tv Key Capitol Hill Hearings CSPAN February 24, 2016 2:00am-7:01am EST
a member healthier based on what they cost. if such an approach encourages the utilization of high value care and discurges only low value services, these tri-care plans can improve health and enhance consumer responsibility and reduce cost. i'm honored to support the men and women of the u.s. military and their families and am happy to provide the committee further assistance. thank you very much. >> i hope that my participation in today's hearing will be of assistance to you and the defense department as you seek to insure that the military health system is strengthened and is able to continue to provide optimal support to those who wear the cloth of this
nation, their families and those who earned a retirement benefit due to their career of service. i believe any framework for reform needs to begin with an assessment of what's working and not working, what the environmental conditions are likely to look like in the future including the go to work the capabilities and needs and what approach will likely insure success in the future. for my nearly 20 years of privileged service at the side of d.o.d. and now v.a. i believe there are four fundamental questions worthy of explosions. first, does dodd have the most effective efficient management structure and tools to deliver on the needs? and is the investment in the direct care system being optimized? there's a great deal of experience inherent in the footprint and the personnel required to establish the foot
print. there's great efficiency to be gained when sizing a system, hen making -- make vs. buy decisions and croort cooperating appropriately and leasing -- when the leasing is broached. i believe the analytics tools need to be maximized especially age.is day and there has been much written on this topic. it would seep that -- seem that there's an opportunity to achieve savings just as has been done in the evolution in which the medical community now supports the war fighter in theater. while not easy, streamlining the number of players and consolidating functions will make the organizations more agile and fiscally efficient. second, does the benefit
available to the population make sense and is it priced properly? the individual that testified just before me spoke eloquently of one component park that ought to be considered. the tri-care benefit has evolved greatly in the last 20 years. having said that one challenge that remain as constant is what to do with the pricing structure which was previously addressed. i believe part of that needs to include indexing. one of the challenges with programs in are developed is that we fail to index them and i hink a simple index would be worthy of consideration. third, is access to care easy? and what is the optimal approach to providing the direct care system with the needed elasticity to insure that access to quality providers is available than to meet the needs that the direct system cannot meet itself. my understanding is an
electronic authorization system that allows work flow to efficiently and effectively move between the direct system and the providers still does not exist. i would say that needs to be remedied. and it needs be grounded in processs that effective and efficient that include supporting how to make sure that appointments work effectively and accurately. lastly, the networks built by those that support the dodd as contractors need to be supported to meet the neetsdz of those in the community. one size does not fit all. those networks should be priced at market rate. and fourth are we promoting health and efficiently supporting those who's unmanaged decisions are bad for the individual and presenting an avoidable expense. it starts with effectively
supporting the patient. if done right, it also results in cost avoidance. so the two go hand in hand. segmenting the population and focusing in on those who benefit most from assistance in the management of their conditions is just smart. and annually reviewing the analysis of the population's health is critical to doing this right. developing and deploig an integrated approach to disease management for that specific provide of conditions is also critical. something that we tried in tri-care when i was doing it. and we failed to focus in on the right spaces where opportunity exists. you want the treatment to be coordinate and well managed regardless of where the care is delivered whether it's in the direct system or in the community there should then be the development of a treatment plan for the individual patient and the modification of the
design of the tri-care program to provide incentives and disincentives with compliance with that treatment plan. lastly the models that appropriately reward providers for quality outcomes and reduce and overall spend need to be adopt as they're the key partner in o delivering care, i would suggest doing pilots to continue to test this but then deploig it effectively and quickly is important. senator giilibrand i would like to draw your attention to one propotype that i was part of one one of the next panel's participants. the first lady in that conway who is a special educator, we had the privilege then captain faison and myself now the navy surgeon general ho prototype how to put a special needs service together to serve the families at camp pendleton. and i believe, sir, that they
worked extremely effectively. there's some clues from a while ago and there are clues from a current pilot that could be rolled up and made vainl as you map the final policy. i want to thank you for the invitation to appear before you today. it was an honor and a privilege for my colleagues and i and our nonprofit owners to be of service to the beneficiaries of the milliontary health system at the sight of the ladies and gentlemen who wear the cloth of the nation that is work we will not return to because we have the awesome privilege of leaning forward in the sight of the v.a. in the current furnace and that's where we stayed focus. i hope that my testimony has been helpful to you as you contemplate the future as you continue to refine the military healthcare system and i look forward to answering any uestions you might have.
>> the military medical community is a dedicated force trying to provide beneficiaries as a high quality benefit and maintain their ready nbc the battlefield. this community works within the milliontary health system it often fails to encourages these outcomes. i commend the congress for addressing these challenges. i make three primary points which i'll summarize briefly. first, tri-care reform is not mply raising beneficiary ealthcare. it should be about replaying a system of five-year, winner take all largely fee for service contracts with a modernized system that provides -- that improves the equal of the benefit for our families and
retirees while saving the taxpayer money. second, tri-care reform has increased focus to the healthcare system in particular on how to maintain the capable built during the wars. as the commission reported "research reveals a long hist referee: the medical community needing to refocus these capabilities after concentrating on peacetime in beneficiary healthcare." g.a.o. was reporting that "since most military treatment facilities provide healthcare to active duty personnel and beneficiaries and do not receive patient patients they cannot maintain combat skills by working in these facilities." although there are a lot of improvements made during the war, military physicians are still reporting. today the service that the physician was referring to has less than 300 special lists.
they are -- specialists. this is largely because the allocations are based on traditional peacetime needs refocusing wartime needs could repopulation it with a critical mass of trauma specialist and drive further advances in battle time care." this brings me to my third point. tri-care reform san opportunity to reform the entire military healthcare system. it is a set of missions delivery systems benefits and benn funding streams. it involves layers and fails unification on the key outcomes of readiness and cost control. a prime example of these problems is the military hospital network. it includes over 50 incare patient hospitals and 300 inpatient clinics.
the purpose is to provide the clinical skill paint innocence for the medical force. but the day-to-day workload at these hospitals are focused on beneficiary healthcare. i show in my written statement how different it is from the deployed and patient workload. this puts military hospital commanders in an almost impossible situation and it creates a climate of confusion within the m.h.s. and affects everything. these military hospitals are expensive and key driver of healthcare costs within the dodd. -- d.o.d. it is driven by a lack of transparency and funding. line service leadership and the secretary defense in congress cannot identify how much is and on ben fish area care ready -- beneficiary care and readiness. i offered challenges and i would
be happy to elaborate on them. i would like to commend you for taking on these issues and for including me in this conversation. >> thank you all. i'll lead this off and i want to thank my colleagues for attending. i'm going to make a general statement and see if you agree wit. the battlefield medical care provided in the last 14 years has produced outcomes historic in terms of warfare. does anybody disagree with that? the answer is you all agree? nod your head. so let's make sure we don't break the one thing that is working. now, mr. whitley, you said that military hospitals are skewed toward basically family care and not battlefield medicine readiness. well, how do you explain that in light of my first statement?
>> so it's a very sensitive issue. and i want to be very careful in how i describe it. you said that the survivalal tes have reached -- survival rates have reached great heights and that's a great testament. what i would caution is using all of that as a measure of success of the clinical currency of the medical force prior to deployment particularly at the start of the wars in 2001, 2002 and three. that measure of the overall survival rate was contributed by many rates. we organized the war differently. we moved patiently differently and we had some of the best men and women that we could have ever possibly had that measure is the cumulative effect of all those things. what we're asking here when we talk about the medical hospitals, we have to go down to more specific measures.
they get at the question of -- >> here's my concern if you're a uniformed doctor or nurse, you can be deployed, tri-care network physicians are not going to be deployed. what i want to make sure is in trying to fix a system that i think is very much in need of repair that we don't destroy the one thing that seems to work very well. i want to look at your reform measures but i want to do anything that dwow in the military hospitals enhances the battlefield medicine. if we need that footprint even though it isn't the most efficient beas these doctors will go to the battlefield themselves and they're going to practice in an environment where they can be shot at. so let's not miss that boat. doctors, when you look at tri-care for families for the retirement community and family members and active duty members, how antiquated would you say it
is? from an a to f rating? >> well, that's a difficult question. i would say -- >> that's why i ask it. >> i would say that i have seen aspects or observed from the outside aspects that -- >> what grade would you give it overall? >> on an antiquated basis? i would give it a b. >> so we're starting a b. >> i would say b-plus actually. i would say b-plus actually. >> dr. mcintyre? >> i would say somewhere in rms of a b-minus in terms of keeping where we need to be. >> dr. whitley? >> i'll be the odd man out. i'll give it a c. >> what's the 30-second answer to get us to a? >> i think that the military health system needs to do a better job of measuring its actual performance and trying to
compare itself to internal and external benchmarks and to work continuously to improve that care. >> doctor? >> i would pay provider mrs for providing the service that makes military providers and make it more easy for those members to do that. >> mr. mcintyre? >> i would insure that providers getting paid for their performance and their quality. number two, i would make the patient in part responsible for their care from an incentive and disinsenity perspective. third, i would index the benefit so that it keeps pace with inflation. and fourth, i would focus on the question of alignment of the providers that are in the direct care system with the providers that are downtown. nals terms of requirements but also what their focus is as a patient.
>> dr. whitley? >> i would focus with respect to the tri-care contracts. increasing greater competition, having annual contracters with multiple winners per location. i would focus on making those risk-bearing and increasing the flexibility to the contractor to manage care. >> could you provide in a three or four-page report to the committee how you go from c to a and b plus to a? be specific. brand. gilli >> our country has a shortage of mental health providers. what do you see as the solutions to this problem and mr. mcintyre specifically how does tri-west insure that mental care providers has the experience they need? and does tri-care require this type of experience? >> so i'll start.
>> we no longer do the work in tri-care. which is why we're here because thatn't have a conflict in regard. it was mapped closed to a military installation but also those in the garden reserve. what we currently do is relevant to that topic and that is we're doing exactly the same thing. and we're looking at the zip codes as to where people live. we're looking at what the direct care system actually has in the way of footprint which is applicable to the d.o.d. and we're going back to train the mental health providers and the primary care providers which is how do you recognize where threat is? how do you be relevant and where do you turn people to if they're in distress?
others? i would say that if we were serious about changing our conversation, we would see a serious investment in infra structure for mental health and send providers and patients to do those evidence-based services. >> what infra structures would you make? >> the problem is na most medical services are not producing a lot of health for the money you spend. as long as you continue to allow a fee for service payment system, they'll go to those services that produce lots of revenue and they'll never been measured on the health produced. i think if we again, go get this point and say i'll m i'm going to pay a lot of money but insists that it goes to services and providers whether it be mental health, op yoid abuse or other things that are away from the standard orthopedic surgery.
you have enough money there. it just takes the courage to make the shift that would be going upstream against some interests they may not want that to happen. >> i would add that integrating mental healthcare into primary care is actually important. i don't mean that mental hale care is pro vied solely by primary hale physician but breaking down the barriers and sharing information about atients with bhavel -- behavioral hale issues are important. they're not aware of those issues. we cannot bring to bear all of the power of the entire multispecialty power that we have in front of us to the kir of those mental health patients. >> i have nothing to add to that
>> another major concern is the care for service members special needs dependence which i mentioned in my opening. military families move frequently. and that means to different service provision. from the private sector experience how you do ensure ha the continuity of needs continue whenever they move? how does tri-west handle provisions of this service? >> i think that's a fundamental question. and the thing that captain faison and myself learn at the time through the lens of the marine corps is you need to come to understand what the needs are and you need to pay attention to them and meet them while they're in your midst. and then you need to prepare and plan for their change geographically. so that if they move from place to place you're thinking about them not only moving forward but to see them on the other side. the same thing applies to those
that are injured and those who have mental health needs. as they move within the system and the military and as they also move between the military and the v.a. last thing i'd sigh if i can go back to a second to the mental health piece that you raised previously. very few providers are trained in evidence based therapies. and we have a network of 25,000 mental health providers now built across 28 states. and we're in the process of looking at that issue market by market. we're doing a test in phoenix. actually this weekend we're doing something today with the private community as well as those who served in the federal space. the bottom line is, it is possible to go through and do that training. are in xpertise of it the d.o.d. spaces and the military. we need to narrow in on the
populations that need services. how many there are. what types of e.b.t.'s you need and to make the investments to actually insure that they're trained. we're going to be testing that in the chairman's hometown of phoenix, arizona starting this weekend. >> and with that, senator mccain? >> dr. whitley, i am very interested in your recommendations. m.t.f. management layers should be reduced. are you talking about one service? >> i think there are many options to do that. one thoopings others have talked about is consolidating the military hospitalization and the existing defense health agency. another would be another single service. i think there are many options the way you should get there, senator. >> would you do me a favor and send that to me in writing? >> be very happy, sir.
>> you also say that they should be managed. does that mean you contract out to a manage group? >> i think that's's an option on the table and used in appropriate situations, senator. >> does that mean like in a ilot sflam -- program? would you recommend a pilot bram e contracted out a nonmilitary organization to conduct some of these functioning? >> i would add senator -- i think that would be an option to consider i would add that there are -- that there are outpatient clinics that are openered like that today in the outpatient systems. >> how's that working? >> my understanding is that the beneficiaries that use them are very happy. the next panel can talk about the experience from a management perspective.
>> this is pretty much along the same line of what we're talking about. >> yes, senator. the best way to -- to motivate people to inprove is to -- is to make sure that they know they're ot the only game town. >> so how do you do that? same way? pilot program? >> yes, sir. you could take specific markets and you could allow beneficiaries to choose among plans or choose between venues from where they're going to receive their care. it would be interesting to see what happens in those pilots. it it would be interesting to ow what happens to cost in >> >> who would be the option? >> i'm sorry, senator. >> you said there would be options. what would the options be? does that mean a private
provider or insurer? >> all of the above. so they could decide where to go for their primary care. that would be a primary care practice. yes, senator. >> m.t.f. can't succeed and their mission has to be downsized or closed. >> the director of systems is half the size of what it was 25 years ago. when was -- it's about half the size. 55, 56, ballpark bedded facilities. and we were close to 100 probably 1020 years ago, senator. our folks coming in the second panel would have the numbers better than i would. >> so to some degree i think what you're talk about is competition? >> yes, senator. >> and right now there is none? >> there is some. nd it manifests in different
ways. it can be an effective tool for managing cost control in this system. >> i wonder if we ought to look at some of these recommendations as at least as pilot programs as a beginning. finally, do you think we should have one service medical corps or should we maintain three or four separate ones? >> i have to apologize -- senator, i was going to comment on that. i want to take a stand on competition. i never studied the joint question. so i have to pun on that one, senator. have a medical staff? >> yes, sir, i do >> i thank you, mr. chairman. >> senator? >> thank you plch, thank you all for being here. dock, to i want to ask you a
question, you and your testimony both what's written before the committee talked about insurance design and value base. that's something i got involved with in north carolina as a matter of public policy when i was speaker. i want to see -- i want to see a little bit more about that and how you think maybe state health plans that have done it to the extent that you can and any member of the panel have benefited from it. and if you could may not be relatesed. but in the briefing materials. -- one thing that jumps out at me and i would be interesting in this are the medical health system afternoon annual patient discharge per 1,000 are some 61.7 for enrollees in the medical health plans. and about 36 -- i mean, there seems be a really big gap. looking out they're
for the gap would be so great? >> first part of the question in what' going on. maybe my fellow panelists might chime in. so first off, i think you pointed out that the program had reduced national barriers to high value services and providerings. in many of the states respect bd this panel, i think it's important to point out that in the stitt of south carolina the medicaid program has produced cost-sharing. and as the senator pointed is very norntpire the state innovation $100 mm grant model. it's highed and is a very important part of the business sector. you pointed out and we're very proud of the fact that v-bid
plans are now offered to state employees in 13 states including north carolina. and one voluntary v-bid plan was taken up by we saw increases in preventive screenings. we saw delineated consumer satisfaction. we see emergency room visits declined. i don't have information on hospitalizations. they tend to occur in a compressed portion of the population. pleasedwhy we were so a see bipartisan support for v-bid program. long-term, wehe will see modest impacts on er
visits and hospitalizations, but more importantly, you will be able to tell your constituents and the american taxpayers that the american health care financial situation is moving not to thing that make people moneys, but are finally moving in a very systemic way to services that make them healthier. agree that providing incentives and direction for value-based incentives is the right ring to be doing. ght thing ot beto be doing. not all in the care is provided in one domain. the chairman of the committee is not here at this juncture, but the air force one through a pretty massive process back at the beginning of tricare, about
20 years ago. they did an amazing job of re-footprinting its installations. focus onnk soemme the sizing and structure, and what do you actually have to supplement it with to give elasticity from a provider perspective? and what types of providers do you want? and if you are going to have an integrated delivery system in the private sector, how do you plug that in? some of those delivery systems, their models need to take care of the entire patient, not part of the patient's needs. i would also offer that some of the prototypes that have been done over the last 20 years are worthy of exploration and assessment. and there may be new prototypes that need to be done, but i think there is a lot that has been tested. and figuring out what its application might look like to thatp making changes,
would be smart. i am particularly intrigued with the notion that you take the defense department for a population it has need for, and a, and in ehe v the same community we are melding these together. there are programs that do this in different ways in different markets. the chicago approach threads it all together. then, you could go out to new mexico. there was a prototype. it took a small community hospital in an air force location and actually tookt h te airman and put them in that hospital. they took the va folks and put them in that hospital.
and then, the private sector was stool.rd leg of the the incentives in communities that are smaller are on their own. they should not be doing everything themselves. e think you might find ther is a lot of fodder there already to step back and say, what do we have missing in models? and how do we footprint forward with the right kind of the requirements before they start doing design and construction? >> thank you, mr. mcintyre. that was a great model. i am out of time, but part of what i was going to lead to is what a high-performing health care system like kaiser permanente -- how it can play into that system. i think that is a model we have to look at and develop.
i do believe that helps us. it is a very important topic and a way to target a lot of the needs in certain areas of the country. the only comment i wanted to make was something i could bring up in the next panel. there was one more thing i wanted to get on the record. i think this is something you may have looked at as well. the aba treatment for persons with autism and the proposed rate cut is something i am concerned with, the timing of it. committee, in this for my discussions with panelists outside of this committee, that we can go back and be more methodical. i think we are making a mistake, potentially cutting treatment options below the national average. proven to be highly effective for those who take advantage of the treatment. thank you. >> thank you, all. next panel, please. >> tom?
>> i am going to have to run to another subcommittee hearing. i will be back as quickly as i can, but let's get started with miss woodson. >> chairman, members of the committee, thank you for placing the issue of military health system reform high on your agenda. the military health system takes great pride in its performance over the last 14 years. we have 95% survival rates for those wounded in battle. our ability to prevent disease preventative medicine services has produced italy historic outcomes in disease and battle injuries. the challenges we face continue to evolve and require new approaches. we have undertaken a number of initiatives to strengthen the military health system in all facets of its responsibilities.
they have been organized around six principal lines of effort, which we have spoken about in previous testimony. i therefore, am encouraged that last year's military compensation commission reviewed and supported many of the initiatives we have already set in motion in the department. let me briefly describe these efforts. first, we have modernized our management systems with an enterprise focus. an agency.ablished agency is entrusted with providing common business and thatproach ensures joint solutions to our customers. we ended a five multiservice markets and developed five-year business plans to promote common solutions and optimize the use of military treatment facilities, while providing required care to beneficiaries. in addition, we acquired and are now preparing to deploy a new electronic health record using
commercial off the shelf products. together with the surgeons general we have established an enterprise wide dashboard to measure our access to care, patient satisfaction, and cost. the agency achieves the inestone on october 2015 and its first couple years, saved over $700 million. we are defining and developing medical capabilities needed any 21st century. with the services this apartment has embarked upon, we provide metrics to monitor readiness. third, as a result of the modernize asian study, we have analyzed infrastructure needs, towell as made adjustments medical personnel markets. is perhaps the main
focus of the discussion today, and that is our plan for reforming tricare. we are appreciative of the input that in recent testimony have expressed support for tricare. tricare benefit was named as the number one health care for customers in the country in 2015, owing in no small part the comprehensive coverage. and by the way, we jockeyed for the position in 2011 with kaiser permanente. we also have heard loud and clear from our beneficiaries. re needty ca special attention. we have implemented a number of initiatives last year to open up more appointments, result apartment issues on the first call, we are improving access to after our care, weather that is through evening or weekend clinics, the ability to e-mail providers, the availability of
24/7 nurse advice line integrated with our appointment system, streamlining the referral process and implementing an urgent cared program that congress requested last year. our contract will be awarded in 2016 and includes provisions that further improve the experience of care for our beneficiaries. 7 proposal incorporates feedback from our stakeholder groups. the fifth one of effort has been to ask and strategic partnerships with civilian health organizations to enhance meet and exceed our responsibilities in readiness, quality, safety, and satisfaction. with of the institute for health care improvement are providing tangible benefits that offer us ways to sustain our trauma system and improve clinical quality and achieve our goals. sixth line of
effort is focused on global health engagement, where the department is deeply engaged in national security threats posed by infectious diseases and building bridges through health care around the world. we have contributed to the surveillance, prevention, diagnosis, and treatment strategies to combat well known outbreaks to include eobla, and now zika. confident that the reforms and the military health system and the health benefit can be further strengthened through a combination of legislative and operational reforms. i am grateful for this opportunity to be here today and it look forward to your questions. -- and i look forward to your questions. >> chairman graham, thank you for the opportunity to appear here today. i am pleased to explain how the contributig.
the a month earlier, agency had reached full operation capability. our responsibility center on supporting the combatant commanders. the defense held agency was created in recognition that mold health care delivery is common across the army, navy and air force. y, whatneed, what we bu a best practice entails in both clinical and administrative environments. the defense health agency helps bring together, and support functions into a new, enterprise focused organizational structure. we are able to help dr. whitson and the surgeons general see and manage across the nhs in a
more unified way. one of the principle ways in which we deliver support is through the operation services. critical enterprise activities include tricare, pharmacy operations, health information technology, medical logistics, public health, medical r&d, education and training, health facilities, contracting, and budget resources and management. in addition to the services that have been implemented, the dha has also brought in joint activities that had previously been distributed to the services that acted as executive agencies. these include the armed forces health surveillance center, the armed forces medical examiner system, the medical examination review board, the fence center of excellence for psychological health and traumatic brain injury, and the national museum of health annd medicine. the dha offers value.
we serve as a single point of contact for many intra-agency and external industry matters. the simple fight the process for our partners and outside colleagues to work with the department of defense in support of a number of imperatives, such as research, global health engagement, adoption with emerging technologies, health care,an and more. has aistence of the dha streamlined engagement with field agencies. external to the department, the dha provides a single point of contact for operational matters within the va, a number of agencies within dhs, the food and drug administration, the center for disease control and prevention, public health service, and more. we have successfully collaborated with the justice department on the prosecution of
health care fraud cases. most recently, with highly suspected activities around compat medications. we work with treasury, state, and the gsa on a number of critical functions. i would like to focus on one shared service in particular, the operation of tricare, the military's health plan. that is part of the mhs modernization plan that dr. woodson just outlined. we have a number of tricare initiatives already underway in 2016. later this year, we will award the next year of tricare contracts. that is one health care will become operational under the new contract. we are simplifying the contract, reducing management overhead in both government and contractor headquarters in moving from three regions to two. byare expanding the need which we manage the quality of our networks to make sure they've meet the expectations for quality and safety we expect
for our beneficiaries, weather in the direct system -- whether in the direct system, or an outside network. crafting thelso to permitmendments tricare enrollees to use urgent care centers. we provide medical leadership at the headquarters and field level with the ability to assess performance using agreed-upon joint measures for readiness, health, safety, satisfaction, and cost. the dha is now an integrated part of the military health system. we are proud to contribute to the modernization of this system and a joint collaborative solution. represent theo men and women of the defense
health agency and a look forward to answering any questions you might have. >> chairman graham, ranking member, and distinguished members of the subcommittee, thank you for this opportunity to provide perspective on defense health care reform. servean honor to as the army surgeon general. we have supported the nation and the army whenever needed. however today, i would like to focus on our recent history. for the past 14 years, we have supported a force engaged across the globe in supporting the joint campaign fighting in iraq and afghanistan and responding to national disasters and other contingencies, such as the was government response to the outbreak in west africa. we've accomplished this continuing to educate and train the next generation of army
medicine we are collecting what we have learned over the last 14 years and ensuring that we are using these lessons to inform our daily efforts and how we prepare for the future. our readiness to serve when it needed is my number one priority. in assuring our readiness, army medicine must continue to support our war fighters. we have achieved a survivability rate of 92%, the highest in the history of warfare, despite the change in tactics of our adversaries and increasing severity of battle injuries. we are not going to lose the knowledge and the best practices that helped us achieve this survivability rate. these advances in combat casualty care resulted from our integrated health services. that spanned from prevention, to treatment of them is an injury, and to recovery and rehabilitation. we cannot however, focus
exclusively on sustainment of trauma capabilities. our experience shows that the army must be agile and adaptable, and therefore, must maintain a broad range of medical capabilities. see ourend, we hospitals and clinics as health and readiness platforms. they ensure we maintain our personnel by exposing them to a broad range of patients with a wide variety of illnesses and injuries. are medical centers also serve as platforms for our army graduation programs. these are the primary means for transferring the knowledge to the next generation of military providers. we must also ensure we provide our soldiers, their families, and our retired population with
access to high-quality health care that meets their needs. improving access to care is a priority for army medicine and i have directed actions to rapidly improve access to care. first, we will enable our beneficiary to book an appointment up to six months in advance. we have already piloted that at some of our installations. we will increase the number of available appointments at increasing the time our providers are able to see patients. we are also working on the no leave a largeich number of our appointmentss unfilled. we are opening three community-based medical homes. as part of the health services enterprise, we will also continue to expand our health program. we are currently conducting a pilot in the emergency department at fort campbell.
we are also expanding remote health monitoring programs and looking forward to expanding to the home. i would like to thank dr. woodson for recently finding the policy to allow us to expand the initiative. i understand reforms are necessary to ensure the longterm sustainability of tricare. however, increase the burden on our active duty members and minimize any impact to the retired population. the firms should encourage beneficiary use of our system, to ensure our medical and military skills are maintained, and should encourage healthy behaviors. degradeorms must not our combat tested system, or readiness in an environment where we must remain rotationally focused and ready, as the next large scale
deployment could be tomorrow. the army's task is like no other. it is to win in the unforgiving environment of ground combat. we are however, a critical enabler to ensure our army achieves this end. our nation's mothers and fathers know that when their sons or daughters become injured, we are there. we are ready. this gives them the confidence to send them into harms way, if called. this is a sacred trust. i want to thank you all for your continued support to our soldiers and two military medicine and a look forward to your questions. thank you. >> chairman graham, ranking member, and distinguished members of the committee. thank you for the opportunity to come forward today to discuss the future of the military health care system. we support the work to enhance
the focus on value and the delivery of health benefit to those we serve, consisting of the sustained good health, readiness of the force we support, and the readiness of our medical force. strong health systems must continuously improve. changes to the air force performance management process implemented in 2015 is part of a coordinated action plan following the military health system review are producing continuous improvements in safety, quality, and timeliness of care. recent evidence includes the joint commission. we had outstanding performance on key quality members. the medical center's top 10% ranking among all u.s. hospitals participating in its measures of patient perspectives. and favorable systemwide performance against national benchmarks in prenatal outcomes, diabetes management, and childcare. we know our performance as a
health system is integral to our readiness and we remain committed to continual improvement. today we have 683 medical airmen put around the world providing medical support to contingency operations. that includes the mobile surgical teams at various sites. in support of diploid operations is inextricably linked to the care we provide in our hospitals, clinics, and our many partnered institutions. the bedrock of our readiness is a military hospital. of the 76 military treatment facilities, only 13 our hospitals. 30 years ago in 1986, we had 73 hospitals. over the last 30 years, the air force has closed and converted 60 hospitals.
our capability to meet combatant command requirements with deployable medical teams hinges primarily on our eight largest hospitals. the broad scope of care we provide to retired military members, their families, and veterans is key to our readiness. the air force has a number of agreements to the va. as we consider changes to the military health system, we believe it is very important to facilitate retiree access to specialty care and military hospitals, and provide tools enabling more agreements with the va and other federal health systems. to ensure our readiness, we have evolved into a model in which critical care specialists devote a portion of their time. i would offer as an example, the medical group at nellis air force base in las vegas.
a surgeon is on staff. but also, at the university medical center in downtown las vegas, which is the only level one trauma center for las vegas. this provides the needed bounds of complex cases for proficient deployable commissions. and additional key point pertains to primary support for active-duty families. experience has shown that primary medical support to active-duty families from our military treatment facilities enhances efforts to support families under stress and strengthens the resilience of families. as changes are considered, we strongly recommend sustaining care for active-duty families in military facilities. i think the committee for its steadfast support. thakn yonk you.
>> distinguished members of the committee, it is my honor to represent the men and women of medicine. 63,000 dedicated professionals who every day on her a trust in caring for those who have sacrificed to defend our freedom. we are grateful for your unwavering support. as you consider potential changes, i would like to highlight important considerations i believe are central to any discussions. military readiness and combat support are our mission. medicine protects and supports the health of sailors and marines around the world. we are igloo privileged to care for their families. -- we are equally privileged to care for their families. navy medicine stands there to protect and care for them.
this is what sets us apart from civilian health care. knows the building health care company in the world routinely leaves their families at home to willingly go into harms way to give for those in need. no health care company in the world daily puts their lives on the line in battle to defend and care for their patients. no health care company in the staff doeriences the performance turnover we routinely experience and still deliver world-class care. and finally, no health care company in the world is daily and singularly focused on the combat readiness of it staff we have the highest combat survival in recorded history. wounded warriors are alive today, who in any previous conflict would have died from their injuries. they are the testament to the effectiveness of the military health system because every one
of them from point of an injury on the battlefield receive their care from men and women who got their experience in our military treatment facilities. those facilities are the foundation of survival. in my opinion, as a former commander, of a former medical health systembust is critical to future battlefield survival. survival is proof that a robust military health system that also serves as our training and search platforms for our battlefield providers is essential to both combat survival and agility in rapidly supporting our deploying operational forces. these three facts are not in dispute. one, we have the highest combat survival in recorded history. two, many wounded warriors alive today would have otherwise died in any previous conflict.
three, every wounded warrior received their care exclusively by men and women who received their training, their clinical experience, and preparation in one of our facilities. this is a system that works and has proven itself time and again. it is also a system that is not perfect and i appreciate your attention to this much-needed area of reform and improvement. the services are working hard to improve access, care continuity, convenience, and satisfaction. we have made important strides in each of these areas, while concurrently increasing enrollment, network recapture, staffing realignment, and other efforts to make sure we provide the clinical experience our help needs to ultimately survival in the next conflict. kid is more than just trauma. 70% of the -- it is more than
just trauma. 7% of the evacuations were not trauma related. -- 70% of the evacuations were not trauma related. we do not have people in uniform for peace time care. all of them have necessary roles and responsibilities in the next conflict. more needs to be done and none of us underestimate this. we are committed to continuing those necessary reforms. we will improve our patient's experience and most importantly, their health. we must do so without putting at risk the very system which has yielded unprecedented survival. we need your help in this effort and for your tireless support, i thank you for helping us in sure that those sailors and marines will have the same or better survival than today's wounded warriors have had. trust hands is a sacred
to do all in our power to return home safely america's sons and daughters who have sacrificed to defend our freedom. i thianank you for helping us honor that trust today and tomorrow. >> i am grateful for your testimony and your service and i appreciate this discussion today. i would like to start with dr. woodson. we are very interested in this issue of comprehensive autism care. -- i amleased pleased that the defense initiated the competence of autism care. however, i am concerned to hear that dha intends to lower reimbursement rates for providers of therapy for autism. i am most concerned that providers will longer be able to accept tricare because the reimbursement rates are too low. are you at all concerned about the impact changing reimbursement rates will have? tot steps have you taken
ensure that access to these services will not be adversely affected by changes in reimbursement rates? why not wait until the demonstration program is complete, so the results are not skewed by a rate change? >> senator, thank you for that important question. let me just a sure you that i am very committed to special needs children. that has been a major emphasis in terms of many of our reform activities. in regards to the rate changes, they were actually delayed a gear and a half. w-- a year and a half. part of our statutes require us to pay medicare rates. we set an amount and we studied it for a few years, did an internal review. we were about to make rate changes and we heard from stakeholder groups, including autism speaks and others. conferences to
engage them and then commissioned two outside studies that confirmed we were overpaying. i would be happy to share the details of these studies with you. finally, to ensure that we won't negatively impact the services we reviewed network adequacy almost on a monthly basis. we will be monitoring this situation very closely. any localityd in that it has been adversely affected, we will make rapid changes. the final point in regards to this is that we put in a safety valve. we are not going to reduce rates right away completely. it is a step-wise progression over a number of years. that way, we can ensure we don't lose providers. concerns some specific with regard to this study and the methodologies. i don't think they are
reflective of the cost. like to request some follow-up information specifically on that. i think it is inadequate. the reason why autism speaks spoke so forcefully against of the proposed rate changes because they are the experts on treating children with autism. i think your study is misleading in its outcome. i will follow-up with specific questions, but i would like this to be re-addressed because i am very concerned there will be very negative consequences for patients. my second question is about innovation and different ideas about how to innovate health care for our service members. when i was in fort drum earlier this month in upstate new york, i was impressed with their approach to health care. they have a clinic on the base that provides basic primary care. but their members and families also go off base for specialty care.
the clinics and providers in the community by a virtue of serving the military population, have an excellent understanding of the needs of men and women in uniform and their families. senator mccain asked these questions to the last panel. had dha looked to fort drum as a --anyone can take the question. share with i will you a pilot we have in san diego county. in san diego, one in five residents is eligible for health care. of those, 662 are high utilizer's. they use 15-30 times as much health care is anyone else in the county. we partnered with county public health. these are folks where the car will break down, and they will
call 911 to get a ride to the er. by partnering with county public , as well as with military provider services, we have health and cut their health care costs by over $400 million. we dramatically cut by over 60% the hospital izations. >> thank you. >> thank you senator. ofarding the innovation health care in the fort drum model, that is a phenomenal model for that area. we have noticed it might not fit in all of our demographic areas. it may not be reproducible. but there are additional things
we are doing. at fort leonard in missouri, we -health.g tela they have an icu set up to help them with that. they are using other types of partnerships in order to achieve some of those same ends. but i agree, for the fort drum community, the model they have works very well. >> senator, i mentioned in my statement that the air force has 13 hospitals. that is below our operational requirement for deployable medical teams. we have had to use innovative concepts to meet our operational requirement. we have about 2500 air force medical personnel indebted in otheembedded. we have embedded service staff
into private sector hospitals in omaha, nebraska and tampa, florida and birmingham, alabama. they are providing care in those hospitals. i would say though, while that model has been successful to some extent, i don't think we can go to too heavily in the direction. as i said in my statement, the military hospital remains the bedrock of our readiness because that employs readiness to the entire deployable team. sector platforms tend to benefit, but not so much the nursing staff. >> there are some other areas too where we have all been doing innovative work. each of these services has this where we have about 45% of our resources and 45% of our patients where they need care.
what is innovative about that is between the services we are able to level fit some resources. depending on where the demand is for care, one of the hospitals can send personnel to other hospitals within that same market where the demand is. rest as an example, we wer looking at the demand for physical there be services. we were able to understand where the demand was coming from. by using some of the assets within some of the embedded facilities, we were able to send physical therapists to those areas that had high referral rates. we were then able to get care to the patient in a timely matter. it decreased some of the demand for specialty care down the road. the is what we use in multi-service markets. >> thank you very much. >> thank you, mr. chair.
mr. woodson, rather than go back through what the senator brought treatment, i would like to join with some follow-up. i think the key there has to do with timing and the most important thing is to understand the value for this treatment, not only for the child receiving the treatment, but also the health and quality of life for the active-duty personnel or military personnel, and the spouses. start withwant to you and then probably ask the other surgeons general to chime in. you are making a very important point about the unique nature of this health system. i also want to get to military hospitals. higher than what
it would cost if the services were purchased in the private sector. can you give me some help in trying to rationalize what the real gap is? there is obviously some structural cause based on the unique nature of what you are doing. give me some sort of sense you believe may be an attainable goal. is that gap right and proper? >> yes, sir. if you look at our cost breakdown, you can see two large buckets. ofse are the facility costs maintaining embedded facilities. those are important as we get casualties back -- >> so there is an unused capacity that you might not find in private health care settings. >> absolutely. these civilian centers are running with occupancies of 90%. we don't do that. then, there is the personal
cost. i don't staff to peace time care . i have in some places, more staff in uniform than necessary for peace time demands. that is because it is a operational war requirement. we put those personnel in places where they can keep their skills current. >> times are to cut you off, but i have a -- i am sorry to cut you off, but i have a couple questions. is there a good breakdown you all caps robot us that gives that to us in an in particl in. col-- is there a good breakdown you can all give us that gives us the breakdown? i think that would be very helpful to get back to this committee as we go through and
identify opportunities. you in your opening statement said you are not perfect. i want to go back and find where those imperfections are and spend the bulk of this committee fixing those. general, do you have a comment? >> yes, sir. i think one thing that is always a challenge when you talk about differentiating the cost of readiness against the cost of providing care, the two are an inextricably intertwined. there is a lot of work we do that is clinical in nature. if you look at our primary care operations, things like medical evaluation boards, and preventive health assessments, posted limit health assessments. all of these things consume a
significant amount of our primary care bandwidth. it is challenging to look at perhaps, the cost of providing care to enrollees to our clinics and cleanly and a separate the cost of readiness, versus just the cost of providing care. that is one of the traditional challenges we have had with answering this question. the two are intertwined. >> with the key is to normalize it in some way so people can understand. we have to set the priority on what we should improve, rather than look at things from a purely numerical basis. it may look like an opportunity to improve, but the consequences can be opposite of what we want to accomplish on this committee, which is to work with you and improve. mr. was in, the tricare legislative proposal did not contain any son, thehood
tricare legislative proposal did not contain this? what should we expect? >> that set of proposals requires additional studies. there are several courses of action depending on what type of reservist we are talking about. let me just give you some examples to crystallize. on the one hand, we initiated reserves to fill a gap in what we thought was medical readiness at the height of the war. the consequence of that was that the reservist and family would have to switch insurance programs when they came on active duty. the possibility frankly, of offering tricare reserves to a larger population, including employer-based options , which might be reasonable. there is the possibility as the commission talked about, of
providing basic allowance for health coverage when they come on active duty. we need to sort that out. and then, there are some other hybrid options that are out there. reserves isth really about not forcing them to change providers when they come on active duty. there are different solutions and we need to work those out and study those more. >> thank you, mr. chair. >> thank you, mr. chair. woodsonay recall, dr. and other members of the panel, in the 2016 national defense authorization act, i advocated for a uniform formulary for improved transition from dod care to the va as service members transitioned out of
active service. this measure was successfully passed. now, we are in the implementation stage. this joined formulary i think it's critical to the quality of care. that relates to a variety of related medical issues that might arise when there is a lack of sufficient transition in prescription drugs and other health care. what is the status of the implementation of the joint formulary from the dod perspective? >> so, i think there has been a lot of progress. certainly in the areas of mental health education, pain medications, and some of those other medications for conditions in which the gap would create a great deal of problems. they have been mapped significantly to about the 96%
level so we have this single formulary. more work little bit that needs to be done on that, but there has been significant progress on that front. >> on the issue of prescription drugs, painkillers and opioids for example, they are an ongoing danger in the military, as is the case in the civilian world. there is and that is something that needs to be addressed not only nationally, but within the military health system. in that regard we are a little bit ahead of the curve. for a lot of different reasons, there has been focus on the use of pain medication. we have developed comprehensive clinicals in terms of guidelines. we have courses that providers must take in terms of pain management. we have invested in research and
integration for alternative methods of pain control. this has been part of our comprehensive set of programs i think that we could even make available in some health care systems. >> on the issue of mental health care, has there been progress there to you think? >> i think there has been progress, but mental health care is really -- the more we study it, the more we try to refine it , the more we find out about it. if i could break this down into a couple different issues, often times dealing with mental healthcare, it is more about -- it is more than just delivering health care. it is about delivering social services and family support. that is one issue. the other issue about mental health care is that we always have this issue about whether or not we have enough providers.
really what we need is a comprehensive, new strategy for how we employee our mental health specialists in a rational way to deliver care. you know, we never will have enough psychiatrists, we never have enough pediatric psychiatrists. if we train them to use screenings, we can help out what we need to do is work on a more rational approach to how we employ mental health counselors, psychologists, licensed psychological nurses, licensed social workers, and a continuum of care that allows us to address all needs comprehensively. i don't think we will ever generate enough mental health providers. >> that is the strategy you say has to be developed, or is being developed. >> we are working on that.
the previous panel talked about the issue of embedding mental health care and primary care practices. we have been doing that for years. we have been developing mental health care technicians. we have already rolled out some of that more comprehensive strategy. still, i think we need to raise different types of mental health professionals in a better way to take care of many different problems. membersknow, active-duty of the military that may suffer emotional or mental diseases, some of them emanating from combat, sometimes are given less than honorable discharges. then, through a tragic irony, are deprived of medical care to
treat the very injury that caused their discharge in a less than honorable conditions. sought to have to hav those discharges reviewed. the secretary of defense has committed to change the policies reviewboard's correction within each of the services. soughtyour infinitnput been on the issue because there are medical issues involved in those reviews? >> the short answer is yes. let me first thank you for your advocacy in this area. we have actually reached out to individuals who have been discharged with so-called "bad paper" to let them know that their cases will be reviewed.
o to your last part about your question, we have given until health professionals -- we have given to mental health professionals, these cases so they can be reviewed. >> my time has expired. i want to thank all of the panel members for your hard work. all of the hard work done by the men and women under your commands. thank you for being here today. >> thank you. how many casualties have we suffered in iraq and afghanistan? not fatalities, but injuries. how many people have been wounded, requiring admission to the hospital? >> senator -- >> does anybody know? >> senator, it depends on how you calculate those numbers, whether or not you include
disease. >> it doesn't matter. as long as it is in iraq or afghanistan. >> it is over 100,000. >> can you imagine the military health care system did not have a military hospital? >> sir, no i can't. >> because the bed space you have is not designed for everyday activities. it is designed for wartime contingencies. >> that is correct. >> most of these beds are empty because they are built for wartime contingencies. >> if i may, those beds are not empty. we work to get care back into our facilities. >> what percentage of your beds are occupied? >> we try to maintain and occupancy of 80% or higher? >> what about the air force? >> we have a lower occupancy than that. we are in the 50% range.
>> what about the army? have ae in san antonio higher occupancy rate. we are looking at the smaller facilities to realign capabilities there. . going to are reform something, we have to understand what we are trying to accomplish here. if you had hospital administrators, with that create a problem? >> sir, military hospitals are just like any other military command. >> that is what you would be doing. >> exactly, yes sir. >> the military command structure cannot be substituted. >> yes, sir. this carries over into the battlefield and it starts in the hospital.
>> at the end of the day, what would happen if we opened up competition to all of these military facilities? where with the military go? >> that is a very good question. >> what would they do? >> sir, again -- >> like a dentist. if it is cheaper to pull teeth --ntown, which it may be, dentists have to stay proficient in pulling teeth. >> absolutely. we are not in the same business. -- nobody seems to be in competition. >> but you treat family members of active-duty duty personnel and that keeps your skill level up? it's good for recruitment? >> yes, senator.
>> does every military member have to go through an annual physical? the answer is yes. isn't that primary care. >> yes, sir. >> those same doctors will be treating kids with a cold. >> yes, sir. >> i would add that we are ultimately a mission support activity. we are supporting commanders conducting missions. in the air force it is global mobility. it is cyber operations. by taking care of the airmen and the families, we are helping the commander take care of that family. >> when you say a military hospital costs 50% more to operate than the civilian counterpart, is that a fair comparison given the unique nature of military medicine? an appleshink it is
and gorges kind of comparison -- oranges kind of comparison. >> do you all agree with me that you could be more efficient? >> yes. >> do you agree with me that everybody has done extraordinary action? you guys are the unsung heroes of this war. i have been to deployed areas where people have been blowed up and it is amazing how you can put people back together again. that whole thing at walter reed is priceless but needs to be more efficient. senator if i may make one of the, the maintenance
military system is essential to the defense of the nation. it example is that it's part of the platform. and fewer graduate medication spots than there are american medical graduates. if we were to eliminate the military treatment facilities and military health system, we could not generate enough to come onnurses active duty. we must preserve the graduate medical education program. i would not give it a b. i will really be hard on you guys to come up with reforms.
[inaudible] >> donald trump won the nevada caucus with marco rubio the projected second place over ted cruz. democrats hold their primary in south carolina this saturday. >> people need to pay attention so we can define things that are easy to understand. large thatent is so the government like this has to
cut through a lot of the noise and the other things going on. neighbors of congress talking about the wonderful things they are doing and trying to get people to be more involved and to make it more personal so that they understand the impact on them and their children and grandchildren. shaftday night, thomas talks about his organization's efforts to bring attention to wasteful federal spending. they also publish the pig book which compiles the list. >> it works with a bipartisan coalition. they came up with a definition of what was called porkbarrel spending and eventually became the term earmarks. we went through the appropriations bills. it went all worked to $29 billion in 2006 and every year in the can find earmarks
sen. cruz: god bless the great state of nevada. what an incredible team we have here on the ground. i want to thank our nevada state chairman, the attorney general of nevada. a tremendous constitutionalist conservative. when he ran for attorney general all the political establishment was against them. he wasn't supposed to win. thank our incredible leadership team that is here across the state network so incredibly hard forging a grassley -- grassroots coalition .
>> they are still counting the ballot we don't know the exact results. i want to congratulate donald trump on a strong evening tonight. the conservatives across this country who have come together behind this campaign. when we started this campaign nearly a year ago, there were 17 candidates in the race. the role of the first four primaries has historically been to narrow the field. we have seen them do exactly that. had at this point, we have four primaries. history teaches us that nobody has ever won the nomination
without winning one of the first three primaries and there are only two people who have won one of the first three primaries. donald trump and us. and the undeniable reality but the first four states have shown is that the only campaign that has be donald trump and the only campaign that can beat donald trump is this campaign. if you are one of the 65% of republicans across this country who doesn't think that donald trump is the best candidate to go head-to-head with hillary, who believes that we do better in elections when we actually -- ande conservatives
the first four states have performed a vital function of race.ing this twocan choose between washington dealmakers or one proven and consistent .onservative today will be the most important night of this .ampaign super tuesday. states, alabama, alaska, arkansas, georgia, massachusetts, oklahoma, tennessee, vermont, virginia,
and the great state of texas. one week from today, the most delegates awarded on a single day will be awarded next tuesday. of the first four states is to narrow the field and give super tuesday a clear choice and now the voters can decide. if you want a president who will stop amnesty, ask yourself who has led the fight against amnesty. if you want a president who will repeal obamacare -- [applause] ask yourself who has led the fight against obamacare. who willnt a president stand for life, american religious liberty ask yourself who has led the fight defending
life, marriage and religious liberty. president who a will defend the second amendment right to keep and their arms, i have been told that folks in nevada kind of like their guns. understand.i you look atyou, those super tuesday states and they like their guns, too. liberalant to prevent a justice from reading the second limit out of the bill of rights ask yourself who is defending the second amendment right to keep and bear arms. americaant to see
unapologetically alongside the , ask yourselfel who has led the fight to stand unshakable he with the nation of israel. if you want a president who on theone will rip to shreds iranian nuclear deal, if you want a president who will utterly and completely destroy yourself, who has led the fight against this iranian nuclear deal, against radical terrorism and who will keep america safe? [applause] elections are about choice. there are clear choices in this
race. if you want more washington deals, corporate welfare, cronyism, more debt, fewer jobs and lower wages, of two candidates to choose from. on the other hand, if you want a president that says no to the bipartisan corruption in washington, that stands up to the lobbyists and special interests, that stands up to the debt that says we will not bankrupt our kids and grandkids, we will bring back millions of high paying jobs, we will see wages going up. we will make young people come out of school to have three to five job offers and we will ensure that our kids and grandkids have a brighter tomorrow. a greater future. a more bountiful america. i want to thank the great people cannotda and i would say
wait to get home to the great state of texas. tonight, i will sleep in my bed for the first time in a month. then it will be back to the campaign trail at texas and all across super tuesday energizing and building that reagan coalition, those courageous conservative libertarian evangelicals am a young people in reagan democrats all coming .ogether tonight, we are one step closer to morning in america.
one. you know that? pundits, wen to the were not expected to win too much and now we are winning, winning the country. soon the country will start winning, winning, winning. volunteers.ank the they have been unbelievable. these people work endlessly and we are not going to pick at it. we have some great numbers coming out of texas. amazing numbers coming out of tennessee and georgia and arkansas and a couple weeks later, florida. we will do very well in ohio. we are beating the governor, that is always good. michigan -- the whole thing. it will be an amazing two
months. we might not even need the two months, to be honest. 45%, tomorrowd you will be hearing, if they could just take the other --didates and add them up [laughter] because the other candidates amount to 55%, to keep forgetting, that when people drop out, we are going to get a lot of votes. want to begin by thanking my boys. eric has been all over the place making speeches. he's getting better than me so i am jealous. don has been all over. this is serious nra, both of
them. both of them. we love the second amendment. nobody loves it more than us. corey, hope, the staff, what a group we have. i want to thank a couple friends of mine that are here. the owner of this incredible hotel. phil said, donald -- for the last three lungs -- three months, donald, i want to put $10 million into your campaign and i said i don't want your money, i am self funding. every time i see him it is hard to turn down money because that is not what i have done my whole life. i grab and grab. i get greedy, i want money. i tell you what, we get greedy. now we will get greedy for the united states. we will grab and grab.
we will bring in so much money and so much everything, we will make america great again. i'm telling you. mine,r great friend of somebody respected by everybody, a great friend of phil. stand up, steve. two great people. steve always has advice. right? donald, i think you ought to do this or that. his advice i like to lift -- listen to. we appreciate it. you have been great friends. tonight,very exciting but it looks like we won by a lot. love theals, i evangelicals. know, liberty university
-- do we love the university? jerry falwell, jr. and he hasable guy, been with us and with us from the beginning. we won with evangelicals, we won with young, we won with old, we won with highly educated, we won with poorly educated, with the smartest people, with the most loyal people. you know what i am happy about? 46% with the hispanics. hispanics.with that.eally happy about >>." chants] trump!
trump! trump! mr. trump: this is an amazing night. i love the country. we are going in the wrong direction. we are going to keep gitmo, and we will load it up with bad dudes. nicell have our borders and strong, we will build the wall. you know that. i have a lot of respect for mexico. you just heard, we won hispanics. mexico is going to pay for the wall. right? they are going to have to. they know it, i know it. we have a tremendous deficit. we have a trade deficit with mexico, they will pay for the law and be very happy. i will talk to them, they will be thrilled to pay for the wall.
we will be the smart people. we will not be the people who get pushed around all over the place. you are going to be proud of your president, and even prouder of your country. ok? [applause] i love this place, i love las vegas. i keep telling steve that we have the best hotel in las vegas. i was so proud. i went to caucus and the people are amazing. the people in this country are amazing.
we have to make america great again. it is going to happen fast. [applause] we love you. thank you. chanting] u-s-a! mr. trump: thank you, everybody. i love you. thank you. [captions copyright national cable satellite corp. 2016] [captioning performed by the national captioning institute, which is responsible for its caption content and accuracy. visit ncicap.org] [no audio]
about the 2017 justice budget request. she testifies at a house appropriation subcommittee hearing live this morning at 10:30 a.m. et on c-span3. department of homeland security secretary jeh johnson testifies before a committee. 2:15coverage begins at p.m. et on c-span3. >> next, white house press secretary josh earnest talks to reporters about president obama's plan to close the guantanamo bay prison. he also took questions about filling the vacancy on the supreme court. >> obviously, his experience
in the region and the amount of work he has put into this thing is a pretty useful messenger. hoping all of you and your readers and viewers and listeners understand what our strategy is and what we are focused on, to advance the interest of the united states, but also keep the nation safe. rare to spend a day in washington, d.c., so i thought it was important to try to make sure that all of you are on his schedule. he is based here, but he spends so much time traveling in the region that it is unusual for him to spend an entire workday in washington, d.c., so we are pleased to have his attention today. thanks. kevin, let's go to your
questions and other topics. reporter: the supreme court. should senate republicans take the advice of joe biden from 1992, the action on supreme court nomination off until after the campaign is over? josh earnest: i would go with both. vice president biden in 1992, in the same speech you noted, said if the president consult and cooperate with the senate, or moderates his selections absent to consultation, his nominees may enjoy my support as did justice kennedy. we have observed in the past that we could spend a lot of time throwing quotes back and forth. that is indicative of some comments that the president made last week about how this process has become politicized. when you consider the record of senator biden on the judiciary committee, it is a record hard to beat.
when you consider that he presided over the last time they appointed a nominee and election year, that was a nominee for forward by a republican president. joe biden was chairman of the senate judiciary committee. he ensured that justice kennedy got a fair hearing and a timely yes or no vote. that is what we are asking the senate to do. there are a variety of examples of this -- senator biden, more than anyone else, has ensured the fair appointatian of nine supreme court justices. i don't think as any other senator that can take claim to that kind of record. he was not just in the senate so he could confirm supreme court justices appointed by democrats. he often presided, even in difficult situations like an election year. so, i know there is often an old adage that sometimes politicians are reduced to the expression
that people should do as i say, not as i did. in this instance we actually want the republicans in the senate to do precisely as vice-president biden did when he served. if so, it will allow the president's nominee, when he puts that individual forward, to get a fair hearing, a timely yes or no vote, and for the supreme court of the u.s. to function precisely as the founders intended. >> obviously senators are going to pick and choose quotes. would you acknowledge that the comments that senator mcconnell made quoting the vice president, which you acknowledge that this has made it more difficult, more unlikely that the nominee will get a hearing and a vote? mr. earnest: i would not , precisely because of vice
president biden's record when he served on the judiciary committee. i said the examples of justice kennedy and his overall record of confirming supreme court justices. there are other elements of his record that are just as enlightening. vice president biden, when he presided over the confirmation hearing of justice thomas, he did not support justice thomas's nomination to the supreme court. yet he allowed justice thomas's nomination to move onto the floor of the u.s. senate. that is exactly the kind of commitment to the functioning of the institution of the u.s. senate that we would like to see republicans demonstrate. again, that is not just a matter of doing as senator biden recommends -- as he recommended, that is doing as senator biden actually did. that is what we are counting on republicans in the u.s. senate to do. they should not do it because
they are forced into a position based on awkward quotes that they themselves have given. goodness knows, there are plenty of them. we could discuss those as well. in some ways, the most important element of this is they have a constitutional duty. they swore to uphold an oath, and fulfill the responsibility that the institution of the u.s. senate has to consider the president's nominee, to give them a fair hearing and give that person a yes or no vote. i know there are at least two senate republicans yesterday he would knowledge that oath and acknowledged that if the president, when the president nominates someone, the hearings should go forward. senator kirk himself specifically referenced the oath he took, not just as a member of the united states senate, but also as a member of the armed forces. he takes that oath seriously, and recognizes that giving the
president's nominee affair hearing is what that oath requires. hopefully he will be able to persuade other members and his conference of the importance of the oath. >> why not name the facilities considered, or at least make a recommendation for a facility to move the transferees that would be left. part of what the administration is saying is that they kind of want to rise above politics with this issue and have congress move forward. are political concerns keeping you from naming these facilities? is it a concern about not wanting to put certain lawmakers on the spot if you named certain facilities or put them on the table? mr. earnest: the reason they
cannot undertake a more thorough evaluation of the specific sites is because it is specifically prevented by congress. congress passed a statute that instructed, and has prevented the administration from undertaking serious planning that would be required to do the prudent thing, which is closing the prison at guantanamo bay and taking those individuals who cannot be safely transferred to other countries, and incarcerate them here in the united states. that is a commonsense proposal. that is the plan we rolled out today -- that the plan we rolled out today made clear. it saves the taxpayers billions of dollars over a couple of decades. at least $1.7 billion over a few decades. and we would be eager, in fact we are asking congress to work with us to allow us to do the
kind of planning that it needs -- that needs to be done to do this safely and in a cost-effective fashion. we are going to need congressional cooperation in order to that. congressional cooperation in this instance is a reference to actually removing a barrier that prevents that from happening. if congress is willing to act on that, then we will be ultimate in a direction of actually having a serious discussion about specific plans and the department of defense has indicated that these kinds of plans could be initiated in relatively short order. this does not necessarily need to be a longer-term goal. what we need to see in the short-term term is a willingness on the part of the u.s. congress to put the interests of our national security ahead of the interest of their politics. >> are you saying that this is the law preventing the administration from putting
forth a more detailed plan? this was a nine page plan that included an appendix. are you saying that laws in the past prevented you from going into more detail? if that is the case, if you need congress to act to pass laws to remove these restrictions, if they do not, what is the plan going forward? mr. earnest: the administration is constrained by law from undertaking planning for a u.s.-based facility. that hinders our ability to put forward the details you are suggesting. what we were able to do within the confines of the law is to develop a plan based on a prototype detention facility. essentially a model that could give us an estimate about what that looks like. what that looks like is eight savings to the taxpayers of up to $85 million a year.
over 10 years that is a savings -- net savings, when you factor in transition costs of more than $300 million over 10 years. those costs explode over the longer term. we're talking savings of $1.7 billion in net savings over 20 years. there is a clear argument. the facts bear this out, even in the nine page report. you can look at the numbers and see there is a significant benefit for taxpayers of doing something that is clearly within our national security interests. it is not just president obama who thinks that closing the prison at guantanamo bay would advance national security. president bush held the same view. senator mccain at one point even held the same view. this is obviously the view of the department of defense. they issued the report. this is the view of about 60 retired military officials who wrote and announced their
support for the plan. we hear a lot of rhetoric on the campaign trail that the president needs to do a better job at listening to his military leaders. this is what the military leader suggests is necessary to enhance our national security. right now it is congress who is not just listening to them, failing to listen to them, it is congress who is actively blocking these steps to save taxpayers money, and to make the country safer. reporter: given what you just said, and what loretta lynch said in november when she said, with respect to individuals being transferred to the united states, the law does not currently allow that. certainly it is the position of the department of justice that we would follow the law of the land. given that it would be against the law to bring detainees to the u.s., it is safe to say that if congress does not act to change the law, the prison at guantanamo will not be closed?
mr. earnest: i am not ready to arrive at that conclusion. what we are focused on right now is congressional consideration of a plan they asked for so we can have a discussion about the best path forward. we have submitted this plan to congress, right on the deadline in the timeframe they asked for. we are interested in a robust conversation about this. reporter: i don't understand how you could say -- to rule that out. it is against the law. i think you just said from the podium and the attorney general of the united states said in congressional testimony, and the defense secretary said that it is against the law to move those detainees to the united states. unless you are going to just let them go, how could you close down that prison? earnest: nobody is talking about letting them all go. we have a plan for how these
individuals can be transferred to other countries, go through a criminal justice process, for the incarcerated in the united states. that is a cost-effective plan. reporter: what is congressional reaction? mr. earnest: the plan we have put forward actually lays out what our argument is, reflects the facts. reflects the facts that we can do it in the way we have outlined and reflects and protects our national security and we are interested in this conversation with congress. there is an emerging trend in congress, where congress isn't in a position of just saying no, congress is refusing to engage. they aren't actively saying no, they are refusing to do the function of their job. they are refusing to even consider the president's nominee to the supreme court and refusing to take action on aumf
or discuss the budget with the president's budget director, something that has happened over the last 40 years. i'm not sure what they are doing in congress, they are doing everything but fulfilling their responsibilities. reporter: on this case, congress has acted. they have been asked to vote in a fashion to say no, they don't want detainees brought to the united states. i'm asking you if they don't act on this and approve this plan that you just outlined, can the president still close that detention facility? mr. earnest: congress requested this plan on this time frame and we have provided it to them. they have to decide whether or not they want to take a look at this. what they have done is put in place barriers that prevented the administration moving forward. they have led us down the path of a policy that wastes taxpayers' dollars and make the united states more vulnerable.
reporter: if those barriers remain in place, can you close that facility? mr. earnest: what the president has said our focus is going to be working with congress and working with congress is working on a time frame and we are asking congress to give it fair consideration and i'm not going to speculate if congress refuses to do that. reporter: rubio suggested that the president is considering turning over the entire naval base to cuba. is that something that is under consideration? mr. earnest: it is not under consideration and we have said that many times. reporter: cost savings over 20-year period. does that mean the american people -- [indiscernible] mr. earnest: in some cases, we are talking about individuals
who were apprehended and transferred to guantanamo bay as teenagers. it does mean that we need to start thinking long-term about how this process is going to work. again, our preference is where possible is to conduct a review and determine how these individuals can be transferred to other countries with appropriate security restraints and make sure we are mitigating my risks they pose to the united states. there is a long process for certifying that. it requires specific prolve of the department of defense. there are about 35 individuals who are currently detained at the prison at guantanamo bay who are eligible for that process. we just need to find a willing partner overseas who is willing to receive that individual and put in place the security restraints we believe are necessary. we have discussed at some length the options for bringing these individuals to justice either through military commissions or through article 3 courts.
the president made an allusion to some reforms of that process that he believes would make military commissions in particular themselves more cost effective and efficient. some of you may have seen earlier today a tweet from the chief of staff who indicated that right now we have a situation at the prison at guantanamo bay that it's not possible for some individuals to actually just plead guilty. that's an indication that we need to fix our broken system and right now, again, as john pointed out, all we have seen is congress throwing up obstacles. we would like to seekonk engage -- to see congress engage with us so we can act in the best interests of taxpayers and our national security and then we don't end up in a situation where this unwieldy problem ends up on the plate of the next
president, whoever that person may be. reporter: people on the hill are calling this dead on arrival. is there a plan b? mr. earnest: the plan was put forward a couple of hours ago. it sounds like it is pretty inconsistent. you have to ask congress if they were disingenuous. sounds like they didn't take it very seriously. and again, i actually think that reinforces a pretty significant problem that congress has. anybody who is paying attention it's hard to figure out what they are doing. they are certainly not doing their job. they are ruling out consideration of the president's nominee to the supreme court and refused to take tangible action against isil and won't engage in a hearing with the president's budget director in the same way that every congress in the last
40 years has. i don't know what is happening. what we are focused on right now is doing the job of the american people and making sure we are being good stewards and i think in each of those instances, what you have is the administration trying to move the country forward and put politics aside and act. on the part of congress, you see nothing. reporter: what you are describing is that the white house is trying to work with congress and dependent on congress to get this prison closed. but in the face of that opposition, is the president willing to leave office with guantanamo bay still open? mr. earnest: that is not his preference. i remember sitting in that chair over there and i believe january 22, 2009, where the president put forward his plans.
we have been talking about this for more than seven years. this has been a top priority. and each turn we have been stymied by congress and that's frustrating. that frustration pales in comparison to how irresponsible it is to treat taxpayer dollars and our national security in that way. reporter: are you going to let the clock keep ticking? time is of the essence. mr. earnest: congress is going to let the clock tick. we put forward a very specific plan for ensuring that doesn't happen. and we are hopeful that somebody in congress somewhere will actually take a serious look at this and be willing to put the national security of the united states and the importance of efficient use of taxpayer dollars ahead of their own personal political considerations. that may be a bold consideration to make in washington, d.c.,
these days particularly in an election year but it's what the american people expect and what the constitution requires. reporter: the president talked about this scary idea for people moving terrorists closer to the u.s. mainland and some ways to their own back yard. given there are among these 91 people here, still about 46 who can't be cleared out, there isn't enough evidence against them but too much worry to release them. moving those people to the u.s. mainland, isn't that shifting the same problem to another zip code so that the next president faces the exact same problem of indefinite detention of detainees with no clear sign of avoiding what has become what the white house says is the rallying point for terrorists?
mr. earnest: you raised several important questions. the first thing as the president referenced in his statement in the roosevelt room is there are hardened, dangerous terrorists who right now, even as we speak, dozens of them, who are serving time in american prisons on american soil, right now. that doesn't make the united states more vulnerable. it makes us safer. they have gone through a criminal justice process where they have been convicted and are serving time and they are being held where they cannot pose a threat to the american people. reporter: for many of these detainees, it is not as clear-cut in terms of the evidence and the trial and that is one of the problems along these many years with closing a facility and how do you get around all that? mr. earnest: there are a group of people that it doesn't apply. we should be able to find a justice process of one form another that will allow the
justice to be served. what's also true there is a process that was put in place on january 22, 2009 that initiated a formal review of the files of these individuals who are detained to determine how and where they could be safely transferred and we are going to continue to implement that process to determine if there are more individuals based on updated intelligence assessments and updated conversations with our partners could be transferred somewhere else in a way that is consistent with our national security interests. i wouldn't rule out that more people from the group of 46 or 56 here that we have here, that they could be moved into the cat engineer of eligible for transfer and that is a testament to the success of the process that the administration put in place on the president's second full day in office. but look, the final thing is the
option is, the other option that right now, congress is nudging us in a direction of, is one that only serves to exacerbate our national security vulnerabilities and allows extremist organizations to continue to use the operation of the prison at guantanamo bay as a recruiting tool. we know they do that and why we give them that weapon to use against us is beyond me. the dollars and cents here just don't add up to a logical republican congressional strategy. there are democrats who are complicit in this, too. members of congress are suggesting that we continue to operate the prison at guantanamo bay after we have transferred all those individuals eligible for transfer doesn't add up. the per inmate cost is only going to continue to skyrocket and when you look at the longer
term cost implications, even in the short-term it doesn't make sense. in short-term we could recoupe the costs in three to five years but be in a situation where we are saving taxpayers 85 million each year by moving these individuals to u.s. soil. over the long-term, the cost savings are even more significant. when you consider the dollars here and fiscal conservative and making sure that government is smaller and taxpayer dollars are efficiently used, that we are looking to cut wasteful spending, $85 million a year, that seems like a pretty sizeable amount. reporter: it seems like this plan was delayed for many months as you try to get costs squared
away. it does sound like you are going to have 30 to 60 individuals and saving $85 million, hundreds of millions, over $200 million for 30 to 60 individuals and i'm wondering if that cost is something the president is comfortable with. is that something the president is comfortable with? do you try to get that number down more? mr. earnest: i think what is true, once we have the opportunity to take a closer look more specifically at the way that a u.s. facility could be used, i wouldn't rule out there would be additional cost savings. congress needs to work with us to see if that is even possible. i guess in the same way that it costs money to run prisons in the united states, it's going to cost money to detain these individuals even if we bring
them to the united states. releasing them at least in some cases is not an option. shouldn't we find a cost effective way to do it. isn't irresponsible to suggest we should $85 million a year to keep these individuals at guantanamo bay, that terrorists use as a recruiting tool? that doesn't make sense. it's not the best way to look out for our national security or a good way to be a taxpayer of taxpayer dollars. when you are talking about people who are strong on national security and fiscal conservatives and people willing to listen to the advice of our military commanders, like a republican trying to make a foreign policy decision. so let's start living up to our rhetoric and do the right thing for the american people.
aa called for nd the administration to put out a specific name of a facility or facilities. the law kinds of restrict but doesn't restrict names of facilities you are looking at. maybe narrow it down. i'm wondering why the administration didn't -- [indiscernible] mr. earnest: this was to develop prototype facilities to look at how this would be done. but we are prohibited by law from developing the kind of specifics and details around a specific facility. so, look, this is exactly part of what congressional engagement should be. we should have a discussion about where this facility will be located.
if they have strong ideas about what would be a good place, they should bring forward those ideas. we are happy to have that discussion and take a close look whether that would meet our requirements and bring about the kind of tax savings we would envision. we would welcome that discussion, but right now congress has passed a law that prevents that conversation from taking place. consistent with anybody's idea about what it means to do your job. reporter: there have been district attorneys that say they are looking to get a backdoor into phones. does go forward and apple does cooperate with the fbi, there are several phones they are waiting to use. you make it sound like it is just this one case. is there a threat that other
district attorneys across the country will be able to use this into phonesy to get or other types of cases that are not terrorist related? mr. earnest: i'm not aware of other cases that may be out there. if they have cases comparable to this, make their own case. i have been asked about this very specific request to the department of justice and independent investigators have made to a judge. they haven't south to do it on their own to obtain access to a phone that was used by a terrorist that is no longer living that was actually in the property and owned by the local government in california. so i have limited my comments to this specific request. i can't speak to other requests that may be out there. if there are additional requests that have to be made, they have to go before a judge.
and that is an indication of the case we have been making. i have not stood up here and suggest that the f.b.i. should be able to decide whether or not they get access. and it shouldn't be apple who decides to get access. there is a court of law and procedure in place to determine and to weigh the merits of the arguments that are made by both sides. the judge has come down on the independent investigators at the department of justice and given the way the president has made this investigation a priority because information that was yielded in the investigation could be relevant to protect the american people, that's why we are hopeful that the f.b.i. will continue to do its important work. reporter: is it your understanding that the n.s.a. is still in the practice of collecting bulk metadata? why wouldn't the f.b.i. go to them to get the information they claim they need from this
particular device? mr. earnest: congress passed legislation to reform this program to ensure that the intelligence comintetyigence coo longer be in the business of collecting that bulk metadata that was included in section 215 of the patriot act. that is no longer taking place. reporter: there is no collection to your understanding of bulk phone records? mr. earnest: based on the law that was passed by congress last year with bipartisan support, it made critical reforms that put telephone companies in a position to collect that data and with a court order, law enforcement officials could conduct the kind of searches that are critical to our national security. but it would not be a situation where the u.s. government was in a position of holding that data ourselves.
reporter: to follow up on something margaret was asking you about, the broader question about detainees. considering there is ongoing theaters all over the globe involving terrorists, where are they being held? mr. earnest: there is a process for this and again, we don't have to envision in our mind how this might work. we have time and time again demonstrated when it comes to terrorists who are apprehended in the united states, we have a process in place where we can make sure they are subject to robust interrogation and can use that information to enhance our national security, that we can get the information we need out of them to make sure to keep the american people safe and turn them over to law enforcement interrogators to put them through the justice system and many of them are actually serving time right now on american soil in american prison
facilities no longer posing a threat to our national security. we have a system in place that works that keeps the american people safe and lives up to our values. reporter: what about the ones captured on the battlefield? in syria, for example. they are not being transported back here. where are they held? since we are engaged in an ongoing battle that involves terrorists that may be apprehended on the battlefield, they have to be held somewhere. if they are going to be detained and the argument that some are making a facility like guantanamo is going to be important moving forward even beyond the 91 current detainees. mr. earnest: that's wrong and over the last seven years we waged a counterterrorism campaign around the world and that has been in iraq, syria, afghanistan and that's been in a variety of other countries. not one prisoner has been transferred or added to the population at guantanamo bay
since president obama has taken office. reporter: so they are being held abroad? mr. earnest: we are on a case by case basis evaluating the best way to bring these individuals to justice or at least make sure they cannot pose a threat to national security. let me give you one example. there is the woman who was the wife of the isil leader that was killed in a raid conducted by u.s. forces in syria, this was last year. and this woman was facing very serious charges related to isil's hostage taking activities. that individual has faced a couple of things. that individual is in the custody of kurdish officials and going through the kurdish criminal justice system and has been indicted by the u.s. department of justice for complicity in hostage taking activities.
terrorist background, she is in custody and no longer a threat to u.s. national security. that is one textbook example how we can make sure we take actions that puts the safety and security of the american people at the top of the list. but also make sure that we are acting consistent with our values. reporter: essentially, what you are saying is because these facilities exist, would it not be possible to take some of the detainees and move them to some of these other facilities, emptying out the prison in cuba? mr. earnest: we would have to evaluate the security measures in place in those other facilities. first of all, we are talking in some cases about terrorists who may pose a significant threat. we need to make sure we've got the security measures in place to keep them safe.
this goes back to the core problem with guantanamo bay. why would another country want to take them? why would they want to take on that problem? members of congress don't want to take on that problem and it is a problem created by the united states government. it is important for us to resolve this question he for the next president takes office. it ends up being a sticking point in our relationship with friends, allies, and partners with whom we have business to conduct. this issue is one that serves to cloud the agenda that has high-profile and high priority national security items on it. reporter: is it your concern that what appears to be happening now which is, it has become political, and this nominee may not get a vote or a hearing, that when the tables are turned, and the democrats
are in control, this will happen again? mr. ernest: there is no denying that what republicans are threatening to do in the context of this supreme court nominee is unprecedented. president'sa nominee has never been denied a hearing unless the president withdrew that nomination. this would be an historic and unprecedented acceleration of politicizing a branch of government that's supposed to be insulated from politics. and while, as the president has acknowledged, there are democrats and republicans who are responsible for contributing to that, there is no denying that what leader mcconnell and other republicans are proposing to do right now would turbo charge that process and may in some ways subject the supreme court to the kind of politics that they've been insulated from
for more than two centuries. that would be a shame. and fortunately, i'm not the only person that's making that argument. we've seen statements from people like senator kirk, senator collins, even somebody like senator blunt, a republican from my home state of missouri, has indicated that he believes that this nominee should get a hearing. again, in some ways, if i were sitting in your chair, the observation i would make is, there's actually not bipartisan support for blocking the president's nominee. in fact, there's actually bipartisan support for making sure this individual gets a hearing, a fair one, and gets a timely yes or no vote. hopefully that's what we'll get. michelle. reporter: today in spain, a former gitmo detainee was arrested as a suspected terrorist recruiting for isis. it was said he was a leader who was trained in weapons and explosives. does that matter?
mr. earnest: it does matter. because of the changes that this administration put in place, again, back on january 22, 2009, the recidivism rate that we've seen from individuals who have been transferred under the formula that was put in place by the obama administration, that recidivism rate is in the single digits. it's quite small. and it underscores how important it is for us to have in place the appropriate security arrangements when we transfer an individual to another country. we can do this safely, we know how to do this. and that's why the president believes it's both in our national security interest, but it also is much more cost effective than what's happening right now. reporter: this isn't just one or two of the 35 that are potentially going to be transferred, went back to fight
for isis. this example today, this is somebody who is in europe while the united states is fighting isis. so, of this new batch, let's say the recidivism rate is in the single digits. in this period of time, when we are at war and isis is acting in other countries besides iraq and syria, isn't that a significant threat? mr. earnest: it's certainly a threat that we're mindful of. again, according to your own reporting this individual has been apprehended by authorities. the other thing is that if we're at war with terrorist organizations that are seeking to radicalize populations around the globe and we know that the prison at guantanamo bay is a prominent recruiting tool that they use, why wouldn't we take that away from them? look, even the gorey videos that were released by isil a couple of summers ago eadvocated some of the themes and imagery from the prison at guantanamo bay. we know that they are seeking to capitalize on thatted a a propaganda victory and we should take that away from them. reporter: but taking the same guys and transferring them to prisons in the u.s., wouldn't that then just become the recruiting tool and wouldn't -- you know, as the argument has been, if there were to be some violent protests surrounding
that, it would be on u.s. soil. i guess at the crux of it -- mr. earnest: i don't think that's a legitimate argument. i don't know that there are any huge protests that are taking place on cuban soil right now. reporter: just as a recruiting tool, your argument that gitmo is the recruiting tool, wouldn't that just then be transferred to having these guys still held indefinitely in the u.s.? being the same thing? mr. earnest: their argument would be tougher because the detention we would have from place would be cleanly in line with american values. that we would ensure this is consistent with the way that american citizens are treated. that certainly is more consideration than these terrorists give to their adversaries, to say the least. but we would be on quite strong moral ground to say that these individuals are being treated humanely, that the conditions in which they are detained are safe
and clean and reasonable. and we would be taking away an important propaganda tool that we know that extremist organizations like isil capitalize on. brett was just standing here at this podium talking about how we're mindful of the threat that isil poses because of their ability to radicalize people around the globe. let's make that little harder for them. let's close the prison at guantanamo bay. reporter: in addition to what we heard the attorney general say not too long ago, we just saw the joint chief send a letter to the hill reiterating that. that it would be illegal based on current law to transfer people to the u.s. so, given what we've heard now, several officials today surrounding the illegality of making a transfer like that, why are you not ruling out executive action to do something more -- mr. earnest: because i'm not going to take any of the president's actions off the table. that's not what our focus is right now.
our focus right now is quite clear given that we have presented to congress exactly the plan that they asked for on exactly the time frame that they asked for. and what we're asking for is legitimate consideration be given to the plan. we've got a very strong case to make about how the plan that we have put forward would save taxpayer dollars and make the american people safer. that's the essence of our plan and it's time for members of congress to put their own political considerations aside and actually consider what's in the interest of the national security of the united states. reporter: that's your focus but it's hard to ignore what so many have said surrounding what's legal an what's not, including the attorney general. so, how can you still say that executive action is possible? that would put a severe limit on
what the president could do. mr. earnest: we're acting on getting the congress to act on the plan that we have presented there today. if they do that, that would make any sort of discussion about the president's executive actions obsolete. and that's why we're going to go ahead and continue to put pressure on congress to do the right thing. reporter: the president could still take executive action on gitmo, is that what you're saying? mr. earnest: what we're focused on right now is congress taking action and i'm not going to stand up here and unilaterally take any options off the table when it comes to the president's use of his executive authority. reporter: how does this change your strategy in general? mr. earnest: since we last met the president did make calls to republicans who served on the judiciary committee.
that outreach continues and it will continue. and i would just observe that while there may be -- while senator mcconnell may claim some unanimity among republicans on the judiciary committee, he cannot claim unanimity when it comes to the united states senate. we have seen statements from senator kirk and senator collins that they believe the nominee should get a fair hearing and a timely vote. their opinion. i think senator mcconnell does too. i think the opinion we value most is what is required by the united states constitution. and the institution of the united states senate has a duty to function and ensure that the supreme court of the united states has what's required to function as the founders intended. reporter: you still think there's a --
mr. earnest: absolutely. i think based on what senator kirk and collins and senator coates has also indicated that he believes that he said, if the president nominates someone, which is his choice, i think that person would deserve a hearing. senator blunt said, i certainly don't mind taking a vote on this issue. neither senator coates nor senator blunt represents a state won in theent obama re-election of 2012. neither of them would describe themselves as a moderate. both of them are conservative republicans. but both of them are out there saying publicly that if the president nominates somebody, they're ready to vote on them. again, i guess it will make for an interesting caucus meeting when senator mcconnell brings together the members of his senate, maybe they're having lunch right now. reporter: -- [inaudible] -- every member of the judiciary committee signed a letter saying no hearing. mr. earnest: i was in the meeting, obviously, i was standing right here.
i'm not sure what senator kirk, senator collins, senator blunt or senator coates had to say about it. we'll do a couple more. hands in the back. jordan. reporter: thanks. back to gitmo. we were told earlier today that there was outreach to relevant congressional parties on the white house's plan. i was wondering if you could expand on which members were warned about the plan before it was released and who did the outreach and whether the president has personally called members of congress about the plan? mr. earnest: let me check on that for you. i know there was extensive congressional consultation that occurred before the plan was formally released. but let me see if i can get you some greater detail about how that took place. reporter: as you mentioned, you've given congress the plan that it asked for, as you put it, and the administration is citing the broadband on spending money to, quote, to move detainees to the u.s. as why you can't give a specific site. but the same law, the ndaa,
inspections have said in this report that you have given that congress asked for says that the report is supposed to include the specific facility or facilities that are intended to be used or modified to be used, etc. so, why -- how are you filling congress' request for that? mr. earnest: i think what this highlights is that every year in the ndaa the congress writes in what language that specifically prohibits the administration from undertaking plans that would lay the groundwork for bringing individuals from the prison at guantanamo bay into the united states. so i think you have highlighted yet another example of congressional dysfunction that they've written the law that includes varying guidance. but the truth, is there's no reason we have to sort of go through all of this. this why don't we have members of congress who actually are willing to put politics aside, focus on the best interests of the united states, and have a serious conversation with the administration about the most effective way for us to close
the prison at guantanamo bay, save taxpayer dollars and remove a recruiting tool that we know isil is eager to use. reporter: senator mccain, when he ran against the president, said he also supported closing guantanamo bay. he's now the armed services committee chairman and he said that the report today is a vegas menu of options -- vague menu of options, not a credible plan for closing guantanamo, let alone a coherent policy to deal with it. is senator mccain just being political? mr. earnest: i think you'd have to ask him how he arrived at his conclusions. i think the facts here are pretty clear. we've made clear exactly how the american people can save money by closing the prison. we've made clear that this is something that can be done safely, consistent with our national security interests. in fact, we've made clear that it would enhance the national security of the united states, to pursue this approach. and again, it's going to be up to congress to decide whether or not they're willing to enjoy the benefits of the outline that we have put forward. are they going to put forward
their own plan? there really hasn't been much of a discussion about that. i don't know if there's a congressional plan to try to achieve these goals. after all, we know there are a lot of republicans who are running for president, who are saying that they would make foreign policy decisions based on the advice they get from our military leadership, consistent with the need to cut government and cut wasteful government spending, and to make sure we're doing everything we can to make america strong and to protect our national security. if we're making decisions based on that criteria, congress would implement this plan today. reporter: last question. in the president's trip to cuba, my understanding he's not planning to visit the base, either the soldiers or the prison. can you confirm that and was it considered and dismissed or was it just never seen as a possibility? mr. earnest: i don't have the details yet on the president's trip to cuba. at this point i don't expect that the president will go to
the base at guantanamo bay. but let me check on that for you and we'll see if we can confirm that in advance of a more full schedule. reporter: the president seemed pretty frustrated today, talked for a long time about this plan that he's sending to congress to close the prison at guantanamo bay. he talked about the number of hours he spent working on this and how many policies -- [inaudible] -- and it was obviously a major promise of his campaign. he's now in the final year in office. he basically acknowledged the impossible politics and you referenced it earlier, no members of congress want these prisoners in their district, their state. i wondered if you could give us a sense of, get us in his head a little bit, how he feels. he's got 10 months left and this is still an issue that he does not seem to be able to get rid of. mr. earnest: i think the way the president sees this is he sees it as an opportunity that he has to prevent a problem that was passed on to him from being passed on to the next president.
he takes that approach not knowing who the next president's going to be. his view is that the interests of the united states would not be enhanced by passing this problem on to either a democrat or a republican. in the oval office. and the president's acknowledged that the politics of this are tough. and that there's an opportunity given that he didn't have any more elections to run, vice president biden doesn't have any more elections to run. that means they have some clarity of judgment that they can use here to do the right thing for the american people. and, again, in a lot of ways, what we're looking for from congress is, even if there's a reluctance on the part of some members of congress or many republicans in congress -- many members of congress, from cooperating with the administration on this, at least they could just remove the obstructions. just get out of way so the people who are trying to act in the best interest of the american people can do their job.
that's in some ways what the president is seeking. if congress feels like they don't want to be involved in this effort, as i mentioned, there's plenty of good reason for them to want to be involved in it. it would enhance our national security and save taxpayer dollars. but if they don't, they can remove the obstructions and allow the united states -- to allow the president of the united states, his national security team and our uniformed leaders in the military, take the steps we believe are necessary to enhance our national security. we can do all of that, save taxpayer dollars, that would be the right thing to do and the president's hopeful he can get that done before he leaves office. reporter: -- [inaudible] -- on the supreme court. you seem to be making the argument in 1992 that even though he had in the past as chairman of the judiciary committee moved along republican nominees and was willing to in a future administration, that there was something about the election year and being in a campaign that made it inappropriate to fill a vacancy, either by the president or the senate moving it. can you explain to us what is
different from june, 1992, to february, 2016? why is his answer different? mr. earnest: there wasn't a vacancy. there was nothing that he said then that prevented the senate from fulfilling its constitutional obligations. he made clear later in his speech that if the president consults and operates with the senate, then his nominees may enjoy my support as did justices kennedy and souter. justice kennedy was confirmed in an election year. so, again, when it comes to evaluating the performance of members of the united states senate, vice president biden's got a record that's pretty tough to beat. this is not -- as i mentioned, we're simply asking the united states senate in 2016 to do what senator biden did himself in 1987 and 1988, when he gave fair consideration to a nominee that was put forward by a president in the other party and
vice president biden advanced the process so that individual could be confirmed in an election year. we believe the senate this time should do the same thing. reporter: [indiscernible] mr. earnest: i think it depends on which part of the you take a look at -- which part of the remarks you take a look at. there was not a vacancy. there was nothing that senator biden said that prevented the senate from fulfilling its constitutional duty. reporter: [inaudible] mr. earnest: i wasn't there in 1992. i was a senior in high school. it's hard for me to assess with a lot of clarity exactly what the dynamics were. but what is clear is that there was no vacancy at the time, there's nothing here that he said that prevented the senate from fulfilling its constitutional duty. and in fact in the same speech then senator biden made clear that he would be open to consultation with the white
house, that was controlled by the other party, and fair consideration of the nominee that was put forward by the president of the other party. reporter: could you tell us a little bit more about the president's -- [inaudible] mr. earnest: that's right. the president periodically convenes meetings with his national security team to discuss the ongoing effort to degrade and ultimately destroy isil. the president will convene the meeting or the next meeting on thursday at the state department. over the last few months the president has convened these meetings not just in the situation room but in other places. you'll recall the president went to the pentagon to have this meeting. i know there was a discussion about our counter-isil campaign at nctc last year. and this week the president will be convening the meeting at the state department. obviously the state department's
been doing important work to try to reach this agreement or at least an understanding around the cessation of hostilities in syria. so given the primacy of the work that's been doing at the state department right now, the president thought it made sense to convene the meeting over at the state department this time. last one. reporter: thank you. speaking of election year politics, i wanted to ask you about something the president said last week. several times you've indicated you wouldn't endorse in the presidential primary and the white house chief of staff said he'd see who the nominee is at the end of the primary process. that's not our job and then he'll decide. the president's remarks during his press conference seem to suggest that he could endorse a democratic candidate in the race. he said ultimately, i will probably have an opinion on it. based both on being a candidate of open change and on a president who has some knicks and cuts and bruises from getting stepped on. my question is, what's changed recently that the president is now suggesting could actually endorse in a primary? mr. earnest: if you take a look
at the way i scroo described the situation, we don't currently have a plan for the president to make public his preference in the democratic presidential nomination process. the president will fill out a ballot and vote absentee in illinois. the illinois primary is march 15. so he's got to make a decision pretty soon, if he hasn't already. so the real question is whether or not we're going to make that public. right now our plan is not to make that public. but i wouldn't rule out the possibility that we may decide to make that public at some point in the future. ok. thanks, guys. we'll see you tomorrow. reporter: -- [inaudible] -- short list mr. earnest: i'll try to come with that tomorrow. >> bring the binder. [captioning performed by the national captioning institute, >> attorney general lorettas lynch takes questions about the justice department's 2017 budget request. it totals $29 billion and
increases funding for countering violent extremism and civil rights initiatives. she testifies at a house appropriations subcommittee, that is live at 10:30 this morning. the homeland security expert, jeh johnson, goes before a senate appropriations requestttee about the from his agency. live coverage begins at 2:15 eastern on c-span3. >> how can we best get people to pay attention to wasteful spending? we tend to find things that are interesting. a little different and easy to understand. large,-government is so this organization has to cut through some of the other things going on. the members of congress talking about the wonderful things they are doing. and try to get people involved
and make it more personal so they understand the impact on them and their families. .> sunday night on q and a citizens against government waste. bookalso publish the pink -- the pig book. the coalitionith against congress and they came up with the definition and it eventually became the term, earmark. we went through the appropriations bills and restarted the earmark. up to $29l the way billion in 2006 and every here, we can find earmarks in the appropriations bill, we release it. sometime around april or may. eastern. night at 8:00
next, hillary clinton talks about gun violence and civil rights and policing practices. she is joined by several mothers who lost children to gun violence. from gabby giffords and her husband, retired astronaut, mark kelly. the event was held in columbia, south carolina. from[applause] [indiscernible]
>> what the church say, amen. are there grateful people in the house? put your hands together. give it to the house. let's celebrate. open your mouth, put your hands together. it is time to celebrate. amen, amen, amen. we welcome you to our services tonight. we are thankful that you were able to get here. we were thankful you are able to get in without the rain. a greatooking for two time as the spirit of excitement
is in the air. we will have a work of prayer. father, god of our solid tears. this is the day the lord has made and we will rejoice and be glad in it. you continue to keep us every day. we come down with an attitude of gratitude just to say thank you, and look at where you have brought us from. have your way in this place tonight as we come with the spirit of celebration. our testimony is with nobody but you. we give your name all of the raise and glory. in the name of the one who was able to turn obstacles into opportunities. in the name of the one who was able to turn burdens into blessings. turn sorrows into joy.
such a blessing. let me thank them for being here. i'm going to acknowledge each of in a minute. [applause] hillary clinton: i want to recognize and acknowledge congressmen jim clyburn. [applause] and mrs. emily: with us both of who are this evening. i also want to it knowledge someone who i first met here in south carolina. , a long time ago,
when i came as a young lawyer for the children's defense fund. to investigate the deplorable situation of young people, young teenagers. being held in adult prisons. and attorney herb muehl who is here with us with his wife, i want to thank them for coming. [applause] the attorney who led me to his automobile at that time, a stick shift. [laughter] hillary clinton: i drove that around the state bucking and moving back and forth as it went from place to place to interview people to gather information for that the children's defense fund eventually filed
with attorney general being involved in that. tonight, we will talk about two very important issues. they intersect and they are distinct but they have grave consequences. not just for the people sitting here with me, but for all americans. whowill hear from women have lost their children. the mothers of the movement. who have suffered as no mother ever should. fulton, meet sabrina her son, trayvon martin, was followed and shot in a housing development where his father lived because he went out to buy a packet of skittles.
society that holds people back disproportionately. we need to be building ladders of opportunity. we need to rebuild trust in our justice system. to the mothers here and mothers everywhere, we know that they have experienced a tragedy that a vast majority of us never will. for is how grateful they are turning their grief into resolve. have been traveling across south carolina the last few days but they have been traveling across america to ask for the kind of real change that we need. there are many state and city officials who are already working to do this. they are having real police involved shootings and in custody deaths handled by independent authorities. i support these efforts. today, i am announcing that we will provide federal resources to support the state and locally driven approach.
[applause] hillary clinton: tackling and ending systemic racism requires contributions from all of us. white americans, we need to do a better job of listening when african-americans talk about the seen and unseen barriers they face every day. we need to recognize our privilege and practice humility. rather than assume that our experiences are everyone's experiences. i also believe that if we work together, to make major new investments in communities that have been leftrather than assumr , andiences behind guarantee justice and dignity to every american, that will benefit all of us. i really applaud congressman clyburn's plan as to how to
better distribute federal plans. who have been left behind over so many years can have a better chance to lift themselves up. [applause] our problemton: with violence goes far beyond the terrible cases where the police are involved. that is why i am deeply honored to have gabby giffords and her husband with us. [applause] hillary clinton: the epidemic of gun violence stocking our land is another barrier holding us back.
the parking lot of a shopping mall. she was doing her job. six people died that day. including a nine-year-old girl who was so excited because she was going to get to meet her congresswoman. she was standing in line to do just that. that capi andful the gune been taking on lobby tirelessly, fighting for commonsense reform. we should all join themkilled b. in this effort. [applause] we needclinton: comprehensive background checks. we need to keep guns out of the wrong hands. need to close the charleston loophole. that led the killer there get a gun, even though he should have
been ordered. we need to revoke the special immunity gun dealers and that they have today thanks to a vote by the congress. they should be held accountable for their products just like any other company. and we need to crack down on purchasing and make this a federal crime. and for goodness sakes, we should bar people on the no-fly list, the terrorist list from buying guns in the united states. [applause] hillary clinton: i know the politics are hard. i am well aware. but sometimes the hard thing is the most important thing to keep trying to do. we can't go on like this.
courage and commitment. >> thank you. i am the mother of trayvon martin. [applause] >> thank you. thank you. wow. [applause] >> thank you, thank you. thank you. i have fooled a lot of you guys because i have changed my hairstyle. let me start off by saying, the reason why we are here, number one, the mothers of the movement, the mothers on a mission, it is because secretary clinton supported us and we have
to stand and support her. [applause] >> we each have a personal story andmy hairstyle. we each have a reason why we feel the way that we do. way we feel about secretary clinton. we met her -- and it is going to make me tear up -- we had the opportunity to sit with her to meet with her, and when we met with her, she walks in as a secretary. political in as a figure. she walked in as a presidential candidate. out as aalked compassionate mother. as a compassionate grandmother. as a compassionate wife. [applause] no way in there was
the world that she was going to be able to sit in the room with 12 different families and each traffic -- have a tragic story about our sons and daughters that have been murdered as a result of gun violence. the meeting took a whole mother turn because we poured out our hearts. no other candidate would listen to us. traffic -- have a tragic story about our sons and daughters that have been did.red as ams. clinton [applause] >> nobody reached out to us. nobody listened to us. ,obody said, black lives matter until this brave and powerful woman stood up for us. [applause] >> i was never into politics. but now i am.
one of the reasons is because of her. because i feel that if she can mend up against all of the that she has to go up against, i can too. [applause] >> so, a lot of you have seen and heard about what happened with my 17-year-old son, trayvon martin. trayvon was 17 years old. he had just turned 17. he was minding his own business. he was not committing any crime. he was on the telephone with a young lady from miami. this person decided to pursue him, to follow him and to murder him. he was clearly profiles.
the media wanted us to believe that it was about the hoodie that you guys know that everybody wears a hoodie. if you are matter black, white, purple or green, african american or asian or hispanic, you wear that city. our young men and women where the hoodies. we have to come to terms with that because only when we come to terms with that is when we get to a solution about why this continues to happen. and so simply, i will say, that it was secretary clinton that stood up for us. secretary clinton who met with us and listened to us. no one took notes for her.
she took notes for herself. she knew about all of the families that were in the room because her research team did their homework. she heard a lot more than she probably anticipated. hearts tored out our her because that is our passion right now and for the rest of her life's. them,stories, as you call the tragedies for us, they never go away. i think about my son a in and day out. i lived with this day in and day out. these mothers live with this day in and day out. we have the opportunity to have someone who will stand up for us .s african-americans and women my vote goes to hillary clinton. [applause]
[cheers] >> we love you, hillary clinton. [applause] >> hi. i am maria hamilton. the story was not in the mainframe, it did not get the national attention. he was demonized, [indiscernible] policemilwaukee department. and he was 31. that had aung man future bigger than life. he talked about bringing duffel bags of money home and taking care of his family. lifented to do a digital
and was in the process of getting it done. his life was stripped from him racism in race -- milwaukee, miss -- wisconsin. this justice is across the board. it is their lives. it is where they live. it is the churches they go to. them to live. i am fighting for life. times, he had anyone bullet holes in his body. managerof starbucks
said he was sitting too close to their stand in a public park. broad daylight, not bothering anybody, not asking for anything. the outfit that he had on, the but she$400 outfit still seen him as a homeless black man that was disturbing starbucks from making money so she called the police three times to have him removed out of there. they came out on both occasions. time they came out the told her it was a citizen, he was not doing anything wrong,
they were not going to make him leave. he called the beat cop that she was familiar with. he had been a beat cut in the area. they had his personal cell phone number, they had his captain number. he missed the first message but when he got it, he instructed not knowingreopen the police officers had been there. he opened it and went to the park and struck him eight times with a baton. considered a weapon because the police had it. it became a weapon.
there has been no account ability. he passed away april 30, 2014. me and my family took to the streets. hall, the police said it was a percent of the investigation. to outside entities were supposed to investigate. a police involved shooting. that did not happen. they did all the interviews of the 60 witnesses. of video.no footage christopher manning said he was hit in the head.
when we went to the das office and saw the pictures, there was roses, no scars. he took pictures right afterward. there were no signs of a struggle. he, brown skin, he had 12 bruises on his body. and they say self-defense. fired byer manning was his civilfor breaking rights and for illegal head down. there was a policy. indicted on a local level. he was not indicted on a state level. he was not indicted on a federal level. to getd 22 months closure and go forward.
can we do? it was not high-profile. here just to be on camera. i'm here because our babies are dying, the police is not being held accountable, there is laws and stipulations and legislation that protects them. they get out of their cars with .heir guns i have to get home safe. the are not concerned with people they engage with doing their shift and when we start making them respect us as human beings in the urban area by coming together, standing up and
opening your eyes and saying things with your eyes wide open. we can get the accountability that we need. and we can love and cherish and raise our families as well. thank you. [applause] i want to give my complete thanks to secretary clinton for allowing us to travel and tell you our story and tell you why it is so important first and foremost to vote but specifically to vote on her behalf. [applause] my name is lucy mcbeth.
wasmother of the man who shot on black friday. jordan and his friends were really excited about shopping and that is all they were doing on november 23, 2012, shopping, going from one multiple next and in the time that they stopped to get chewing gum because my son said you guys were going to the next mall and pick up girls, we need to get some chewing gum because our breath stinks, typical for teenage boys. also what is typical is that they are playing loud music. booming music. and so in that thread half minutes time that the boy stopped to get chewing gum and the driver of the car goes into the convenience store to get chewing gum and cigarettes, a man, michael dunn, 47-year-old white software developer pulls in next to the boys in the parking lot.
those three and a half minutes he begins an argument in about the with my son volume of the music and because he was emboldened by the state of florida and this expense of law that is all over the country. based on that law, being emboldened and its implicit bias. and his racist attitudes. he was concerned they were thongs -- thugs and gang bangers. he shot 10 rounds into the car. he was aiming for my child and three of those bullets did kill jordan instantly. the other seven bullets he continued to shoot at the boys as they were trying to get out of harms way. he tracked them as if he were a policeman, tracking them as they
moved out of the parking lot. that what gave him carte blanche, so to speak and the ability to shoot to kill , ask questions later, shoot first, ask questions later, what gave him the authority is the and thee gun culture radical gun laws that we have here in our country. and because the gun laws have become so extremely radical we see this proportionately in our community of color that people are acting out their implicit biases and racism through gun violence towards our communities. it is known that statistically that 30 times more a black man
will be gunned down more than white men. 30 times more, a black woman through guned down violence in a white woman. and black men will particularly live one year less in this country because they died by gun violence. they will live one year less in a -- than a white male. i have had the great and profound privilege to stand on the podium with president obama as he gave his executive orders in this country toward gun violence prevention. and being able to stand on that podium with him, i could only think what my father would think. was branch president of the naacp and served on the executive word. i know he would roll over in his if he knew that his
grandson died by systemic racism, acted out by gun violence. the same things he had been fighting for for the last 30 or 40 years. i have to now fight on his behalf. [applause] i have watched her as senator herton and i have watched as secretary of state. i have watched her bring allies back to the fold, back to the fray, countries that had long been forgotten about and she has done a good thing. [applause]
i have no doubt in my mind that she will execute the executive orders of president obama. i have no doubt in my mind that is will make sure that there .overage of background checks i have no doubt that she will make sure that any individuals in this country that are selling high volumes of guns that consider themselves in the business of selling guns and their gun dealers, i have no doubt she will make sure that they are fully and duly licensed. [applause] the high number of black market guns that are infiltrating our guns aremost of those
being used against community best amenities of color. i have no doubt that she will make sure that she's keeping guns out of the hands of dangerous criminals, the mentally ill, and definitely making sure that she is putting into place commonsense measures in our existing gun law. she is not against the second amendment rights for people to bear arms. make no mistake about that. but she understands that with the second amendment rights that people have to have commonsense measures put in place. [applause] i know that she will execute -- i do not say gun control because this not controlling your gun but gun violence invention basically to save us from ourselves. [applause] make gun that she will
dealers and gun manufacturers accountable for the numbers of guns and the immunity that they have in this country towards what is happening in the gun culture. so i stand here before you, sit here before you to say i have no doubt that she is the candidate of choice. i have no doubt. i have no doubt that she cares about what is happening in our communities and the nation at large. i have no doubt that she is the candidate that will protect and serve the constituents that have placed her in office. i have no doubt that if my father were standing here with me today he would say, well done because you're making the right choice.
[applause] >> good evening, everyone. giving honor to god who was first in my life, i am here today to endorse this wonderful woman. [applause] fellow mothers said before me, we have a personal experience with her. go lookinghave to for her. she came to us. ok? not one of the presidential heridates even considered and secretary clinton, she reached out to me several times
before the meeting. and -- in chicago. her staff, they constantly called me and told me anything that i would need to call them and they would see what they could do. at first i was saying why are they calling me, no one else reached out like that. official had reached out like that. you know how you get larry sometimes because what is going on? , there was no catch. she was just genuinely concerned about me. that time and time again, even after the meeting in chicago. follow-upshe had
letters, telephone calls. it was not like this was annex which haitian. of us mothers. because as you listen to the other mothers you know we cannot be exploited. all right? [applause] all -- my son died on july 17, 2014 by the hands of police and five others. let's not leave them out. there were five other officers. 11 times he said i cannot read. but the officers chose to take his life.
and to add insult to injury, there was no indictment. we have a video showing the his civil rights and equal rights and human rights were violated. get andid not indictment. estimatethe justice what kind of world we live in? that day, i will never forget as long as i live. whole to get to see the tape, the full video but from what i have seen it plays over and over in my head. it is like a reoccurring nightmare. it is worse than a nightmare. because i never wake up.
at first i could do nothing but take to my bed. they had killed my son, my firstborn or no reason. he was not armed. he was not committing any crime that day. he had just broken up a fight. ifwas targeted and i say to inc gardner was a white man the suburbs standing on the corner selling cigarettes it would not have gone down like that. [applause] my because of some very -- family were there for me from beginning to end. some good people. i have the national action network, i had the justice committee, i had a lot of people
and gave meterwards the strength to get out the bed. it was the lord. he talked to me. me i going to leave there and die like your son or are you going to get up and uplift his name? and i thought about it. i thought about there is so many other young men and women just like me that is faceless and nameless. i said to myself, my case was very high-profile. every american has uttered the name eric gardner. so now i have to be the voice of the voiceless. take this cannot anymore. we have to give up and do something about it.
we cannot stay in our comfort zone anymore. we have to step out of the box. i never thought i would be up here. i never thought i would be an activist. i never thought that i would be in front of you making this statement. but it is what it is. today, i had to turn my sorrow into a strategy. mourning into a movement. and us mothers, we empower each other. my son's death would not be in walk, speak,ll rally, do whatever it takes until my voice is heard and until justice is served. [applause] you to why i ask all of
vote. and to pick the right candidate. and i think the right candidate is secretary clinton. she is the one for us. she will stand with us, she will be with us to my and try to change policies. her becauseendorse she endorsed us first. all right. [applause] thank you. wow. see why we call her mama [indiscernible] i am the mother of sandra bland. for those of you who do not know, it has been more than a tougher. it has been more than an extra
ordinary journey. sitten tell people that to among these mothers and to know what ain't really is, you come across people and people do not know what to say to you. when you talk about in 2015 getting a phone call that your hanging in aound jail cell from a five foot something partition. not only does that not add up, something is wrong with that. she was unlawfully arrested while she was down in texas on a job interview. she didn't get the job. she was going to be a student ambassador at her old alma mater, prairie view a&m. sandy was extremely smart. sandy was a young lady who just said, listen. i know my rights and i'm not going to allow you to put your foot on my neck because i know
what you're not supposed be doing. so when she was unlawfully stopped and arrested. there was no -- for the entire world to see, the tape was put out and there was that foranders tape, thank god that that we were able to hear because there is never any audio on these tapes that seem to come out from the other side. you can be doing absolutely nothing because she pulled over because she was targeted and the officer sped up behind her so she is pulling over to let him over. , pulled overrested for a failure to signal. she ultimately after the stop became and there was a shift in
the stop, she was charged with assault on officer. i do not know if any one saw an assault on officer but because of what she was charged with, she was put in jail where she should have never been. and it was indicated that she should be placed separate and apart because of the violent nature. sandy was merely minding her own business. not takefficer could it. he had an ego situation going on that day. as a mother i say to any officer and to anyone who is here to serve make sure that is what you're doing and you are not isolating and neglecting. that is what i say to you. because i know for fact if your boss says mike i was wrong,
you're wrong. at the same time because of the way our justice system works the german has been indicted on a perjury charge. ok? but he is still being paid. he is still on payroll. regardless of the fact that they the determination was in progress. as a parent you say how long is the process, how long is a question mark we do not know. it could take a year, months, we do not know. he was dead wrong but guess what? you do not get any justice right now. because he needs a fair trial. mothery to you as a these mothers have talked about the time of separation that we had to have from the world. we are grieving, we had to grieve in the open. so when you did not see me at first i was actually in a season. , summer, five seasons
fall, winter, and spring and the season of shut up and sit down. i was literally in the house. closed, darkness everywhere. all you could do was cry. and he would have thought that myself, cornell west, and don king had the same barber. [laughter] there was no way i could step out of the house at that time and tell the story because what you would have heard would not have
i am very angry, but i'm not angry enough or iot. -- to riot. i'm eangry enough to vote for this lady. heering]g and c >> i will tell you why, just as a mom, and am looking at my sisters -- these are some bad sisters right here. i am honored to be on this stage with them. this has turned into a ministry. i had a chance to meet this marvelous mothers and now we are in the mothers and the movement. i am grateful for the opportunity. i met secretary clinton at the congressional black caucus. congresswoman sheila jackson lee, who has been awesome from day one - day one! somebody call my family and
said, hey, we are not taking it. that is form day one. she introduced me to secretary clinton. i was thinking, oh god. this is the secretary, oh jesus. she was smooth and held my hand and looked me in the face and said, what do you want? what do you want out of this situation? we are in a room full of people. this is the secretary. didn't excited and she even know it. i am trying to be real cool. [laughter] i said, i want justice for my daughter. justice is something different for each of us, i am sure. but justice means it is time for us to start getting justice. that is really what it means. [applause] after that she came and she met with us and you want to talk about someone who walked in --
she needed no introduction. we all knew who she was. she walked in, being who she is. she sat with us. she knew every story she asked us but we would like to see done. she told us, you guys would be strong as a unit. we were thinking, secretary, we hear you. we heard her, but we each had our things going on. when i tell you today, i could go in my dining room, take my shoes off and say, secretary, come on over and have a seat. she would be at home. that is the type of intimate feeling i felt, sitting in that room with her. she did not allow the media in, which was awesome. there was no exploitation here. ok. [applause] i am sick and tired of hearing that. i am a little over 50 and i have
to tell you, there is no exploitation here. there are no payments being made. there are no secret e-mails about this. [laughter and applause] [cheers] right? i'm just saying. i'm just saying. please understand that she followed up. she told all of us before she left. she was already late for the next function. but she didn't -- she took our photos. she was very genuine. you cannot fake compassion. you cannot fake genuine. you cannot fake the fact that you care. i don't care if it is in a nine-month span for an election. she has proven that. when people say to me, why hillary? i say, why not? [applause] i don't think that there is a
better, more qualified individual to get the job done. as we sit here, yes we are her cheerleaders, absolutely. no, we are not being coerced. you cannot take our personal interaction and turn it into a public lie because we are telling you, this is what has happened for us. when i say to you that i made the decision to support secretary clinton, it is because grandma, butom, she has so many other titles that she proveed herself in. i don't have to go back and tell you what she has done. check it out on the internet. [applause] honestly. and to be able to sit here and endorse her, it is an honor. it is an honor.
i will tell all of you before we get out of here today, we are serious when we tell you, you do not have an option not to vote. you don't, okay? there is no option, alright? you have no time and no right to complain if you don't get out to vote. [applause] ok? if you are tired, if you are angry, get angry enough to get to the polls. take someone with you. if you knows that there are a group of teens hanging ont h the corner, go get those teens and make sure they are registered. let them know why this is important. we are going to have a situation if we stay home. we are going to have a situation if we don't vote for this woman. hey! that's where my vote is going. i would not be out here, far from chicago, wasting -- hey!
[laughter] wasting time if it wasn't important for us. we are running from place to place because this is serious. it is critical. we have nine months to put her in. she is the new baby. when you are pregnant, you expect a baby. [applause] hold on. let's take this nine months and let's deliver this baby. let's turn what has been a long history into her story. [applause] >> hello, everybody. i am not a mother.
[laughter] but i will tell you a story anyway. it was about five years ago. gabby was meeting with her constituents in a supermarket at a safe weight grocery store -- grocery store. she tried to govern from the middle, to reach across the aisle to get things done on behalf of her constituents and the american people. constituentser were met that day in the parking lot by a young man with a gun who was clearly mentally ill and should not have been in possession of the firearm. he shot gabby first, giving her a serious, traumatic brain injury. he murdered six others, including as secretary clinton mentioned, a nine-year-old girl who had very high-minded ideas andt service and democracy wanted to meet gabby. she was next in line and i never met.
gabby was in the hospital for six months. i was the commander of the space shuttle at the time. i did my final spaceflight when she was in the hospital. about six months later she got out of the hospital and resign from congress six months after that. that following summer is when the shooting in aurora happened where 12 people died, 58 were injured. this happened in about 30 seconds. that is about twice as long as what happened in tucson. that was when gabby and i first started to think about this issue differently. how did we get to this point as a nation? how did we get to the point 85% of allhing like children who die from gun violence in the developed world die here in the united states. it is complicated. there is not one thing, there
isn't one single thing we could change that would result in some of us not being on this stqagage tonight. it is a very complicated and complex issue. incredibly political. it is incredibly driven by money and politics. [applause] and it is driven by a very powerful corporate interest who is very good at what they do. the result has been that we c urrently have a congress in the grip of the gun lobby. it is not only congress. it is state legislators. it is governors. it is city councils. it is mayors. it often also happens to be the president of the united states. not currently. [applause] but it has been in the past. i think what all of us need to
recognize is that elections matter. [applause] gabby and i took a look at all of the candidates running for president. we all know there are a lot of them. there are less every single day, which is good. there are a lot of them. we looked at their records on this issue. you know, it is very clear and it does not take long to figure this out, that there is only one candidate who has the record and the experience to stand up to a very powerful corporate interest. [applause] [cheers] an dd iwhy gabbjy are here today.
to encourage all of you to get out and vote. it is the most important thing in the individual does, especially in a presidential election year. obviously, everybody would not be in here if they weren't going to vote for secretary clinton. [cheers and applause] what is more important than that? get your friends to get out and vote. find the one friend who is going to vote for somebody else and change their mind. gabby has fought about this issue as well -- gabby has thought about this issue as well. she takes this seriously. she served in congress for two and a half terms. before that she was in the legislature. she is a gun owner and i am a gun owner. at the same time, there are things we can do to keep guns out of the hands of criminals, people who are dangerous, people
who are mentally ill, or domestic abusers. [applause] there is a lot we can do and there is a lot you can do. and there is a lot a president clinton can do. [applause] and gabby is going to tell you why that is so very important. [applause] >> hello! south carolina! [cheers] be here today. i'm here to talk to you about hillary clinton. hillary is tough. [applause] she is courageous. us safer.ight to make
[cheers] know, theinton: you , turningthe commitment sorrow into strategy, it is just such a great message for everybody. something that i hope people take with you when you leave here tonight. something that is yes, important for each of us appear, but should be -- important for each of us up here, but should be important for each of us. i have determined that together we will have justice. we will reform the criminal justice system. we will provide accountability for those in positions of power
and responsibility. progress towards common sense gun safety measures to deal with the gun culture and the epidemic of violence. we will keep guns out of the hands of those who should not have them in the first place. we will look out for one another. we will show more kindness, more respect for every human being. every single one of us deserves nothing less than that. [applause] i thank these extraordinary mothers. i thank marc and gabby for being with me tonight. i really hope that this is the beginning, that this is a movement, that yes, it does result in change. bring more people, as president obama said, to
god bless the great state of nevada. what an incredible team we have here on the ground. i want to thank our nevada state chairman, attorney general added lik. a tremendous, strong rentable constitutionalist conservative. when he ran for attorney general, all the political establishment was against him. he was not supposed to win. i can't imagine what that feels like. [laughter] our incredible leadership team that is here, the men and women across this stage that worked incredibly hard forging a grassroots coalition. [applause]
they are still counting the ballots. we don't know the exact result, but i want to congratulate donald trump on a strong evening tonight. and i want to congratulate the grassroots, the conservatives across this country who have come together behind this campaign. [cheers and applause] when we started this campaign nearly a year ago, there were 17 candidates in the race. fourole of the first narrowes has been to the field. we have seen the first four do exactly that. at this point, we have had four primaries. history teaches us that nobody has ever won the nomination without winning one of the
first three primaries. and there are only two people who have won one of the first three primaries. [applause] i.ald trump and [applause] the undeniable reality that the first four states have shown is that the only campaign that has beaten donald trump and the only campaign that can be donald trump is this campaign. [applause] if you are one of the 65% of republicans across the country that doesn't think donald is the best candidate to go head to head with hillary, who believes we do better with elections when we actually nominate a
firstvative, than the four states that performed a vital function of narrowing this race and presenting a clear choice. you can choose between two washington dealmakers, or one proven, consistent conservative. [cheers and applause] one week from today will be the most important night of this campaign. one week from today is super tuesday. [cheers and applause] states, alabama, arkansas, georgia, massachusetts, minnesota, oklahoma, tennessee, vermont, virginia, and the great state of texas.
[applause] today the most delegates that are awarded on a single day will be awarded next tuesday. [cheers] fourole of the first states is to narrow the field and give super tuesday a clear choice and now, the voters can decide. if you want a president who will stop amnesty. ask yourself who has led the fight against amnesty. [applause] if you want a president who will appea repeal obama care. [applause] ask yourself, who has led the fight against obamacare? [applause] if you want a president who will stand for life and marriage and religious liberty, ask yourself, who has led the fight defending
life, and marriage, and religious liberty? [applause] willu want a president who defend the second amendment --ht to keep and bear arms [applause] olks in nevada flks kidn of like their guns. as a texan, i understand. you look at those super tuesday states. they like their guns too. if you want to protect that second amendment to stop a liberal justice from taking the second amendment out of the bill of rights, ask yourself, who has led the fight to defend the second amendment right to keep and bear arms? [applause] if you want to see america standing unapologetically
alongside the nation of israel -- [applause] yourself, who was led the fight to stand unshakable with thy with the nation of israel? and if you want a president who want a one will rip to shreds this catastrophic -- who will on day one ripped to shreds this catastrophic nuclear deal. if you want a president who will utterly and completely destroy isis. who has led the fight against this iranian nuclear deal, against radical islamic terrorism, and who is best prepared to keep america safe? [applause] elections are about choices and
there are clear choices in this race. if you want more washington deals, if you want more corporate welfare, if you want more debt, if you want fewer jobs, if you want lower wages, you have two candidates to choose from in this field. on the other hand, if you want a president that says "no" to the bipartisan corruption in washington, that stands up to special interests, that stands up to the debt, that says, we will not bankrupt our kids and grandkids. we will bring back millions of high paying jobs. up.ill see wages goign ng we will ensure that our kids and grandkids have a brighter tomorrow, a greater future, a more bountiful america. that's what this choice is about. i want to thank the great
people of nevada and i want to say, i cannot wait to get home to the great state of texas. [cheers and applause] tonight, i will sleep in my bed for the first time in a month. and then, it will be back to the campaign trail in texas and all across super tuesday. energizing and building that reagan coalition, those courageous conservatives, libertarians, young people, and reagan democrats all coming together. [cheers and applause] closer ore one step to morning in america.
donald trump: oh, boy. we love nevada! we love nevada! thank you. thank you. oh, this is a great place. thank you. [crowd chanting "trump"] [cheers and applause] thank you very much. great evening. we will be celebrating for a long time tonight, have a good time. have a good time. [cheers and applause] you know, we weren't expected a couple of months ago, we weren't expected to win this one, you
know that, right? we weren't. of course, if you listen to the pundits, we weren't expected to win too much, and now we're winning, winning, winning the country. [cheers and applause] and soon the country is going to start winning, winning, winning. so i want to thank the volunteers. they've been unbelievable. these people they work like endlessly, endlessly. we're not going to forget it. [cheers and applause] and we've had some great numbers coming out of texas. [cheers] an amazing numbers coming out of tennessee and georgia and arkansas and then a couple of weeks later, florida. we love florida. so we're going to do very well in ohio. we're beating the governor. that's good. it's always nice to be beating the governor. and michigan -- the whole thing. i mean, it's going to be an amazing two months. [cheers]
we might not even need the two months, folks, to be honest, all right? so tonight we had 45%, 46%. and tomorrow you will be hearing, you know, if they could just take the other candidates and added them up. up,if you could add them because you know the other candidates amount to 55%. they keep forgetting that when people drop out, we are going to get a lot of votes. they keep forgetting. they don't say it. so, i want to begin by thanking my boys. eric has been all over the place making speeches. he's getting better than me. so, i am a little jealous. [cheers and applause] and don went up to elko. he loves the rifle stuff. this is serious rifle. this is serious n.r.a., both of them. both of them.
[cheers and applause] we love the second amendment, folks. nobody loves it more than us. so just remember that. and corey and hope the whole staff and group, and charles and stan, what a group we have. it's just been amazing. i want to thank a couple of friends of mine that are here. the owner of this incredible hotel, mr. and mrs. ruffin, stand up. great job. phil said, donald, like for the last three months, he's driving me crazy. he said donald, i want to put $10 million into your campaign. i said, phil, i don't want your money. every time i see him, it is hard for me to turn down money. that is not what i have done my whole life. i grab and grab and grab. i'm greedy. i want money. i tell you what we are going to do. we get greedy, right? now we're going to get greedy for the united states.
we're going to grab and grab and grab. we're going to bring in so much money. and so much everything. we're going to make america great, folks. i'm telling you. we're going to make america great. and another great friend of mine, respected by everybody, a great friend of phil's. mr. and mrs. steve wentz. stand up. stand up. two great people. steve is always calling. he's always got advice. right, steve? donald, i think you should do this and that. his advice, like to -- i like to listen to. so steve and family, you've been great friends. thank you. thank you. so, this was very exciting tonight. .ut, i'll tell you it looks like we won by a lot, evangelicals. i love the evangelicals. i have to tell you, pastor jefferies has been so
incredible. and as you know, liberty university -- do we love liberty university? [cheers] jerry fallwell jr., he has been with us since the beginning. i want to thank jerry and his family. it's been amazing, the relationship. so we won the evangelicals. we won with young. we won with old. we won with highly educated. we won with poorly educated. i love the poorly educated. we're the smartest people. we're the most loyal people. and you know what i am really happy about, because i have been saying it for a long time, 46% with the hispanics. 46%. number one with hispanics. [cheers and applause] i'm really happy about that. so -- [crowd chanting "trump"] thank you.
so i'm very proud of you. this is an amazing night. you know, i love the country. i love the country. we are going -- [cheers] we are going in the wrong direction. we're going to keep as you know gitmo. we're keeping that open. and we're going to load it up with bad dudes. we're going to load it up with a lot of bad dudes out there. we're going to have our borders nice and strong. we're going to build the wall. you know that. we're going to build the wall. and i have a lot of respect for mexico. and you just heard we won hispanics. but let me tell you, mexico is going to pay for the wall, right? going to happen. going to happen. they know it. i know it. we all know it. we have a tremendous deficit. we have a trade deficit with mexico. they'll pay for the wall. they'll be very happy about it. believe me. i will talk to them.
they are going to be very thrilled. they're going to be thrilled to be paying for the wall. we're going to be the smart people. we're not going to be the people that get pushed around all over the place. we're going to be the smart people. you're going to be proud of your president and you're going to be even prouder of your country, ok? [cheers and applause] so tonight, folks, this was a great evening. i love this place. i love this state. i love las vegas. i have spent and invested so much money over here. trump international hotel. i keep telling steve, we have the best hotel in las vegas. he's fighting me all the time. [laughter] but i just want to say, it's a great state. and they have great people. and i was so proud. you know, i went to caucus. i was all over the place tonight. the people are amazing. the enthusiasm, it was unbelievable to see. the people of this country are absolutely amazing. i love you, folks very much. remember, make america great
[no audio] since the start of this campaign, only one network has taken you on the road to the white house. from the policy speeches to the candidates visiting diners, and of course, they campaign rallies. the republican race has now narrowed. the democratic race has sharpened. we are going to stay in a south carolina with the big democratic
primary this saturday. and then we move on to the multistate primaries and caucuses in march. this race is just getting underway. follow all of it here on the c-span networks, online at www.c-span.org, and of course on c-span radio. >> "washington journal" is next. we are going to look at news and take your phone calls. the housemates at 10:00 a.m. eastern. at 10:00 a.m.eets eastern. ch live house coverage here on c-span. this hour, we talked to senator mike rounds, who serves on the u.s. services committee. tonkorepresentative paul ition regarding
the flint water crisis. a reminder. you conjure in the conversation on facebook and twitter. years itma: for many has been clear that the detention center at court panama bay does not advance our national security. it undermines it. ♪ this good morning on february 24, 2016. closing guantanamo bay has been on the president's agenda since 2008. in the final year of his final term, president obama is eyeing a proposal to close the detention facility. lawmakers on capitol hill are resisting the idea. what do you think about president obama's plan to close guantanamo. republicans, (202) 748-8001