Say can i go back. Because the students are some of the, you know, most intellectually stunning people ive ever had the opportunity to be around. And they so the faculty, you know, has not theyre jumping at it. Yeah, and many instructors ive talked to had the occasion of teach anything prison and outside, you know, talk about the level of focus, commitment, he had dedication, air not distract bid iphon distracted by iphones. How are the Second Chance pilots ensuring they meet labor market demands . This gets to your idea that you distinction between job training and education per se. Any you you can answer this. We are proud and excited, happy, Second Chance pell sight. Im really excited to be coordinating the partnership between the three cuny institutions. For us, we will, in putting the application together, weve looked at what Employment Opportunities there were in new york. We went to the department of labor and looked at where the Growth Industries were. And then we worked with our Community Colleges continuing Ed Department to match what the Growth Opportunity was on the employment side, with the industry recognized credentials that we were already offering at the Community College level that were now folding into the, you know, what were going to expand under Second Chance pell. There have been also National Studies done on surveys with companies that are hiring new employees, and it is not really the type of degree that theyre interested in. Theyre interested in hiring people that can critically think. That can communicate well in writing, and i mean, those are the two major things that theyre looking for. So those are definitely things as fred mentioned earlier that college can provide. Heres a question about entrepreneurship. How can we better incorporate entrepreneurship so individuals can become selfemployed or come out of prison to start a business, using the education they received either before, but more important, sort of during incarceration. The idea here is that this questioner asks, is there an opportunity for job building as is tl is for supporting families. I think it is extraordinarily person. Jackson college in michigan, we were offering a national program, Jackson College was the provider. They did a good thing. They talked to the students about what it is you want to do, what kind of courses, what sort of majors do we have. What bubbled up that was extremely important was being entrepreneurs. Many colleges these days offer courses. Thats what Jackson College did, and i assume as a Second Chance pell site that may be apart of the offense. I know i mentioned the federal agency council, one of the agencies that participates is the Small Business association. As part of the participation, theyre giving out micro loans to formerly incarcerated people. They realize how important it is to start your own business, and fostering and encouraging entrepreneurship. We have in colora californ multiple prisons, the last mile project, and they brick in investors to do a shark tank type experience, and thats been very successful with us. And then we encourage the folks, especially career technical certifications to continue their education, and now get an aa in business. So many of our College Programs are business related. So they can now have that as a backup when they move home. Ive got a ton of questions, but were going to run out of time. One final question here, which is a great audience question. But is there anything we havent covered here that you think is worth talking about to this community about prison education, what is needed in terms of politics, policy, funding, creative thinking . What have we not talked about . I think one of the things i would add to this discussion is if youre trying to change your system and policy and pitch an idea, it is really important to understand what the Research Says and use that, but also, get out and see whats going on around the country. And one of the things that is really inspired california is many of our leaders have gone out, even around world, and looked at oversigther sites. There is a lot of great things happening out there. It is inspirational to us woochlt he hope we can offer the same thing for other people to come see us. So i would add two things. One, i would add that any at every point possible, include the voices of folks who are directly impacted, right. So learn as, you know, as fred was just saying, ask students what theyre interested in, in building programs if there are folks here starting from scratch and building programs. Get the input of folks who will be students in those programs. The other thing that i would add is really i hope that what we can do is take this conversation out of the criminal justice realm and bring this conversation into an educational justice realm, into a realm thats about diversity and Higher Education. So that we recognize that we, you know, can close that gap, the racial gap, socioeconomic gap in Higher Education. I think doing that, and putting our focus there, the criminal justice side will take care of itself. I think people need to go to prisons or jails wails with an and inquisitive mind actually see what theyre like. I think there is a lot of people who have no idea what they look like, what they smell like, what the effect is. I think that means people arent really thinking critically and analytically what criminal Justice Reform looks like on that level. There is a lot of Great Questions im not getting to. Let me end with this one, and ill read it verbatim here. It is great to use data to change peoples minds. The perceptions about people in prison. Well never reach peoples heads without reaching their hearts. How would you, each of you respectfully, reach peoples hearts about the integrity, intelligence, character and courage of people in prison . I can tell you what weve done is you have to take the state senators to the prisons, and have them visit. Then they can see what is happening. Thats from the policy level. But at a real grassroots level, it is one officer at a time. It is having them attend the graduation, and see hear people speak and see the transformation, not just read about it, but see the transformation. And it is one heart at a time and it does work. I think it is that, and i also think it is directly confront, asking individuals a couple of questions. So how would you want your loved one treated. Should he or she be caught up in this system. What do you expect of individual w s when they return, since 95 return home. Lastly, do you want to be judged by the worst that youve ever done the rest of your life and have people concentrate on the answer to those. They begin to see their way as to how we treat people in prison matters and we have to provide hope, opportunity and skills. Shawn . I dont know if i can add anything more. I mean i think it is. I think it is about, you know, i do think it is about hearts, right. Is there let me look at my own life. But i also, i also want justice. I also want the freedom to live my life and i dont necessarily want to wait for people to like me. Before i get what im supposed to have. So yes, committed to changing hearts. Really interested in changing policy. Because i think, you know, there will be some folks who are close to the middle who we can get to come over and there will be other folks who we wont ever get to come over, but still need to demand equity and justice. Yeah there is no good answer. I mean, you have to find the best lever that works. Whether thats for some people, its a fiscal level, fiscal lever, and for other people, it is, you know, we saw the video earlier, you know. And someone who the numbers may not get to, seeing that video might say you know what, you know, ive been demonizing people or thinking about people in the wrong way. Thats going to change it. Using ever lever thats available. Well, thank you to you audience. Thank you to the panelists. Thank you to david sokolow, wayne, class for putting this altogether. I hope this has provided food for thought at the least and maybe some practical ideas for all of you to implement in your daily lives. So thank you. [ applause ] today, three former white house chiefs of staff discuss president ial transitions, and challenges facing the incoming administration. Live coverage begins at 6 30 p. M. Eastern on cspan. We have more now from this conference on inmate job training and education former inmates and analysts talk about academic counseling, barriers associated with reentry into society, and the importance of connecting the criminal Justice System with other Government Agencies. Good afternoon, everyone. All right, so wlielkd e would l transition to our second panel, reentry. Weve had a wonderful afternoon with nick turner setting the stage and giving us the framework. A moment of opportunity to address Justice Reform, to address the intersections of Racial Equity and most importantly, to think about what are the strategies and Power Solutions that we need to ensure that individuals who are formerly incarcerated, individual whose are currently incarcerated have the opportunities they need to thrive and realize their full potential. Were transitioning to the topic of reentry. Youve heard many of the stats already from our speaker and from our first panel. Many young many folks focus on youth approximately see, pols face the consequences of mass incarceration. 40,000 barriers that are documented by the American Bar Association that relegates folks to second class citizenship basically. Barriers to education, housing, licensing, and those are critical areas which we know are very important just be able to thrive economically and contribute to your communities. We also know that education and training matters while behind the walls. There is lots of research. The last panel talk about that research. The return on investment. That was mentioned by fred. But we also know we need to really think about how those things that happen while in prison, actually translate and coordinated when folks are returning home. We started this day off by se seeing a video of young people and children and how incarceration impacts families. And so as we enter into this next panel, before i introduce the panel, you know, lets keep that in mind. This whole work that were talking about is really about not just individuals, but about families and about communities. And so im really pleased today to be able to introduce our panel. First, we have vivian nixon. And vivian and all the information is up there in your packets. She is executive director of the college and Community Fellowship. It is a Nonprofit Organization that helps formerly incarcerated women. Next, we have terry fazaio, director of education at the Pennsylvania Department of corrections. She is responsible for Educational Programming across 26 state correctional institutions in the state. And then we have will heaton, director of policy and Public Affairs at the center for Employment Opportunities, which is a Nonprofit Organization, offers comprehensive employment services, exclusively for people with criminal records. And last but not least, we have deanna hoskins, senior policy advisor for corrections and reentry at the department of justice, bureau of justice assistance division, where she oversees Second Chance act portfolio, which we heard a lot about in the last panel and supports for the departments work, federal inter agency Reentry Council. So join me in welcoming our panel. [ applause ] so what well do is we will have a round of questions that will ask the panelists, well leave a little time for audience questions from you all before we d do our closing session. As always please tweet out questions, please tweet any ahha moments, anything you want to reemphasize to reconnecting justice. Ill start off with you terry. At the state level, so we i mentioned having the need for a strong continuum of education and training while incarcerated, as well as, you know, making sure that those opportunities are coordinated upon reentry. And so in pennsylvania, your department has received an improved reentry education grant. From the u. S. Department of education, which youre using the focus on Career Pathways programs. Can you talk a little bit about how that work is going, and what do you see as some good things happening in some ahha moment as soon as. We at the department have recognized that it is important for us to take our inmates and provide them with some marketable skills to use upon their release. These marketable skills will help them to attain employment, but we dont just mean any job. We want them to gain a Life Sustaining employment where they can help to support their families, have some benefits and things when theyre working with many of the workforce investment boards in pennsylvania, and we have a lot of employers working with our vocational advisory teams. We have regional vocational board meetings and working with employers to tell us what jobs are available, what jobs are out there and what certifications theyre actually looking for. Our goal with this grant is to take our Vocational Programs and tweak the certifications that we are offering so they are matching up whats out there. Many of the employers right now are telling us that they actually have more Jobs Available than they have applicants to fill them and we have the workforce. We just need to make sure they have the correct certification skills upon reentry. They are willing and able to look at hiring exoffenders as part of their workforce. The next year and two years of our grant are going to be focused on taking our curriculum, our textbooks, and our Certification Programs and updating them and bringing them into the type of work that these employees will see and actually do when they are in the field. Many of our programs are old. Some of the equipment is old and thats not whats being used in the field. So, this grant is to help us move that continuum over so that these people are practicing and using the equipment they will be using in the field. Great, great. Well build on that with you vivian to talk post secondary opportunities. We talked a lot in the first panel about the importance of postsecondary and college. Connecting that to the workforce pieces, talk about your work while the women are incarcerated and returning home. Thank you for inviting me to this wonderful event. Im happy to be here with so many colleagues i have worked with throughout the years. We have a continuum of services. When you think about the expansion of opportunity that is now occurring through the Second Chance initiative, we know that there are going to be more people coming out of prison with some exposure to college. It is very unlikely all of those people will have earned degrees while on the inside. The work we do at college and Community Fellowship is becoming ever more important because what we do is create a bridge from postsecondary opportunities presented to people while theyre incarcerated and making sure theyre able to connect to similar opportunities into the community. Many things have to happen so that works. So, the first step in our bridge is our Second Chance mentoring grant where we have staff going into womens prisons in new york state, talking to women about college opportunities, both those who have had some college while incarcerated and those who have or are close to getting a high school equivalency. When they come out, theres a pathway that we have from what we call our Community Sisters program, which is a program that works with people who are not quite ready to enroll in college yet because they have other housekeeping issues they have to take care of upon release, finding housing. Many do need to work at least part time, getting reunified with children, and all of the other stipulations that are demanded of them if they are on parole. Once they move through that phase, they go into a phase we call future fellows. That is the phase during which we help them apply for financial aid, find the right school, help them fill out the application, pay for the applications, help them find other scholarships. We provide various incentives to people. So, if a person doesnt have a laptop, they can get a laptop. If they need books for a semester, well pay for the books. The next phase is called our fellows stage. Thats for people who have successfully completed 12 credits at 2. 5 gpa or higher. They get a little bit more incentives in terms of computers or cash scholarships. We have annual scholarships that range for the person most improved in academic pursuits to the person who has the least debt associated with their academic pursuits to the person who is most community involved. We give about ten scholarships every year at our graduation event. And we also have a graduate program. Thats called college beyond. Many of our students come right all the way through that pathway from Community Sisters up through fellowship and to graduate school. The glue that holds our Work Together is really that its not its not just another door you knock on to get another scholarship. Its not just another form you fill out to get support. It is one to one academic counseling, tutoring, mentoring and then also groupbased network and social Capital Building through life skills workshops that people take at their will depending on the topic, plus Community Meetings that are mandatory where the Community Meeting is not always somebody standing in front of the room giving information to participants, but us helping participants facilitate each others progress. Share information that they have learned along the way. We have people who have learned how to really navigate the housing system really well in new york city. Thats not an easy thing to do. Why not have that student teach the others how to do that . The same thing with the child care system and other systems that our students are involved in. We believe in Building Social capital. We believe in Financial Capability. Every student gets Financial Capability training. We do Home Ownership workshops. For us, reentry is not the goal. Its a very specific point in time where people should get stabilized. Our goal is lifelong, resbi inauguration, sustained Civic Engagement and a life that one can enjoy and be proud of and can pass that on to their children and to their communities. I was great nick mentioned the buzz. It is multigenerational when you provide education to a parent. The last thing i will say because im probably going on because i can go on. The last thing ill say i forgot what the last thing was. You know what . We can you know what, well have a few more minutes. Just one quick thing. We recently added a career enhancement education program. So, many of our students have been telling us that on their way to getting their college degree, they are working in a job. Its not at a level thats really, you know, economically sufficient to live in new york city. But, if they get this one certification, they can get a promotion while they are still going to school. So weve partnered with one or r funders and were paying for City University of new york certificates in Health Related fields and in business fields. Thats giving our students a boost up in the world of work. Thank you. Great. No, that was excellent. A lot of what you commented on and talked about what you do and Building Social capital is the values we espouse. A lot of the work we do in our work is connecting how you think about whole families, the parents, the children, the young people. How do you provide the support they need in a program way supporting the programs, but also what are the policy Solutions Needed to make sure what vivian just discussed and really taked about talked about how the program can thrive. Im going to turn it over to you, will. Talk about ceo. Im going to tur you, will. Talk about ceo. You are a comprehensive model as well knowing that reentry is a point and time, not the goal. And that folks who are returning home are dealing with a whole host of issues beyond just getting a job or getting training. So, what are talk about your program and what are some of the Public Policies that will make it better for your program to thrive and people going through your program to achieve goals. Certainly. I want to reiterate my thanks as well. Its a privilege to be here today with all the speakers. Quickly, a background about center for Employment Opportunities or ceo. We are a nonprofit that was a demonstration. We have a lot to thank for that institution and we continue to work with them closely. We connect with folks coming home within the first three months of their release, usually. Theres a lot of research out there that says those are some of the most vulnerable moments in that reentry as people come home. What we do is we are very, very focused on when they come to our organization, they are enrolled into a oneweek Life Skills Education course that focuses on a number of things. Upon graduation, we hire them on as our own employees and immediately provide them with employment through social enterprise model where we provide transitional work crews via Service Contracts we have with a lot of Government Agencies at the state and local level. What that Work Environment is able to do is its definitely about the work itself but its a very constructive prosocial environment that allows people to start preparing for what they need to be able to cope with when they transition into an unsubsidized job. Three to four days a week, seven to eight hours a day, they are working with fellow crew members and theres a ceo staff member thats working alongside with them. At the end of each day, theyre provided with oneonone feedback. What went well . What didnt go well . What was causing difficulty . What affects when you go home . We pay them every day. I think one thing that a lot of times people not familiar with this work dont appreciate is, you know, somebody it can be very, very hard to manage your finances. And to have to wait two weeks or a month, you know, for us in terms of managing that in finances is very, very difficult. So, being able to provide a little bit of income on a daily basis is something that, again, helps alleviate the stress that so many of these individuals are coping with. Then, one additional day a week, they come into our office where they have a job coach. They are working on building a resume, practicing their interview skilling skills, how to talk about a felony conviction in an interview. S, h about a felony conviction in an interview. For a lot of individuals as well, they are terrified and, i mean i tell everybody all the time think back to when you were, you know, in grade school or high school and walking to the first Job Interview and never done it before. What was running through your mind . Thats what every single one of these individuals is dealing with. After they go through that phase of the program, what we are really, really focused on is not placing somebody in a job, but how we help them stay connected to that job over the long term and use it as a bridge to a much more fulfilling life where they have a much more opportunity ahead of them for a career growth. So, for the next year, once we placed them into a fulltime job in the local community, they have a Retention Specialist that we call that works with them over the course of the next year to navigate the array of barriers that all of these individuals have to cope with, whether its housing, transportation, child care. I mean, you name it. Health care. But what all that is, its focused on helping them create a more stable way to focus on succeeding in that job. Another thing i say to people is think about the fact that if each of us have to go into work at 5 00, 6 00, we walk out, we didnt know we were going to sleep. How focused are you going to be on your job when you dont know where you are going to lay your head that night . Thats a big deal. So, thats what we are focused on. What we are trying to incorporate into that, more and more now, is Vocational Training and skills. The shorter term stackable skills that are aligned with what the labor market demands are in the local communities where we run our program. For most of the individuals with whom we are working, they have the equivalent of seventh and eighth grade education. They want to get to that college education, postsecondary education, but theyre not ready at that particular moment. So, to kind of transition over to some of the policy changes that really give us one or two headlines. Definitely. I would say what fred referenced earlier is the number of occupational licensing barriers that economist, i mean its something close to like on average every state has 150 of these and some well over 200 or 300. Theres story after story of individuals who have come through our program where they are motivated, you know, beyond belief in terms of wanting to get back into the workforce and they just run into these walls where you cant even become a barber. Its like what does your felony conviction have to do with that . The second thing is take a look at some of the way our current funding programs at the federal and state level could be much more effective in directing resources towards fully formerly incarcerated individuals or just previously convicted individuals. Theres a connection between that and what teri was talking about. For folks who arent necessarily ready to jump into a more Traditional College environment. So, turn it over to you, deanna. You are at the federal level but have deep experience doing much of this work locally in cincinnati. Talk to us a little bit about what do you see for opportunity at the federal level in funding and policy. Youre leading in helping to lead the Interagency Group thats focused on this. What would you say are some of the big opportunities, you know, building from what nick said, this is a moment in time . Working on a federal level with bureau of justice assistance, number one, comes from community. You have these expectations and you get to the federal level and you see where the levers are. And one of the benefits, i think, is the federal reentry intraagency council. That is all the federal departments coming together to look at the policy that is are impeding within their organization. So, of course, the department of education, department of labor, usda, Small Business association. Where each individual agency has taken a look to say how can our agency contribute to some of the things to increase the probability of individuals being successful. Opportunities that im finding overseeing the Second Chance portfolio is the solicitations are a lot of times focused toward correctional facilities behind the wall. How do we change our solicitations to have greater impact from continuity of care behind the wall to outside the wall . So, one of the opportunities we are taking advantage of in 2017 is strategically writing what we want correctional facilities to do, no longer opening it up to tell us how we could do the reduction. Still have the plan but these are some of the elements we want to see in place. We want to see people leave prison with a state id. We want to see people leave the roll of medicaid. Theres a waiver for food stamp eligibility. We want people enrolled in food stamps when they leave prison and not have to wait on the outside. Theres another rule where individuals who get Social Security disability. You could be eligible and approved 90 days before release. We need to implement those. Using the Grant Funding opportunities to be able to impact some of that change that we want to see that doesnt cost to do is actually collaboration and having states replicate what the government is doing as well. Excellent, excellent. A lot of what we heard in the first panel and what we know to be true, we are focused on education and training, the housing issue, food issue and so forth is a huge barrier to becoming stable at your point in time of reentry. So, leveraging at the discretionary level and at the federal level is important. I want to turn we talked about this in the last panel and of course class work is about lifting folks out of poverty, by also making sure we have an explicit Racial Justice equity lens. So, well start with you, vivian. When we talk about universal policies, sometimes we miss the importance of drilling down and talking about specific individuals, especially folks of color. So, you are working with women who African American and latino women who are disproportionately living in poverty, who have increased consequences of criminal records. So, how does the intersection of race and gender play into your work and how do you see it affecting families and communities . How much time do i have . Well, we agreed on two to three minutes. So, i just, for context about how i look at this issue, these are hard conversations to have. Having conversations about race in america is hard because on the one hand we have done so much. We have made so much progress. We are so much more inclusive, but in many ways we are still a very segregated society. We are segregated by neighborhoods. Sunday morning is the most segregated hour of the week. Despite the progress we made, i think theres a way that we have been conditioned to view whats expected of people of color. So, just remember, people of color are historically their role in this country was to provide a low cost workforce. Over the years, that has taken different forms, right . From slavery all the way through reconstruction and through industrialization, which, when that phased out caused a problem, a gap in employment for the population that fed into ghettos and prisons. We still talk about people coming out of prison because they are people of color in terms of what we need for them to do is work. Everybody making that connection . It impacts the way we do work because we teach women not only to refocus their value as human beings from their own center, not from what is expected of them from our society. One of the first questions we women that come to us is before you got in trouble, however you got in trouble, whether you were wrongfully convicted or not, before that happened, what did you want for yourself . Not heres the program and heres what you have to learn how to do. Its what do you want. What do you want to do . What does a fulfilling life look like to you . That is not the way we have dealt with people of color in this country. We also believe in political engagement. We have a whole advocacy component to our work. We engage our students to work to restore the real act. We engaged our students to get the State University of new york to take the question of of their admissions application. That is a very empowering experience. Now you have women of color learning. Hey, i can actually impact what happened to me and my family. I can be engaged in a way that im not just fighting for my every day life on the street but i am fighting for justice for all of my people. Thats a hugely empowering framework to do this type of work. Okay. All right. Now, will, i want you to add because i know ceos framework is empowered in communities and youre lifting up your policies through there, but it is also in line to what vivian was saying. Definitely. I think theres two points i would like to inject into this conversation. I mean, one, i joined ceo in january. My position didnt exist before then. They definitely engaged in the policy arena at different times, but when the board of directors approved a new fiveyear plan at the end of last year, they created this position because while ceo will always remain a direct Services Organization and working within communities, regardless of how much we grow and all the other nonprofits that work in the same space that we do could grow, our ability to actually change this problem and just eradicate it is limited. We cant reach everybody, and theres going to need to be significant policy shifts to reverse a lot of what vivian has been talking about. Thats really where a lot of what i do now is thinking about how do we use ceos program as a platform to better inform more effective policy change and systems change at the federal, state, local level. And i think where i spent a lot of time working with government officials and in looking at how the workforce system can be much more effective, i think pennsylvania is a great example of when they developed their state plan, they had agency heads from department of labor, department of human services, and department of corrections was there at the table. One of the biggest things thats allowed us to be more effective and grow within that state is the state actually required local workforce boards to use 5 to 10 of funding to run transitional jobs programs. Its proven transitional jobs programs can be a bridge to get people connected into the work force. Then, thats just the starting point. It can be how they continue to build from there. But, that took leadership. But, you know, i think the other thing that really, you know, just to kind of speak more to what vivian is saying here, you know, a big reason that i came to ceo and have been involved in this work is this coming february will be ten years since i was convicted of a felony. When i sit down and talk about my trajectory to that plea hearing and what has happened in the ten years since then compared to so many of the participants we work with and even a few days ago in chicago when i was talking to somebody thats in a similar reentry program, their paths are so different than what i experienced in so many ways. A lot of that is because of the fact i was blessed to be born in a different zip code. I could go on from there. But, you know, somebody, i have heard this on a couple occasions and somebody said it again a few days ago in chicago, where i was. You are almost better off being guilty and rich than innocent and poor in this country. I mean, we have to do something about that. Its not i mean its an obligation that every one of us should wake up every day determined to fix. So, my own personal story, and theres many others out there, but its that difference in what those journeys are. Its not what we want this country to be about. Thank you, will, for sharing your story. We have the data to show if you go in this door and you are a person of color, you get this treatment. You go in this door and you are not and benefitting from white privilege. We all need to Work Together. I want to turn to you, teri, and talk about intersectionality in a different way. I know your work, much of your reentry work talks about young adults and how important it is to focus on young adults, especially communities of young people of color to make sure they are on the right career path as they are coming home as well. In pennsylvania, we have a very large youth offender population within our adult institutions. Ten of our institutions are designated for those that are under 21 but tried as adults and convicted as adults. In these institutions, all of our Staff Members are certified within the department of ed and we offer all types of education from that beginning abe level and ell, esl, up through any of these Vocational Training programs once they have reached their goal of either a ged or in pennsylvania we have a secondary diploma program. We worked with the department of education and we work with the individuals. We get their transcripts from school, the high school where they have been. A lot of programs are certified with the department of ed and we do a combination of those they earned plus ours and get them a commonwealth secondary diploma program. This diploma is recognized within pennsylvania now by many of the employers as being the equivalent of a High School Diploma or ged, so it is important for these youth to get that piece of credential first. We work a lot with the education Guidance Counselors and were looking at different career aptitude tests to form pathways for them. Find out what they want to do with with their lives much like vivian is saying, not we are telling them what they have to do with their lives, but what they want to do and getting them into the correct Vocational Program training. We are working and using a little bit of the Second Chance pell grant. We are using the post secondary courses. This is giving them a taste of what it would be like to do some of these classes on the outside. Weve also traditionally in pennsylvania have not transferred inmates from institution to institution for different programs, and we are looking at pulling that back and tweaking that a little bit so when somebody does attain their High School Diploma or ged, we give them that aptitude test. We find a Vocational Program thats not in the prison theyre in. We are transferring for Vocational Programming to get them what they need when they are out there. Thanks, terri. Ill turn it over to you now to talk about how can we, you know, tap into how the federal government can be more intentional about applying Rational Equity lens, thinking about gender and also thinking about the important age and developmental needs that terri mentioned, given that they have so many of their incarcerated population as youthful young people serving adult sentences. First i want to say thank you for acknowledging that because a lot of times even on the federal level with our Grant Funding we create policies or funding opportunities thats as if everybody on a Playing Field is equal. We are not deliberately seeing youthful offenders between the ages of 18 to 24, here are funding to help support what those individual needs are of those individuals in that age group. Or either saying that communities that are black and brown communities are having a greater impact and these are the things that are lacking that put them at a deficit before going into the prison system let alone coming out. So, a lot of times, if we create our solicitations or policies as if everyone is starting at the same starting point, we are going to keep coming to this place of having to readjust. Until we get very courageous and very deliberate about saying here are specific funding opportunities or here are specific things that need to assist this population so they can have equity in education, they can have equity in the job market but i have to say through this leadership were getting there. We have to move a little harder. I think innovation, visionary, having individuals at the table who have the courage to say, you know, we are doing this, we are doing some great work, but now its time to be deliberate to have a greater impact in what we are doing. Basically, the taxpayers are getting a bang for the dollar. We are supposed to be good stewards of money. Again, in my position, just taking it a little step further to say how do we help youthful offenders. How do we help individuals of black and brown communities . How do we help women . Because a lot of times we still do a cookie cutter approach, even from a policy level. Thats a really good point. Im going to turn it over to an open question before audience questions. You know, a lot of people talk about theres a rising tide. Lift all boats, right . Universal policies work for targeted populations. We all grapple with that. What im hearing from all of you here is, thats not the case and we really have to think about, you know, placing the how do we support investments and policies that support social Capital First and really communities grappling with all of these issues, but ensuring that state and federal investments and policies are nested around all of that. So, im going to turn it over to an opening question from everyone. So, we talked about challenges. We have already hit on solutions. Because this is a Solutions Center crowd here and we have talked about some of the silos. So, if each of you could leave us with one, maybe two changes that will bolster a more collaborative or comprehensive solutions that will improve the reentry point in time of education and employment outcomes. Yeah. I will be very brief. So, you kn, you mentioned the way we think about the rising tide lifting all boats except the boats that have holes in them, right . So, i think one of the things we can do is find out where the holes are and plug them and understand the interconnectedness with criminal Justice Policy, health policy, education policy, housing policy all of these labor force policies. All of these are very interconnected and the federal Reentry Council was a brilliant idea because it helps those different components talk to each other. The one thing that i would like to see done at the federal level is for there to be more flexibility in the solicitations for innovation, for things that are working on the local level to be able to be scaled up. So, one way to do that is to replicate programs like ceo that has multiple sites across the country. Another way to do that is find out whats really working and then teach other organizations that wont have to lose their own identity, but learn how to do what we do within your organization. You dont have to be a clone of us, but theres some tools we can give you. We just started a Technical Assistance program at college and Community Fellowship, and were putting out an rfp to anybody who wants to work with reentering College Students because there are very specific things we do that are not commonly done in the reentry sphere. There are many ways to implement good practices going forwards. Some of it at the policy level. Some at the Technical Assistance level. Its not separate from all the other social policies. Its not separate from poverty. Its not separate from health care or education. Criminal justice is infused in every area of our society and we need to treat it as such. Okay. Terri . One of the disconnects with our system had always been we can provide all the services and training and everything to our offenders while they are in there, but when they transition out and go into the Community Correction centers, halfway houses, theres always a disconnect. We never knew what they were doing. No communication in between. We have now started to work closer with the bureau of Community Corrections, and we are ensuring that everything that our inmates got when they were with us, certifications, diplomas, anything like that, our systems are now talking to each other and we are providing that information. We have open communication where they can call me if im sitting there. I will provide them with anything i have. We are starting to make that connection where we can work, continue to provide help and services to the inmate upon release and helping them make that next step beyond the Community Corrections center out into the actual world and living on their own. It did require and still requires more policy change on our side, but it is something that we need to improve a little more. But its starting to improve. Excellent. Will . I think two things. One, as we think about how to write change policy at any level is just keep the humanity of the problem front facing in front of us. You know, theres a mantra in ceo and its not just unique to us, but its the idea that theres the right program for the right person at the right time. We are all unique individuals. Your point, government can be hugely impactful, but its often times a very blunt instrument. We just need to continstantly c back to what individuals need. O instrument. We just need to constantly come back to what individuals need. Then, i think secondly, to reiterate what vivian said is, you know, like the Second Chance act. I think its done a lot of great things. It provided funding for a lot of programs across the country. You know, the reauthorization is before congress right now. Going a step further and when we find programs that we know work and theres evidence to back that up, be more intentional about providing a pool of funding to help them scale and really replicate across the country instead of just, you know, thinking about we want to keep trying new ideas. We need to do that, but grow the ones we know work. Deanna . For me, its really simple. If we are making policies about individual lives, the individual lives we are talking about need to be at the table. We cant make decisions and policies without having formerly incarcerated individuals at the table without telling us what is impacting their lives. Another look at this that none of us at the table could look at because we have not experienced a walk through what they have walked through. For me, im also pushing on the advisory committees. We are going to make a decision about the lives of individuals who have experienced this, the people who experienced it need to be at the table. Great. Great. We have a number of questions and well be able to get to a few of them. But we heard a lot of themes that were reinforced here. You know, supporting innovation, rolling back what we know hasnt worked, you know, over the last several decades, even more than that, as you talked to us about vivian. Centering the voices and the folks who are mostly impacted who have been impacted into our work. Not just the program at work, but the policy work and really thinking about the role of interactions with state and federal and local policy and programs. So, turn it over to some of the questions here. How do we ensure that government at all levels, state and federal, are working together to achieve progress and a common agenda . You are one example of that with the interagency council. But who wants to take this . I can jump real quick. Ill go back to the pennsylvania example. I mean, terry is sitting right here, but i think a lot of the progress ceo has been able to make within this state and right now were just operating in philadelphia, but were going to be a a new program site will be opening up the next few months in pittsburgh and then we hope to replicate further, but there is real leadership at a number of Different Levels in that state administration. I think thats allowed programs and funding to be, you know, pulled together in some innovative ways. A large part of whats allowing us to open the site in pittsburgh is we are being able to take funding from the federal snap Employment Training program and pairing it up with wioa funding. The states are allowed considerable latitude in how they administer the programs. I think the more that we can have sort of the, you know, uncommon allies together in a room where they dont necessarily think they should or could be working together. But when you everybody gets in that room, you see the overlap and how you can integrate and Work Together is where the magic can happen. Together is where th happen. Thats a perfect example of what you were saying, criminal Justice Policy intersects with with every piece. Talking workforce, talking about food policy, and here we are talking about justice. Its a perfect example. Terri, do you have anything else to add about working together with the state with some of your counterparts . As will was saying, our secretary and executive deputy secretary are extremely supportive of the reentry efforts occurring. Its not the traditional way d. O. C. Worked in the past. Working with the other agencies and branches, all of them combined together have come together and pulled a lot of really good initiatives and programs, which are starting to affect the funding thats coming in for us. Okay. So, this is an interesting question. So, anyone can feel free to take this. What are your reactions or solutions to research that shows box efforts are actually increasing discrimination against africanamerican workers or we can open it up more broadly . How can we make the ban efforts in the workforce sector as well as in Higher Education sector more effective . Yeah, i want to flesh that out, why that conversation is happening. People are saying that because employers are being encouraged to not ask about criminal history at the front end of an application process, they are finding ways through written applications or email applications to decipher the ethnicity of the applicant. If they can easily decipher in their minds the ethnicity of an applicant, they will make assumptions about their criminal history so people arent even getting a foot in the door. Im not sure of the validity of the concept. But i dont think thats a reason to put the box back. Yes. So, more importantly, how can we make the efforts more effective to connect to the work you all are doing . Ban the box efforts need to connect to actual state and local policy that disallows the discrimination against people who have criminal records. And, you know, employees need to be held accountable for diversity in their work spaces because employers cannot start throwing out all applications from black people. They just cant. Because eventually the workforce is going to be so devoid of diversity theyre going to get themselves in trouble. So, i dont think its a big as big of a problem as people are imagining it is. I think enforcement, having backup laws like the laws we have in new york state, article 23a of the Employment Law that prevents employers from blanket discrimination. Anybody else . I think i agree with ms. Vivian that individuals are fearful of change and who are not for ban the box are the ones speaking on this. I have to say that when you allow an applicant, everybody to be equal coming through the door, whether its evaluating or knowledge skills and abilities in a competitive workforce, the person who makes it to the interview, the offer, is the best candidate for the job. Now, if they have a felony conviction, thats when you have to look at the eeoc guidelines of what the conviction has to do with the job in relation to the job. I share that to say because even on this job, me coming to this position when president obama banned the box, i was convicted of a felony in 1998. I made it through the federal government based on knowledge, skills and ability of what i ran through a position through a competitive process in a federal government, and once my felony came up, my felony had nothing to do with the job i was getting ready to perform. When it was said and done, individuals are looking for the best candidate to carry out the job. I happened to bring extra skills that made it pretty good. So, i want to say that with fair policies behind ban the box, it created Employment Laws that do not allow individuals to have that blanket policy. Like ms. Vivian said, it all will be exposed. I hadnt to this point until more research comes out to prove it. Will, anything to add with connections to wioa and the pipelines you are building and how philadelphia is one of those ban the box cities . Are you thinking about connecting those particular policies and opportunities . No, we think about this all the time at ceo. You know, its a little before i came, but in new york city, we are getting we are celebrating the oneyear anniversary of the fair chance act. That went a step further in terms of not just government positions, but all positions. You know, it kind of presented a conundrum for ceo because the name of our organization in new york city is just so in there that when were calling up employers where they are looking for employees and we are starting to match up our participants, most employers know we are working with folks that have some type of criminal history. We are almost, by the fact we are getting on the phone, crossing over what the law intended to not happen in the first place. What i would say is, you know, i think, you know, theres a lot of great resources out there that looked at the two most cent studies that presented part of the conversation. We need to really look beyond just the box. What this is, i really appreciate the fact this spurred this much conversation about this issue, you know, kind of to what some of our previous speakers said about this. This is a unique moment where theres a lot of attention on this. For us, what we are more focused on is how can we work with employers, big and small across the country, and right now we work mostly with smaller businesses. To think about how are you changing your own hiring policies and practices to better reflect a more inclusive, you know, hiring procedure . You know, going just beyond that first step at the door. Yes, its critically important. Its just rethinking, you know, that stigma that is associated with the felony conviction from the very, very most basic, you know, thinking. Okay. I think we have time for one more question. Ill direct it to you, terri and have everyone else jump in. So, in addition to the work you are doing with the workforce boards, credentials and pathways, do you also connect folks to Substance Abuse or drug treatment or Recovery Services . We know that that is an issue that much of society, especially formally incarcerated individuals and thinking about Mental Health needs. All of our correctional institutions have a multitude of different type of treatment programs in there. Many of the inmates are required to attend aa or na. Anger management, different programs like that. Those run side by side with our education programs. We work very well within the institutions where they can be dismissed from class for an hour to attend a Certain Group or program they have to attend, and then they come back to school and vice versa. They have ample need to a lot of the Mental Health. They are identified and we have a lot of Mental Health programs. A lot of our employees actually go through Mental Health First Aid Training and cit, Critical Incident training to learn how to deal with the different items and things that may happen if we have students in the classrooms that have Mental Health issues. But each of our institutions does have the availability for all types of treatment programs as well as education programs, and we work side by side in conjunction. And those programs do continue on the outside should they be released to the Community Corrections centers or bureau halfway houses, Different Things like that. Through the department of corrections or through another agency that youre coordinating with . Most of ours are through the department of corrections. We have a couple of them that are contracted within the state, but most of them are department of corrections run and the employees are department of corrections employees. Anything to add about how your work intersects with supporting individuals who have these needs . And if not, deanna, if you want to add. I would say definitely. While were very much focused on employment services, those Retention Specialists oftentimes are trying are partnering up with other nonprofits that can connect housing or other kinds of medical services and whatnot. One of the things we really want to be able to do is just be a part of the much broader holistic solution because at the end of the day, its not just one thing. Its a whole multitude of things that when pulled together in a very coordinated way is where we can ultimately see people succeed to the best of beyond their ability. And i was going to say through our Funding Sources there is what we call mandatory requirements. And part of the mandatory requirements is that if youre applying for funding to do reentry efforts, there must be a connection to nontraditional providers providing houses, Substance Abuse so were providing that continuity of care behind the wall into the community again. Thats a mandatory requirement. When you say nontraditional providers, can you explain that a little . Youre talking about correctional facilities and state agencies. We can connect to other state agencies or bigger agencies. But a lot of times in communities, its the smaller nonprofits, its the mom and pop shops that sometimes are providing services that individuals dont want to traditionally arent aware of. But individuals are getting the services they need. Mentoring is one. Formerly incarcerated individuals working with other individuals coming home is a nontraditional service that has not been recognized by federal government or state agencies. So were encouraging some of that on the ground level to happen and occur. Vivian, you kicked us off with this series of questions and answers about talking about the interconnectedness of criminal Justice Policy with other forms of social policy, including housing and education and workforce and then Mental Health. So what are some last words you have to say before we close out the panel . Definitely connected with the best providers of those services in the local community. So we dont provide Substance Abuse treatment at our location. We dont have a housing specialist. We dont have medical treatment but we did a lot of work to find out who was the best provider of that service for this population in our local community and developed partnerships with them and built into our student tracking system, our data system, so that the referral is not just heres a phone number. Good luck. Our referrals are it goes into our system, we make the phone call, we make the connection, we follow it to make sure the meeting happened, and a reminder pops up on the counselors screen. And we have trained all of our direct service counselors in Trauma Informed Care so we can recognize when somebody may be having an issue, a Mental Health issue, or Substance Abuse issue. Weve scoped out potential Domestic Violence situations and intervened because we train our staff to look for those things. I really believe in Small Community based solutions where people can develop positive rips relationships, where theyre both giving and receiving something rather than and thats harder work to do and its more expensive work to do. But as deanna referred to diana referred to, it works. There are Church Basements all across the country having aa meetings every night, and people are staying sober. So we need to support that work. Its valuable, and it means a lot. The last thing i want to reflect everybody before you leave this room on dianas courage and wills courage and something that ive learned in 16 years ive been doing this work. You are all sitting in this audience, and youre listening to experts talk about the work that theyre doing to solve this problem of the connections between criminal justice involvement and poverty and other things. And unless i tell you that i spent three and a half years in a new york state prison, you would not know that. And i say that as the last thought to get you to understand that people who have felony convictions dont come out of prison with horns on their head. Were just people. And many of us are trying to have a positive impact on our society. And we just really thank the federal government for really opening the door for that to happen in this administration. Okay. So with that, i want to join me in thanking our panel. [ applause ] you will now hear from class executive director olivia golden in a few minutes who will tell you a little bit more about our work. We definitely dont see this event as a oneoff. This is the second part of a series. But we definitely are going to delve deeper into these intersections because our mission is all about lifting folks out of poverty and really thinking about the implications that poverty and all of these things have on not just poor people but communities of color. So once again, lets thank this great panel. [ applause ] tonight at 9 00 on cspan 2 civil rights activists, scholars, and political operatives on president obamas legacy and civil rights and race. Heres a portion. I think weve been handed an xray and we can see all of the cancers that are in our body as a country right now. And that is a shocking, destabilizing thing. I agree we have not achieved the level of hope and change, the shift in public discourse, the sense of unity as a country that president obama articulated so beautifully in 2008. But i think we may be missing something really important about that. I believe personally the reason we havent achieved and i think blm and others have done such an amazing job pointing this out the primary obstacle to change is white fragility and white supremacy. That is on the table now. That is out for everyone to see. We have the xray. We can see the trump supporters. We can see the Tea Party Movement in 2010. We can see the issues with race and bias and policing now. And until we cant do surgery without that xray. And so i think it probably took the country too long and maybe even the president too long to be able to identify these things when a lot of these folks in this room knew that already, right . More on president obamas legacy on civil rights and race tonight at 9 00 eastern on cspan 2. Here are some of our featured programs thursday, thanksgiving day on cspan. Just 11 00 a. M. Eastern, nebraska senator ben sasse on american values, the founding fathers, and the purpose of government. Theres a huge civicmindedness in american history, but its not compelled by the government. Followed at noon with former senator tom harkin on healthy food and the rise of Childhood Obesity in the u. S. For everything from monster thick burgers with 1420 calories and 107 grams of fat to 20 ounce cokes and pepsis, 12 to 15 teaspoons of sugar, feeding an epidemic of childhood obesitobe. Then at 3 30, wickipedia founder talks about the online evolution of the encyclopedia. Theres five to ten really active users. Theres another 20 to 30 they know a little bit. A little after 7 00 eastern, an inside look at the years long effort to repair and restore the capitol dome. At 8 00, Justice Kagan reflects on her life and career. And then i did my senior thesis, which was a great thing to have done. It taught me an incredible amount, but it also taught me what it was like to be a serious historian and to sit in archives all day every day. And i realized it just wasnt for me. Followed by Justice Clarence thomas at 9 00. Genius is not putting a 2 idea in a 20 sentence. Its putting a 20 idea in a 2 sentence without any loss of meaning. And just after 10 00 at an exclusive ceremony in the white house, president obama will present the medal of freedom, our nations highest civilian award to and bill and mellinda gates. Watch on cspan or cspan dost org of the free app. If james maddon is the architect of the constitution and he mirk then George Washington is the general contractor. If youve built a house or put an addition on, it looks more like what the general contractor has in mind than the architecture. Edward larson talks about president washingtons role in unifying the country and ratifying the First Federal documents n. His new book, George Washington, nationalist. They wanted to recruit washington in. Hamilton had talked to washington before about you know, this democracy stuffs never going to work. Youre going to have to be our king. Of course, washington was a true republican. He believed in republican government. Sunday night at 8 00 eastern on cspans q and a. A discussion now on Health Care Policy and technology with Technology Leaders on latest industry innovations and Market Movement to Value Based Health care. Thank you, everyone. I hate to take your away from your lunch and conversations, but im sure youll very much enjoy hearing from our next speakers. I want to thank you for the wonderful reception last night. Great food, great conversation and now, a couple of reminders. We are live right this minute on cspan 2, so welcome cspan audience. Later today, you can find this section on cspans website. A reminder for those tweeting, please use the hash tag u. S. And hot 16 and follow at usn hot. Check out our website for recaps of yesterdays and this mornings program. Lets begin. Im so happy to introduce our next speaker. Ed has served as chief text message officer and chief software architect. He thoroughly Understanding Health care challenges from inting emrs, billing systems an as much more. Ed is is vastly familiar with cryptography, which may explain why hes been so effective in cracking the digital code of health care, so join me in welcoming to the stage, ed park. Thank you. Hello and good afternoon. Im chief operating officer at athena health. It is terrific to be here today. Lets see. Where did this go. In early 80s, here we go. There we go. In the early 80s, William Gibson woet a book that predicted the rise of the internet. In it, he observed that future is already here. Its just not very evenly distributed. Nowhere is is that more apparent than in the difference between health care and other industries. Weve all heard our friends and colleagues lament that health care is is 20 years behind other industries. So, its a little bit depressing and unfortunately, more than a little bit true. But i consider energizing because its a challenge. It means that we know what health care is going to look like because were living it every day in other areas of our lives. So what hope to do over the course of the next 15 minutes is explain my perspective on where health care is different from Silicon Valley in what we might do to put health care back on track. But first, woops. Heres my future. These are my two kids. Sophie and claire. Like all kids, they go through phases. My little pony, transformers and po pokemon. When they accused for tsked for went to am. Com. You can read reviews, you can share your like dislike of the movies on social media. You can actually buy pokemon new or used from several different retailers. Even get it online streaming yigt now for instant gratification. Just a marvel of consumer experience. Contrast that to our experience in health care where dual monitor, green screens and silent applications remain the norm. Why is there such a vast difference between our experience with amazon and health care . Why is this vs. Gulf . Well, to answer that question, i decided to dig deep and i read all of amazons annual reports since 1997 and what i found surprised me. I expected to find some technological magical bullet, but found a difference in philosophy. Jeff said we sbed to build the worlds most customer centric company. Note that he didnt say the most sophisticated online presence. He didnt say we intend ed to build the biggest cost online presence. And thats been all of the difference in how they evolved over the years. Im going to go deeper into am sopson, but it applies to most other companies. So first, amazon started with data. They take the bites of quick stream data they have to Distribution Centers with mathematical presession and one of the decisions they make is that theyre going to share their online store front. You cant tell whats sold by amazon and whats sold by somebody else because amazon knows you dont care. From the perspective of a company that was focused on world domination, the idea that you would share your online store front, your most valuable real estate, with possible competitors doesnt make specti company trying to become the it makes all the sense in the world. Further more, they decided to reach out distribution infrastructure. All these centers that you just saw they spent that money building out, they decided to lease that out to other folks, even possible competitors. From the sper perspective of trying to build a silo Ground Breaking organization doesnt make sense, but from the perspective of the company trying to build the most customer centric company, it makes all the ens in in the world. They were trying the figure out how to get you your stuff as quickly as possible and they know you dont care if its sold by amazon or somebody else. Nowhere is this more evidence than in the 2007 introduction of the kindle. Amazon has ten years earlier billed itself as the worlds biggest bookstore and the it had spent hundreds of billions of doll dollars building that infrastructure out only to biit with introduction of the kindle. Why . From the perspective of a company that was trying to leverage assets baseded on its physical footprint, that makes no sense, but from the sper perspective of a company trying to be the most customer centric company, it makes all the sense in the world. They know you wanted or o at the beach and so, they decided that was what they were going to do. They dont even need to take top billing. This is the site i built in 2006. My first child was on the way. I wanted to travel, but couldnt do it because of the obvious. This is a mash up of google earth, flickr and amazon. You click anywhere in the world and up pops the most interesting flickr photo frs the area and most interesting books from amazon. The site ended up doing pretty well. It was a hobby site, but named one of time magazines top ten websites of 2006 and it paid for dinner for quite some time before i could get back to my day job. The point though is that amazon doesnt even need to take top billing. Theyre happy to be part of someone elses experience if thats way you the customer want to consume your data. Most recently, amazon has even decided it would resell its core computer infrastructure. Amazon web services. If youve been following Silicon Valley, you know most start ups today actually build all of their stuff on top of amazons core computing infrastructure, amazon web services, so as with their distribution infrastructure, their online store front, they decided to reach out to other folk, even competitors. The example of this is netflix. So, amazons number one competitor in the online video streaming space is netflix. And netflix runs on amazon. Com. So just very interesting. And this quote from the vp of computering, i think embodies e thos of whats really going in Silicon Valley, that most important hightech companies in this day and age manage to compete and collaborate at the same time. Again, in whatevers the best spres of the customer. Most recently, you have amazon prime air. This idea that drones would go to a warehouse and deliver your small goods within a couple of hours. Now, look, there are some obstacles in the way of this, such as the faa and theyre the occasionally, a kid with a bb gun. On the other hand, you have to admire their chutzpah because theyre trying to continue to push the edge of what it means to be a customer centric company. Of course, amazon does not have a lock on innovation. You always have folks like kayak who are constructing a site against multiple partners or mint. Com, who are building a customer centric financial snapshot, so you see this ethos everywhere in this valley, competing and collaborating at the same time in the best interest of the customer. So, back to health care. So this is our big data. Despite 34. 7 billion of meaningful use money out the door, this is more common than any of us would like to admit. For the 4. 7 billion we spend on meaningful use, we got something that looks like this, circa 1990s or earlier applications that run in our data centers. Under the covers of this, most of us still run our own data centers. You have our own cios who pull out their hair trying to make sure the lights blink and backup plans are set. Most folks in Silicon Valley are running on amazon services. These applications dont talk all that well with each other. This is to protect the innocent version of a technical integration diagram for all these different systems that are supposed to talk with each other. It is wired together with hl7 the technical equivalent of bubble gum and duct tape. Back in the corner you can see my favorite park that, dark cloud called the internet. I hear its going to be big. Because it doesnt work all that well, we have to rely on the lowest common denominator, paper. Thats the reason doctors still get 1,311 faxes per month. The method of preferred handling is cards at the front desk. The dominant method of shuffling around patient records is manila envelopes stuffed with paper. So whats the alternative . As it turns out, my kids i love them to death, but they dont always get along. My wife ended up buying this book for them we belong together. Its simple. Sisters should get along so they work well together like cookies and milk or Peanut Butter and jelly or hot chocolate and marshmallows. So cutesy, but as it turns out, this is very much the way Silicon Valley ends up thinking. If we unpack the pokemon example from earlier and look behind the scenes on how thats orchestrated, when you go to amazon. Com what happens is soon as you hit the page, amazon runs 200 to 300 parallel web queries behind the scenes and orchestrates them to construct a page perfectly personalized to you, the customer. A very different way of thinking about the hl7. Further more, amazon continues to innovate to make things transparent and easy to use. As i was preparing for this talk on sunday, i didnt have a bunch of time. I decided to talk to my echo at my kitchen counter and said, alexa, could you please get me a pizza . In 20 minutes there was a piping hot Pepperoni Pizza at my front door. An interesting way of thinking. Just if you take a step back, you have what used to be earths biggest book store now collaborating with my kids favorite pizza joint to get a pizza in no time at all with a completely transparent means of talking through and collaborating with it. Just different. Again from the perspective of a company that was trying to be the worlds biggest book store, it doesnt make sense, or distribution or the kindle. From the perspective of a company trying to be the worlds most customercentric company it makes all the sense in the world. Ill end on this. Many of you may know this painting. Its called the doctor and was painted by luc fields in 1887. You see a doctor attending to a child. The child is in a victorian home on a makeshift bed consisting of two mismatched chairs. You can see the parents in the corner waiting, watching and hoping. Everything that can be done for the patient has been done. The doctor is sitting with the child in a moment of perfect presence. I think the question for us is this, we have seen what Silicon Valley has been able to do by putting the customer at the center of their world. What would happen if we truly put the patient at the center of ours . Thank you. Thank you so much, ed. Its great to hear about the promise of technology in this space. Its with an eye toward the realm of possibility, im honored to introduce the next group of speakers ed will join. Laura wallace, Vice President health and Life Sciences at microsoft. Laura has distinguished herself in management roles in ibm, lotus development, various Startup Ventures before joining microsoft in 2003. Since then, she has played a key role in the tech wave that is transforming health care by delivering software and Technology Solutions to Major Health Care providers, health plans and life science organizations. As one of our founding sponsors, we also like to thank microsoft for their continued support of this event. Lets give a big hand and a warm welcome to laura wallace. Our next panelist is yumin choi. He focuses on medical devices and diagnostics. He lectures on entrepreneurial finance at tufts, serves as mentor in startup accelerators and director of a number of Cutting Edge Health care companies. Please give a warm welcome to yumin choi. Next im delighted to bring out stephanie tilenius. Stephanie never backed away from a challenge, particularly if it involves destructing old ways of building business, whether building google wallet, shopping express or founding planet rx. She has brought her special touch to helping people manage Health Conditions with an app that connects people with health coaches. It is my distinct pleasure to welcome stephanie tilenius. To guide the conversation today, we turn to scott hensley. Host at npr. Scott was the Founding Editor of the wall street Journal Health blog and headed over to npr in 2009 to become host of shots, online channel for health news from npr scientist desk. A warm welcome to scott hensley. Take it away, scott. The stage is yours. I appreciate it. I want to start with you. Amazon accomplishments are amazing. It was simpler for them to define the customer. How do you think about the customer in health care when there are many people involved, many people paying and many people getting paid for any given service or procedure . Its a lot more complicated in health care. I think what we are beginning to see is a pivot towards the patient. The pendulum was moving right from the Insurance Company to the employer to the doctor, and i think its beginning to converge back on to the patient. Thats clearly at least the intent behind whats going on with valuebased care. We are seeing that also happening in the private marketplace with the advent of retail clinics and urgent care chains. Youre beginning to see the consumers are take a voice in here. I think that it is much more difficult. Its not quite as black and white who the consumer ends up being. What i do see at the end of the day is that health systems, providers and employers essentially need to have more could you tell us about the app, the service. Its like think of it as like Facebook Messager or face time. We take all your data and connect over 100 apps and devices and match you to the perfect coach. Its consumer driven in the sense its pulled. The consumer is controlling the experience, deciding who their coach is. Its on your phone. Its very comfortable, fits into your life. You dont have a nurse calling you at 7 00 at night when youre eating dinner with your family. And its very much personalized to you. We use evidencebased Clinical Programs and we really match to help you lead the best life possible. Lets face it. We spend, we spend 20 of our gdp on health care in 2025. We all know that 86 of that is on chronic conditions, and 29 of that is arguably wasted. We could do a lot in this country to avoid getting those chronic conditions. So weve taken diabetics and taken them from 15a1c and got them off their meds. Consumers love it. Its right on your phone. Coaches are right there program, data, everything in one place. People check their phones 150 times a day and its convenient to be able to have a conversation through text, audio and video with a health coach. Its a different modality, a different way of thinking. Consumers are ready. Some are concerned about data and hipa, but they want a great experience. Who pays for that . We get paid many ways. We get paid by consumers directly, employers, pairs and providers. We are working with United Health care. We are deployed with large providers like partners. We have lots of employers, fortune 500 employers that offer it as a benefit to their employees. Laura, i have a question for you. From your Vantage Point in a company that started as tech and for some time has been moving into health care, how does a tech Company Become a Health Care Company . Its an interesting question because i think from a microsoft perspective, we dont become a Health Care Company per se. Our mission is to enable individuals and organizations throughout the planet to achieve more. So we really look at who are these Health Care Companies that are out there, whether it be startups, how do we enable them to deliver a better product, better service, leveraging platform . You do need to build Health Care Expertise because standards matter, certifications matter, do you have a trusted platform, a trusted cloud to leverage so you can build Solutions People would be comfortable putting their data in a cloud leveraging that. You have to build core competencies. You have to offer Building Blocks of capabilities that you can leverage like skype for business, for virtual care or leveraging Cloud Analytics in a hipacompliant way. Its enables the scenarios and building the tools and platform to bring those solutions to life. Yumin, as an investor evaluating companies and thinking about through the health care lens applying technology, what are you looking for . What is the sort of calculus youre making about when a company is sort of got the right angle or on the right track . Or not . Its an interesting question because its pretty complex. Health care is wonderful in that it is there are so many different stakeholders, different innovations happening. Whats great is, we dont have to go that far in the future because all that innovation happened 20 years ago. Email, great, lets use that. Text, great, lets use that. Its a lot of catchup whats difficult for us as investors, were looking into the future and looking at what the vision for health care should be. But we need to look at where it is now. Where health care is now is not health care. If you want to unpack that word, its not health, its sick. We focus on people that get sick and we drive all health care towards people that are sick. Its not really care because for care to really happen, it has to be before the person is sick, before the patient becomes a patient, really is a consumer. So from before through whatever the treatment is and post that, thats really care. As you think about health care, we always say we focus on triple languages. Improving costs, improving quality, lowering costs and focusing on the consumer experience. It sounds easy to do, but when you look at a company with those three pillars of foundation, its really challenging when you say, okay, well, youre lowering costs, but at what expense . What is it coming out of . You were going to improve quality, great. How do you do that while lowering costs . It starts becoming a multivaried analysis not x plus y equals z. We Like Companies and just to go beyond that, the timing is challenging. Weve invested in companies that were great. We knew this was going to happen. It takes a long time for things to get adopted and for everyone to buy in. When we missed a mark, its usually, hey, we invested 15 years before we should have. It is a challenge. Then youre scratching your head going, this is going to happen. Five years later, it starts happening. Those are the challenges we face as we look at the market. Its exciting. There are so many innovations and things we can do to make it better. One thing you mentioned to me was an investment you didnt make. That was investing in a company that does ehrs or emrs, that creates them. You looked at that, you saw it coming. Why did your company decide to skip that . What did you do instead . If you know emr world, there are a lot of them out there. Now there are some that have bubbled out to be a clear market leader. It took a while. These are 1970s based technologies. As were looking at that, its hard health care is a regional business. As you think about, hey, mass general where im from near boston, mass general bought this system. That may not be appropriate for Providence Health system and the northwest, right . So as were looking at it, it was tough for us to place a bet on something that was going to be a big winner. What we wanted to focus on was the Service Aspect of it. We did make an investment in a company that does emr optimization and analytics. Athena is unusual, but well get into that later. Like epic or some of these big systems. You passed on us, too. We passed on athena about six times. You guys need a little time . Is that why you put me in the middle . Athena health was a clinic business so we passed on that. There are clearly some things we missed. As you look at the emr market, what we are finding is after the initial wave of installations and implementations happened, hospitals are spending more money to optimize these systems. You cant print because when we built this system, the computer was static and the doctor was at the office seeing patients. Now doctors are mobiles, using ipads and iphones. Something as simple as printing a document becomes a huge nightmare. Hipa compliance nightmare. It gets printed in weird rooms and half the time the drivers arent installed. There are lots of complexities about installing these systems which have this big opportunity in the back end which we are now dealing with. Where are we now . Yumin talks about the early days. With the penetration of emrs right now whats the next phase . Whats the challenge . We are still early into it. I remember actually in the early 80s, there was a guy out front of my street. He was actually digging our yard. What are you doing . We are laying down the cable. They were actually literally wiring our entire neighborhood for cable and they had these dirt trenches all over the please and laid these wires in. Thats where we are right now. We are actually in the process of just laying basic infrastructure in place. The interesting stuff is just about to get started. Thats my perspective on it. As one example of what you can begin to do once you lay the cable, these days i think i get all my internet over the cable modem center buried in those wires. With the infrastructure we have in place today, one thing we are able to do with athena, we have 85,000 physicians in all 50 states. We can predict things like the flu. Which antibiotics work in which areas of the country because we have that data coming in. We can see it. We can see where zika or people have protection medications are beginning to popup and appear. We can say watch it, you should get a zika screening. That surveillance and optimumization can happen once you have the basic Building Blocks in place, but we are still early. The things youre talking about, thats within your network. How do you get past the wald garden of athena and connect with what lauras doing or what vida is doing with stephanie . Athena, we like to think of ourselves not having a Walled Garden but an open patch of land anyone can plant stuff into. In Silicon Valley there is a guy named bill joy, chief scientist at microsoft systems. No matter who you are, most of the smart people in the world work for somebody else. Interesting, right . Its the reason most of the folks in Silicon Valley collaborate, compete with each other because they know no Single Company is actually going to have a lock on all the innovation. So they figure out a way to make it all open. We call our program word construction please. We have over 1,000 companies signed up. Over 100 are live in our marketplace which is online equivalent of the app store. We make our data freely available, identified to working with folks at cdc, et cetera. We have taken a very open stance to everything we work with. We think its very important. We think its inevitable that is what is going to happen going forward. Stephanie, you talked about all of the trackers and data sources that youre able to draw upon for your service through the app. What do your customers and Patients Want . Whats standing in the way of them getting it . Well, i definitely think inner opability. They dont know about epic and athena and dont understand that technology. We have consumers that we have they will take the app and show it to their provider or we have a provider report we distribute. I agree integrating into the mrs is challenging. The doctors dont want the daily device data we get flooding their emr either. They just want a summary and simple summary of analytics and outcomes and understand how the patients doing. There is a lot of opportunity to Work Together to make it simplistic both for the consumer and providers to distill down here is whats going on with the patient real time. There are a lot of things that happen between doctor visits that are important. They are sometimes more informative than the seven minutes the doctor has. What would be an example . Someones Blood Pressure on a consistent basis. Someones heart rate when they work out. Their water intake if they have chf or copd. There are so many different variables if they have crohns or ibs what theyre eating. There are a lot of stress levels, a lot of things we capture that are important for the physicians to understand how the patient is doing on an ongoing basis. What is your perspective on this . Youre calling on customers who have their own emrs, working or competing with other systems. What do you think is the way to maybe get through or over some of these barriers . Its interesting. Weve got a Global Business and we see Different Things certainly in the u. S. And rest of the world. A given example in the u. S. , i think basically we talked about people made the investments in the emr. Its been a significant investment to get those significant records. Everyone is struggling how do we get insight out of that . I find some of the more innovative hospitals are thinking what are some patientfocused, high value care scenarios that go beyond that. Ill give an example of childrens mercy in kansas city. Tell you a story of a young boy named winston. He was born with missing part of his heart. Children with this condition need a series over their early years of like three different procedures. The first one at birth and between a period of 9 to 18 months, theres been a mortality rate of 20 , 25 . What happens the parents are going home with their threering binder, monitoring, faxing in information on some frequency about whats happening with the child. The problem is when they get ill, they take a turn for the worse rapidly. Winston was fortunate we met this little boy this happened to him but he was in the care of childrens mercy center in kansas city who built an application called champ that leverages a device, it could be any tablet. They built an application. Monitoring is done realtime and recorded, data stored up in the cloud along with video image data. A physician could see stress changes in the visualization of that child. They run analytics. If it hits a certain trigger, theyll alert the physician to take a closer look at this patient. For winston, thats what happened. Basically this champ application saved this childs life. But this is a case of how do we think beyond the realm of whats traditional . How do we leverage new technologies and do things radically different to improve outcomes, but in some ways a simple application that actually can be applied now to a number of different conditions. The interesting thing though, weve got constraints in the u. S. That people outside the u. S. Dont have. Working with the startup there called ringmd. They are head quartered in singapore. Theyre supporting patients all over southeast asia, but work with a government in india. In other areas they work in wartorn pakistan. Theyve got a patient there who maybe has to travel quite a distance to get a diagnosis. When they get back, if thats not right or they have a reaction to medication, they cant travel again. They built this application where the patient can select a doctor, select a speciality. They store their patient information in the cloud. They arrange virtual consults and built this up to 8 million subscribers providing health care to areas that just never would have access to Board Certified physicians. Its one of those cases where youre seeing more rapid innovation outside the u. S. , but the potential we have here, and i think the openness and the collaboration between companies and emrs, the whole interop thing will be essential to get those step functions. Do you have any ideas what the path might be to see more interoptability and more sharing . Theres been a step function change over just the last five years. Five years ago most folks were actually not focusing on inner opability. Over the last five years, the installations has quintupled. The interopability problem doubled. Folks have begun thinking about this and acting upon it. Theres a lot of regulation and pieces of meaningful pieces trying to put the hole in the dike. Important things are measurable industry progress have been industry collaborations like quality or common well. Vendors have gotten together and said, look, we have to figure out how to solve interopability problems. The first time our customers are asking us to solve it. This goes in the category of i think most of these companies will end up reh companies as well as others, as well as other folks in the industry will compete and collaborate at the same time. I am very good friends with executives inside most of the major ehr companies, and we compete in the market for clients, but when it comes down to it, we collaborate when our customers ask us to collaborate. We think thats very important to do. Is part of the issue now that even if its technically possible, sometimes the computing players in the Health Care System arent ready to share their data . Yeah. Historically the problem is that in order to execute interopability you have to have two missile keys. The first missile key was technology missile key which is a possible to actually exchange the data . The second missile key was the willingness of the institutions to actually exchange the records to being with. For years theres been this problem where you couldnt turn both missile keys at the same time. We are seeing that change. A lot of that is due to political pressure. A lot is due to the fact that Health Care Needs to be more networks. Most institutions will not survive as single monolithic institutions. Hospitals are partnering with Community Hospitals or urgent care chains or retail clinics forming networks. Youre not going to put that all under a single ehr in our lifetime. Thats not going to happen. Because they are beginning to form these networks, interoptability is becoming an existentially important thing in health systems. I believe well see this solved. Are you seeing signs of that . I hope so. That has over 200 different systems. None speak to each other or very few do. When you start digging into the weeds of why thats a problem, its not only that you have these systems, you have different groups that call things differently that have different nomenclature that have different codes. How do you unify that to make sense . It becomes exponentially hard. Were mobile. Oftentimes we go to see erp, but now we see the specialist, urgent care. None of that gets translated into one system. If your doctor, pcp or hospital may have information about you, how do you port that in . How do you unify that or build this holistic version of that person . I think there are a couple of different ways you can do it. I dont think there is one way to succeed. The number is typically kept whether you move jobs, wherever you are, arizona or massachusetts. You carry that around. You Start Building a real i interesting profile and behavioral profile around that member. There are unique ways people try to transfer data that will Start Building a profile of you as a consumer and health care consumer. Those are the things we are looking at actively. We have a company that goes out and scours to get all the views, the amazon type of reviews. Right now you want to see a specialist, maybe an orthopedist and how do you find that . There are ways, both passive and actively that will build a profile. We have a company that goes out and scours to get all the views, the amazon type of reviews. Right now you want to see a specialist, maybe an orthopedist and how do you find that . You go online and put the doctors name in. You get one review. Parking was horrible. That doesnt help me. How do you start incorporating data thats already out there on facebook . On twitter. All the important things. How do you do that in a realtime fashion that is scaleable