
is health navigation. we need to organize that into helpommunities in order to families and individuals to end up in the right spot, because you hear do, largely that good things happen. but you also see that large numbers of people are not getting what they need and a lot they dids a matter of not survive the large moat to get there. >> i think that has to do with a couple of things. a lot of states have anti- sigma campaigns and other activities. bringing understanding and recognition of mental health helps to bring that together. when states are talking about programs to meet the needs of returning soldiers and armed
2:02 pm
forces members, people come out of the woodwork for being at those meetings and to support them. it starts a dialogue about mental health and suicide and ptsd and trauma that can drive the discussion about everybody .n society i also agree that it seems to be getting better, but there's still some ways to go. >> this is the perfect question to end the discussion on. it's kind of where we started. i almost take it for granted that we are making progress, as linda described. and we see it every day, i think. we see evidence of that progress. and incidentally, we do not want to see discussions in these special chat rooms. we want to see it on facebook and mainstreamed discussions. >> facebook is over. >> it is? i'm just getting used to it.
2:03 pm
it probably is over. but one of the most compelling slides that we saw was your slide release of the success of interventions for mental illnesses compared to things like heart disease. understood and remembered that slide and were less defensive -- we're almost apologetic about raising the issue of mental health in general, broader conversations. and we all see it. that in itself breaks down barriers. amongs, there is stigma people with mental illnesses. ishave to realize there stigma that we all feel about this issue. when i see that slide, when i see those numbers, i think that really does help move the
2:04 pm
conversation forward. to underscore what karl said. i think for a family that has an adult child that develops schizophrenia, worse than the stigma is navigating how to get help. morenk sometimes the services we have, the more complicated it gets. that is what i'm always afraid of. how do you help people? my hope is that parity and the aca and these new delivery systems will keep families involved during that very difficult journey at the beginning of illness. >> we have come to the end of our allotted time. several thanks are in order. first, we have done a number of briefings on mental health, substance use. we have never had a response
2:05 pm
like this. i want to thank you for signaling, i hope, a new sensitivity and openness to try to deal with some of the gaps in the system that you have heard so eloquently identified today. colleagueshank the at the robert wood johnson foundation for not only cosponsoring this briefing, but helping in a very direct way to shape it in a terrific conversation that i think it was. and that brings me to the final item on this list, which is i would ask you to taking -- to join me in thanking the panel for that particularly good conversation. [applause] fromdoes not absolve you filling up your evaluation forms. [laughter] thanks again. [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2013]
2:06 pm
>> if you missed any of this discussion, it is available in the c-span library. go to c-span.org. we're going live now to the board -- to the press club as conventionn baptist and catholic leaders are discussing health care. this began about five minutes ago. least, expanding the mandate to cover anyone with moral or religious objections to providing access to the services. we ask congress to prevent such abuses from happening in the future and we call on americans to rembert the great cost this country has endured in order to achieve religious liberty and freedom of conscience in order that we might continue these blood-bought rights for ourselves and our prosperity. -- austerity. the archbishop will forgive me
2:07 pm
if i quote martin luther. hisink we can agree on words as they apply to our government and on its audacity in curtailing the religious freedom in this case. to go against conscience is neither right nor safe. here we stand. we can do no other. god help us. thank you. >> thank you. archbishop? >> thank you. let me say for the record that your quotation from martin luther is happily accepted. thank you. manye grateful to see so leaders of other a denominations southerns, including baptists, the church of jesus christ of latter-day saints, the national hispanic christian leadership conference, the
2:08 pm
international society for , andtian consciousness orthodox christian and jewish leaders, as well as leaders of faith based and civil rights organizations all come together to sign a statement supporting religious freedom. many of the signatories on this hold doctrinal objections to the use of contraception, yet we stand united in protest to this mandate, recognizing the encroachment on the conscience of our fellow citizens. catholic bishops have said from the beginning, the underlying issue with the hhs mandate is not about any specific teaching. in fact, other signatories on the letter do not share our
2:09 pm
view on contraception. in probably disagree with us many other ways. understand the core religious freedom issue at stake here. this fitting that statement has been released during the 494 freedom, which has been embraced by catholics and people of many faiths as a show of great respect for religious freedom in the two- week time frame that leads up to independence day. it is also fitting that the final rule on the hhs mandate time.sued at this sadly, the mandate divides our church into three separate camps, houses of worship on the one hand, accommodative to
2:10 pm
res initutions on the other, and in addition to that, for-profit entities run by religious believers. we in the catholic church have never seen such a distinction between what we do within the walls of a church and how we serve our neighbors. the faith by which we worship on sunday is the very same fate by which we act in the world -- faith we act in the world the other six days. for-profit institutions still receive no relief or accommodation at all, except for the belief that many of them have been able to -- relief that many of them have been able to obtain so far in the courts by way of preliminary injunctions,
2:11 pm
or temporary restraining orders against the mandate. as cardinal hollon stated on friday, we appreciate the extension of the effective date by five months, meaning the effective date for the accommodative nonprofit institutions is now january 1, 2014. also as noted on friday, the united states conference of catholic bishops is still analyzing the specifics of the accommodation. this is a 110 page rule, and of course, it is complex. it involves reviewing the income -- the intricacies of health insurance law. plans to issue a more substantive analysis of the final rule once analysis has
2:12 pm
been completed. -- thethe outside outset, hhs itself has acknowledged that the final rule is very similar to the 2013 proposal, which the usccb commented on in detail on march 20. in addition to this ongoing analysis, the usccb will continue to seek relief from the courts and the congress as appropriate. senatorsust recently, dead fisher and tom coburn introduced -- deb fisher and tom coburn introduced legislation in the senate that would provide a legislative fix to the mandate for those who object because of moral or religious convictions. 1204 isill 1200 for --
2:13 pm
the identical companion bill to the legislation introduced in the house earlier this year by congresswoman dianne black and others. once again, we are pleased to stand with so many partners from other faith traditions in raising continued awareness over religious liberty concerns and the hhs mandate. those present today in a statement that we have signed _ this is about religious freedom, the religious freedom enjoyed by people of all faiths and of no faith at all. hold dearthat we all as americans, and something most worthy of preserving and defending. thank you. >> thank you, archbishop.
2:14 pm
doctor? >> i am anne hendershot, a sociologist working in american colleges in the past 20 years. i was happy to be put to that in the last 20 years because i knew that my conscience would always be respected. as a pro-life catholic, i was happy to teach in an environment where i would not have to compromise my beliefs to supervise student internships in places like planned parenthood or other proposed -- abortion providers. never be askedld to compromise my beliefs. unfortunately, the obama administration tells the human services mandate on preventive services threatens those protections.
2:15 pm
including religious ones like the catholic colleges i have taught in and our forced toh in introduce drugs like elah and plan b. it will require me to purchase insurance at my church teaches is immoral. it will mandate me and my employer to pay for and provide access to products and services that are against deeply held moral and religious beliefs. ofalso provides the children rural and religious institutions, like my college, to avail themselves of contraceptive, sterilization, or drugs without parental knowledge. such information will not appear on the parents claim statements
2:16 pm
at the end of each month. last month, my current employer became the first university in the country to drop its requirement for student health insurance due to moral and economic concerns connected to dhhs mandate. submittedrance henry a public statement protesting the new guidelines from hhs and to force catholic institutions to choose between following their fates were providing -- following their faith or providing health insurance. in his statement he wrote that by making its insurance coverage mandatory, our government has violated the conscience of people of faith and infringe on our rights to practice our religion -- a religious beliefs. in may of 2012, the franciscan sued the federal government, concept -- stating that the
2:17 pm
federal government constituted a threat to their ability to teach. at that time, it was one of 12 lawsuits filed by 43 organizations, including the university of notre dame and other catholic colleges and universities. there are now over 60 total lawsuits against the mandate, have brought by family-owned businesses and half provide religious institutions. cases that, those have received early routing -- willingness on the religious freedom issue, the vast majority have been awarded temporary hults to the mandates. unfortunately, though, on the non-profit side, many of the cases, including france's university's case have been dismissed because the courts have claimed the religious institutions have not yet been injured by the mandate. other campuses and religious
2:18 pm
institutions disagree. we have already been injured because our constitutional right to religious freedom has already been compromised. the refusal by the obama administration to classify that as institutions like franciscan or neutered game has already compromised religious right. alreadytre dame has compromised religious rights. as, as theyn target have done to catch adoption agencies that will not place children with same-sex couples. unless catholic colleges and universities and christian colleges are given some assurance that their religious liberty will be protected, the threats will continue. rejecting our claims of religious liberty, it is likely that in a misguided attempt to protect women's rights, we will be forced to facilitate our students' participation in things like student internships
2:19 pm
at the clinic for abortion providers. similarly, catholic universities may be forced to accept as leaders those who openly disavow the catholic faith or are hostile to the catholic faith. but if we protest on religious liberty grounds, we will be told yet again that we have no right to protest because we are not of it is institutions. obama appointee to the eeoc recently wrote that when it came to the rights or women's rights, she was having a hard time coming up with any case in which religious liberties should win. we are already at a place where the establishment clause has shifted from a legitimate desire to keep the government from entangling itself in the affairs of a religious organization to a justification of an anti religious secularism, of cushing religion out of the public square. this threatens people of all
2:20 pm
faiths. >> thank you. finally, our final speaker. >> according to the third amendment of the american constitution, congress shall make no law respecting an establishment of religion or prohibiting the free exercise thereof. of ourus freedom is one most important rights. thever, it is not only rights of those in the united states, but a globally recognized human rights law everyone has the right to freedom of thought, conscience, and religion. this ride includes freedom to change his religion or belief, and freedom either alone or in community with others in public or private to manifest his religious beliefs in teaching, practice, worship, and of service.
2:21 pm
the right to religious freedom has not only been one of the cornerstones of the american lel system, it has also been a priority of the united states foreign policy to promote human rights around the world. for example, during the cold war, the defense of international religious freedom enabled the united states to affectively showboat importance of respect for democracy -- show the importance of respect for democracy and human rights. violations of human rights around the world are still widespread. totalitarian regimes continued to undermine the role at -- the rights to religious freedom in many countries. however, there are other forms of violations of religious freedom. although they are not as brutal and systematic of those of totalitarian regimes, they're also unjust and should not happen.
2:22 pm
the hhsthe case in mandate, which forces believers to make a choice between obeying the law and violating deeply held religious beliefs, or vat the -- or obey their religious norms and disobey the government. institutions, family- owned businesses, and private persons should not be forced to services thatand violate their deeply held convictions. businesses and individuals chirred not pay fines to uphold their religious ideas -- should not pay fines to uphold their religious ideas. violation of religious morals is unacceptable. ,n the case of dhhs mandate this includes abortion inducing drugs.
2:23 pm
a government that undermines religious freedom norms in its own budget -- jurisdiction -- it is time to restore the american tradition of respecting freedom and human rights. if this happens, then america will once again be able to become a leader in the global cause for the defense of religious freedom as the universal and fundamental human rights. >> we are now open to questions. if you have a question about please raise your hand. when called upon, speaking to the microphone, state your name an agency and to whom you are addressing your question, and finally, your question. >> michael winters, national catholic reporter. a two-part question for archbishop loyd.
2:24 pm
do you anticipate closing ministries if the mandate takes effect? and if not, why is so much money and time being spent on this campaign? and for the rev., many people objections of conscience to the civil rights act. why is this any different? think we have to recognize what the mandate does on a national level that is different than what was obtained before. of that is, to create a sort three-tiered religious system. you have exempt houses of worship. yeah accommodative institutions. and you have private for- profits conscientious individual business owners. that state of affairs did not
2:25 pm
exist. that state of affairs sets up a new situation for religion in the united states. that alone, that change is worth spending a lot of time on. it is important also to recognize that the suits that have been brought have not been recognized by the conference, but rather have been brought by an arrays -- an array of liketutions, institutions universities, charities, and the like. these institutions and individuals have recognized that their religious liberty is at stake. regarding the question of the accommodation, it is a 110 page rule. there are many intricacies in it. until now, we have been dealing with two previous iterations of
2:26 pm
the rule. now we have the final rule. we will subject that too intense study. that work is getting under way now. >> and the reason we would support the civil rights legislation that you mentioned and the difference from this sort of mandate from that -- that legislation, i believe, can be found in the founding era, in the words of the declaration of independence, and communicated in the right -- in the bill of rights, rights that are held self evident. we believe what was happening in the civil-rights movement was the oppression of people buying and arctic -- an anarchic system that ran counter to civil rights and human dignity protected in the constitution. what you have here is you have a government not allowing people to maintain a sense of dignity
2:27 pm
and exercise of freedom of religion, which is also guaranteed in the united states and it's a natural right. we believe there is great continuity between the civil rights movement and our standing together. >> in the letter, you ask for an expansion of the exemption, but you do not specify how far you think the exemption should go. you also have the for-profit companies. are you asking for the exemption to be expanded that fared, or just as far -- that far, or just as far as the organizations that you represent? and as far as the timing of the announcement on friday of the final rules, did that come as a sixth prize -- as a surprise? were you expecting it later?
2:28 pm
>> to whom are you addressing your question? >> who can answer it? at it.ll take a crack anyone else who would like to take a crack at it would be great. for the last four years under the church amendment, great latitude has been given to private business owners and religious organizations in matters of religious conscience and health care. latitude that we are now moving away from. that is what we would call the and we wouldn tat certainly like to see that restored. failing that, something much more ample than what we see now. concern for our institutions is
2:29 pm
a concern to serve. to be able to do our ministries of justice and charity and education and health care according to our own lights, according to our own teaching. but our concern is even broader than that. conscientious private individuals, because religious freedom is first and foremost in the individual. st. francis said that we are not to be part time christians, but full-time christians. runant people to be able to their businesses and daily activities according to christian principles, should they choose to do so. that is the extent that we would like to see it to go to. >> i would agree with the archbishop on that, and to note that the frustrating irony of
2:30 pm
the government seeking to tell us what religion is, when churches in this country for 200 years, over 200 years, have been serving, as the archbishop mentioned, not only in word, but also in deep in ways that are rooted in grounded precisely in our convictions. that is a frustrating place to be at this point. >> yes, sir? >> katama hall with the "washington times." this question could be for anyone. is thethe statement emergencyn between contraception verses more traditional contraception. why it isstate important to this debate that you make that distinction? a doctor or at
2:31 pm
medical professional appear, but i would say that what has been areoved under the mandate all fda-approved contraceptives. by itsparticular, ella, own manufacture, and by most scientific accounts has been shown to induce an early abortion. and certainly, if you believe there is a human life there and you believe it is being taken brings you beyond the realm of contraception into abortion already. and that is problematic, very problematic for a lot of people. >> and the issue, of course, is broader than simply that of contraception in any of these forms.
2:32 pm
many persons of faith and others of this coalition have widely divergent views on contraception and abortion and other things. we think the issue here is the principle of free exercise of conscience. filingd with others in their religious convictions even if we do not necessarily hold the same. if you are saying that to religious companies should have religious freedom, in a sense, are you setting up a situation in which the employees religious freedom is against the employer's religious freedom? and why should the government stepped in and side with the employer rather than the employee? >> we do not believe that the
2:33 pm
status quo restricted the freedom of employees. we are asking for employers not to become worse into participating in the purchase of devices and services to which have a religious objection. we believe this compromise is the freedom of conscience of those employers. when a prospective employee signs on to a church institution, or a business that is being run consciously, intentionally as a christian institution, one understands there is a kind of mission there. there.is an ethos
2:34 pm
those employers are generally very up front right at the beginning about that. it is always a person's race whether he or she wants to sign on to that sort of thing or not. -- a person's choice whether he or she wants to sign on to that sort of thing or not. >> i want to know what the next step is after this open letter. are there more plans to use some specific things after this? begun ank we have ongoing conversation with one another and with the broader outside community about these things. we are not going to back down on this question. i think the government has been waiting us out for some time, to keep -- thinking that roman catholics and evangelicals and others who are opposed to these things are going to go away. we are not going to go away. we will continue to speak to this. and i think the next step is to ask the administration again to
2:35 pm
reconsider, as we have in his letter, and to work with members of congress to work with this legislation. >> this is sort of a follow-up to the two previous questions. how do you respond to the government argument that there is a difference between ,ndividuals and corporations and that while individual owners of the corporation or business however that his rights protected by the first amendment, for-profits and secular corporations do not? >> i would think, first of all, it has always been understood that individuals in our country
2:36 pm
have been able to run for- profit corporations according to christian principles. wouldn't it be a shame if that suddenly became impossible to do? anonymously.ng we are speaking by way of comparison -- analogously. we are speaking by way of comparison. but corporations do have a form even under the law of what one might call personhood. and certainly, church institutions do, by which the character of the enterprise is shaped and designed. we would certainly like to see that respected. >> if there are no more questions than, thank you. and happy write-in and happy reporting. >> happy fourth, everybody. [captioning performed by national captioning institute]
2:37 pm
[captions copyright national cable satellite corp. 2013] this you missed any of discussion, you can see it any time at the c-span deal library at c-span.org. over the last few months we featured a number of co's and other corporate leaders as they
2:38 pm
testified at congressional hearings and spoke at other public events. tonight, we'll show you some remarks on topics like the economy, immigration, tax policy, and employment. we will hear from the leaders of american express, apple, citigroup, microsoft and others. here is a preview. >> microsoft and across the technology sector, we are increasingly grappling with a significant technology challenge. we are not able to fill all of the jobs created. the numbers tell the story. at a time when unemployment nationally hovered just below 8%, the unemployment rate in the computer and mathematical occupation has fallen to 3.2%, and in many states and many subcategories, it has fallen below 2%. unfortunately, the situation is likely to get worse rather than better. the bureau of labor statistics
2:39 pm
has estimated that this year, the economy will create over 120,000 new jobs that will require a bachelor's degree in computer science. and yet we estimate that all of the colleges and universities in the country put together will produce only 51,474 of these degrees. that is why high-skilled legislation -- high skilled immigration in this legislation is so important. it addresses three things. first, it addresses the green card shortage. it eliminates, or goes very far to reduce the backlog. it eliminates the per country cap. and it creates the new green card category for advanced degrees. all things that are needed. thend, in the h1b area,
2:40 pm
bill quite rightly have ascreased the number of h1b' that are available. it improved portability so that switchloyees can employers. and even though we have lingering questions about potential unintended consequences, we recognize that compromise is needed all around and we hope to be able to work with this committee and its staff as you go through the details. there is a third thing this bill does that is of extraordinary importance. .nd that is this it creates a national education fund. the reason there's a shortage of high skilled labor is that we have systematically under
2:41 pm
invested as a country in the education of our own children. consider this -- there are over 42,000 high schools in america, but this year, the number certified to teach the advanced placement courses in computer science is only 2250. klobuchar, we're very grateful to the work you and senator hatch led to create the ared proposal. this bill follows much of that model, but time -- i hope you might improve even further. raise the fees on some green cards. invest that money in the american people, so we can provide our own children with the educational opportunities they will need to develop the skills to compete in an increasingly competitive world.
2:42 pm
microsoft spends more on research and development than any other company in the world. $9.8 billion this year, and yet we spend 85% of that money in one country, this country. the united states. has come to washington because we want to keep jobs in america. we want to fill jobs in america, and we want to help create more jobs in america. we know that in the short run, we will need to bring more people from other countries to america, and we hope that in the long run, some of them will follow in the footsteps of the alexander graham bell's and albert einstein's and other great scientists and entrepreneurs. but we want to do more than that. we think the country should seize the moment to invest in our own children as well.
2:43 pm
and if we're going to do all of that, if we're going to do any of that, we need your help. thank you. >> a peake at our programming tonight. we want to hear about your experiences working for a company, or if you run your own business. we will take your calls and comments from facebook and twitter. c-span is bringing you argument from some of the supreme court key rulings. tonight, same-sex marriage with hollingsworth verses. and u.s. verses windsor, a closely decided cases last week. that is tonight at 9:00 p.m. on c-span. record temperatures have played much of the country in recent days. that with the topic this morning on "washington journal." >> from atlanta, we want to
2:44 pm
introduce you with dr. loren louis. she is an epidemiologist. what is an epidemiologist? an epidemiologist is a public health professional. sometimes, as in my case, it can be a doctor, also research epidemiologists. in research on public health problems, research that impacts populations. what effecty populations. >> what would you say is the key ?ole in investigating
2:45 pm
localhelp state and health departments address environmental concerns, including events like heat waves. again, the cdc and heat waves. what are you doing to help people, prevent, etc.? variety ofhas a resources for state and local health departments and for the public. you can access a lot of that information on the cdc website. our primary concern is making individuals aware of what they can do to protect their health. a lot of these information is available on the website. the health department address concerns in their states and communities. our messages, or some of
2:46 pm
themessages to emphasize to public to stay cool, stay hydrated, and stay informed during extreme weather events. in that is what is happening arizona and nevada. from an article, get used to heat waves, the sec warns. -- the cdc warned. is there concern over higher trend and more extreme storms? >> with climate change is anticipated that he waives will become stronger and longer and more frequent. it is impossible to relate to any one event like the heat wave that is happening in the west
2:47 pm
right now. it is impossible to relate that specifically to climate change. however, we do expect to see stronger, longer, and more frequent he waves. -- heat waves. host: and you can see that dateline on our screen. extreme heat waves and public health is what we're talking about. you can call in. also make a comment on or send an e-ed mail. there is an initiative run by cdc, climber ready state and city initiatives. what is this? >> cdc's role in climate change is to help communities prepare for and adapt to impending
2:48 pm
changes related to a climate change. what this initiative does, it supports state and local public health departments in assessing what their vulnerabilities are for their communities related to climate change. what should they be most concerned about in terms of the potential health impacts on their communities? and it also helps communities implement surveillance systems, assistant to monitor and track potential bonuses and injuries that could be related to climate change. and finally, this initiative supports intervention that can help communities address climate change. for example, in arizona, this initiative funded communications messages that the state provide schools and to educators on how to keep kids safe during extreme weather events. cdc: how much money is
2:49 pm
putting toward this initiative? guest: i believe the initiative is a $7 million initiative. and how many states are participating? now, 16 states and two cities participating. and we are hoping we will expand. and we're also hoping that those 16 states and two cities will produce models that can be replicated by other cities and states. host: this morning in the "the new york times" dr. lewis is this article -- what do you say to people who do not necessarily agree with the view that climate change is affecting weather pattern? well, i cannot really say much about those who do not
2:50 pm
agree with climate change, or don't believe in climate change. as i said earlier, we cannot lend any one specific event to climate change. but i can tell you we are seeing more extreme weather events. host: and you have worked on extreme weather events before, according to your biography, including hurricane sandy, the alabama tornado outbreak, and did not -- in american samoa. what has been your response in each of these weather events? my branch provides assistance, whatever that means -- whenever that may be, to state and local health departments. during hurricane sandy, we deployed staff to help in shelters, conduct surveillance for injuries and illnesses in the shelters.
2:51 pm
inalso provide assistance helping states possess the needs of their communities, so they can allocate resources to communities that have been affected by disasters. , 130 degreesrees out west right now. what is your advice to people? guest: number one, stay cool. anyou can come and go to air-conditioned environment if at all possible. and if you do not have air- conditioning, there are public libraries, malls, family and friends. stay cool. hydrated.y drink plenty of fluids. stay away from kaffir needed fluids -- caffeine needed andds and of course, of all
2:52 pm
drinks with high sugar content. and stay informed. with local weather alerts and know the signs and symptoms of heat illness, so you can be aware of what is happening and when you might be at risk. host: how many people the u.s. to meet or do you know have died during his recent heat wave? guest: i do not have those numbers. i have seen an immediate report of one death, but i do not have the specific numbers. the first call comes from chris in indianapolis. good morning. i don't think i have called in before. an interesting topic. my question is, do you look historically back to how people this?ith
2:53 pm
it,y time you hear about you're hearing about breaking the record in the 1920's or the 1800's, or whenever they started keeping track of kings. how did people deal with that back then? there was clearly no air- conditioning. they did not have the relief that we have today because we have technology. we were looking at things like that, -- when you are looking at things like that, using that as a basis? i know we are worried about climate change, but we've had these extremes before. what did people do? released arecently report from the heat wave that occurred in 2012. you may remember, this was a unique event because there was a severe storm that swept through the mid-atlantic states into parts of the midwest, leaving
2:54 pm
millions without power. around 3.8t was million people were without power. at the same time, a heat wave struck the same area. states,worked with four maryland, ohio, virginia, and west virginia, where 32 people died within two weeks. and we compared those deaths during that event to similar deaths during similar heat waves that have occurred in the past, such as the chicago heat wave that occurred in the 1980's when 700 people died. and we found that fewer people 2012 to previous events that were very similar, previous very similar heat waves. know for certain why fewer people died in the 2012 incident. we do know that states for a
2:55 pm
very proactive. they were very prepared and they responded quickly. when temperatures started to rise, they had prepared messages ready to disseminate to the public. the capt. communication with the public. they set up: stations for people without power -- they set up cooling stations for people deployedower and also staff to go door-to-door to check on the most vulnerable people, adults over 65 who live alone and may be without air- conditioning. i cannot tell you for certain whether these prevented deaths, but perhaps they did. host: the next call is just in baltimore. caller: my question regarding , i recently read an article about how sunspots
2:56 pm
have a more direct correlation. could i get your comments? guest: cdc is not involved or not focused on the environmental causes of climate change. our focus is on how communities can prepare for, adapt to, and protect the public from potential changes related to climate change that can impact helps. that is the focus of our work. host: we have a tweet before you. does the afforestation and other real andd are elimination make the effects of heat waves worse? >> again, that is not the public focus of this ec role in climate change, so i'm not the best person oto answer that question. we do know that man-made
2:57 pm
changes to impact climate change. host: another tweet. tol the good doctor to stick healing. the levels of heat wage -- of heat waves are changes in the are what thete earth does. any response? as an as i explained, epidemiologist, i am a healer. whether i am a doctor wears a white coat and a stethoscope, rather than khiel one patient at a time, i like to heal communities and populations. host: jim in cincinnati, you moron. -- you are on. thank you for taking my call. with all these forest fires west andry year out
2:58 pm
with the wind blowing from the west to the east, what about the denver, colorado area? are there problems that they can prove that have been brought about by the carbon in the year from these fires? it seems to me there would be far more common -- carbon from that that there would be from any power plant. answeri cannot really that question in terms of the contribution of wildfires to climate change. we do know that carbon emissions from power plants do contribute to climate change. but i do not have any information on the contribution of wildfires. in stanford,e connecticut. one very important factor in every condition is climate change and the condition
2:59 pm
[indiscernible] do you agree? guest: could you repeat the question? caller: this is common with climate change and a very important factor in every .isease and climate change do you agree with my comment? host: did you say the condition of soil? caller: condition of soil and condition of air. it is a factor in every disease, the air. andthe condition of soil the air-conditioned. host: dr. louis, could you follow that at all? think i think so, and i it is all related.
3:00 pm
climate does impact soil conditions, but the role that plays in climate change and i don't know. jim tweets into you, we're spending $8 million because it is hot in summer. is there a future for this country? guest: that is a very good comment. and i'm glad that issue is race. heat illness is important because it is common. federal people die every year because of heat. that is more from tornadoes, hurricanes, and flood. what is most important is that these deaths are preventable. no one should die from heat related illness. it takes an hour and a half long.
3:01 pm
, closeg, muscle fatigue to heat exhaustion. that was a new one. getting to ae cool and getting hydrated. it is correct. sounds like heat exhaustion. if these continue, i suggest you seek medical advice. host: when you say get hydrated, is there a limit to how much someone should hydrate at first? guest: there is no limit really, but the cdc recommends if you are working or exercising outdoors during a hot day or extreme weather events, a cdc recommends that you drink too-4 cups per hour of fluids.
3:02 pm
as i said earlier, avoid decaffeinated and high sugar fluids. we also recommend do not wait until you are thirsty. maintain hydration before you get thirsty. host: 170 degrees sunday in las vegas. -- 117. how long can someone be outside in the temperature without suffering consequences? guest: there is no set time. there are lots of variables. some people are more vulnerable to heat than others. that includes people better 65 and older, people with chronic medical condition, such as heart disease. people on certain medications may make them more susceptible, and of course infants and young children. my best recommendation is to avoid high temperatures, of being outside during the peak
3:03 pm
temperatures of the day if at all possible and pay attention to how you feel and the warning signs of heat exhaustion. host: you are on the washington journal with laura and it was from the centers of disease control. -- lauren lewis. caller: being 80 years old has the curse of our deep in throwing a lot -- having been through a lot of things in knowing the answers. surviving in high heat is simple. when i wasn't the army in the mexico, the heat got up to 125 degrees during the peak of the day. we worked outside a lot of the time. i do not know of anyone having severe problems with the heat.
3:04 pm
we lived back when we did not have air conditioning. in new orleans we have pretty high heat. we just had giant ceiling fans. so i guess the only thing that it's different than what we hear about now is we were young. guest: well, heat is not new. i agree with the calller. but also heat illness and death is not new either a lot of the comments you made, wearing hat, protecting yourself from the sun, wearing loose, like clothing are all common sense recommendations that do protect
3:05 pm
you. when at all possible, stay out of the heat. fans make you feel better, but when temperatures are really high, syrians blow hot air and do not protect you against t heat. host: dr. willis practice internal medicine in atlanta. she served as a clinical instructor from four house college of medicine and earned a master's in public health and epidemiology from emory university.
3:06 pm
still and individual. please mention climbing into a cool water tub. that lowers bader -- body temperature quickly. guest: i am glad you brought that up, calller. when people are suffering from heat adoption or heat stroke, which is a serious illness, climbing into a cool water, or taking a cool shower can bring body temperatures down quickly and is recommended under those circumstances. since you brought it up, some of the sentence of heat exhaustion symptoms of heat exhaustion are excessive sweating, weakness, sometimes painting -- feinting, cold, clamy skin, week polls. if you feel any of those signs or symptoms, get to an air- conditioned environment and hydrate. try to bring your body temperature down.
3:07 pm
a good way to do that is a cold shower or cold bath. host: and and baltimore. -- ann in baltimore. caller: i have a quick question. and i think surname lucy mae calling in about the soil. the impact of the soil when it draws into the house in the indoor air quality and how that affects a person's health and how that is impacted by climate change. there was wondering if you could speak to that. guest: i am not sure if anyone has looked or whether we know
3:08 pm
whether soil conditions impact indoor air and whether that is related to climate change. i do not think we know. host: easton in jacksonville, florida. caller: based on some of the callers, i understand the redundancy, but i was more curious about some of the other diseases being affected by the rise in temperatures. there is obvious malaria and things like that. guest: that is a good question. we anticipate with climate change to see an expansion of the pollen season, and that would in fact impact people with allergies, people with asthma, air quality, people with other we also expect to see changes in the distribution of vector-borne elvises like mosquito-borne illnesses like west nile and limes disease. other impacts changes in quality and the quality we might see.
3:09 pm
host: jonathan, sacramento, calif.. caller: hello, doctor. what do you think is behind the climate change? just about two weeks ago it was raining over here in sacramento, and now it seems to be in the three digits. guest: again, we cannot really relate that to climate change or specific changes we could not relate to climate change, but we are seeing where events tend toe weather events. host: dr. louis, every year we read about a young person out there practicing and dying on the field and often comes with
3:10 pm
the heat. the work with athletic departments? -- do you work with athletic departments? guest: yes, we do. athletes of all ages who practice their sport, workout during hot weather are at risk for heat illness. cdc provides tools and educational tool kits for coaches, athletes, nurses to help them understand how to prevent heat illness and what to do if one of the athletes becomes ill. host: this tweet from laura -- guest: that is a good question. people are more vulnerable to hot and humid heat than they are to dry heat, because humidity interferes with the efficiency of the body to regulate heat, which primarily comes through sweating.
3:11 pm
so hot and humid heat is more of a risk. host: dog canyon tweets in, are low-sodium diet is more likely to cause more cases of heat stroke? >> i am not aware of low-sodium diets causing heat stroke. cdc does not recommend taking sodium supplements for potential electrolyte imbalances during heat. we recommend it heat cramps occur, which can occur from excessive sweating and the result of electrolyte imbalance. we do recommend hydrolyzing reaching we do recommend hydrated with fluids. we do not recommend it sold supplements or low-sodium diets. host: how much warmer our cities
3:12 pm
over suburbs? guest: there is what they call a heat island affect in cities due to the concrete and the effect that has on the distribution of heat and the sun. i think it is fair to say that cities tend to be hotter than rural areas. host: you have worked on tornadoes and other events as well. any common thread among the different events that you can identify? guest: one common thread is be prepared, be prepared, be prepared. the better prepared individuals are four extreme weather events, the more protected they are. whether it is being prepared and knowing where the safe room is when there is a tornado, having a plan for your family, and
3:13 pm
making sure to check on a neighbor and friend, that can protect individuals during most events. that holds true with states and public health officials as well. the better prepared your state and local help our, the better able they are to protect you and your communities. caller: good morning. are you concerned with the inadequate electric grid that we have? my power company wants to offer me all kinds of deals if i will allow my power to be cut off at peak times. i know we were supposed to be to doing work on a grid but was not done. does this bother you? my second thought is i think the american people really should
3:14 pm
know what the climate change -- weather climate change is true or not. host: let's get a response to that. thank you for calling in. guest: i am not really the best person to ask or answer questions about your electric grid or electrical service serving you in your community. this varies from state to state and region to region. there are other agencies better local utility companies that are in the best position to answer questions about the status of your service. i can say that there is a lot of evidence that supports changes, climate change, and we are seeing more or rear events happen more frequently. -- more rare events happening more frequently. we are encouraging people to be prepared and adapt.
3:15 pm
>> jody tweets in with all of the climate changes to come, the question still remains, are we able to adapt to the climate we created? >> well, that is what c.t.c. is working towards. i am confident that can happen. it is a matter of being prepared
3:16 pm
and putting resources towards identifying what vulnerabilities are and putting intervention in place to address the vulnerabilities. host: allen in georgia. please go ahead with your question or comment. moving on to larry in clinton, missouri. caller: good morning. there is one question i would like for you to answer. i will bet that you cannot. what we have now is you were telling everyone to go to a cool place, which is all electric and the only way you concur off -- the only way you can cool off. the government, as we speak, is at war with people who are poor and are not afforded to have electricity. they will raise the electricity bills. you know it and i know it.
3:17 pm
i am working with my electricity company here in the area to keep the electric bills down and so the court -- so that the poor people can do it. our president is against that all together. trying to do away with cold in trying to do away with the things that you are doing to protect the environment. how was it going to protect the old people and the people who cannot afford the electricity. i have been down here 16 years where i live now. obama and his crew are against cold and the other things that can help us out. there has to be a better way. the environmental protection agency needs to be eliminated in my humble opinion. host: any comments for the calller? guest: what i do recommend, and
3:18 pm
it sounds like you have an air- conditioned home and electricity now, but if you are ever in a position where that is compromised, and during extreme heat and very hot days, my recommendation to you is to be aware in contact your local public health and be aware of where you can go to get relief from heat. that is the best information i have for you. host: how closely it as the cdc work with other government agencies involved with climate change issues? guest: c.t.c. works very close with epa and other federal agencies. we have a complementary role when it comes to climate change, and we work really side by side during extreme weather events. as i stated earlier, our role is more in trying to protect the public and help state and local health the permits put
3:19 pm
protections in place to help the public to adapt. host: we have been talking to an epidemiologist for the center for disease control. she joins us from atlanta. thank you for your time this morning. two more segments. turning our attention to the likes looking at the white house where preparations are waiting for the return of the president and the family. the final stop was tempted near where president obama met with former president george w. bush. president obama also addressed the ongoing political conflict in egypt today. encouraged morsi to respond to concerns being voiced by throngs of protesters who are seeking his removal from office. the white house confirmed that the president called him while traveling in africa. it came as the military said that he must meet the demands
3:20 pm
of millions of protesters who have taken to the streets. that is from the associated press today. reacting today to the death of william h gray the third. he passed away suddenly monday in london. the president released a statement saying he was a trailblazer, probably representing his bloody and -- -- beloved he passed away monday at the age of 71. up, a panel discussion from this year's national cable and teller -- telecommunication meeting. anay a panel caused interruption disruption. the future of everything. this is coming up at 6:00 30 eastern here on c-span. over the past few months we
3:21 pm
have featured a number of ceos and other corporate leaders as they testified of congressional hearings. this book at other affair event. we will be showing some of their remarks on topics like the ,conomy, tax poly, regulations and unemployment. you'll hear from leaders of citigroup and microsoft among others. here's a preview. i want to say a few key things. i think the consumer has really demonstrated incredible veryience in a challenging economic environment. the question is how long will that last? the consumers held up relatively well. inwill also see that spending. you see that in the credit performance. the right operates have substantially come down and for the industry overall. that -- they are at historical lows. we are performing 50% better.
3:22 pm
that demonstrates some view that the consumer help is pretty decent. consumer confidence has held up pretty well. i have been of the view that the economic recovery is going to relatively slow. i think what we have to hope for is that it will stay stable. >> we would like to hear from you about your experiences from the company or if you run your own business. what is your own business to corporate america? we'll hear from you on facebook and twitter. that is tonight at 8:00 eastern. the federal reserve board of governors approved capital
3:23 pm
requirements for larger financial institutions today. it is part of an international agreement and a key provision of the 2010. frank financial law aimed at preventing financial crises like 2008. ben bernanke call this an important step that will make u.s. bank safer route more and higher-quality capital. it also strengthened the global financial system. the final vote in support of this framework was unanimous. >> good morning. i would like to begin by welcoming our guest to this area. this marks an important step in the effort to enhance three seconds of the u.s. banking system and to promote runner financial stability.
3:24 pm
the final row we are considering put some place the comprehensive framework that the board has been developing for some time in consultation with our domestic and international colleagues and revelatory -- regulatory agencies. it requires our organizations to hold more and higher-quality capital. it will act as a financial cushion to absorb future losses while reducing the incentives for firms to take excessive risks. strong requirements are essential. we hope to have safe and sound banks that can weather economic and financial stress while continuing to meet the credit needs of our economy. commitmentthe u.s. to implement the revised international regulatory capital for a work known as for organizations. the role also incorporates aspect thattial
3:25 pm
promote the agenda. today we will also be considering proposed technical changes to the capital rule that became effective in january of this year to conduct warm with the final rule. we have many of the staff to spend long hours working on this rulemaking. they should be commended for their conscientious effort. i look forward to today's discussion of this initiative. they are joining us by the conference call. let me now turn to governor tarullo who is late a key leadership role. >> thank you. while strong requirements alone cannot ensure the safety of our financial system, they are essential to good financial regulation because they are available to absorb all kind of losses no matter how unanticipated.
3:26 pm
along with the stress testing and capital review measures we have artie implemented in the additional rules for large institutions that are on the way, they will be an essential component of a set of mutually reinforcing capital requirements. they will have several important consequences. will consolidate the progress that has been made by banks and regulators over the last four years in improving the quality and quantity of capital held by banking organizations. this assures that as memories of the crisis phase efforts to build and maintain higher capital levels will not be allowed to wayne. shortcomingsmedy in our generally applicable calculations that became apparent during the financial crisis. also enhance the effectiveness of the collins amendment which we have strengthened our making it out a couple to capital out there --
3:27 pm
buffer as well as requirements. adoption of these rules means that we will have met international expectations for u.s. implementation of the basel three capital framework. this gives us a firm position for which to press our expectations that other countries implement it fully and safely and promote global financial stability. in characterizing this role as a milestone, i should note that this marker has quite different meanings for baking organizations and systemic importance on the one hand and the thousands of smaller banks on the other. today will mark the end of major modifications. most of the significant changes from the proposed rules we issued last year that were made in this final rule are intended to reduce and simplify a number of those from current standards
3:28 pm
that will be applicable to smaller banks. in respect to larger organizations, we have a number of initiatives that remain. before turning to those initiatives, i know that work continues on simplifying some of the more complex provisions in capital requirements applicable to a higher institutions. of particular interest is work on standardized capital requirements that would provide a sound backed up for model derived risk weights. as to what remains, beginning in the fall we will extend full stress testing plan reviews to organizationsso with greater than $50 billion in assets that have not fully covered in the exercises we have undertaken since 2009. rulemakings that will enhance capital requirements for the eight
3:29 pm
organizations already identified as those of systemic importance. we're very close to completion of of a proposed rulemaking that will establish a leverage ratio threshold about the required minimum. , itite the innovativeness seems to have been set too low to be an effective counterpart to the combination of risk way to capital measures that have been agreed internationally. ready in the next few months to issue a notice of proposed rulemaking concerning the combined amount of equity in long-term debt. they should maintain in order to facilitate. third, after the basel committee has completed final ofhological framework global systemic importance, we will issue a notice of proposed
3:30 pm
rulemaking to implement this framework in the united states. given the current state of the work, you may have noticed this late this year. fourth and finally, the staff is currently working on a recommendation for an advanced notice of proposed rulemaking to see comments on possible approaches to requiring additional measures that which are rectally address risks related to short-term wholesale funding. -- which directly address risks related to short-term wholesale funding. this would round out a capital regime of complementary requirements that focus on different vulnerabilities and compensate for the inevitable shortcomings. would conform to the mandate given to us by congress to apply to large banking organizations, more exacting supervisory requirements that
3:31 pm
become progressively strip -- structure as it increases. consideral rule we today is a broader elements of the regime. forward-dation for the looking requirements embedded in stress testing and as a base on which to add all surcharges. >> i will focus my remarks on those elements that are most hurt and to community bank. begin by emphasizing that having adequate levels of capital is just as crucial for smaller banks as it is to the largest institutions. the crisis demonstrated that community bank can still be devastated by economic turbulence if and when they did nothing to cause the problem. there were able to with stand the adverse conditions and
3:32 pm
continue to serve their committees with those that started with solid capital positions. as proposed last year, it would have achieved the objectives of increasing the quantity of capital in banks of all sizes. it also would have created substantial regulatory burden on community banks. i believe that we have maintained the objective of capital requirement but what about the more onerous burden. it received 2600 comments with the majority coming from community banking organizations. in addition, they sought input from community bankers or in person meetings. they held several large are s.ached -- outreach session i met with representatives from organizations of various sizes different business models. i know several members of the board did the same. this is critical to understanding how different
3:33 pm
elements would affect organizations. after hearing their concerns, changes have been made to the proposal to reduce the complexity and to minimize the would be burden that placed on smaller community banking organizations. we will discuss these in detail. i want to comment on three changes in particular. comments or concerns about the burden of there isng the risk, the potential reduction in credit availability due to the interaction of the proposal with other mortgage related rulemaking. it would retain the current risk way for residential mortgage loans. second it would allow the non- advanced approaches to make a one-time election to opt out of the requirement to include most elements of a oci. while they would not be required to recognize unrealized gains and losses in the capital,
3:34 pm
they would not be permitted to switch back and forth to take advantage of unrealized gains unrealized losses. their tier one capital. in recognition of community banking organizations little -- limited access, it would grandfather certain existing securities as permitted by the dodd frank act. ultimately, the relevant measure was not to compare to the proposal but to evaluate it against existing regulatory requirements. ase quality and quantity of bank capital without introducing necessary complexity or capital volatility. it would require all things to hold more common stock and retained earnings than is the case under current requirements. because most capitalize with
3:35 pm
common stock and because view thisarnings, i as a validation of the community capital model rather than an additional burden. the requirement would be increased from 4% to 6%. the turkeys have become an important element for community banks. these have become an important element for community banks. it would also create a capital observation buffer that would work to limit distributions as they approach regulatory minimums. stressed their limited access to markets and resulting dependence on retained earnings. this is especially appropriate for community banks. it simply mandate earnings retention until this is above regulatory minimums.
3:36 pm
who knew this would have more stringent lists? there are high concentrations of either these assets. there are less than expected for observing losses. rates would increase as well as high volatility and commercial hbcrestate loans called loans. when it applies only to a small subset of commercial real estate ares, construction loans of the type that resulted in large losses during the recent crisis in the savings and loan crisis. the staff has prepared a one-
3:37 pm
page summary designed specifically for community the keyat describes changes discussed today. i am hopeful this will allow community bankers to quickly zero in on the changes that affect them. i would like to inc. our staff in finalizing these requirements. i am glad it will contribute to a more resilient banking industry that will benefit the overall economy. i will now turn it over to mike ipsen. >> thank you. i will briefly discuss how the final rule fits into the larger package of reforms that have been undertaken in response to the financial crisis. then i will turn it over to describe the final rule in more detail. the stronger ones are a key part of our regulatory reform program. the hallmark is that they should increase -- the hallmark is that they should increase in stringency.
3:38 pm
today's role deftly needs the principles -- definitely meets the principles. many changes have been made to reduce word in on community banks. role dovisions of the wal not apply to medium-size banks. they build on the stronger and increased tendency. i will briefly mention three these other areas. stress testing, capital surcharge, and resolution. have the stronger definition of capital in today's final rule as these changes come into effect. this satisfied the principle of stringency. bank holding companies below $50 billion in total assets are not covered at all by supervisory stress testing or rule.
3:39 pm
the very largest holding companies are subject to a tougher stress test that includes a global shock to financial markets. as he mentioned, we are working on a proposed rulemaking to implement the surcharge. the surcharge will build upon the fossil three framework in today's final rule. , the surcharge meets the principle of increasing stringencies in only eight are currently on the list of sins systemically banks. we may measures that will make them more resolvable in the event of failure. these are beginning to summit resolution plans are living wills to the fdic and federal
3:40 pm
reserve which will improve their prospects for orderly resolution. haver supervision, we designated resolve ability as a core expectation. on resolutionk meets the principle of increasing stringency. it only affects large bank holding companies. programents of this taken together are intended to increase the resilience of the financial system and ensure that the banking sector can support strong and stable growth in the economy. the final rule is the result team extraordinary 1 effort. it represents a major step in the regulatory capital framework. the final rule enhances the agency for capital regulations ensure that they maintain strong capital positions that will enable them to continue the creditworthy borrowers even times of
3:41 pm
financial stress. they found stronger capital requirements with lower the probability. this morning i will highlight some of the main provisions that would achieve this goal as well as key revisions that were made to the proposal to address burden concerns by community banks. s will help answer questions about the details of the roles following my remarks. restructure the rules into a harmonize itprehensive framework. incorporates requirements consistent with the basel three capital standards established by the community on banking provisions.
3:42 pm
including minimum capital requirements for depository institution holding companies and the requirement that all federal agencies remove credit ratings from the regulation. includes alternative standards of credit worthiness to credit ratings contained in the final rule. the agency's final rule applies to all banks, bank holding companies that are not subject to small bank holding policy statements, and certain savings and loan holding companies. the companies raised significant concerns about the appropriateness of the proposed regulatory framework for their business models. in order to provide the board more time to consider issues, it is not apply to savings and loan holding companies with more than 25% of their total assets held in underwriting companies. the final rule does not apply to
3:43 pm
grandfather even terry savings -- loan companies grandfathered unitary savings and loan companies. rule increases the quantity of regulatory capital for all organizations by establishing a new minimum common equity tier one capital ratio and a stricter set of eligibility for instruments. most organizations already meet the higher capital standards and the role will help preserve the benefits of the stronger capital he related to the financial crisis. it also advises the framework to revise the capital standards. the final one establishes --itation by capital does it capital distribution.
3:44 pm
this conversation buffer is to provide incentives to conserve capital during the nine economic times so they can withstand severe stress events but still remain but the minimum capital levels. the final rule and the sizes common and equity because it is the highest quality form of capital. the final rule also revises the roles for calculating risk weighted assets. to note thatnt certain provisions of the final rule apply only to large internationally open banking organizations. the final rule layers on a number of macro prudential features for these firms. they are subject to a countercyclical buffalo but allows regulators to increase capital, -- conservation.
3:45 pm
in addition, these are subject to additional credit requirements as well as an additional requirement that takes into account off-balance- sheet exposures. they miscalculate their risk- based cap chelated ratios. they use the more conservative ratios when determining compliance with the minimum and capital conservation buffer. it establishes a robust organizationsr of all sizes. at the same time, it reduces complexity and regulatory burden for non-java nationally active banks. since this closed at the end of october, if you'd over 2600 common letters. most supported a more robust standard. many expressed concerns regarding the burden imposed by the capital.
3:46 pm
they requested exemption from the proposal. relatet notable concerns to be for posttreatment of accumulated comprehensive income. the proposed risk week for mortgages, the regulatory capital treatment of securities that currently count as tier one capital, and the timeline for the client requirement. under our current rules, most and are notecure included in regular trade capital. would have required institutions to include most components in their common equity capital. most asserted that this aspect will cause significant volatility and capital ratios due in large part to fluctuations in benchmark interest rates.
3:47 pm
recognizing that the tools used by more complex banking organizations for managing interest rate risk are not readily available for all banking organizations, the final rule addresses this by allowing non-internationally active banking organizations a one- time option to keep excluding most from regulatory capital. have concerns about the proposed treatments of residential mortgages. it would have entered tuesday more granular framework for residential mortgages by providing -- dividing exposure into two categories. then assigning risk weight. andould limit this jeopardize jeopardy. it asserted that the proposed weights were not appropriate. the burden has an impact on the mortgage industry.
3:48 pm
in view of all of these comments, the final rule contains the current treatment. another significant change is related to the treatment of securities and other capital and that will no longer need the criteria under the final rule. it would have required all banking organizations to take capital.nonqualifying many encourage them to grandfather nonqualifying capital for banking organizations with less than $50 billion in total assets. in light of the smallest firms, access to capital markets, it allows banking organizations with less than $50 billion in
3:49 pm
total assets to grandfather securities and other nonqualifying capital instruments. it is subject to limits consistent with our current rules. these would be subject to the proposed phaseout with the dodd frank requirement. turning to the timing for banking organizations to come they requested, more time to comply with the requirements of the final rule. in response, it requires large internationally active organizations to comply with the final rules including the provisions beginning in january of 2014. other organizations are subject to the rule and would have until january 15 for compliance. provisions for banking organizations and allows the more time to make the requisite system changes and retained earnings.
3:50 pm
the analysis of the proposal indicated that the overwhelming majority already have sufficient capital to comply with the proposed rule. final rules for the indicates that an even greater number of organizations would meet the new requirements if they were imposed without transitions today. more than 95% of ankle during companies that meet our current requirements would meet the minimum equity tier one ratio. nearly 90% would meet the common equity buffer level. aggregate shortfall for institutions not meeting the buffer is about $2 billion. this has decreased by $1.5 billion since our analysis of the proposal which we attribute to increases in retained earnings as well as modifications from the proposal i have described. meet ther holdings
3:51 pm
minimum common equity tier one ratio and almost 95% meet the minimum buffer with an aggregate shortfall of approximately $2.5 billion. in closing, it improves the quality and regulatory capital. it leads to a more resilient banking system. a meaningful addresses concerns regarding implementation burden of the proposals and maintained rugrats toward -- maintains this toward a more robust banking system. my colleagues and i will be pleased to answer your questions. >> thank you very much. thank you for your recitation. thank you for your hard work. we technically have two votes. one is on the capital proposal. the other is on market capital rule. the twoe followed by votes.
3:52 pm
let me begin with a question. one of the criticisms related to banksis the idea that calculate their own risk rates using internal models. called thishave the exams. it is related to the issue of comparability across country and whether banks in different countries are assigning approximately this to risk assets. on the comment protections and validations, what we do to ensure that the risks being assigned are in fact reasonable? how does this relate to our stress testing and what we have learned? systemfederal reserve
3:53 pm
has implemented a coordination is used tohat basically that established standards for exiting banks from parallel runs. there is a supervisory requirement that they had to meet the standards in order to exit parallel runs. they use this as their minimum capital requirements. to date no banking organization has received that approval to exit parallel runs. we have taken a number of steps to make sure they are well on their way to achieving that point. some of the exercises include sexualizedalized -- examiners who are able to take a consistent approach across banks and understand what they are doing.
3:54 pm
and using supervisory process to help move them to where we think they need to be. validations of models, it is a very important components of the final rule as well of these guidance on validations that we used as part of the examination. there is in the united states is a standardized floor for risk weighted assets. while there may be some variability and there will, banking organizations under our current rules once they have exited will have to calculate two sets of risk ace capital requirements when using the advanced approaches and when using the standardized approaches. they are bound for the minimum capital purposes in determining where they are in the buffer based on the more conservative
3:55 pm
of those two measures. that provides a baseline level of comparability. >> i would just add me up and spending a lot of time recently okasan on the point you make about comparability of risk weighted assets across different banks or lack there of. they publish a paper that reported on a horizontal exercise that was done across the trading but capital models. there is one coming looking at the capital martyrs -- models for risk requirements. they found a loss of variability of risk weighted asked -- asset calculations. the committee is focused on the issue of how to address concerns. in the u.s., we have a capital loor and have been putting banks three stringent process. other countries have done different things. some have impose different
3:56 pm
floors in different areas are higher risk with uncertain proposers were they have observed models giving results they do not have confidence in. it is definitely an issue we are paying a lot of attention to and working on. >> think you very much. -- thanks very much. much.nk you very i just question i want to ask. the proposed rules that we put out a year ago suggest the risk ratios on the value residential loans and high cre loans. the final proposal has kept the cre loans buton has abandoned the higher weight lt loans.lt
3:57 pm
they express concerns about both proposals. i was hoping you could explain tome why it was decided alternate one area but essentially leave it alone and another. >> with respect to commercial real estate -- >> go ahead. >> with respect to high , these are ones that have been associated with higher risk both in recent crisis and in past financial crises. the staff would recommend the -- risk ratesat reflect that. we did make some changes to the definition of high commercial real estate loans to clarify that they would only apply to a subset of acquisition development and construction loans. are actuallyt safer because they have a lot
3:58 pm
of equity commitments and would not be subject to the higher risk. i would like to clarify that agricultural loans would not be covered and certain developmental loans would not be covered. we actually did make some changes in response to comments that were particularly targeting the concerns that were raised. with respect to residential mortgages, we think there are to going withs the current risk for now. a lot ofn is commenters were concerned about the burden of calculating the ratios as well as differentiating mortgages based on project had a glorious. -- product categories. keeping be treatment and not
3:59 pm
raise additional burdens on smaller banks in particular. the other aspects of comment that commenters focused on was that the proposed risk weights could interact with other residential related regulations that are either coming into effect or that will be coming into effect. that will affect the mortgage market at this time may not being known. it may not be prudent to wait and see how they all affect each other in mortgage lending before it is adding additional regulation. not changing the risk weights at this time will give the board time to see how they all interact with each other and affect mortgage lending that means there is less risk
4:00 pm
sensitivity in assigning weights, but they can do that in the future if they choose to change the risk weights. that is the reason for the difference in approach. >> thank you very much. ok, i will turn to governor duke. >> two questions. i talked a little bit about the comments he got from community banks, but also savings and loan holding companies, particularly about the extension -- exemption for small bank holding companies, but not for small slhc's. c'sre are a number of slh whose activities are nonfinancial. talk about how we address those comments for this institutions.
4:01 pm
with respect to the smaller savings and loans holding companies, in dodd-frank there is a provision that provides an exemption from the requirements or small bank holding companies. those with $500 million or less in total assets. there is not a similar provision in the act for small savings and loan holding companies, so we do not have the latitude to provide an exemption. mentioned, we are providing a temporary exemption from the rolls for insurance savings and loan holding theanies, in that requirements are bank centric, they do not take into account model, thes practices of insurance companies. they raise concerns about for certain firms that only prepare their financial statements according to statutory
4:02 pm
principles and not that there was a burden principle there. they raise concerns about the reaction to requirements that we proposed and how that interacts with the state regulatory requirement required by the state insurance regulator. so we thought it was appropriate to take more time to look at what adjustments should be made to address the specific insurance companies'business model concerns. with respect to the commercial savings and loans holding companies, given the activities that they are engaged in, we thought it would be worthwhile to wait until the board proposes some kind of review for intermediate holding companies, largely to allow that regime to come into play until we establish consolidated requirements for those firm so we do not have wings moving out of lockstep with one another. put the framework in
4:03 pm
place first. >> thank you, and the second question, we talked about the parts of the basel agreement included in the role, but tell me the main differences if any between what was agreed to in basel and the united states' final rule and how we differ with the implementation? >> i will take the first question. the primary difference in the u.s. implementation is the basel accord uses credit ratings to risk weight certain exposures. in united states we are not not able to do that. we are asking to finalize alternative standard's that do not involve credit ratings in the final role. there are a couple areas where the final rule is more stringent two i wouldand highlight is nonqualifying capital instruments. it has a statutory aspect where
4:04 pm
we are required to phase out instruments over a time, whereas basel would require a lengthier time. is third item i highlight for tier one capital instruments, the final role requires they be cap equity, where the accord is more flexible and certain debt astruments could qualify tier one capital under the accord. so we are tighter on that. >> with respect to the basel the u.s. nowwith finalizing our basel 3 rule, you're just finalize their text within the last week or two. nearly complete the basel three implementation and the role making sense across the major basel committee member companies -- countries, because other jurisdictions have limited their roles.
4:05 pm
-- rules. they will take effect on january 1, 2014, so we will be moving to get started with the phase in periods. there is a couple areas where areeuropean final rules not in line with the basel standards. a couple we have heard about from commenters are treating of credit risk and treatment -- risk weight on sovereign debt. the basel committee has a process that involves regulatory capital, assessment across countries, so both the u.s. and european union will be going through that process now that our final roles ules are final. we will see what the committee says about our rules and the european rules. jersey should and will
4:06 pm
reviewed for the comparability of their rules against the basel standard. >> think you. i want to follow up on the question and april's answer. particularly with respect to the residential mortgages. as you explained him of the is not making any change in residential mortgage risk way. is this an area where the complementarity of our capital hoosiers will make a difference, at least for stress tests banks? won't the adverse scenario and he portfolio's pacific stress testing mean there will be a higher capital expectation for those $50 billion and above banks? >> the stress testing of residential mortgages is very sensitive and we gather a lot of and we the loan level,
4:07 pm
will capture things like loan to value and other characteristics, and it will be a risk sensitive calculation. they're giving up risk sensitivity and the changes we ,re making to the final rule but we have retained a lot lot of risk sensitivity to the supervisory stressed testing. x thanks. >> i would like to commend -- for intensive work on this final regulatory capital rule. i would like to thank the fdic and the occ for their participation in what has been a long and challenging process. i am pleased to say the efforts have culminated in a set of decisions jar now reflected in this final rule. anis rule appears to be a improvement and reflects the comments.
4:08 pm
while i applaud the work reflected in the final capital rules, we should not pretend that these are a panacea. to the development and the mitigation of all financial crises. capital is a very important indicator of a banks ability to turn to red shareholders for theyficant losses before implicate the insurance fund or taxpayer resources. apple is one measure of the resilience to losses much of the value of financial assets. experienced during the financial crisis, capital can be quickly eroded and risk weights are imperfect. a anchor can quickly defended into a failing mode. for capital is eroded, before capital plans are triggered, and before liquidation authority is indicated, supervisory safeguards play an early and necessary role in slowing a banks dissent into failure. such supervisory safeguards are
4:09 pm
meant to assure that banks are able to identify and correct their own emerging risk through good governance and appropriate risk management. capital requirements do not compensate for good governance and appropriate risk management. as we know the federal reserve and the prudential banking regulators do not regulate the entire financial system. these regulatory capital rules did not apply to the entire system. strong all to say that levels of capital are necessary that are not sufficient. as a feature of an overall regime of prudential supervision. i questions to you this morning are all about how these final capital rules have been tailored to fit within the broader framework of prudential supervision. meworas of supervision must have requirement that are capable of being understood by the banks, who have to comply with them, by the examiners, who have to
4:10 pm
examine for them, and by the public, which ultimately must trust them. balanced against these features is the simultaneous need to not unduly constrain a bank's ability and engaging in mitigation, particularly in communities that are stressed or with the competitive alternatives. it looksquestion is, as if the complexities of the proposed capital rules have been reduced for community banks, as compared to what was proposed. i would like to hear you explain whether it would be possible for banks to implement these rules without requiring them to engage in time-consuming extra research. yes, i think as governor duke mentioned, we are engaging in several different means of
4:11 pm
outreach to help community banks understand the ruyleles. we are putting out today a guide that is the basis for the most standard community banks do not engage in foreign transactions, more exotic exposures. the most important changes on one page. i would anticipate going forward some other outreach documents that are more detailed that help a bank understand what it is changing. we will propose regulatory rules, and that is what many banks use to walk through the steps in the calculations. for will be coming out public comment soon as well. in addition we will do outreach to our examiners and banking organizations again with an educational focus as well as standing ready to answer their questions. >> [indiscernible]
4:12 pm
able tol have to be first check the capital cap relations of the banks number and then the examiners will figure out what lies behind the ratios that resulted from the capital calculations, and then determine what condition the bank may be in by virtue of the ratios. no ratios might bear resemblance to what appears to be occurring in the bank, or the ratios could be masking emerging problems, and examiners will need to understand what the emerging problems might be. in short, examiners need to synthesize the capital regulations into their determinations of safety and soundness and financial stability. for this reason, exami to figure out how to pierce the complexity that is more suited to economists and modelers. however much risk weights and capital ratios can add the information that they yield will never be perfect. capitalse as these
4:13 pm
weights become, examiners will still make decisions with limited certainty about the outcomes. at the end of the day, there will still be rogue traders, viruses that infect software, there will still be sloppy bank management practices. by questions about this are sure that theo we final capital framework preserves the ability for examiners to make these determinations? band andfinal world of protocols for using prompt- corrective action? if not, what efforts were made to align the prompt-corrective action designations with the capital requirements to clarify that the implications associated with the various pca thresholds need addressed? >> the changes to the framework has been made to align the
4:14 pm
framework with the new minimum capital thresholds. and so, the penalties a bank capitalrough the pca categories remains the same, but the thresholds for what constitutes a well-capitalized taking organization has been raised so that the triggers come earlier. there has not been a change to bankbility to designate a less than well based on supervisory evaluation. i think the factors you described are very consistent with how bank examiners think the way it isand waited for supervisory purposes, that the holding company and the depository institutional levels. the regulatory capital ratios theone aspect, n even mostorntspect to determine if a bank meets the minimums. there is a series of other things that examiners can
4:15 pm
consider, what is the risk profile of the bank on a more qualitative basis, what are its asset quality trends, what kinds of concentrations and other exposures doesn't have, and how do those factor into violating its adequacy. for the larger bank holding companies and banks, we have the additional tools of stress testing which provides another piece of information to think about beyond the regulatory capital minimums. what if the overall capital management of the bank and how that evolves over stressful time? i would highlight something that is consistent with our rules, it requires the bank to do its own oss -- analysis with regard to ratios, how it has enough capital to continue. >> i wanted to turn to the public trust.
4:16 pm
of some large financial institutions know how to hide loss exposures that passed through the safety net by transacting an ever more complicated and overtake financial instruments. if a regulatory system tolerates methods of arbitrage and away the weights of capital requirements, such a system itself will encourage an underpricing of risk. we learned from the financial crisis that this underpricing of risk punished investors who accept the more risk than they thought they had bargained for, it punished far worse who were overleveraged, and it punished citizens who lost their jobs and homes. ty regulators, we have a du to understand that risk is fairly priced. i would like to see regulators across the entire system, including those that regulate money markets and derivatives,
4:17 pm
-- to make more transparent to risk imposed not only on investors, creditors, and counterparties, but those that passed through to the public. in this regard i note the draft alterativeincludes and quantitative disclosure requirements for banking with 50 billion dollars or more in total consolidated assets for those that are not subject to the advanced approaches, disclosure requirements, and there are these advanced approaches banks which are required to increase the amount of publicly available information about their banks. can you describe these disclosure requirements in more detail? >> sure. have bothtioned, they qualitative and quantitative aspects, and they go through different categories of exposure. equity exposure, and
4:18 pm
to describe their risk profile and characteristics as well as their policies for taking on risk and managing that risk. these requirements can be met in a number of different ways to massoud's u.s. banking organizations are subject to pretty extensive exposure regimes to the sec and reports and the way that the regime is set up, if a and can point to and draw together all of the disclosures that make various requirements and bring them together to the extent they are le,evant to meet the disclts a i and then for more qualitative banks, there will be new requirements for the bank to be explaining to the public its risk profile and its view of itself. >> i would add the largest organizations are the ones with the disclosure issues are the most pressing because of the complexity and the size of those
4:19 pm
institutions. we have worked internationally to improve disclosure expectations for those companies, so that financial stability board had a project called the enhanced the closure test for sucking up with recommendations on disclosures, which included tracking how risk weighted assets are changing from one type to the next and giving more granular breakdown about how risk-weighted asset cap collations are done across classes within companies. organizationses to look at those regulations, and there will be follow-up to see how organizations are improving their disclosures. we ought to be able to sustain momentum to have some meaningful improvements in disclosure over the next few years. havingfinal question, to do with the fact that i think prudential supervision needs to preserve prudent lending,
4:20 pm
particularly and our nations most distressed and credit-start community, and interview these were is there are competitive alternatives. we want to ensure there is not an unnecessary reduction in economic activity among people and places that have historically had tenuous access to mainstream financial services. , and,ce in the proposal a4, you raise this as well that risk loans are given a heavyweight, but certain mending done in pursuit of community development is excluded. i question, what was the rationale for that exclusion? i am thinking this is for the institutions that are community to vomit financial institutions, that they should be able to continue to engage in community development lending under that exclusion.
4:21 pm
was that the intent? >> the community development loans that are excluded are ones preferential other treatments. national banking act, so the rationale was just to lineup regulatory treatment for those type of loans across the --including capital roles. -- rules. >> thank you. governor stein? >> can you hear me? yes, we can. christ i want to add my thanks to the staff who have brought this rule to completion. we have made a significant contribution to strengthening the financial system. with all the complexities of the is a simple idea at the heart of this, that more capital and higher quality capital is perhaps the single best will we have to insulate
4:22 pm
taxpayers and the broader economy from shocks to financial intermediaries. there are a lot of moving parts, and we can think of specific things we might have done differently, but the substantial increase in common equity that entails for the banking system represents a major step forward. thanks to all of you. i have just one specific question. it relates to something that governor duke and others have alluded to, the treatment of accumulated of her comprehensive income or aoci. the prior draft or should remove the so-called aoci filter that prevents aids and losses on securities from falling to the regulatory capital. this removal of the filter would afs gains anda losses hitting the capital. in the final rule, there is a
4:23 pm
provision to retain the filter, to keep their capital ratios gains andfrom afs losses. i think i understand the logic behind this provision. artillery that bears on interest rate risk. -- tanks face risk on both sides of the ballasts -- balance sheet. stableeases the value of deposit franchises and the library of the -- on the liability side. if you were to flow through gains losses to castable, but ignore changes in the value of the liability side, you would be painting a misleading picture and you would introduce what would be spurious volatility into measures of regulatory capital. that is the motivation for offering relief to smaller this volatility would be burdensome. i think that makes sense, and i
4:24 pm
think i anderson the logic. the question i have is, if we aoci filter in place, there is no regulatory capital device in place that attempts to capture interest rate risk. as we have seen, a good reminder of the fact that interest rates can move around, pretty sharply. is, whation i have other mechanisms aside from capital regulation, on the supervisory or the stress testing side, do we have or can we used to reassure ourselves that tanks are not getting overly exposed to interest rate risk? >> i will take it. you pointed out wisely that the do not have ae full fair value balance sheet, so we did not actually changes in the interest rate as they affect deposits.
4:25 pm
your comment about capital not capturing interest rate risk is only partially correct in that we do not have a standardized a asdoing it, but our rules far back as 15 years ago contemplate that should be measured in the sense of a capital adequacy. or recently, because of the environment, we issued an interest rate advisory two firms were expectations were in this very brown, how they should be adjusting and managing relatively low interest rate risk environments. with the understanding that rates would rise. we wanted our firms to not because off guard. outlined some of the expectations we have around changes in ages trades and how they could affect the capital, and
4:26 pm
their governments. --2010 them a we received that was received relatively well. in 2012, we put out a series of --to address principal concerns raised by banking organizations. in that guidance we went into more detail on the use of the the appropriate methodologies that one should consider in assessing the asset on capital, as well as the basic things, assumptions about net margin projections as well as multiples and interest income. from the overall standpoint, what we are devising firms and totructed our staff to do is continue to be diligent in pursuit of risk and insurance, but not come up with a quantitative adjustments as much. q are incorporating in our
4:27 pm
and a's basic assumptions about and what that would do to your portfolio. we have the basis for which we can move forward on this, and our firms are integrating that into the actresses. practices.-- it remains to be diligent as rates increase, to follow up with firms as they implement changes to strategy so we do not fall behind. the idea that interest rate risk management is not given as much attention, we are a little bit ahead of the curve in and is betting that. our guidance does address the concerns you are highlighting. >> thank you. >> thank you. >> thank you, mr. chairman.
4:28 pm
i, but the staff on bringing this forward for final consideration. ofave witnessed the process careful consideration of comments and lots of thought, thoughtful approach to the whole project, and i would say the final product seems to be an improved balance between implementing basel numeral three and improving and raising capital standards, in a way that avoids unnecessary regulatory burden. in particular, it seems to me this time for us as a reviewing comments and reacting to public thought has resulted in a better balance for smaller institutions that have less access and different business models. we have reflected their concerns in the final product. an area in which we have received a good deal of comment proposedgone ahead as
4:29 pm
is mortgage servicing assets, and i would ask on question. assets,gage servicing can you comment on the questions that we had and the comments and concerns that were expressed in our own glasses of them and decisions that we are seeing? proposal, we are maintaining the deductions of these efforts from capital. i think the rationale behind it is similar to our current rules, limitations on how many acids can be included in capital, and because of the intangible nature of these assets, there is concern of the ability for a bank to realize the value of these in times of stress. did preserve the proposal and we do still have strict limitations on the inclusion of mortgage servicing assets in the final rule. the idea is service will have a
4:30 pm
fair transition time in which to add just for this. there are a handful of firms that at concentrations, and will have to adjust their business models to address it. the thought is there is difficulty in realizing the value of these. thank you very much. what i would like to do now is ask for positions. issues, one is the broad capital proposal, the other technical amendments to the market risk cap old role, and after we hear positions, we will take two votes. let me start. vice-chair, can you hear us? >> can you hear me? >> yes. >> thank you. i support approval of the proposed final rule on standards and the proposed rulemaking are
4:31 pm
market risk. i would join others in thanking the staff and the banking supervision for bringing joint loan making to fruition. [indiscernible] as a majort basel 3 understandent, and i certain community banks around the country are concerned about complexity, regulatory burden, and the potential impact on the cost and availability of credit. the proposed of changes, the role we are looking at today shows appropriate sensitivity of these concerns. , this proposal raises the quantity and quality of capital ricardo banking organizations, large and small, and create the capital
4:32 pm
conservation buffers so supervisor can act to restrict capital by firms undergoing stress. as the governor noted, it toains an agenda of work ensure the safety, soundness, and solvability of the largest financial institutions. the crisis should the need for both capital requirements to safety and soundness requirements in the system. important toare this goal. we are told about the uncertainty of the rules of the road that govern their businesses. i hope the publication of this rule will serve to mitigate uncertainty. >> thank you. >> thank you. i support approval of both the items on our agenda.
4:33 pm
i believe strengthening requirements, including the addition of a capital equity requirement, is an important element of a stable system. due to capital conversation buffers, it is a prudent safeguard for banks approaching regular for a minimus. the approach included in this , combined with exercise, and additional comments mandated by dodd-frank create multidimensional approach to the adequacy of our largest institutions. at the same time, i think this capital role will prove to be workable for maintaining the capital strength and community banks tomorrow without unnecessary operational complexity or capital volatility. the time we took to review the comments we received and processed potential changes to the proposal that would be concerns areo prep
4:34 pm
different from those that were proposed. it is time to provide clarity so institutions can proceed further strategies. as i read through the lengthy federal register and i realized it is all too easy to discount the hours of hard work that it took to reach this outcome. i want to recognize the staff work that went into achieving such a balanced result. i wanted to thank governor tarul lo for his efforts. he has been determined to create a strong capital regime with appropriate incentives work risk management and safeguards for arbityrrage. him to spendred endless hours in discussion and negotiations with counterparts community,rnational other regulators, within his sport, and occasionally with me. the product of these negotiations r is a strongule
4:35 pm
that will promote resiliency and i am proud to support it. >> thank you. >> thank you. i want to say among the more productive hours i spent in this pursuit are the ones in governor duke's office. i support both of these rules. >> thank you. to -- i too want to voice my support. i want to commend the staff for their tireless work and bring this to fruition as well as the work of governor tarullo and the committee. >> thank you. >> i support both items. i wanted to add my thanks again not only to the staff, to governor tarullo who has been a force of vision and implementation on all of this.
4:36 pm
again, just offer my support. thank you. >> i support both items. thank you again to staff and governor tarullo. >> i support both items. these are important steps to making our banks safer, to more and higher-quality capital. i would like to thank the staff for their hard work. i would like to thank governor tarullo, but this was a board effort. i think it shows in the final product. this will represent an important international commitment that we are fulfilling which will trigger international monitoring and comparisons of the different regimes, which will strengthen the global financial system at the same time. we have been received lots of to domestic answers, concerns of small banks, and that is a delicate balance that we have managed reasonably well here.
4:37 pm
governor pointed out, the beginning or the framework in which more will be done to strengthen our largest and most internationally active x, including looking at the leverage ratios, capital surcharges, senior debts am a and holding companies liquidity, stress tests, so many components which will work together to ensure stronger banks. it isl comment is that good to have rolls out there in black and white, but ultimately the implementation by the banks, by the examiners him and by us here at the board will be critical. we will need to make sure the are safe and there are adequate safeguards to make sure they are adequately capturing risk. we will need to develop
4:38 pm
capability to assess risk as we were doing in the context of the stress tests. we will need to strengthen her supervision and our examination to adequately make use of this as themework, and governor mentioned, disclosures will be important so the public what the capital standards are, how they are applied to individual institutions. the have learned through our stress testing that effective disclosures is an important mechanism for increasing confidence in our banking system. i am pleased to support these measures. could i have a motion to pass the final regulatory capital proposal? >> moved. >> all in favor, please say aye. are there any nos? any extensions?
4:39 pm
thank you. i need a proposal for the risk capital rule? all in favor? any opposed? any extensions? both measures passed unanimously. worknk the board for their and participation. the meeting is adjourned. >> tonight we will speak with corporate leaders. one is brad smith. here's part of his testimony. in microsoft, we are grappling with a significant economic challenge. we are not able to fill all the jobs that we are creating. the story. tell
4:40 pm
at a time when unemployment hovers below eight percent, the rate in the computer and mathematical occupations has fallen to 3.2%, and in many states, in many subcategories, it has fallen below two percent. is likely to get worse rather than better. the bureau of ladenburg statistics has estimated this year the economy will create over 120,000 jobs, new jobs, that will require a bachelors degree in computer science. and yet we estimate that all of the colleges and universities in the country put together will only 51,474 ofar these degrees. that is why high-skilled immigration and this legislation is of such great importance. the bill you are considering
4:41 pm
does three important things. first, it addresses the green card shortage. very farates or goes to reduce the backlog, it eliminates the per-country cap, and creates a new green card category for advanced stem degrees, all things that are needed. second, in the h-1b area, the bill, quite rightly i believe, has improvements in the number of h one b's that are available, but for companies that changes to ensure that american workers are protected. it raises the wage floor for h- 1b employees. it improves portability so h-1b employees can switch employers. it addresses a number of other issues, and although we have some lingering questions about potential language and potential unintended consequences, we recognize that compromise is needed all around, and we hope
4:42 pm
to be able to work with this committee and its staff, as you go to the details. there is a third thing this bill does. --is of extreme extraordinary importance, and it creates a national stem education fund. such ason we have shortage of high-skilled labor is because we have systematically underinvested as a country in the education of of our own children. overder this -- there are 42,000 high schools in america, but this year the number certified to teach advanced placement course in computer science is only 2250. senator, we are grateful for the work that you and senator hatch has led, to create the i-squared opposable. for aates the model
4:43 pm
national stem education fund. this bill follows much of that model, but i hope you might raised it even further, the fees on visas, raise the fees on some green cards, and invest that money in the american people, so we can provide our own children is a great educational opportunity they will need to develop the skills we need to increase in an increasingly competitive world. as a company, iker soft spends more onmicrosoft spends research and development than any company in the world. and yet we spend 85% of that money in one country, this country, the united states. our industry has come to washington because we want keep jobs in america. america,o fill jobs in and we want to help create more jobs in america. we know in the short run we will
4:44 pm
need to bring more people from other countries to america, and we hope in the long run some of them will follow in the footsteps of the alexander outwardells and eight -- and albert einsteins. we think the country should seize the moment to invest in our own children as well. if we are going to do all of that, if we are going to do any of that, we need your help. thank you. onpart of what you will see tonight plus program. we want to hear from you, so call in or comment on facebook or twitter. it begins tonight at 8:00 eastern on c-span. fromg a transition journalism to books is
4:45 pm
exhilarating and overwhelming and frightening. but wonderful. choice because i had long wanted to be working on a book because of the freedom it allows you to dive into a topic and lose yourself and go off on tangents. >> sunday, mary roach will take your calls and facebook comments and tweets, sunday at noon on c-n on " book tv" span2. >> now a discussion about the recent court's most term. linda greenhouse is joined by a panel of legal scholars.
4:46 pm
>> good morning, ladies and gentlemen. it is a pleasure to introduce but the panel. probably the most storied panel to highlight a council to review the most ending of the supreme court term. it is a great tradition of our circuit him and it will be moderated by professor howard. one of the danger of doing's something for so long and also for professor howard to be doing so long for so well, is how much of a contribution he makes to this conference. i would like to highlight in terms of investor howard. he is the american scholar, one who knows that thought alone
4:47 pm
does not ripen into truth. he has been involved in bringing constitutional governments around the world, from eastern europe to southern africa to asia and south america. if i may make a personal note, and one that have professor howard to thank for, you are the chief architect of the constitution of the commonwealth of virginia. because of your work in your voice, we were able to amend those provisions of the 1902 constitution of disenfranchisement and those that held a lot of the wya back and help to the little boy to reach his way and find his way to the fourth circuit.
4:48 pm
professor howard, thank you for your great work in thank you for bringing this great panel. professor of law and public affairs at the university of regina school of law, prof. howard. [applause] >> good morning to all of you. i might say at the outset that you do not have to worry about the virginia constitution. we are just across the border. that does not have the jurisdiction here. our plan is to review the decisions or the highlights of the most recent term of the supreme court, a term that began last fall and has just concluded. we have a star-studded panel. we have as good a panel as we have had at this conference. i will introduce them quickly. first we have linda greenhouse. many of you know her from her years of covering the supreme
4:49 pm
court as correspondent for "the times." she is a lecturer in law at yale law school. second to her right we have allyson. she has clerked for judge wilkins of the fourth circuit and worked for justice david souter. she teaches law at the college of william and mary. she is one of the rising stars in the legal academy. third to her right is john, who teaches law at northwestern university law school. he is a prolific scholar. he writes books the way most of us write letters. he has two books coming out. one on technology and democracy and one on the originalism from the harvard university press. next we have ted olson. he served at one time as solicitor general of the united states.
4:50 pm
he has argued 60 cases before the supreme court including two cases of this current term. i am sure my fellow panelists will join me in thanking the chief judge and the judges from the fourth circuit who made us feel so much at home during this judicial conference. here we are at the eighth year of the roberts court. it is a courts we will be talking about only by way of snapshots from a few cases. it is always difficult to generalize. when can we say about the
4:51 pm
roberts court? what might we say about it based on what the judges have done in this recent term. several questions of the kind i suspect might be on your mind. the first is, how conservative is the court? some commentators characterize it in the conservative terms. some would say that it is the most conservative court we have had since the 1930's before the 1937 constitutional revolution. some would say that is something of a character and they point to liberal exceptions, cases such as the case decided this week, the defense of marriage case. most people would think this is a court that is somewhat to the rights of with the warren court was in the 1960's or even the burger and rehnquist courts. the second question is, what is the correlation between the positions of justices and the presidents who put them there? teddy roosevelt's disappointment in the justice holmes. president eisenhower's
4:52 pm
disappointment in earl warren and more recent examples, or like harry blackmun and david souter. i think we do not see that sort of pattern anymore. by and large, at least across the board, there is much more of the correlation between what presidents thought they were getting and how the justice actually performed. the third question has a ring of popular debate about it. can we hang the label of judicial activism on the roberts court? that would take time we do not have, to take a party meeting of judicial activism. it basically means you do not like what the court did. if you do not like what they did, they must be a bunch of activist judges. it is hard to get past that definition. sometimes, the roberts court has --haved as a minimalist score
4:53 pm
court years ago, when they decided the northwest and boston municipal case looking at the voting rights act of 1965 and avoiding a constitutional decision in that case. sometimes the roberts court uses uses avoidance techniques, such as standing in the proposition 8 case, sending that case back on standing grounds. in other cases, the court can strike back and be assertive. exhibits a -- exhibit a in that category could be the citizens united case. you fairly may debate the question of judicial activism. there is the question of the relationship between the court and congress and political bodies and legislative bodies. generally, one can fairly argue that this court is less deferential to congress and the
4:54 pm
political bodies than one thinks they ought to have been. last year, the health-care case, they weighed in and laid down with the majority of the court felt about the commerce clause, doctrines we have not seen in a long time.
4:55 pm
they also struck down section 5 of the voting rights act and the stock down doma. another question that interests the business community and the rest of us is, can you call the court pro-business? that is a lot of cases to look at. you could put them all together simply. if you were judging the court from the perspective of the united states chamber of commerce, they would have to be pretty happy with this court. they have been on the winning side of the last couple of terms in every case they have filed a brief period of the chamber is much more -- they have been on the winning side of the last couple of terms in every case they have filed a brief on. there are cases that seem to favor arbitration over litigation. there are cases in which the courts made it harder for plaintiffs to sue in the case of harmful drugs or workplace discrimination. there is a fair amount of evidence about which you might make some judgment about the court's view of business. is the court an ideologically divided court? we like to play the game of deciding labels on the conservative side. on the liberal side, that is always risky because it may suggest judges are like politicians. that is a felonious assumption. it helps us think about the
4:56 pm
court. in this particular term, almost 1/3 of the cases were divided 5- 4. most cases are decided that way, almost 25%. the four most conservative members are on one side and its most liberal members are on the on the other side arrayed against each other. that was the case this week in the shelby county decision that struck down the coverage formula of the voting rights act. there was a miranda case, an important self-incrimination case. there was a case that involved foreign surveillance, again 5-4. there is that pattern. there are significant divergences from that pattern. for example, unanimity. one tends to overlook how often -- 9-0.rt comes down 9-1.
4:57 pm
in this term, they were unanimous in just about half of the cases, including cases in melding -- involving warrantless dog sniffs on cars, cases involving farmers challenging market regulation. the proposition a case that came down this week, we found -- proposition 8 case that came down this week, we thought scalia joined justice roberts. we had thomas, alito, sotomayor, and kennedy in dissent.
4:58 pm
people always wonder about justice kennedy. what role does he play in the court? he has replaced justice o'connor as the justice in the middle. what role does he play in the court? there is no justice that is more often in the majority than justice kennedy. in this particular term, he was in the majority 80% of the time. in the three most important cases, those involving affirmative action and the voting rights act of 1965 and same-sex marriage, he was the only one in the majority in every one of those cases. some of his leadership has been pretty dramatic.
4:59 pm
we will long be parsing the doma case, the case we will be talking about this morning and what is justice kennedy up to there? those are some of the questions we might ask. i put them on the table as general thought as a way of giving perspective to our discussion of the roberts court. we have wonderful people lined up on our panel. we want to focus our discussion on a few cases. we make no pretense at being comprehensive. you cannot do that in a program like this. if we try to, very few of you would still be in the audience by the time we finished. it would be overwhelming. much better to take a few cases and try to air some thoughts we will pay particular attention to the marquee cases, the voting rights act of 1965, the shelby county case, the affirmative action case, and the pair of same-sex marriage cases, united states versus windsor.
5:00 pm
we will make time for a few other selected areas along with that. we want to start out with those particular cases. we have met and talked about it. we have parceled out our assignments.

44 Views

info Stream Only

Uploaded by TV Archive on