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tv   Key Capitol Hill Hearings  CSPAN  March 21, 2014 10:00am-10:31am EDT

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we will take you to that just a minute. biden -- vice president biden is speaking to the health centers association and that will be live at 10:15 a.m. weekend, 48ery hours on c-span twos and 48 hours on c-span three, booktv and american history tv. c-span2 and c-span3. ui for being with us. the speaker pro tempore: the house will be in order. the chair lays before the house a communication from the speaker. the clerk: the speaker's rooms, washington, d.c. march 21, 2014. i hereby appoint the honorable luke messer to act as speaker pro tempore on this day. signed, john a. boehner, speaker of the house of representatives.
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the speaker pro tempore: the prayer will be offered by our chaplain, father conroy. chaplain conroy: let us pray. gracious god, we give you thanks for giving us another day. you have blessed us with all good gifts and with thankful hearts we express our gratitude. as the hope of a delayed spring lifts the spirits of all working at the capitol, we ask your blessing upon those in our world facing difficult and uncertain futures, most especially in crimea and venezuela, as well as other chronically suffering communities. in this moment of prayer please grant to the members of this people's house as they meet with their respective constituents the gifts of wisdom and discernment, that in their words and actions they will do justice, love with mercy, and walk humbly with you. may all that is done this day
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be for your greater honor and glory, amen. the speaker pro tempore: pursuant to section 3-a of house resolution 515, the journal of the last day's proceedings is approved. please join me in the pledge of allegiance. i pledge allegiance to the flag of the united states of america and to the republic for which it stands, one nation under god, indivisible, with liberty and justice for all. the chair lays before the house a communication. the clerk: the honorable the speaker, house of representatives. sir, this is to notify you formally pursuant to rule 8 of the rules of the house of representatives that i have served -- been served with a subpoena issued by the commonwealth of pennsylvania, county of lucerne, for testimony in a criminal case. after consultation with the office of general counsel, i have determined that compliance with the subpoena is consistent
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with the precedents and privileges of the house. gned, sincerely, christa macadone, constituent co-worker. the speaker pro tempore: the chair lays before the house a communication. the clerk: the honorable the speaker, house of representatives. sir, on march 13, 2014, pursuant to section 3307 of title 40 united states code the committee on transportation and infrastructure met in open session to consider resolutions to authorize 14 prospect tuss, including three leases, 10 alteration projects, and one project design included in the general services administration's f.y. 2013 and f.y. 2014 capital investment and leasing programs. our committee continues to work to cut waste and the cost of federal property and leases. the lease resolutions approved by the committee will save the taxpayers $39 million over the terms of the leases.
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all alterations and design projects approved are within amounts appropriated in the consolidated appropriations act of 2014, and three of these projects will consolidate agencies out of lease space and into federally owned space, avoiding $6 million annually in lease payments. in addition, the committee has included space utilization requirements in each of these lease resolutions to ensure agencies are held to appropriate utilization rates. i have enclosed copies of the resolutions adopted by the committee on transportation and infrastructure on march 13, 2014. signed, sincerely, bill shuster, chairman. the speaker pro tempore: referred to the committee on appropriations. pursuant to section 3-b of house resolution 415, the house stands adjourned until noon on monday, march 24, 2014. for morning hour debate and 2:00 p.m. for legislative business.
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>> vice president joe biden is set to deliver the keynote address that should get under way within 10 minutes or so. we'll have it live. the president himself preparing for a trip next week to europe that will include the meeting on ukraine with the g-7 in the hague. this is the prime minister, the president of russia, putin signs the crimean peninsula into russia today. the vice president speaking here short-term. we'll have it live for you at the gathering of the community health centers. we talked about qualified
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federal health centers this morning on "washington journal." we'll show you some of that discussion until the vice president begins. host: located in washington, d.c., a few miles from the capitol building it self. vincent keen is the president and c.e.o. of unity health care. first of all, what is unity? >> guest: good morning, peter. unity community health center here in -- unity health care in washington, d.c., is a network of community health centers that provides health care social services, a whole array of supportive services to people who historically do not access health care on the mainstream. basically our commitment is to the underserved. to those who are marginalized, including the medicaid population, including the
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immigrant population, including those who may just simply not be able to identify with mainstream health care. unity is a federally qualified health center, and it enables people to get health care in their sights, in their local communities, and also addresses whatever their specific needs are. we serve about 100,000 patients a year. we have 1,000 employees, and we provide health care to the homeless population, to residents of the g.a.o. communities, within all eight wards of the city, as well as four school health centers. we are a large network, but there's over 1,000 similar type programs in the united states under the community health center banner. host: mr. keane, what's the official definition of a
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community health center? and you spoke of unity being a federally qualified health center. what does that mean? guest: well, the term federally qualified health center comes from the legislation, which really -- to fully understand you have to go back to 1965 when the concept of a community health center was first established. that was established by president johnson in his war on poverty. there was two health centers set up in very impoverished neighborhoods, one in mississippi, and then one in boston. and from those two health of them thousand basically have been replicated over the last 50 years. what defines a federally qualified health center is several things. one, that they must-- we must provide competitive health care services. -- comprehensive health care services. it's a whole ability to -- an ability to serve the whole
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patient. we must provide services regardless of the ability of the patient to pay. we must be opened to all comers. and if we do pay, you pay on a sliding fee scale. and then i guess -- a third and very important part of what constitutes a federally qualified health center is that you must actually have a governing board that is at least 51% of the consumers who use those services. this allows for community input. it's locally owned, locally governed by the community that we serve. host: mr. keane, where does your funding come from? guest: well, today our funding, and this is true of community health centers nationwide, we started off actually in the earlier days receiving federal funds. we still receive direct grants to provide care to the uninsured, to those who are at a
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certain level of poverty. but most health centers now, as well as getting their federal grants, they also use medicaid, they use medicare. a lot of health centers actually because of the need -- some people will pay based on their ability to pay. in the case of unity, we receive revenues from medicaid. the district has been very generous in medicaid coverage unlike several states. so we receive money from medicaid, just like any -- it's attached to the individual. we receive money from medicare. we receive money from the patients themselves. but we also receive several special grants. for instance, we provide health care services in the d.c. department of corrections, and that's based on a grant that we received from the district government. in the case of unity we also receive private money from
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foundations and individuals. in that sense we have a very broad-based funding support system. but i would say at this point with the expansion of medicaid through the affordable care act, medicaid is probably one of the largest sources of our revenue just now. host: does a community health center operate like a hospital? can it be used as a clinic? an emergency room, doctors office? guest: well, i would think the latter, peter. it's probably more akin to a doctor's office where in fact it was not a hospital. those of us who are experienced with the hospitals, that implies a longer stay. it is not an emergency room, although unity health care and several health centers throughout the united states, they offer urgent care and they offer urgent care from the
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perception of longer hours of service so that people can gain access, but it's not a hospital. it's not a minute clinic. it is akin to a doctor's office where you or i might go for physicals, a whole array of services. what is unique to community health centers, it's not just a one-on-one doctors visit. it is the patient is the focus of the service. and that patient may engage with their primary care provider which can be a nurse practitioner, doctor, or physician assistant. they also engage with a nurse. they also engage, many of them, because of the complexity of their illnesses, will need what we call case management and care management. and the focus under the affordable care act today is what we call patient centered medical home. where the patient literally is at the center of his and her care. and that patient also is
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educated to take responsibility for their health care. that's more than just a doctor visit. a doctor is critical to that, but he or she has a team that surrounds them in providing that care which doesn't -- it actually starts before the patient comes in, and it continues after the patient leaves the office because there's follow-ups, might be referrals to consultants, and in some cases to doctors, to hospitals for procedures. so it is primary care focused. in other words, preventing illnesses, preventing folks from going into the hospital, but being able to recognize when they need such care that we have access to get them in there. host: we are going to put the numbers up on the screen for the rest of this morning's "washington journal," we'll be live from unity community health center in washington. >> ladies and gentlemen, the vice president of the united states, joe biden.
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>> good morning. can you feel the excitement in the room? we are so proud today to have with us the vice president of the united states. this is our opportunity to publicly express our gratitude to vice president joe biden and to president barack obama for believing in our community health centers and for moving
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forward with the promise of accessible and affordable health care to millions of americans. as you know the vice president's just back from a mission to europe where he met with leaders from poland anti-balkans -- and the balkans about the crisis we are having in the ukraine. from a personal perspective we want to make sure that he knows how much that we appreciate his eing here. [applause] >> community health centers love joe biden. [applause] >> throughout his public life, including 36 years in the united states senate, he has truly been
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a man of the people. a fierce fighter whose work has advanced the ideals and principles upon which this great nation was founded. he is a leader who has stood shoulder to shoulder with us in the fight to expand health care access and sustain a strong safety net in our nation. oe biden knows health centers. he knows what they mean to our communities and the people that we serve. and from a personal experience, he also knows that tragedies and hardships that often befall families through no fault of their own. and he has stood up for the working poor, the frail and elderly, and most vulnerable this this nation. he clearly understands and is a huge advocate for the expansion of behavioral health services in this country. [applause] >> like all of us he believes
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that government as more responsibility to lift barriers, particularly for those in need and provide the opportunities for health, education, jobs, and the chance for a better life in this nation. he also knows government can't do it alone. it's up to all of us, all of us in the room and those in the greater nation to ensure that we live up to the highest ideals this country represents. vice president biden exemplifies the true meaning of a public servant. and he serves for the greater food. so please join me in giving a warm, warm welcome for a great american and a champion of america's health centers, our vice president, the honorable joe biden. [applause] >> thank you very much, doctor. thank you.
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we got this backwards. i came to thank you. thank you very much, folks. it's a great honor to be with you. please, please, let me begin by apologizing, my voice. i just got back as the doctor says, been traveling around the world a lot, and apparently i acquired a sinus infection. so my doc told me i couldn't do an event last night in new york, which i felt badly about. i said how about this morning? i said, hell, there's 1,000 doctors there. i'm fine. there's nothing wrong with that. if you guys can put up with my voice, i'm sure glad to be here with you. thank you again. look, i mean this from the bottom of my heart. you are the blood and the sinew, you are the moral backbone of this country. you and so many thousands of people like you who just believe in possibilities and believe that it's one person at a time. you help one person at a time.
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and so my admiration for you is ually as deeply held by -- stop moving -- what's this thing called? teleprompter. barack kids me, he said, joe biden, i'm learning to speak without a teleprompter. joe is learning to speak with one. seeing all of you i really mean it. the reason i'm here and barack wanted me to be here is to thank you. thank you so, so much for what you have done. not for us, but for the american people. so many millions of people, vulnerable. so many millions of people knowing what they need and having no access to get it. first off, the president and i think you provided an incredible service that you provide to this contry. nothing to do with the a.c.a. just what you have been doing. it's an incredible service you
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have been providing. you have more than 1,200 community health centers, and 9,000 sites. all 50 states. here's what i want you to think about. think about what those cities, what those communities, what those neighborhoods would be like if you hadn't been around. i mean it. think of how fundamentally the lives of those communities would be changed without you. those community centers you run, 150,000 hardworking men and with t. feels like that all of you today, 21 million patients, 21 million patients rely on you-all. more than 3.7 million, about 18% of your patients are children. for them and their families,
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you're the first place they go for primary care. you're the first time they have probably ever seen a dentist is because of you. the first time they have ever seen behave yorble health services, maybe when they walkthrough your doors and benefit from your care and expertise. emphasize care. without you the country would be a very different place. that's not hyperbole. without you the country would be a very different place. the thing i love about you all, i don't know you, but i spent a lot of time in the community, the thing i love about you all is in face of all that you see, you remain optimistic. i mean it. it matters. it matters. you believe in possibilities. you're always looking about what can be better. why can't we get this, that, or the other thing done? great things happen when people believe. i have to admit the doc's right.
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i served -- every time someone says i serve in the senate 36 years, i bless myself. can't be that hold. during my career, as a lot of you know we senators and congressmen, we are called case worningse. i had probably more caseworkers than most in one of the smallest states. i allocated more of my staff's salaries to people who are the people around the phone going into somebody's home trying to help them with things that matert. mattered in their life. i was blessed with so many competent caseworkers who not only believed but were determined, were determined to take care of people. one family, one person at a time. that's not some global thing we do. any of you have daughters that are grown, raise your hand. i always kid -- i
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have four granddaughters, and i kid -- i adore my daughter, i always kid them and say granddaughters are better than daughters. they go what? think about this. all you guys who have grown daughters. one night when they are about 12 1/2 years old, you tuck this beautiful little butterfly in bed. and the next morning you walk in here's a snake in the bed. dad, don't cheer so loud at my games. dad, don't kiss me in front of everybody. dad, johnny's really a good guy, i promise you that. all you women -- you-all come back to your dad somewhere between age 20 and 24. in my case it was 24. but i've got this magnificent daughter who is -- who's bitten with the bug that she can be the agent of change that she wants to see happen. she's -- all of my kids, all
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went into public service. i wonder how that happened? now they put me in a home i'll have no window with a view. one of them should have gone out and made a lot of money. my married daughter who lives in philadelphia but works in wilmington, delaware, runs a not-for-profit for at-risk kids. those being let out of the prison system trying to work their way back in. and she is like all of you. she really believes, she really believes that things can be made better. think of what it's like, it would be like if we didn't have all you guys. i'm getting too maudlin about how much i appreciate what you're doing, but i mean it. this country's always been the defining feature of this country has been about possibilities. we have always believed that anything's possible. and the kind of work you have done has -- reflects that belief. i have been traveling around the
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country a lot lately. i have been traveling around the country constantly, actually. what i have done since the affordable care act is every community i go into i ask to meet with the advocates. i meet at the diners and coffee shops. a lot come from your ranks. and i met with moms and daughters. i met with seniors and students. i met with small businesspeople, guys that run the diners. during those visits in those coffee shops, i have gotten pretty clear picture of why i'm convinced this -- the affordable care act is going to work. in miami, i met with a registered nurse and a couple of enrollment counselors from alogical health center, were 9 -- local health center, where 95% of their clients live at or below the poverty line making $12,000 to $20,000 a year. they said they never thought, they never thought they'd ever be able to afford health care.
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and the enrollers never have been more rewarded, they say, than watching the look on a mother or father's face or a young person's face when you say, you're covered. you're ok. you can afford this. how many stories have heard and you have experienced where clients walking out of the health care center crying with joy that they never, ever thought this could happen. but since december that particular center has enrolled dozens of people a day. and their clients, as i said, just never thought this could happen. one of the things we underestimate most, one of the things we underestimate the most to me, any way, is not, i think, the affordable care act, the single most incredible gift is giving to people. is giving to them a sense, a sense that -- it's lifted a weight off their shoulders about
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-- it's given peace of mind. like nothing else could for them. how many of your clients do you know go to bed at night staring at the ceiling wondering if god forbid they lean over and look at their wife, and she gets breast cancer what happens? or what happens when my children get sick? am i going to be able to sleep in this house the next night? after this happens? am i going to be able to afford to be here? am i going to lose my home? am i going to lose my sense of well-being? and i think the single biggest thing we do is we give people peace of mind. you give them peace of mind. i hear that more than anything else. in phoenix i met with community health center workers who were once in the shoes of their linets. -- clients. denied or dumped out of coverage because of pre-existing conditions and they reached a lifetime cap and they personally know what it felt like to live paycheck to paycheck and put the
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health of their families ahead of their own health. they told me, numerous examples, you-all 2340e, helping people enroll -- you-all know, helping people enroll at the certainty is one of the most rewarding things they have done in their careers. they tell me nothing beats seeing the relief on people's face when they can finally afford coverage from theirselves and their families, maybe for the first time sleep easey. as i said it's what i love about you-all is you not only believe in possibilities, you -- these stories i have heard from scranton to atlanta to minneapolis across the country, another reason why you're in it, a reason why you do what do you. the thing that bothers me, anybody ever thought this is going to be easy never had insurance. seriously. sure you're a very wealthy person, you can buy whatever
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insurance you want. it's a complicated business. it's a complicated business. it doesn't matter whether you have a g.e.d. or ph.d., when you get that -- how many people do you know who have nothing to do with affordable health they come to you because they know you know something and say, i just got this thing about open enrollment. what do i pick? what do i do? and so it's difficult for people who have been able to have an afforded health care their whole adult lives, why do we think it would not be difficult for people who never, ever, ever had insurance? look, it's complicated. so we shouldn't be surprised that it's complicated for people who never thought they would be able to have insurance. no matter how good the bargain is, folks looking at it for the first time, but that's why they
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are so vulnerable. with patients and empathy you look these people in the eye. the first thing you do you calm them down. the first thing you do is how many people have you spoken to question mark you can tell by the look in their face that they are almost embarrassed to ask you questions. they do not want to feel stupid. that is why they trust you. you dispel their fears. you put them at ease. you walk them through the process. it is tedious. to add to the difficulty, we did not help you in the front end. my boss, my friend, barack obama is an incredibly patient man.


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