Transcripts For CSPAN Washington Journal 20140321

Contrary to conventional media about consumption, and new survey finds that the nature of news itself the idea of the socalled filter bubble. There are relatively few differences by generation, party or socioeconomic status in the level of interest with which people report following different topics. We want to learn from you this morning as we go through the papers in this first hour on the washington journal how you get your news. Whered you get your news and how do you get it marco you can also make a comment on our twitter feed. You can take part in the conversation currently going on on facebook facebook. Com cspan. And you can send an email to us. Heres a little bit more of this study by the Media Insight project. There are five devices or technologies that majorities of americans used to get news in a given week. First call up is from ralph in manoa, new york. On a democrats line. Caller i am a uaw worker from upstate new york. I get my news straight from my union from cspan also. Host what kind of news do you get from the uaw . Caller anything that has to do with the work wastes. Economics and new organizing. The same is true for cspan. Host ralph, hang on for two seconds. I want to get your response to this. That is a comment that several of our Facebook Commenters have done. They do their own research. Caller i would respond that cspan is actual news, it is not opinions or opinion talkers like the other cable talk shows. Host that is ralph in new york. This is dan in asheville, north carolina. Caller good morning. Host whered you get your news . Caller caller facebook is one of my sources. I am so happy that i can watch cspan on my ipad. I did away with cable maybe four years ago. Host really, so you just get us to the ipad . Caller ive had to go without cspan and washington journal and now i can watch washington journal on my ipad. I can get all my news with the various news sites. Host what are your favorite news sites, dan . What do you go to daily . Caller i have a special search query on google news. Then i go to the English Version of the german magazine der spiegel. I will go to the state newspaper in south carolina. Sometimes i will go to al jazeera. I like to read the russia times. It is interesting. The russia times america section covers a lot of stories that are not picked up at all by the western press is. You get different perspectives on news that way. Host thank you for calling in this morning. Here is a little bit more from the study put out by the Media Insight project. Next call comes from maxine in new york city. You are on washington journal. How do you get your news . Caller usually it is cspan, but lately it has been msnbc. A lot of whites calling here and they get me stirred up at the comments they say. I live in harlem. A lot of white people live in harlem now. They are part of the community. When i see them on the train, i look at them with such contempt from all the things i have heard them say. I go home at the end of my workday. I watched Chris Matthews and sharpton, just to hear some of the whites that are not racist. I dont want to turn against these people, but they discussed me. I know they hate the president because he is black and he shouldnt be there. It shouldnt be like that. It is 2014. Host jerry is calling from austin, texas. Caller i get my news from all the sources. There are a couple that stand out. Cspan, obviously being one of them. There is a little podcast called the no agenda show. They call media assassination. They blow through the smoke. They really analyze the news from a different perspective. I dont agree with them 100 , but the no agenda show is pretty good. Host how do you get your news . You can see the numbers on the screen. Here is a chart in this study. Most americans use many media devices for news. You can see it here. This is the percent of americans using each Device Television is close to 90 . Laptop or computer is 70 . Radio, 65 . Paper, newspapers or magazines a little over 60 rate cell phone is around 55 . Finally, on the tablet the less than 30 of americans get their news in that way. This was on National Review this morning. The campaign spot, the president s busy morning. That is in the National Review this morning. This is in new york magazine. This is a missive he wrote about msnbc and some treatment by the media that he received. I want to show a little bit of this article. This is alec baldwin writing. Caller i cannot worry about the future of the country when the young generation doesnt really believe what they are getting over television news. Host what are some of your favorite news sites . Caller i watch all of them. I kind of scanned all of them and see what is being promoted. What the major stores are. Host ever find yourself doing independent research as well . Caller i do quite a bit of reading and have quite a bit of knowledge about things. It is disturbing the loss of credibility of the mass media today. I dont believe you really had this skepticism years ago. People basically believed walter cronkite. They turned on their news and they believed it. Today they really just dont believe what they are getting over television. Host david do you still get a newspaper delivered to your door . Caller yes i do. Host laura is calling from sebring, florida. We want to know how you get your news. Caller i watch free speech tv. I love it. It has good documentaries. It has good reporting and it is not backed by any corporation. So they dont have to be biased. They can tell you the truth. They are all paid for by our dollar. And cspan, i like to watch cspan in the house. I really like to go to the real facts. If youre going to talk about something, watch the senate and watch the house. Dont say i heard it here heard there. Watch it. Host thank you maam. These are the evening news ratings for the evening shows the evening news shows in the last week or so. This is from the numbers for the week of march 10. You can see here that i Million People watched nbc nightly news. Abc 8 million and cbs 6. 6 Million People watched those evening newscasts. Then you can look at the cable ratings as well. This is from tv by the numbers. The week ending march 18. Fox news, 1. 2 Million Viewers cnn 613,000 msnbc 400 2000. Msnbc 4002000 402000. Mitch from harrisburg, pennsylvania. Caller i get my news from pbs news hour which comes on at 6 00 third iwatch that for one hour. Then i will watch cspan every morning. Then i watch a lot of the cspan hearings or whatever you have on their, cspan1, that is. Host mostly tv, hot . Caller caller definitely. I was getting the harrisburg patriot for while, but it might be the front page or maybe a back page and that was it. The rest was all advertisements. So i gave that up. There is no good reporting here. Then i watched the local news and it doesnt matter what time of the day you watch local news, 5 00, 6 00, 10 00 00 or 11 00 it is just a repeat. There is nothing new. Host so, what is the solution . Caller i would say for harrisburg pennsylvania the solution would be to get some more hire some more reporters. Im sure people need more jobs. Get out there on the street. There are crimes. Theres a stabbing or shooting every day and they will keep running it and running and running it over and over. Basically, i get my world news from pbs world news and then cspan keeps me uptodate. I do have to watch the local news. Sometimes they might have a water advisory. That may be uptodate. It is just amazing. There and even say that enough on tv about susquehanna. They will talk about harrisburg or bishop or the catholic school. They dont even mention other schools. Host that is mitch in harrisburg, pa. This caller is from is david from todd, north carolina. Caller i like stations that cover all of europe, asia, africa. They give us an unbiased look at what is going on without any of the politics. Host what station did you say, david . Caller live station. Com. And then suspicious observer on youtube has great weather. Naturally, cspan is not quite as fluid as it was on youtube. Thank you. Host this is from pew research. It is about twitter. Twitter is a years old today. Tony in fort worth. How are you doing, tony . Caller very good. I get my news from cable television. I watch fox and msnbc as well. Host do you get different versions of the same story . Caller i get different versions and make my decision between the two. Msnbc is better as far as unbiased reporting. I voted for the president twice. But they are so for the president that i cant believe them. I certainly dont believe fox news. Fox news has some good reporting if they keep out there conspiracy theorists. The other morning i was watching fox news and they reported on the missing plane. Then they brought one of the contributors on and were claiming terrorism. That was not reported anywhere else. If they can keep out those they are pretty good reporting as long as they keep to the story. Im thinking back to the election, they had mitt romney thinking that he won the election so much that he didnt even prepare a speech if he didnt win. If they would just report the news and less make our own decision, they give decisions and set of news. I dont think that is a good ng for either msnbc or for fox news. Host tony, what to do in fort worth. Caller well, i am retired military, a disabled vet actually. Host how much news consuming do do in a day . Caller i watch morning news mostly. And that i might catch something on an evening to catch one of the late shows on cable. Al sharptons shows way too slanted for me. I think the president is a good man. He has made mistakes like all people make mistakes. He is not a perfect man. Host do you go to any news sites yourself like the fort worth newspaper . Caller yes. Host heres a little bit more from the media inside project. Americans go to reporting sources. Depends on the news topic. Sondra from massachusetts is on the line. Sondra, whered you get your news. Caller i read the local paper. I deduct what i can from that. I turn around and i get washington journal. So i sit and watch it paid iwatch the congressmen when they get in actions. I listen to the lies and stories. Then i listen to the people who have all kinds of mixed opinions on this channel, cspan. I cant believe how they come up with some stupid ideas. We should come up with our own thinking. Take and deduct what is truth from fiction. What is wrong with you people . You believe in fiction and lies. There are a lot of lies in paper and a lot of stories being told to build their thing. There are truths. Get to the truth of the matter and listen. People listen to your heart. You know what is going on. If me a break. Host obama invites bids. This is from the hill newspaper. Gail, fairhope, alaska. Caller i am from alabama. Host i am sorry. That is what was on the screen and i just saw alaska. Caller he is not one of my favorites. It is across the bay from mobile, alabama. It is the most scenic, successful, most wonderful town in the south. Host do you agree . Caller absolutely. Host well, donna. Whered you get your news . Caller this may sound corny. I am a graduate of the university of georgia, however, i get my International News on channel 12 nbc. From brian williams. I like him. I kind of believe what he says kind of. With a grain of salt. I also get my news from the mobile register. I give it three times a week now. Host really . Is that the morning paper . Is that the only morning paper . Caller for mobile, alabama, yes sir. Friday, sunday and wednesday. Tthe times pku in new orleans is also published three times a week. The Times Picayune in new orleans is also published three times a week. I read Time Magazine quite a bit and i watched cspan. I go to the library and read the New York Times lowes quote newspaper when i can. Sometimes a little bit in the wall street journal. I dont do internet because i am not savvy in that regard. I dont have any children, nor do i have anyone to educate me in that area. I do have emails. I get some smatterings there. I keep up with entertainment through entertainment tonight on tv. However, having said that, my disdain i live in the south obviously. We all know the south is no longer democrat. We know the south is inundated by republicans. I am almost afraid to vote and let it be know that i am a democrat by heart. Having said that, when i read the editorial page in the mobile register and read the commentary from some of the people in this area about people like hillary clinton, i cannot even read the entire article because of the sheer ignorance of the people. Nor can i i cant read the editorials, nor can i watch fox news. Host that is a lot of information you have given us. We appreciate your calling in. That is in political this morning. Alice calling in from cambridge, ohio al is calling in from cambridge, ohio. Do you have any favorite sites . Caller well, i like democracy now. I listen to it a lot. Let me give you a little history about my journey through the news. I started reading the paper at a very young age like six sixth grade, way early. I kind of graduated up through the news ranks on tv and wound up on pbs. Now, pbss most shows are partially commercialized, so that avenue has gradually gone down. I agree with a lot of the callers, but a lot of the news is just crap. It is not really news. Some subjects are not covered at all, like when like the Bradley Manning trial. He goes by Chelsea Manning now. Total blackout on just about anything, except on the internet host . Host do you use searches to find out what youre interested in . Caller a lot of times i will go on twitter and find out from a lot of people i follow or news people themselves. I picked up the links from them. If i want to look in deeper yeah, i do a google search. Host how much time do you spend per day looking at news, allie echo caller al . Caller in any conflict the First Casualty is always the truth. You try to find out a little bit about it and you go by your moral compass. You have to weigh and judge everything. Host back to the Media Research project survey. Haraldson, east st. Louis, illinois. Democrat. Caller i read the st. Louis postdispatch. I read the st. Louis american and the riverfront times. I read the examiner and the globe and the inquirer. I watch the sunday morning programs, and i watched cspan a lot. I do a lot of channel surfing. It seems to me that every time i switch the channel to cspan during the day, there is some republicans saying something about something. And then at night it used to be more balanced on cspan. It is to have right and leftwing. It seems to be, i guess it is the money. It is the way with the regular news and the newspapers. The talk about the sunday morning programs. Meet the press has been on over 50 years. And all that time i have been watching it, i am 68 years old all the time ive been watching it they have never had a black host. It never had a female host. How are you going to get a balance in news when you keep on having the same people in the place to ask the questions . Youre never going to get the truth because it is going to be biased. Look at how they are doing this president. He cant speak for himself he is a black president , but he cant have every time he nominate somebody he is knocked down. How does that look to the rest of the world . Why cant anyone else see that . That is why russia is acting as it is acting. You dont back this guy. He is sitting there as the president. Host bloomberg is reporting that Vladimir Putin signs lost completing crimea is accession to russia. Ralph, silver spring, maryland here in the suburbs. Caller i get my news from several sources. I get it from the Washington Post newspaper every day. I watch some of the msnbc stations and i watch fox news and i get from wtop radio. They send me something every day on their website. I get something from another news source. I get it from a lot of various sources. I would say i have heard a couple of the callers, maybe one or two who seem to indicate some sense that republicans did not like the president because he is black. I have to challenge that most adversely because ive never run across anybody that i know of that are republicans or that are white because who have criticized the president because hes black. It is always been policy and decisions. I just want to get that across. I have been around for 84 years and i grew up in washington dc during the segregated periods of time. I have no problem whatsoever with the president being black. I will leave it at that and thank you for taking my call. Host ralph, youre 84 years old. How much surfing do you do on the internet. Caller i do a lot of surfing on the internet for a number of pieces of information that i want. Host thank you, sir, for calling in. This is from cnn. Mark in carrollton, ohio. Whered you get your news . Caller i have dish network. I watch rt news which is the only Tv News Network that has no advertising. Therefore, they have no bias, opinions, they tell the truth. For example, last weekend they walked the streets of crimea for three days, interviewed dozens of crimea who were in favor of voting to return to russia, which they were a part of for four centuries. The good thing about rt news is they focus on the political corruption that is going on in washington dc they focus on the corruption in wall street. Host mike watches rt. Scooter in chief is the story. The president will be speaking at uc irvines 2014 commencement on june 14. That is the big story on their front pages morning. Here is from the hill newspaper. The dnc and rnc raised 17 million each raised 7 million each. Next call on where you get your news is ralph in wilmington, delaware. Ralph, whered you get your news in wilmington . Caller i get my news from the philadelphia inquirer. I subscribe to the american prospect. I watch cspan. I watch fox every now and then, but i cant deal with it too much, though. Msnbc are still my favorites. Host how much time do you spend consuming news everyday . Caller i am a news junkie. Horribly pretty probably three or four hours a day. Host do you use twitter or any social media sites . Caller no, i dont. Host a little more from the study on how we consume news. Rose harrisburg, pa. Hello, rose. How do you consume news, rose . Caller well, i listen mostly to fox news and i listen to abc news on channel nine on my tv. My husband is a democrat and i am a republican, so thats how the conversation goes. I love bill oreilly. I dont agree with everything he says, but i really like him a lot. Host does your husband watch fox news with you . Caller yes, he turned me onto fox news. He doesnt agree with everything they say, we avidly watch it and like it. Host do you use a computer . Caller i go to yahoo news. Host are you retired . Caller no, but im not working right now. I am college educated. I have hopes of finding a job if the economy ever gets any better. Host rose, thanks for calling in and watching cspan. Here are some tweets that we have received on this issue. Timothy wilson, north carolina. How do you consume your news timothy . Caller how do i consume it . Through all sources. But i find the best is the overseas station al jazeera bbc. I think they tell a lot more truth than the American News stations. Except for probably msnbc. The media has just really failed the American People over the last years, ever since the invention of fox news and Rush Limbaugh and those guys. They never tell us what we need to know. It is always something. It is more about entertainment. Theyre out to make money. They get on one issue that is entertaining. They used to give the American People what they want. I think that is a reason we keep making these bad choices. I think that is the way george bush got in. Fox news announced him president. The whole day before the votes were even stopped. They rushed people into thinking he was president. It was a slick move. It was very cunning the way they did it. They do not tell us what we need to know. I think cspan is very good. They always say that cspan, and please dont cut me off. Speakers call in and talk about the president and call him a communist and all kinds of things. You dont say anything. If someone calls in and makes a good point about israel, a debatable point, they get cut off. It seems like we have more respect. The gentleman that called earlier was exactly right on the head. That is why russia is acting the way they are acting, because they disrespect this president through congress and the media. It is really bad. Host do you think that this president is treated any differently than any other president . Caller of course. You know that. Anyone with half a brain could see that. I am going to give you an example. Getting rid of obamacare it was the republicans idea. They dont want this guy to succeed. Mitch mcconnell said that. And the news media, they could play a big part if they came out and called these people what they were. Instead, they will cover it up. They will go to some of the story about something that has nothing to do with our economy. I noticed during the george bush administration, the minute you said anything against him because we were at war, we are at war now. We want to look unified. They could say anything about president obama. It is really lopsided. Everybody has an opinion. There are no facts anymore. Host this is charles in raleigh, north carolina. Caller good morning. Msnbc are incorrect. Msnbc is not opinion, it is facts. Anything that is false, they retracted very fox news, that is false. A lot of that stuff is false. One thing i know but the media is that the things it put on our to boost ratings. I watch news about three hours a day. I am disabled. The caller to call before me was right about a lot of things he said. There is no perfect news on tv. There is no perfect news on the internet. I used to read seven newspapers, but i stopped because the newspapers are printing the most false stuff. They make more mistakes than any news. I am not putting them down, but i could tell you that msnbc is a good news station. A really do put out the news and facts. Whoever made the statement about al sharptons show is wrong. Host obamas agenda for all asia. It gets a bit trickier. Usa today reports this morning on representative Luis Gutierrez ethics panels reviews. Next call comes from bill in philadelphia. Bill on our republican line. How do you consume your news . Caller good morning. I start with watching cspan 1 2 and three. I then watch fox news. I watch msnbc. I watch local news. On sundays i watch all the talk shows. I start by comparison. By watching cspan i am watching the senate and house of representatives. You listen to the hearings as much as i can. I dont even begin to wonder if theyre telling the truth or not telling the truth area i know what they have said. When i go to the news, if i go to fox news, i will hear what they are saying. When i go to msnbc i will hear what they are saying. When they lie or do not tell all of what was said, i form my opinion. Regardless of whether the senator or the congressman lied, the news reports it. If they lie about what they lied about, i dont trust them one bit. Msnbc is horrendous for doing that. Ive never seen a news station so lopsided to the left as msnbc is. Host what about use of internet and other sites . Caller i am a former Computer Network engineer. I absolutely go on the internet. If i hear something im not sure about, because i cannot watch every piece of cspan, i will go out and find that. I will find out wherever that was occurring and i will compare that. I hear the same thing on sunday mornings when i am watching the tv shows. They are so absolutely slanted. As far as president obama, his policies are what i gauge myself as a republican. I dont care anything about what his race, gender is or anything like that. He is a bad leader. Host this is from the Washington Post. Gay men and lesbians have been allowed to serve openly. Transgender people are still banned from the military. A District Court judge in Leavenworth County where manning is being held is scheduled to hold a hearing on the petition on april 23, according to a legal notice a list this week in the local newspaper, the leavenworth times. If youre interested in reading interview with ernie made off. Here is the front. Next call comes from randy in bossier city, louisiana. Caller cnn fox. A friend of mine turned me on to a ww cr. Com. It is worldwide christian radio. Dont let the name fool you. Theres another one, ww rrb. Com. Dont let the name for you. Drudge report, news watch magazine, and that is free for the first year. If somebody gets that, it is news watch magazine. Com or Something Like that. And i like threats watch ltlah. That is a black talkshow host. I started to go to the internet. I felt i was not getting the truth from a lot of the mainstream. I mean, they have got good entertainment, but i need some news. Host how much time of the day do you spend consuming news . Guest caller i drive at night and i usually get a lot of that at night. When im at the house, i will get on the internet, and i will watch, like i say, cnn. That is for entertainment. But ive got to go to the internet to get the truth. Like there is a talkshow host mark levin, and like yesterday and he did not even want to talk about this, apparently. About a situation in syria where they have slaughterhouses chopping off the heads of christians and muslims that dont gel with the rest of the groups. Host why would mr. Levan not want to talk about that . Caller he did want to talk about that, but he said it just made him sick because there was a news reports that broke this news, and he was trying to get into the mainstream media. Nobody would touch it. If i am a christian, i get my head chopped off, i want somebody to know about it and these, like i say it is skipped over, you know, and you cant really good i good idea of what is going on in the world. Host randy, thank you for calling in. The front page of the Washington Times here is the headlines feds ran up 1. 3 million booze tab last year. This is shara. Good morning. Caller i am a former journalist, and i get my i wake up and i get about 20 minutes because i search all of the networks, and ive read the headlines, and i get most of the news that way. Then i drive in, i do morning drive with npr, evening drive with npr, and then if i turn on the tv, it is pbs or nhk and the bbc, but i find the most effective way is to go directly to the people who are making the news. The city council meetings. I go to them. I go to school board meetings. I also watched cspan when there are some things happening that i really want to see. I do not listen to the pundits because they do not know as well as the senate, the congressmanen and the president what is going on. I do core briefs, i do my own analysis. Everybody else to me is pundits and they are giving their opinions. Some people just cannot distinguish between news and opinion. Twitter is not news. I also watch the daily show and coldbert, because it is amusing, but i find that people consider shows like yours a news show when it is just commentary from American People. Not that there are not people who do or do not know what is going on in the world but most of them are repeating things that they dont see or experience for themselves, and the best way is to know your community, go to meetings and to read the local papers, which i do, but it is also to participate in your government. That is the best way. Host all right, we have to leave it there. Thank you for calling in from the cleveland area. If you are interested in getting this survey that we base our question on this morning for yourself, here it is, it is called the media inside project sponsored by the Associated Press and the American Press institute. We are going to spend the rest of the washington journal this morning looking at the nations unity Health Center. We will be live from unity health side from washington d. C. , a couple of miles from the capital. In just a few minutes, the president and ceo of this group, Vincent Keane will be joining us. We will talk with two other officials from unity as well as the washington journal continues. I hope this is the last time it will be necessary to take the time of the house to discuss these subject of the irancontra committee. Let me echo the sentiments expressed by the gentleman from indiana and thank him for the relevant for the privilege of having served with him. He has had the most difficult task of all to preside over us. Sometimes contentious and confusing process, but i think the committee has in fact produce a product that the house can be proud of, and now we are in the process of closing out our responsibilities. I would confirm what the gentleman from indiana indicated , the conversations today with the senior officials with the white house, we have a commitment that as of january 31 they will have completed their declassification of those materials the committee has voted to release. I have given my word to the gentleman, mr. Hamilton, and also to mr. Foley, that if the white house fails to meet that deadline, that i would join with mr. Hamilton in coming back to the floor at the appropriate time to seek a further extension of the irancontra committee. I do not expect that will be necessary. My colleagues on this side of the aisle the important thing is, the investigation is essentially complete, the committee will continue in business until march 1 to wind down its affairs with a very limited staff. As of march 1, the documents will be transferred to the archives under appropriate procedures, and after that date members of the select committee on iran, all of the requests will require a majority vote of the House Select Committee on intelligence. I think, mr. Speaker, it is a good package. I think it is one that deserves the support of the house. I think it satisfies the concerns that many of us on the side of the aisle have expressed in recent days and im delighted that we were in fact able to work out this accommodation. I would at this point asked the chairman to yield, to join with me in a colloquy, with respect to explaining specifically what is intended in that paragraph on the resolution, paragraph number two that deals with the committee closing out its affairs. Mr. Chairman, our resolution provides only for one exception to the provision that the committee will have no further investigative power. That exception allows the select committee to receive materials in response to requests made prior to the adoption of this resolution. Will the gentleman please excited to the benefit of the house what is covered by this exception . Will the german yield . Will the gentleman yield . There are two pending requests for information of which i am aware. I am not aware of any other requests. Find more highlights from 35 years of house covers on our facebook page. Cspan created by the cable tv industry 35 years ago and brought to you as a Public Service by your local cable or satellite provider. Washington journal continues. Host and the Unity Community Health Center is located in washington, d. C. , just a few miles from the Capital Building. Vincent keane is the president and ceo of Unity Health Care. Mr. Keane first of all, what is unity . Guest good morning, peter. Unity Community Health center here in washington, d. C. Is a network of Community Health centers that provide health care, social services, a whole array of services to people who has shortly do not Access Health care on the mainstream. Basically our commitment is to the underserved, to those who are marginalized, including the medicaid population, including the immigrant population including those who may just simply not be able to identify with Mainstream Health care. Unity is a federally qualified Health Center, and it enables people to get health care in their site come in their local community, and also addresses whatever their specific needs are. We serve about 100,000 patients a year. We have 1000 employees, and we provide health care to the homeless population, to residents of the jail, communities within all wards of the city, as well as how centers. We are a large network. There are over 1000 similar type programs in the United States under the Community Health center banner. Host mr. Keane, what is the definition the official definition of a Community Health center . You spoke of unity being a federally qualified Health Center. What does that mean . Guest well, the term federally qualified Health Center comes from the legislation, which really to fully understand, you have to go back to 1955 when the concept of a Community Health center was first established. That was established by president johnson in his war on poverty. There were two Health Centers set up an very impoverished neighborhoods. One in mississippi and one in boston. 1000 of them basically have been replicated over the last 50 years. What defines a federally qualified Health Center is several things. One, we must provide hombre heads of Health Care Services, so in other words, it is a whole ability to serve, and ability to serve the whole patient. We must provide services regard as of the ability of the patient to pay. We must be open to all comers. And if you do pay, you pay on a sliding fee scale. And i guess a third and very important parts of what constitutes a federally qualified Health Center is that you must actually have a governing board that is at least 51 of the consumers who use those services. This allows for community input. It is locally owned, locally governed by the community that we serve. Host mr. Keane, where does your funding come from . Guest well, today our finding and this is true of Community Health centers national wide, we started out in the earlier days receiving federal funds and we still receive direct grants to provide care to the uninsured to those who were at a certain level of poverty, but most Health Centers now also use medicaid, they use medicare. A lot of Health Centers actually because of the need to some people will pay based on their ability to pay. In the case of unity, we receive revenues from medicaid. The district has been very generous in medicaid coverage unlike other states. We sit receive money we receive money from medicaid, it is attached to the individual, we receive money for medicare, we receive money from the patients themselves patients themselves. We also receive grants. In the case of unity we also receive private money from foundations and individuals. In that sense, we have a very broadbased funding and support system. I would say at this point, with the expansion of medicaid through the Affordable Care act medicaid is one of the largest sources of our revenue just now. Host does the Community Care center operate like a hospital . Can it be used as a clinic . An an emergency room, a Doctors Office . Guest i would think the latter, peter. It is probably more akin to a Doctors Office where in fact it is not a hospital, and those of us with experience in hospitals that implies a longterm a longer stay. It is not an emergency room, although Unity Health Care and several health under throughout the United States offer urgent care and they offer urgent care from the perception of longer hours of service so that people can gain access, but it is not a hospital. It is not a minute clinic. It is akin to a Doctors Office where you wereor i might go for a range of services. It is not just a oneonone doctors visit. The patient is the focus of the service, and that patient may engage with their primary care provider, which could be a nurse practitioner, a doctor, or a physicians assistant. They also engage with a nurse. They also engage many of them because of the complexity of their illnesses will need what we call Case Management and Care Management, and the focus under the Affordable Care act today is what we call patientcentered medical home where the patients literally is that the center of his and her care. That patient is also educated to take responsibility for their health care. That is more than just a doctors visit. The doctor is critical to that but he or she has a team that surrounds them in providing that care, which does not it actually starts before the patient comes in, and it continues after the patient leaves the office. There is followup, there might be referrals. And in some cases to doctors hospitals. It is primary care focus. In other words, preventing illnesses, or venting folks from going into the hospital, but being able to recognize when they need such care that we have access to get them in there, peter. Host we will put the numbers on the screen. For the rest of this mornings washington journal, we will be live from Unity Community Health Center in washington, d. C. We will begin by talking to Vincent Keane president and ceo, who we are talking to now, and then we will talk to a couple of doctors from the Health Center as well. 202 5853880 if you live in the east and central time zones, 202 5853881 for those of you in the mountain and pacific time zones, and medical professionals, particularly if you worked in a Community Health center, we would like to hear from you as well. 202 58538823. You can also send in a tweet as well, cspanwj is our twitter handle. Mr. Keane, how has the Affordable Care act affected Unity Health Care Community Health center . Guest well, the Affordable Care act is one of the most significant events probably in the last 100 years in terms of providing coverage for folks who lack access to health care. For the most part, the aca, the Affordable Care act provides opportunity for people who were previously not covered by insurance to get covered. That was in two ways. By the expansion of medicaid and by the exchanges. That helped Health Centers nationwide to serve those who were not previously served. In other words, yes, the answer is the aca has been a very significant has had a very Significant Impact in increasing access to care for those who had liked it. How does that impact Health Centers . It increases your patient load. And also we have to be prepared for that influx of new patients. Committee Health Centers nationwide serve over 20 Million People, 22 Million People. I the time the Affordable Care act is fully implemented, we will be serving nationwide up to 35 Million People. Here in d. C. We expect our population to come to our Community Health centers to grow. However, the district, as i have said before, has been very generous in terms of its coverage. As you realize, in many states they are not covering medicaid which was the original intention of the Affordable Care act and that is going to limit some of those who could have coverage if they were open to that, but you will hear later on from one of our physicians thats one of the challenges that Health Centers like unity face is how are we going to have the manpower to take care of that influx of new patients . Dr. Robinson later on well talk about that in terms of some of the creative ways that unity and other Health Centers nationwide are affecting that. So definitely the aca is focusing on the right things. Number one, it is focusing on prevention. So it makes us focus more on prevention getting people into care earlier, and also if they focus on primary health care to prevent the issues you addressed earlier about admitting people into Emergency Rooms and hospitals. Of course, in addition to that there is great advantage is in terms of covering kids until they are 26 years old on their parents so a lot of opportunities in the Affordable Care act that will benefit Health Centers, but more port it will benefit the people we serve. Host mr. Keane, any downside for chcs and the Affordable Care act . Guest the potential downsides again, are probably you know, we have historically relied on federal funds direct from the federal government. Those funds are Still Necessary and i think it is greatly important that our congress realizes that even with the Affordable Care act and it is wonderful, it is still not going to cover all of the expenses associated with running a Health Center, taking care of a population who have chronic illnesses at a greater rate than the general population. As i indicated earlier, peter, a patient comes to our Health Center with chronic illness they need more than a doctor. They often might need language translations. They will often need mentalHealth Services. These are services that are not always directly reimbursable, so we are pleading to the congress to recognize the ongoing funding through these trust funds for Health Centers, which was established under the aca, but needs to continue, needs to be refunded so that as well as drawing on the Affordable Care act reimbursement system, that we can always also get federal response to continue to fill the gaps that are there. So i would say it is not a downside, but it is a worry that the federal government continue its direct funding to Community Health centers as the needs expand. I would extend that to funding for teaching Health Centers where we can teach the workforce of the future, and i would extend that to Something Like the National Health Service Corps, which is a key Workforce Pipeline for young men and women in the country to work in underserved and rural areas, and they get grants from the government to do so. So increase funding, sustained funding as well as all the other advantages of the aca will ensure access for 35 million medically underserved people throughout the country. Host Vincent Keane can anybody go to a Community Health center . Guest we are open to anyone. Our primary focus is of course the medically underserved. Those who historically have been cut out of the mainstream system. Those who are perhaps economically disadvantaged linguistically, other challenges. So our primary focus would be on that level of population, the underserved in whatever category, whether it is financially or not. However, with the Affordable Care act we are recognizing that there is a new covered population, and that would be the folks above 200 of poverty. I hear them being referred, some of them to the invisibles, invincibles, the young, 26 whatever the invincible age is, i dont know. That is the new population. It is good to get them into care both from a Risk Reduction for the system as well as for improved outcomes because that is a general demographic that young people do not seek health care during that time, yet that is often a time when chronic illnesses, other social issues come up that really impact their longterm health. So we are saying yes, we are open to take care of those that have historically been part of our mission, however that Mission Starts to creep a little but as we can see people a little but above the poverty line. With medicaid expansion, people are actually going to be flipping back and forth between medicaid and between the insurance exchanges, so at unity and Community Health centers will be there for them regardless of their covered status. Host Vincent Keane is our guest, president and ceo of Unity Health Care. 202 5853880 if you want to preserve a, east and central time zones, 202 5853881 out in the pacific, and medical professionals, we would like to hear from you as well, 202 58538823. David in glen cove, new york, good morning. You are on the washington journal. Caller yes, good morning. I have a couple of questions. I have a feeling what if somebody comes to the Health Center and gets diagnosed with, lets say cancer, and they are told what at that point . Are they told to go seek a hospital . And how to they pay for this . Host if you can hold on for just a minute, mr. Keane we will get the second question as well. David . We are listening. Go ahead with the second question. Caller the second question is is the Health Center really targeting people below the poverty line . If so, how do they pay for care that the Health Center cannot provide and are told well, you have cancer or you have a terminal disease that you have to go to hospital . Host all right, david, i think we got the point. Vincent keane. Guest david, very good question, and is a challenge that many Health Centers it turns on a daytoday basis. The answer to your question, david, will depend a lot of times on the state in which that person resides, but in terms of unity in the Community Health centers responsibility obviously is for the whole person and for their longterm continuity of care. So a patient comes in to our Health Center, is diagnosed with cancer, here in d. C. Thankfully, we have a system. Medicaid is generous. We also have a city run program called the alliance. Generally speaking we can get that person into a hospital for diagnosis, procedure, and treatment. I am not saying that is true in every state. Each state, each Health Center has to come up with with the continuity of care land. A lot of times these are based on the generosity of hospitals who are willing to kind of make their resources available, but here in d. C. , if you came in and were not covered it would be our responsibility at least to try to connect you to the care. 90 of the time, and i am sure one of my physicians can be more clear on this, 90 of the time that person would be able to be connected to Specialty Care and hospital care. David, that is not true in every state, and i think you said you are from new york will stop in new york medicaid may be more generous, but i certainly can assure you that it is a challenge. At the same time, a Health Center needs to be connected to other medical institutions to build those relationships, that actually address serious problem for the help center is not capable of addressing. I hope that answers your question. Host john is calling from houston, texas, a physician. Hi, john. Caller hi. Guest hi, john. Caller hi. I served in the early to mid1980s in a Community Center migrate clinic in south texas on the border. My experience with that it was like we were a fullservice health facility, and basically a onestop fullservice place for our population, however and i have not been involved with the Community Health centers in a long time, but i do recall at that time it was up the beginning of my career that there were, how shall i say it local medical political influences, at least in the way we practiced in our community and i was just wondering if that has changed over the years because even though we were colleagues with our practitioners in the private sector, there was always a little bit of tension about competition and we always had to kind of be kind of careful about how we issued referrals because we relied on our doctors and the private sector to provide Specialty Services to our patients. I would say the people that needed services that we could not provide, we had a very Strong Social Services Department that were able to individually evaluate each person to see what sorts of services that were available locally or reasonably that would solve whatever problem it was that we were trying to address. Host all right, john, thank you very much. Mr. Keane. Guest thank you, john and thank you for your service in texas. I have a lot of friends in that area and brownsville and others that have served in a Community Health center, and the National Health Service Corps through which you came is still a critical element of our workforce resource. The answer is exactly as you said john. Every Health Center has to build relationships with its local services, other private practitioners, whether it is hospitals, and particularly specialists. You are absolutely right. Sometimes we have to rely very much on generosity. Is there competition . Well, yes. Generally speaking there are not competition for those who are not covered and are uninsured and do not carry a payment mechanism. I would say the answers your question right now john, is there is more competition today because with the Affordable Care act all of a sudden, many entities are coming into this market that historically have not played in this before. Historically did not want to see our patients because they do not carry a payment mechanism. So Health Centers are going to experience composition, but i am confident that the quality of care that you get at a Health Center is second to none, and we kind of welcome back competition. Thank you. Host jenny is in lancaster ohio. Jenny, go ahead with your question or comment. Caller my comment is i think it is ridiculous that every time you turn the tv on, you have all these commercials for medications, and people do not know with those medications are. Only a doctor or pharmacist would know. And the Health Care Gets attacked up skyhigh. Gets jacked up skyhigh. I think that is what make a lot of the medicine go up in price. Host mr. Keane as a medical professional, what is your opinion of that . Guest well, i would probably venture to leave that to one of my other guests. Let me just say, there is no doubt about it. There are many factors that are contributing to rising prices and rising costs in health care delivery. No question about it. Our caller reflects the medications, and certainly you know, there are people alive today who would not be alive without medication, and sometimes those medications are expensive. Health centers deal with very hard allele patients so that education plays an Health Centers deal with very chronically ill patients, so medication place an important use. That is where our Care Management comes in. There is real i love about that. The other issue she brings up his medical malpractice coverage. Generally speaking, in some cases, medical malpractice coverage increases the overall cost, not quite as large as people tend to think however, i do think that there has been a tendency in the past to practice expensive medicine but generally speaking i think our doctors are there to take care of patients. They are committed to that, and yes, you want to be sure that your patients always have right of redress, but i think the two issues she mentioned do have an impact on health costs medications are important, of course being able also to educate the patient because a lot times a patient may be on multiple medications and is not really know enough about them to address that issue. Host mr. Keane, how many physicians do you have a unity . Are they fulltime . Are they volunteers . Guest actually, when i say physicians, we include in the physicians all providers, that is psychiatrists nurse practitioners, medical physician assistants, dentists and podiatrists. We have 180 in our network of serving 100,000 people a year. And these are various levels of discipline. We focus a lot on primary health care, we focus on pediatrics, so we have a very diverse array of physicians and providers. We see a very diverse population ranging from babies preterm all the way up to senior citizens, so our services are geared toward that, as are most Community Health centers. We have grown significantly in the last several years and taken on Additional Health responsibility particularly in the jail, that requires us to increase our workforce, which we are always excited, and we invite any young or middleaged or older practitioners who might be out there, wanted to come to d. C. Unity would be a great place to come to. Host rich, brodheadsville pennsylvania, you are on washington journal. Caller since the aca came about, i am now covered under my wifes insurance. She works at a state university. Under the aca, we still have our same doctor, same coverage. We have not lost in the coverage. We get an x or 30 on the paycheck every paycheck, so there is a plus. There the other thing the other thing im noticing since the aca came about, it looks like a lot of committees, right down the road from me, there is a satellite Medical Center. That is good, that is providing jobs and helping the economy but the entire thing of this is, you know, with the whole aca 69 of people who havent now are satisfied. They are content. Yes, there are problems with it, but how can people be against something that is giving People Health care who never had a before . And the right wing, the republicans want to take what is helping peoples children and cut it and leave those people who do not have insurance before now they dont have any health insurance, and they are back to where we are before. Why would republicans want to do them . I find a heartless, senseless, and downright well we know why they want to get rid of the aca. You do not have to be a brain surgeon to do that. Host i think we got your point. Did you want to ask another question very quickly . Caller dave Medical Centers we see popping up, if a patient goes in there that is not have insurance, is there funding, is there aca laws that help fund these patients, you know, that he not have insurance . Host we got your point. Thank you, rich. Mr. Keane . Guest thank you, rich. I think your remarks from the aca from somebody who serves previously unserved community absolutely, everything you say is correct. I am not quite sure, and i think i mentioned one of the callers earlier, there is a competition coming up. Some local pharmacies are setting up many clinics. Some local institutions are setting up more like urgent care centers, where people can get access to the Health Center, to patients who were not previously served. If you are setting up a Community Health center, if you are setting up a federally qualified Health Center, nothing changes for that person who does not have insurance. The same for primary care based on their ability to pay and that is our mission that is our charge. That goes back to our founding in 1965. You talk about something that i think is very important. We employ over 1000 people in the district of columbia. That is a significant business initiative. Some of our Health Centers throughout the United States and rural areas are economic engines within the community, and that is critical, as well as delivering health care because as we know unemployment poverty are contributing factors to poor health outcomes. Host smiley tweets into you, mr. Keane how do you reach the poor, rural people . They have the highest Interest Rate and no health insurance. Guest thank you. This is the challenge of every Health Center. How do the Community Health centers reach them . Every Community Center has an Outreach Program where they have folks, i mean, the best way of reaching folks is by word of mouth, getting the word out. Some Health Centers are very creative about how they use, how they educate and market themselves. Some have established mobile outreach vans to go out into the communities. Some Health Centers actually have home visitation programs where in fact they go out with the resources. For instance, here in unity, we would have home visitation programs where those folks who find it difficult to come in. Rural Health Centers have come up with very creative ways. I have not had that experience myself, but mobile outreach, home visitation, getting transportation is often a barrier to getting people in for health care. These are initiatives that every Health Center takes upon itself to make sure they are serving the population that has been designated to them. Now, i would have to say that part of our mandate really is not to build a Health Center and hope they will come, but rather to actually build a Health Center and actually make sure that the community is being brought into that network of care. Host are their strength on how you can spend your federal funds . Guest yes, there is significant oversight responsibilities attached to receiving federal funds. There are audits i need to be done on medicaid and medicare funding, and yes, our funds can only be spent directly on primary care is an all of those ancillary services associated with primary care such as social services, dental, all of that. For instance, going back to one of your callers, we talked about we cannot pay for hospitalization for people. We cannot pay for things that as it were happen outside the walls of the clinic. We can set that up, arrange for a relationship, develop agreements between hospitals and ourselves, however, we cannot pay in other words, there are our designated services that are allowable under our grant that we must be responsive to and consistent with. There is a lot of oversight. I mean, this is not money that is wasted. This is not taxpayers money. We are very conscious of our responsibly to become good stewards of taxpayers money entrusted to us on behalf of the indigent and those who are underserved. Host john in evansville arizona, thank you for holding. You were on with Vincent Keane president of Unity Health Care Community Health center. Caller my grandson is a resident physician in annapolis, and he serves clinics for the poor. His student loan is being that so he is being helped out on that by the service. He recently said that that was going to be reduced or cap. Capped. Do you know who is responsible or what can be done about this . Thank you. Guest ok, peter, there was part of the question i did not get. Host he was talking about the education loans that his grandson received for his medical education. And whether or not those are forgiven. Or reduce. Guest yeah, i got that, and actually that is a very significant concern we have. When i spoke earlier about the federal funding, he may have been served through the long repayment row graham, the National Health Service Corps. It is quite possible that that is reduced, and there is an issue that several of us throughout the United States are coming to try to address this week. There is a National Meeting here in d. C. Where we are trying to bring a cross the fact that another 15 Million People you cannot put them into coverage without providing them access through your doctors, physicians, nurse practitioners, so a significant component of that is loan repayment and scholarship. We just have to really advocate strongly for that not to be capped not to be reduced. That is a challenge, and i agree with the caller that it is a worry, and it is a worry for those young men and women coming into the medical Health System and teaching that their support may not be there be on the next couple of years, and it certainly is a critical recruitment issue for Health Centers and indeed for the medical system throughout the United States. Host Vice President joe biden will be speaking to the Community Health centers Organization Association today. That will be live on cspan at 10 15 a. M. Eastern time. Kathy in santa fe, new mexico. Caller good morning. I called to see if i can find out why dental and vision care is it better paid for by our insurances for older people. We need our teeth to chew to get good nutrition, and we need our vision to read the labels on whatever we are buying. Host thank you maam. Mr. Keane are those services that you provide . Guest thank you very much, and i certainly identify with her as i am getting older myself, and with teeth and vision problems. In early speaking, she is correct. Dental and vision are very difficult and expensive to cover under private insurance, however, here is where the Community Health centers come in again. Community Health Centers offer dental and vision services. In addition to that, they often will build like in our case i can only speak to what unity does. We actually do have ophthalmology we do have vision screening. It is very cripple for people who are diabetic it is very critical for people who are diabetic. Much of our population is diabetic. So having that Service Available and then having the proper reserve system. Not every Health Center will be able to do that because it is an expensive resource, however, it is critical, and we are very aware of that. Dental is similar. Most Health Centers will provide dental services. There is funding to do that, but it is always, we need to embellish that funding additional funding, and build relationships with dental schools and with other vision entities to ensure that number one, if somebody is diagnosed with even glasses, they can actually get them. If someone is diagnosed with needing dentures that they can get them. So these relationships have to be built because Health Centers can provide the service, but not necessary the ancillary areas. Host mr. Keane, do you need to have an id to go into your Health Clinic . If so, do you have nonenglishspeaking people to help as well . Guest yes. One thing about Community Health centers is that they are very culturally diverse and they actually are very aware of the needs. Many of the folks that we see, and this is throughout the United States here in d. C. , one of our sites in the northwest section has 100 lane which is spoken. 100 languages spoken. We emphasize linguistic and cultural sensitivity to that. So the answer is yes. Most Health Centers will look at what is their predominant, what is the population other than english that is predominant. In our case, it would be spanish, and we would have folks and Staff Members who can do the translation and cant medicate with them can community with them. The answer to the question about an id is not as such. Generally when someone comes into to the Health Center, they are enrolled in the Health Center. That becomes their idea. Do they need a drivers license . They may need some modification if they want to get on public benefits, but in terms of lets say if we are asking the question about who can be served, the answer is in Community Health centers, all can be served, regards us of their legal or immigrant status. Host been thinking, president of Unity Health Care Vincent Keane, president of Unity Health Care, thank you. We will be speaking with more in the Unity Health Care, just a few miles from the capital. We will put the numbers back on the screen after we show you who we are speaking to next. Andrea anderson from unity health, and dr. Keisha robinson as well. If you want to dial in, if you have questions about the Community Health Center System or about health care, you can go ahead and ill in, and dial in. 202 5853880 for those in the east and central time zones. 202 5853881 if you live in the mountain and is it that. And if you are a medical professional, we want to hear from you, 202 5853883 as we continue our program from unity. At the end of the day, i think the community will need stimulus so i think the fed will not be raising rates for quite some time, but i am optimistic that the u. S. Economy is going to accelerate. I think one of the core things here, one of the core dimensions, is the fact that last year, the u. S. Economy grew 1. 9 with this goal drive from higher taxes and spending cuts reducing growth by 1. 3 percentage points. Without that fiscal tightening the u. S. Economy would be growing over 3 . You know, cbo does not make policy regulations. That is very important because policy choices depend not just on the analysis of the consequence of different courses of action, but also in how one the ways those consequences, what values one applies. It is up to our elected leaders your and my elected leaders, to make those policy judgments. Our job is to help congress understand the consequences of courses of action. This week and on cspan, views on the u. S. Economy would be cbo director and experts from td bank, the financial times, m. I. T. , and the university of maryland pulls up that is followed by the First Press Conference by new fed chair janet yellen. Saturday morning at 10 00 eastern. And on booktv, live coverage from the virginia festival of the book. First, a panel on africanAmerican History followed by laura. That starts saturday at noon on cspan2. And on American History tv, who might have been Time Magazines person of the year in 1864 . Historians decide saturday morning at 8 25 eastern. That one, then at 1 00 talking about the pick live on cspan3. Washington journal continues. Host Unity Health Care Community Health center is located a few miles from the capital and washington, d. C. , and we are live there this morning on the washington journal, and we are joined by dr. Andrea anderson with the medical director there. Dr. Anderson, what is your job . Guest hi, thank you for having us. I am the medical director of the Health Center. As our ceo explained, the network is a large network, and i am the medical director of one of the largest Community Health centers located in the Northwest Quadrant of washington d. C. We are the center where vincent was referring to that over 100 lane which is are spoken. I am the medical director of that fight. We serve about 21,000 patients, and we have over 100,000 patients each year. I also service the discipline director of family members for all of Unity Health Care. I direct curriculum and policy affecting family physicians. Host what are the negatives navigators used throughout the Community Health center . Guest good question. We have a wide variety of comprehensive Health Services within our centers. One is that we utilize the patient centered medical home model. So team based approaches to health care. It is more than dr. And patient in an exam room taking care of the problems you need. It is true that we need a village to take care of the patients, so we employ a variety of staff and practitioners in the health care, one of which are navigators. To help the patients navigate their way through the complex health care system. As we know, it can be confusing for many patients, especially underserved patients who may face language barriers educational barriers, time barriers, so many things can really impede a persons ability to effectively navigate the health care system, so navigators are very important aspects of the care that we provide. Host what are some of the services, dr. Anderson, that are provided at unity . Guest we have a wide variety of services. Primarily we focus on primary care. That is what i do. I am a family physician, and that means i see patients from the whole range of their life from birth to death. Just last weekend, considering my day, i saw newborn patients i see nursing mothers, elderly patients teenagers the whole gamut of patients we can provide will stop in addition, we provide Specialty Care. So at our site, we have Infectious Disease services. We have podiatrist services, dental services, Mental Health. A wide variety of services in that way. Vince also made reference to us providing care in the d. C. Department of corrections. We also provide schoolbased Health Centers. We have four schoolbased Health Centers in which we have fully functional Health Centers located within d. C. Public schools where the majority of children are and we know children are spending most of their days at school and most of their time is spent in school and around the school community, so we bring the health care to them. In addition, we have a mobile van, which is fully functional which is a fully functional Health Care Center that is mobile. That is actually how our organization was originally founded, as Health Care Care for the homeless, before we expanded to become a federally qualified Health Care Center. That is just a part of the wide range of services that we provide, and there are several innovations within the, within those services that i am very proud of and excited about. One of which would be a group visit, and i can talk more about that if youre interested. Host what is that . Guest group visits think of it like this i as a physician might have 100 patients on my panel with high Blood Pressure. Obviously i have a lot more, but to make the numbers a little simpler. Instead of me having 100 different visions with those visits with those patients and telling them the same thing about how to take their medications, but exercise and modifications, i might want to meet with 10 or 20 of my patients at the same time in one room with patients consent so we can all have a visit and discuss that issue. The beauty of this vision is that the visit is that employees the knowledge of the practitioner, which would be myself at the medical register there, but also capitalizes on the collective wisdom of the group, so for example, i might say it is important to eat vegetables if you have diabetes, for example, and i can say that, but someone in the group might fail, yes, and they are on sale this week on our local supermarket. And someone else might say oh, yes, and if you cook it this way, it tastes better, how it tastes in our country, and you can use this bison that spice postop and another person gets a yes come i did that now my Blood Pressure has been lowered or my diabetes is better. So the Group Receives an enhanced experience of health care and they can really benefit from one anothers experience. So we provide group visit that my center, the upper cardozo Health Center, for a variety of concerns. Prenatal care, chronic pain, grief, and were looking at providing group visits coming up in the future for Pediatric Health care. Host dr. Anderson, how many physicians on your staff are fulltime . How many are volunteers, etc. . Guest the majority of physicians are fulltime. I would say over 90 or fulltime. We do not have any volunteer physicians, and that is part of the legislation of the federally qualified Health Centers that all of the physicians, and this includes again nurse practitioners, physician assistants they are all salaried employees of our center. Or our partnership of whatever center we are partnering with. So we all our employees and have our primary focus here at the center. We have a large variety of centers, so some of our physicians, particularly our specialists, may work at different sites throughout our network, so they may spend one day a week at one site, todays a week at another site, so on and so forth like that. Host what percentage of your patients that walk in our crisis patients . Guest crisis patients . That can be a very broad definition, and i would almost argue that by definition, based on the population that we serve and the challenges that they face, they could all be considered crisis patients at some point or another. I think all of us experience difficult times in our lives, especially the patient that we see. They may be dealing with multiple medications. They may be dealing with low health literacy. Low english proficiency. They may be homeless. They may be experiencing violence in their lives. They may be recently unemployed. There are so many things that can contribute to someone being termed a crisis patients or a high risk patient, as the termite be used. So we again employee a large as the term might be useful to so we again employ a large righty. Ive been with you need for several years now they did comfortable opening up to me about certain things, but they also build go opening up to the mao are the chief manager or the social worker about other things. That is why we work as a team so that we can all benefit the patient in the most opportune way. Host Andrea Anderson has her m. D. From brown university. How did you get interested in this aspect of health care . Guest when i was a young girl i had a primary care physician who to this day i credit him with really inspired me to be a medical professional. We also visited a Community Health center in art the permit in new york in our neighborhood in new york. As they went on with my training and education i came to be impassioned to speak those who have no voice. I was very inspired by the fact that it is my responsibility that if ive been given something i need to reach back and give it to others. That is what inspired me to get involved in medicine. I was fortunate to be a member of the National Self hers was Health Service corps, at which time i received caller ship funding and later on loan repayment for my medical education. Many physicians, as you may know, come out of medical school owing more than 200,000. That is starting out already in debt. The National Health Service Corps is a wonderful way for these clinicians to receive subsidies to pay back those medical loans and still work in the communities that they care for and are passionate about. I am also a by we the is the addition i legal position, i speak spanish, so i was motivated to work the latino population is welcome and that is what im able to do at our site. Host Andrea Anderson is the medical director at unity Health Center. Here are the numbers by times of time zone. We are going to begin with a call for message driven from massachusetts. Caller thank you for imparting the information that you have given us this morning. Several, one having to do with the systems. Community Health Services servicing different sites, is a reflection of a significant need of the population during the last two years of the United States. Host i apologize, it is a really bad connection we are getting with you. I do not know if you could clearly, but i said that he said that Community Health services are a reflection of the unmet medical needs in this country today. Guest that is true. I would happily agree with that. Theres so much more to a persons medical needs then their insurance coverage. That is actually very important about their health care needs, that is why we are very excited about the Affordable Care act. However, they need access to physician with a needed place where they can feel comfortable, they need a place where people are not afraid to talk about some personal things, whether they be a little of Substance Abuse, whether they be dealing with violence in their homes whether they be illiterate and not able to read. There are so many aspects that are unaddressed in the Traditional Health care paradigm that Community Health centers are definitely stepping in and filling that gap. As i mentioned with the group visits that we have, ongoing counseling, partnership with community resources, really caring for the whole patient not just the medical needs. That is why very proud to be a Community Health Center Position of and we deathly encourage others to encourage others to think about the medical profession and get involved in the Community Health center movement. Host a tweet caller [inaudible] guest great question. We are realizing it is not enough to treat patients, we have much prevent them from becoming sick, and allow them to live out their lives in the most beneficial and opportune way. I would say a good 50 would the dedicated to prevention. In that i could highlight some programs that we are very proud of at our center. One would be a program called up to reach out and read program in which we encourage Early Childhood literacy starting from age six months of among our patients. We know that People Living in poverty are less likely to read to their children. These children were more likely to start school two years behind their peers. Children from lowincome families are already behind because they had not had the exposure to books great we. We give books to each of our children as they come in. We also address the growing epidemic of childhood obesity. We know this is the first generation that will not outlive their parents because of the epidemic of childhood obesity. At our site we have a program called we can where we are not only addressing the needs of the obese child of the entire family. Bringing in the whole family, we have a demonstration kitchen in which they can try out lowcost recipes, we have volunteer exercise teachers that come in and do yoga and different exercises with the family. Really trying to highlight the need for the entire family to be involved with the children. We are seeking to prevent secondary teenage pregnancy in our community, and the rates of teenage brings you gone down pregnancy have gone down but it is still there and there are still women who are having a bs earlier than they would like. We have a program in which adolescents can be referred, who have already had one baby under the age of 16, and we have intensive social work, parenting classes, fatherhood groups, to help these parents be good parents and prevent having another baby earlier than they would like. Finally, received funding for the title x grant which provides family providing services to low income women. This is so important that people are able to plan their families, they are able to not be pregnant if they do not want to be pregnant. So our entire staff is trained on the various Family Planning methods of including the range of just as control pills to longacting methods. Each week, i am doing several of those sieges on women who like to have them dish procedures on women who want them. I would highlight those programs as instances of revenge and prevention that we focus on. There are so anything that can effect a persons experience of life and we want our patients to be happy healthy, thriving, and we embrace the entire gamut of what good health means and that is something im very proud of here at Unity Health Care. Host a caller from wisconsin. Caller i would like to know you are an extremely educated person, and your doing what youre doing, what influence drugs or Drug Companies have over the centers and a percentage of cool control is over the centers by drugs and Drug Companies . Guest that is a very good question. Obviously, pharmacies and drugs are Important Health care. We do not want to be overly influenced by Drug Companies and their representatives. That Community Health centers that influence is very low. Patients have a limited area they can access. They are not eligible for the newer, fancier, more of the drug. In another context i really and credit our leadership for really curtailing the access of the drug company to us and really encouraging us to make educated decisions based on what patients have access to, what they can understand, what really felt it was their lifestyle. One would be if they could not read the label, or they cannot extend it understand it as a family member. Theres a lot of drug company endless, but i would say that influence is very low here at Unity Health Care. Host dr. Anderson, are you staffed 24 hours a day . Guest close to it. It feels that way. We have normal hours at most of our centers, but recently we had the opportunity for about two years now to have extended hours at a several of our health sites. Two in particular, one which would be my Health Center and another at the minnesota avenue here in washington dc. We are able to be open from 8 a. M. In the morning to 10 p. M. At night. This allows us to be open for when others are open meeting us in meeting us. We recently in the last two years have opened up sites that i mentioned, and we are open until 10 00 p. M. At night, and that allows access for patients in the community to come in and use those sites. The care business visit our walkin business, but we do encourage that would patients and we encourage them to become a patient of our center. We. Them up at a we pay her up with a primary care physician. In addition to the reason why they came in that day. We also utilize Electronic Health record in which all of the sites are able to communicate with each other through the electronic records as well as with the department of corrections as we mentioned yesterday. Right now, we are at the pitiful darkside Community Health center, and if they patient was seen there needs to see me after hours, ive direct access to their Health Record and i can provide information and treat them appropriately. Similarly, if the hospital calls, and asks questions about a patient i am able to access our Health Records from home as well and are by those answers about the patients needs to we are very fortunate to be utilizing the Electronic Health wavered record as well as by in these facilities. Both my site as well as the parkside Health Center, we received help from the Grant Funding from the grant that preceded the Affordable Care act so that we could renovate expansive and be ready for the newly covered americans who are benefiting from the Affordable Care act. Host 36 for the funding of committee Health Centers nationwide comes from medicaid, 23 from federal grants say local and private grants, and contract, 17 , private funding of a seven percent self fake, six percent, and other public insurance three percent. Those of the funding mechanisms for the Health Centers in the nation. Dr. Anderson is medical director. How far away from funding problems and decisions are you . Guest we have a very astute chief Financial Officer who was always on top of the numbers. I am not directly responsible for obtaining the funding, but we do have one we do encourage all of our physicians to have granted funding for the things theyre involved in. One of our physicians is instituting a new problem called the ark description program. In which we are prescribing nature to our patients. To combat the scourge of obesity stress and our kids, attention Deficit Disorder we see that children are really suffering from not being able to go outside, not being able to interact with nature. That is one example of Grant Funding that one of our providers has access to have and is implementing throughout our centers. For the overall funding of our centers, we have a Financial Department that constantly is worried about that and constantly on top of that. We encourage physicians to acquire Grant Funding if they of a project they want to work on or if something is interesting to them. I think as a Community Health center provider, as we provide the services that is always in my mind, and that should be in the mind of any medical professional. Health care is offensive, and we want to provide the best health care that is necessary for the patient, but also keep in mind the cost to not be ordering unnecessary test, not be ordering unnecessary medication, having unnecessary visits if the patient is not needed or they would not benefit from it. While we are not directly involved in financial issues, we do have them in the back of our mind, and we are able to impart the health care that we need. I want to thank our leadership in that, that they allow us to do as much as we can within the services that we are able to provide. If theres something were not able to provide we can always petition for that. We need to provide health care within the constraint of the financial situation that faces us. Host a tweet guest that is something that comes up often. I am not sure what the word what the concept of loophole is used in that context. I took a hippocratic oath to serve patients, to care for the health care needs. We do not ask about nationality, we do not ask about that is status of our patients are working, they are family members rate have dreams, they have children, they have a desire to live out their lives just like anybody else has. As a physician, my goal is to treat the patient and the best way that i can. I was in that Community Health centers are a way for people to achieve total health, i feel like they are a great mechanism in our community provide hope that they expand. Regarding the issue of Illegal Immigrants we serve people regardless of their ability to pay, regardless of their national origin, regardless of who they are where they come from, every person is served with dignity and respect. We are caring for their entire health care needs. Host the american medical colleges reject that there will be a dock are sorted by 2020 of 92,000. News 92,000 doctors. As a medical director, what do those numbers say to you . Guest it says that we need more brick easterners practitioners. My colleague will talk extensively about the innovative programs that we have at Unity Health Care to really fill that gap. One of which is our medical Student School and our residency. Where he teaching Community Health center in which we are training the next generation of students and practitioners to work in this kind of context. For example you enter that i did my Residency Training at harvard ucla mezzo enter in los angeles candle point of Medical Center in los angeles, california. It is mission driven, and has a emphasis on my merry health care and underserved care. The vast majority of residencies in these days act is mostly in hospitals, and they may have some exposure to the Community Health care setting but not a lot. We are trading those students and residents in our centers as our home base, people that look like them. Students that come from our community, and we know from experience with both the National Health Service Corps and other and it seems that entities that people from those areas are likely to return to those areas to deliver health care. That is something were working on here at Unity Health Care to really provide students and residents with an idea of the vast array of Health Care Services that we provide. I have heard the sunday times of people visiting our helalth centers. They are impressed with the array of services we provide to the type of physicians that we have covered just the experience of the patients there. If we can train our learners in our sites, they are more likely to be the people return and work for our sites later. However, another thing that has been a benefit of our program is that even among our staff we have had medical assistants, nurses come to be and say i was not about being a doctor, but i thought it was outside of my reach. Actually seeing people in training, seeing what it entails, they are even inspired to follow their dreams and go if that is a goal of theirs. We have many tangible effects that are both shortterm and farreaching, beyond what we can imagine. We are very excited about that. Host robert in kentucky. Caller the affordable Cap Health Care act, medicare is a good program. It has been a good program for years, theres a little bit of flaws in certain things, and i think everybody in the world should be entitled to the medicare. And try to advance the Medicare Program , and improvements of having the obamacare. We already have a existing medical for people and we could find a way to advance it to make more dock tours more doctors accept medicare and advance it, it would work out for everybody in this country. Host andrey anderson, any opinion on that . Guest thank you for your call. Definitely, what you are speaking to, really underlying it speaks to coverage for all. I do think that health cares rifle on that people should be covered. By Affordable Care act is the law of the length of it was passed by congress, and we are benefiting from many of the provisions that she mentioned like the preexisting conditions. Previously, people with preexisting conditions whether it was simple as asthma or having had a miscarriage at one point for many insurance companies, that would preclude them from obtaining an individual plan or individual services but we are very happy that that has been removed removed from the insurance companies, that people of all Health Statuses can receive care at any level. We know that the Medicare Program is for those over 65 and it provides robust coverage. It could be written more robust gevo but when people get to 65 they are able to be covered. I have had some the patients priebus to the Affordable Care act, maybe they were 61, or 67 they are not or 57, they were not ready to retire, but they are outside of the coverage limit, not quite to that point where they can receive conference of services. Comprehensive services. By the billy fundamentally, all should be covered, and we need to have a healthy community. We need to interact with one another, and it is in just to have coverage for one and not another when we are all working together in the community. Host do you see a downside to the Affordable Care act as a physician . Guest hmm. I would say that the downside may be first of all, let me first say that im very supportive of the Affordable Care act bad im happy that we have an administration that sees the need for health care and health care for all. I wish that im could be more expensive, but we are working what was passed by the congress and trying to make it work in the best possible way. More people do not understand all of the benefits that are open to us of the Affordable Care act. I wish that there could be a little more education more people could know about the services that are offered, especially low income communities, young patients, latino patient, patient to speak spanish or a different language ever they may still feel that health care is not within the reach, coverage is not available for them. We do know that it has been made available through the Affordable Care act of and there are so many great benefits. Im a new mother, and i was able to get Many Services through the Affordable Care act that i did not even know were available for me the. Me. With more expansions, more education, more wordofmouth and more coverage in our community i really see that we are seeing benefits and we will see them even more in the longterm as this act does more. Host final tweet guest good question. We know that Mental Health is a problem in our community. Death only one underserved area that we are working very hard to address definitely an underserved area that we are trying to address. We have mental Health Clinicians that work in our sites and within our department of corrections. We know that Mental Health is often stigmatized in our community. It is an integral part of every person. I tell my patients that her brain is a part of your body to. Just as your body can get sick, sometimes your brain can get sick as well. We need to have clinicians were sensitive to that and able to address those needs. One thing that we have done and are center is we have colocated our mental Health Services. I mentioned the teambased health approach, previously when i came to our community, we had a Mental Health community that was on our restore and it was very clear that youre going to the Mental Health department. I can create a lot of ideas in peoples heads. Now all of our clinicians are collected from the center they would be coming to see me for them at becoming the seed feeder triticum of the beginning to see the social worker, referral, or the Mental Health provider. They are not stigmatized in that way. It helps us to provide comprehensive Health Services because i might be seeing a patient in my exam room, and next door might be my psychiatrist or the psychiatrist of our team that is seeing another patient. A five question i can go over and asked them and maybe we are seeing the same patient so i want to change mrs. Smiths high Blood Pressure medication, will that interact with the antidepressant and she is taking . Because the clinician is right next door, and asked that question and we can have Seamless Health care that is so important that important in our communities. In addition, we are institution Mental Health screenings for all were patient. Just as you come to any doctor need your Blood Pressure taken and your respiratory rate taken, we are also mandatory doing Mental Health screening and mandatory hiv testing. Also for children because that is a large area where theres not copy the service comprehensive service. We realize that a persons Mental Health is just as important as their physical health and we are making sure that those issues are addressed to ensure the patients overall wellness. Host Services Provided by the Community Health Services Include primary care, event of health care Preventive Health care, dental of farmers think of health and Substance Abuse the funding request or . 6 billion for the next year. That is the quest for Community Health center federal funding. 3. 6 billion in the current funding level. Our guest has been Andrea Anderson, the medical director at the Unity Health Care center upper cardozo branch. Thank you for your time. Guest the wife or this opportunity. We really appreciated it. Host we are going to be one more doctor out of unity just a few blocks from the Nations Capital. Keisha robinson is the regional director at unity, and she will be joining us in just a minute as we continue our visit at the Community Health center. I hope this is the last time it will be necessary to take the time of the house to discuss the subject of the irancontra committee. Let me echoed the sentiments expressed i mr. Hamilton and thank him for the language of having served with him on the committee. It has been a very difficult task of a to preside over a contentious and confusing ross s. Process. I think the committee has produced a product that the house could be proud of and we are in the process of losing our responsibilities closing out our responsibilities. I referred to with the gentleman of the for an indian educated, and with the senior officials of the white house said, that we have a commitment that as of generate 31st, they will have completed their d equation of those military is that the committee has voted to release. Ive given my word for the gentleman mr. Hamilton and also to mr. Foley that if the white house failed to meet that deadline could not would join with mr. Hamilton and coming back to the floor at the appropriate time to speak seeking further expansion of the life of the irancontra committee. I do not expect that that will be necessary. My colleagues on this site of the aqaba the important thing is that all of this resolution to the essential committee will continue with very limited staff. To documents will be transferred to the archives and the appropriate security procedures and and after that date except for the members of the select committee on a rant of all of the requests for access to the materials will require a majority vote of the health to the on Intelligence House Committee on intelligence. I think it that despite the concerns satisfies many of the concerns many on the side of the aisle have expressed in recent days. I would at this point of asking chairman to yield to join with me in a colloquy with respect to explaining specifically what is intended in that paragraph in the resolution, number two that deals with the committees closing out of its affairs. I resolution provides only for one exception to the provision that the committee will have no further investigative power. This allows the select committee to receive the journal in response to requests made prior to the adoption of this resolution. Will the gentleman please play the benefit of the house would likely that covered by the exception . There are, as i have previously discussed with the gentleman rome wyoming, two pending request for information of which im aware, im not aware of any other request. Find more highlights from the five years of house covered on our facebook page. Cspan, created by americas Cable Companies than five years ago of an but you today as a local service by your cable or satellite provider. Washington journal continues. Host on your screen is Unity Health Care Community Health center of a located a couple miles from the Nations Capital in washington dc. That is just a couple of miles from the Capital Building wealth. We are visiting their live this morning, talking about the Community Health care system in our nation. Next up is Keisha Robinson. Shes a doctor of osteopathic of and she is the medical Education Regional director. What is osteopathic . Guest osteopathy is a philosophy, in which we as physicians go to the organization and medical schools who treat the entire person. We have a foundation that the body can heal itself in essence, sometimes in addition to medications and other support. That is the whole premise that the aday has a natural tendency to heal itself. In essence, im the regional director of medical education with the help of the support of our executive Team Management at Unity Health Care. I oversee our medical students who are osteopathic medical students. Their home base in the main campus is in mesa, arizona. What is so great about osteopathic medical students who come to our main campus is that they spend their first year in mesa, arizona, and then they come to our campus and rick complete the remainder of their medical School Education from secondyear, their jerk of and fourth year up until graduation. Host how does the philosophy of osteopathy did i get it correct that time . Guest yes. Host how does that philosophy translate into a patient walking in the front door at unity . Guest so, unity actually has the foundation of that philosophy, and that his treating the entire person not just looking at what problem they may enter the doorway, but also looking at their Mental Health, their physical health. When you think about, with incomes in when someone comes in with a history of asthma, we can help prepare bodys natural tendency to heal itself. We can teach that to our students will drink this throughout their education. Host how do you find these medical students . Do you recruit them . Guest we partnered, and the first graduating class of the National Association of Health Centers of 2011 of 100 to 110 medical students. They had 10 to 11 Community Campuses in which their duties are assigned to students are assigned to, and they spend the last three years at those centers. Being a partner with that school of medicine, we are introduced to the osteopathic medical students. Host we will continue our visit, putting the numbers up on the screen area when did you first decide you want to be a physician . Guest as a young child. I recall my grandmother telling me that even before i could remember. My grandmother was a strong inspiration to me in choosing a path that i have chosen. I was sure under the publication of diabetes from repetition to stroke or heart attack, ultimately leading to her death. I learned that a very early age that i wanted to be a part of the movement to help patients prevent preventable competition from a chronic condition. Host what made you choose osteopathy . Guest i would say i chose it because it shows made. I was extremely attracted to repetitive help. Preventative health. I wanted to learn more about the way the body heal itself and in what avenues i can help a patient further live their life in an optimal way. An additive about learning about osteopathic medicine, that was an additive i was not expecting. Preventative health is the core and foundation in my passion for what i do today. The fact that operate osteopathy was addressed to me following my undergraduate training to buy had other colleagues and students who chose osteopathic medical schools over other schools simply for the basis of how do you want a function, how do you want to treat your patient . You do not want us to see the patient and trade them for sore throat, youre going to do more investigation about how they can prevent a sore throat if possible, how can we stimulate your immune system so that we can prevent future occurrences. It is all about education. Host dr. Robinson has served into dub in two Medical Centers, and she is now the direct your the direct or. Heidi reach out to patients who may not be able to come to the clinic, such as jails, homicide is homeless shelters, etc. . Guest the regional director of medical education, and the new york college of osteopathic medicine, how do we reach out to the community . We have a Health Center within the department of corrections, and a homeless site. We reach out to the because we offer our services to any and every person in this community regardless of the ability to pay. A lot of times, because ive been with them for almost 10 years now, and i have worked in ward eight in southeast washington dc, which is the area that i am from. Reaching out to them was not a difficult matter. I am seeing their mother, their children combined zynga cousins and their friends and their classmates their children, cousins, and classmates. The word reaches out to the community. Host lets take some calls for dr. Robinson. Seo is a nurse in tampa, florida. You are on. Caller hello dr. Keyes robinson to buy appreciate you, and your osteopathic medicine. My first baby was born at 22 and my doctor, who was an older man have a man cap at least 55 he and not deliberate and by that cool an older man, at least 55, and yet not delivered a baby since med school. But he said delivering my baby was a beautiful vehicle. Miracle. I heard you say that you wanted to become a doctor, i wanted to become a nurse or teacher because theres a lot of teaching in nursing. And i wanted become a nurse ever since i was eight. Host are you an rn . Guest caller i am. Host are you working now . Caller i broke my arm. Host please enter your comment for our guest. Caller i do not think the public knows how much all of us even though we are older, im consistently volunteering at the clinic which is across from the hospital where i worked. I work in icu, and i work 1216 hours, and the most i worked as when a 1. 5 hours. 21. 5 hours. Host anything you would like to respond to . Guest absolutely. I am very moved, and understand the passion of how providers and physicians impact our lives on a daily basis. The importance behind that is also making sure that we also have positions in the future to do exactly what was done for this caller. That is to be a memorable component in their life, and delivered her child. I would like to take it back to our medical students, and not only are we becoming a Community Campus for our medical student our second Year Medical Student who come here and they are responsible for completing the curriculum that is through the university. This will be the initial exposure that they have in our Community Health centetr settings. Having handson Clinical Experience without other providers. This is a very important this is initial impact or impression of how theyre going to move forward. They use this as foundation in their future, whatever career they choose them theyre going to use this as a foundation for that practicing medicine. In essence, we also have a residency, as dr. Anderson alluded to. We welcomed our first year class of 2016 for residents have and that is spearheaded by dr. Donovan who is a program director. We partnered with the rightcenter Wright Center for graduate education. It is extremely important to pay it forward to our future patients and our future physicians. We are really excited about the import of that, and training our positions. Training our physicians and our students to practice within the community. It is about recruitment, it is about retention, we would like to capture all of the future physicians not only through medical school and residency but also before that. I knew that i wanted become to become a physician at a young age. Just to give them an idea of what it is to be a Family Practice in addition, a primary care provider, serving the community. Research has shown that homegrown providers are individuals who are interested in the field of medicine whether they are from the area or they are trained and educated in the area. They tend to want to stay in the area and practice medicine. We are physicians who are embarking on this longitudinal initiative to further our providers at our Community Health centers. Offer multiple experiences in our patients lives. Host eightweek a tweet guest yes. We have social services. Initially, it they need any resources or information we definitely refer them to our social Services Members which is what dr. Anderson related to alluded to as our home team component. Host kerry from las vegas. You are on with Keisha Robinson m. D. Caller i couldnt live in washington dc because of the pricing, used to go to the Unity Health Care clinic in wanda should did easy in washington dc. When i referred to places like georgetown was because i cannot get a place in your elect. It is not at with what youre all doing but it is with the politicians. I could not afford to live there. When they talk about community who are they talking about . Host dr. Robinson . Guest actually, currently where i am sitting is in parkside Health Center, and having practiced here for the last eight years, i can vouch for patients who we have help significantly over the years. It is unfortunate that your experience was not as helpful as i would expect for it to be. Whether you will bring referred for consultation or what have you given the price of living has risen, that is definitely true. Regards to the services we provide we also make sure that we provide services to the rules for low most vulnerable. That includes at or below the poverty level. That is interesting because i would have been very passionate about making sure that you received the care that you deserved. I am sure that is a benefit for las vegas and the disadvantage for us that you left us. Ultimately, i do not know particularly about the politicians and the politics, but they do not being on the front lines as a physician and seeing patients have Regional Bank but being on the front lines, and seeing patients on a daytoday basis, i fight for you everything the day. For anyone, we see anyone without regard to ability to pay. That is what drives us. We turned no individual away. Host that he is calling from pennsylvania. Hello. Caller hello. I have a comment. Im a viewer of cspan on a regular basis of and i must say that it is refreshing to see guests that are intelligent articulate, and informed, and actually are addressing the questions put to them. Aside from the right thing with the doctors are doing in their communities is a wonderful thing , local ideology aside. Guest thank you very much. We appreciate that. That Unity Health Care, we have a very strong role model the founder of Unity Health Care. Looking at what she has put forth, and providing care to Unity Health Care she is a great role model for all of our providers, all of her staff, all of our administrative Staff Members. To live up to what she has done, thus far, it is a really great role model. Thank you for the compliments, but we have a long way to go, as far as health care. Host in 1975 congress authorized the Community Health Center Program a federally qualified humidity help centers receive federal grants and receive reimbursement from medicare and medicaid. Over 9000 facilities, about 153,000 employees over 22 Million People served, 88 million annual patient visits. That is national figures. Caller from silver spring. Caller i am a chiropractor, and i was wondering the way they medical immunity by his chiropractors Community Views chiropractors. How do communities view chiropractors, and ringing chiropractors into your system and, being that there is a shortage of physicians . Guest actually, one of our Board Members as a her. Ringing chiropractors into our organization is an opening to an avenue in which we can further expand and feed our patients. Being an osteopath and having a lot of insight into the field is obvious the dash into the field of osteopathy and chiropractic field, i do not think that anyone is going to close their doors to any avenue in which we can further the health of our patients. Host Community Health Center Requirements did you have more you wanted to add . Guest i wanted to mention some of the concerns and barriers that we are facing that is very apparent to access to care. Im sure everyone has seen the projections for the next six years where we will have a shortage of physicians overall. I wanted to highlight the importance of the longitudinal initiative were doing with her students and a residence. The reason why it is so important is because we are actually training educating our future positions physicians. With this being there initial exposure to communitybased headings we would like to make sure that our students and our residents choose to, i think it is a Great Foundation to enter the dark shirt the introduction to their future endeavors. With that said we have a shortage of physicians. Were making every effort we possibly can to increase access to our patients and our community. We have six residents and our firstclass event we will have 18 in the next three years. We will have 30 students in our next or years three years. We will have 48 learners. I think that is very important to point out in our initiatives and our growth. Host meet accountability standards, that is according to the health and human Services Department. Barbara in florida, go ahead. Caller i would like to know if the doctor could [indiscernible] host what was that . Barbara is asking the so called death panel,. Is that something you wish to address . Host we are going to move onto trish in florida. Guest caller im wondering if you could answer a couple questions for me. For several years ive been struggling with a bladder infection. Host im sorry, we will not be able to diagnose problems over the air. Could you get to the crux of your question . Caller i have pain all over my body, and they diagnosed me as fibromyalgia which they just give me a pill for. What would you do differently than what my doctors are doing . Host dr. Robinson . Guest if you were my patient i would definitely have to reevaluate you from the beginning to get a fleet history to get a complete history. Not just your systems but other avenues. The field of osteopathy, we look at mind, body, and spirit. A force in a driven area for your whole Optimal Health to occur. We would have to look at the history with specialists and recommendations work even in what has worked and not work. Ultimately if your circumstances warrant certain areas of treatment that an osteopathic physician can provide, and we can move forward than that. We do not want to eliminate any of the celestial i could be part of the collective extended achieving your Optimal Health. Host weve been talking with the regional director at Unity Health Care, located just outside of washington dc in the capitol building. Thank you for being with that we want to thank all three of our guest. S. Allowing us to be live with them this morning talking about Community Health centers. The house of representatives is coming into session today for just a quick pro forma session. We will take you to that just a minute. Vice President Biden Vice President biden is speaking to the Health Centers association and that will be live at 10 15 a. M. Reminder, every weekend, 48 hours on cspan twos and 48 hours on cspan three booktv and American History tv. Cspan2 and cspan3. Ui for being with us. The speaker pro tempore the house will be in order. The chair lays before the house a communication from the speaker. The clerk the speakers rooms washington, d. C. March 21, 2014. I hereby appoint the honorable luke messer to act as speaker pro tempore on this day. Signed, john a. Boehner, speaker of the house of representatives