Ripon Forum Winter 2014

Rep. Adam Kinzinger on sacrifice & public service: “If you believe in what you’re doing, it’s worth it.”

Winter 2014 Volume 48, No. 1

The

crusader Congressman Tim Murphy leads the fight to strengthen America’s mental health system

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“Ideas that matter, since 1965.“ Volume 48, Number 1 Cover Story

Cover Story (cont’d.)

4

The Fight to Rebuild Our Broken Mental Health System

By Tim Murphy Over 2 million Americans with serious mental illness go without treatment each year. This Congressman believes it’s time to help them, and he’s got a plan to do just that.

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The Real Mental Health Crisis in America

By DJ Jaffe According to this expert and activist, the problem facing the nation’s mental health system is not one of money. Rather, it’s one of misplaced priorities.

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The Wisconsin Example

By Robin Vos The Speaker of the Wisconsin State Assembly discusses how his state is reinvesting in mental health care and a package of reforms that was recently approved.

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“This is an issue that found me -- I didn’t find it.”

A Q&A with Gordon Smith Over a decade after the death of his son, this former Oregon Senator is spearheading a campaign to raise awareness of depression and end the stigma of the disease.

24 The New Politics of Evasion

By William A. Galston & Elaine C. Kamarck

A quarter century after Democrats moved to the

center to regain relevance, a look back at their

move and the lessons for Republicans today.

Sections

15

The Invisible Wounds of War

By Patricia Driscoll Today, one veteran commits suicide every 65 minutes. A look at the work being done to end this epidemic and care for the combatrelated injuries that no one can see.

3

The Cost of Doing Nothing

By Mary Giliberti After years of deep budget cuts, an examination of why investing in mental health care not only saves money, but saves lives.

Politics & Perspective 20

A Proactive Step Toward Better Cyber Security

By Patrick Meehan At a time when Congress is seemingly paralyzed by dysfunction, progress is being made to keep America’s cyberspace secure.

22

In Pursuit of the American Dream

By Greg Smith & Roger Fortin Is it possible to quantify happiness? These two researchers think they have developed a formula that will do just that.

In this Edition

29 News & Events -- Ripon Society hosts Pew

Research for Discussion on American Electorate.

32 Ripon Profile -- Rep. Adam Kinzinger

photo of Rep. Murphy on cover and page 4 by Greg Kahn Photography, LLC Publisher The Ripon Society President Jim Conzelman Editorial Board William Frenzel Thomas Tauke Michael Castle Michael Oxley Billy Pitts Pamela Sederholm Judy Van Rest Jim Murtha

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RIPON FORUM Winter 2014

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THE RIPON SOCIETY HONORARY CONGRESSIONAL ADVISORY BOARD U.S. Senators: Pat Roberts - Senate Chair Roy Blunt Richard Burr Susan M. Collins Orrin G. Hatch U.S. Representatives: Thomas E. Petri - House Co-Chair Pat Tiberi - House Co-Chair Renee Ellmers - Vice Chair, South Cory Gardner - Vice Chair, West Erik Paulsen - Vice Chair, Midwest Bill Shuster - Vice Chair, Northeast Spencer Bachus Marsha Blackburn Charles Boustany Vern Buchanan Michael C. Burgess, M.D. Ken Calvert Dave Camp Eric I. Cantor Shelley Moore Capito Bill Cassidy, M.D. Howard Coble Tom Cole Ander Crenshaw Rodney Davis Charlie Dent Sean Duffy Rodney Frelinghuysen Jim Gerlach Kay Granger Sam Graves Tim Griffin Richard Hanna Darrell Issa Lynn Jenkins Dave Joyce Mike Kelly Adam Kinzinger Leonard Lance Frank Lucas Kevin McCarthy Patrick Meehan Candice Miller Randy Neugebauer Tom Reed Jim Renacci Reid Ribble Peter Roskam Jon Runyan Steve Scalise Aaron Schock John Shimkus Lamar Smith Steve Stivers Lee Terry Glenn Thompson Mac Thornberry Mike Turner Fred Upton Greg Walden Edward Whitfield Members of Congress (Retired): Bill Frenzel - Chairman Emeritus Bill Archer Henry Bonilla Michael Castle Geoff Davis Mike Ferguson J. Dennis Hastert David Hobson Nancy Johnson Bob Livingston Jim McCrery Robert H. Michel Susan Molinari Don Nickles Michael G. Oxley Bill Paxon Deborah Pryce Tom Reynolds Tom Ridge Gordon Smith Don Sundquist Tom Tauke Robert S. Walker

In this Edition

Every time there is a mass shooting in America, a predictable political storyline unfolds -- Democrats and those on the left say it’s time to pass tougher gun laws, while Republicans and those on the right say it’s time to reform the way we treat the mentally ill.

The Democrats have been fairly specific in their policy prescriptions, whether it’s closing the gun show loophole or limiting the size of clips that are used in guns.

Republicans, on the other hand, have tended to speak in generalities about mental health reform, leaving the impression that their specific policy prescriptions on the issue are vague and unformed.

This past December, Congressman Tim Murphy (PA-18) introduced a piece of legislation that could help the GOP reverse that impression. Murphy has over three decades of experience as a clinical psychologist and is helping to lead the fight for mental health reform on Capitol Hill. His bill is based on two simple premises. First, the vast majority of mentally ill individuals are not violent. And second, those individuals who do have a serious mental illness require treatment, but are not receiving it under the system that exists today.

According to longtime advocate and activist DJ Jaffe, Murphy’s plan is also based on another fundamental truth about the issue -- namely, that the problem America faces is not one of dollars. It is one of misplaced priorities, where, in his words, the latest “cause célèbre” such as bullying receives the bulk of the funding and attention while those who are most seriously ill are left untreated and ignored. We look at Murphy’s plan and this problem in this latest edition of The Ripon Forum with essays from Jaffe and the Pennsylvania crusader, himself.

We also look at the steps being taken to fight mental illness in the State of Wisconsin, where the Assembly has approved and Governor Scott Walker has signed into law a mental health budget increase and package of related reforms. As Assembly Speaker Robin Vos writes in an op-ed for the Forum, both the budget increase and reform package were passed with overwhelming support, reflecting not just the bipartisan nature of the issue, but the fact that those who have been affected by this disease come from all walks of life.

This includes the U.S. Senate. In 2003, Gordon Smith was serving as the senior Senator from Oregon when he received word that his son, a 21-year old college student who had been battling depression, had committed suicide. Over a decade later, Smith is spearheading a campaign as President of the National Association of Broadcasters to raise awareness and end the stigma of mental illness. He talks about this campaign in this latest edition, and also discusses what it means to be a member of the “fraternity of suffering” who have been impacted by the disease.

For what it’s worth, I’m a member of that fraternity, too. My older brother suffered from mental illness. He spent all of his adult life in and out of hospitals and halfway houses, or hiking the Appalachian Trail, where, in solitude, I imagine he found some relief. He was a gentle soul and the smartest member of our family. And yet his temperament was masked and his intellect lost to a disease that – 30 years after his diagnosis and six years after his death -- we still do not fully understand.

We govern by crisis in America. It should not take another crisis – another shooting – to take action on this issue. To that end, we hope this edition of the Forum helps further the debate and, as always, we welcome any questions or comments you might have.

Lou Zickar Editor The Ripon Forum louzickar@riponsociety.org RIPON FORUM Winter 2014

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Cover Story

The Fight to Rebuild Our Broken Mental Health System Tim Murphy Over the last year, as chairman of the House Energy and During my investigation, one barrier repeatedly showed Commerce Subcommittee on Oversight and Investigations, up for families trying to help a loved one with a serious I embarked on a detailed review of the nation’s mental- mental illness: Families and caregivers often are unable to health system. With my 30-plus years of experience as a share vital information with a physician about a loved one’s clinical psychologist, I was profoundly shocked to learn just medical history because of the consistent misinterpretation how archaic and ineffective federal mental health policy is of the privacy rule under the Health Insurance Portability in our country. and Accountability Act (HIPAA).

My legislation Easily two million patients with serious and persistent strengthens HIPAA by empowering parents to talk about mental illness, many of and receive information whom lack insight into their about a mentally ill loved schizophrenia or bipolar one, which will allow disorder, go without medical physicians to make an treatment. Why? Because accurate diagnosis. the federal government has Clarifying HIPAA never approached serious rules is only the beginning mental illness as a health of changing the paradigm care issue. This laissez-faire so those with serious mental approach to brain illness has illness are treated with directly resulted in growing dignity and compassion. rates of homelessness The legislation also and incarceration for the encourages states such mentally ill over the last as Pennsylvania to adopt 20 years. Sadly, it has also “assisted outpatient led to numerous tragedies, treatment” (AOT) laws, including 38,000 annual which ensure that mentalsuicides. health providers target care The result of my and resources to the subset comprehensive review is of seriously mentally ill legislation I introduced in who have repeat visits to December titled the Helping the hospital emergency Families in Mental Health room. New York state’s Crisis Act (HR 3717). This With my 30-plus years of experience AOT statute, known as bipartisan legislation marks “Kendra’s Law,” has as a clinical psychologist, I was the most significant overhaul reduced incarceration, of the nation’s mental health emergency-room visits, profoundly shocked to learn just system since President John homelessness, and how archaic and ineffective federal F. Kennedy established substance abuse by about mental health policy is in community mental health 70 percent among the centers 51 years ago. It mentally ill. our country. refocuses programs and The current approach resources on psychiatric to mental health can best be care for patients and families most in need of services but described by its deficits: too little integration with primary who are currently the least likely to get it. My bill increases or physical care; too few psychiatric hospital beds; too few treatment options, integrates mental and physical care, and psychiatrists, psychologists, and clinical social workers, reduces barriers and the stigma associated with mental especially ones who are trained and specialize in treating illness. the seriously mentally ill.

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The Helping Families in Mental Health Crisis Act in treating mental illness. This individual will ensure promotes integration of mental health with the rest of the federal tax dollars are spent on effective programs and medical system. It also expands the number of pediatricians treatments.

For far too long, those who need help the most have and primary-care doctors trained in behavioral health so been getting it the least, and where there is no help, there children and young adults can get immediate attention.

The inability to find qualified medical help deepens is no hope. We can, must, and will take mental illness out of the shadows of ignorance, the severity of damage to despair, and neglect and into that the human brain, making bright light of hope. It starts with recovery all the more difficult.

The current approach the Helping Families in Mental Currently, patients wait on to mental health can best Health Crisis Act. RF average two years after the first signs of psychosis before be described by its seeing a doctor. A breakthrough deficits.

In his sixth term representing treatment project at the Pennsylvania’s 18th congressional National Institute of Mental district encompassing suburban Health called Recovery After Initial Schizophrenia Episode, or RAISE, has shown Pittsburgh including parts of Allegheny, Washington, tremendous results by treating the patient earlier with Westmoreland and Greene Counties, Rep. Tim Murphy also serves as a Lieutenant Commander in the Navy wrap-around services and low-dose medication.

Unfortunately, successful medical models such as Reserve Medical Service Corps as a psychologist RAISE are not getting out into the broader community. treating Wounded Warriors with post-traumatic stress The Helping Families in Mental Crisis Act places a new disorder and traumatic brain injury. Prior to serving in emphasis on evidence-based models of care by establishing Congress, Dr. Murphy, author of “The Angry Child” and an assistant secretary for mental health and substance-use “Overcoming Passive-Aggression,” was a practicing disorders, who must have clinical and research experience psychologist specializing in child and family treatment.

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The Real

Mental Health Crisis in America It’s not about money. It’s about misplaced priorities.

By DJ Jaffe

Prior to the 1960s, the United States mental health with schizophrenia have anosognosia. As a result of their budget was primarily spent providing treatment to people illness, hallucinations and delusions trump reality and with serious mental illnesses. Today, we’ve largely prevent them from recognizing they are ill. Not knowing abandoned the most seriously mentally ill and used the they are ill, they refuse voluntary treatment. John Hinckley budget for everyone else. “knew” the best way to get a date with Jodie Foster was As a result of this shift, about 200,000 mentally ill are to shoot Ronald Reagan. Russell Weston “knew” there homeless, 240,000 seriously mentally ill are in prisons, and was a “ruby red satellite” in the U.S. Capitol that could 125,000 are in jails. That’s more than three times as many be used to reverse time and shot two guards in order to as are in hospitals. find it. When people In 1955, there were are that seriously ill, half a million public voluntary services psychiatric beds for will not work.

If the seriously ill – you build it, they which translated to will not come. A 340 beds per 100,000 kind, compassionate individuals. Today, system would help there are less than the most seriously ill 100,000 beds – get care, rather than which translated to pretend they don’t 17 beds per 100,000 exist. individuals. Because Congress is of this shortage, being misled by the it’s harder to get non-profit mental into Bellevue than health industry, In 1955, there were half a million public Harvard. which argues that psychiatric beds for the seriously ill.

Anyone well ordinary life events enough to walk in like bad grades, being Today, there are less than 100,000 beds. and ask for treatment unemployed, having Because of this shortage, it’s harder to is not sick enough to an unhappy marriage get into Bellevue than Harvard. be admitted. That and this year’s cause makes involuntary célèbre, bullying, are admission – becoming a “danger to self or others” -the mental illnesses worthy of Congressional funding. the only path to treatment. Hence, the “psychotic killer They ignore the homeless and psychotic who can’t get on a rampage” headlines we seem to be seeing so often treatment, sleep on the streets, forage through dumpsters these days. Community programs are no better. They for food, and scream at voices only they can hear. largely accept the highest functioning and offload the Money is not the problem – mission creep is. Mental most seriously ill to shelters, jails, prisons, and morgues. health spending totaled $100 billion in 2003, representing Programs that used to spend money treating those with 6.2 percent of all health care spending. By 2014, it is serious mental illnesses now spend those same dollars on expected to double to $204 billion. The elephant in stigma campaigns for those without any mental illness. the room is getting treatment to the most seriously Most people with mental illness are not more violent ill. Instead of treatment, the non-profit mental health than others. The same cannot be said, however, for the most industry argues for public education. This is based on the seriously ill. Up to 50 percent of the three million people mistaken assumption that the reason people do not get 6

RIPON FORUM Winter 2014

Public Psychiatric Beds per Population, 1955 and 2004–2005 State Mississippi South Dakota Delaware New Jersey New York Minnesota North Dakota Connecticut Wyoming New Mexico Virginia Alabama Kansas Maryland Missouri Montana Nebraska Louisiana Indiana Oregon Washington Pennsylvania Georgia Tennessee California New Hampshire North Carolina Colorado Massachusetts Kentucky Illinois West Virginia Utah * Hawaii Wisconsin Maine Rhode Island † Florida Texas Idaho Alaska * Oklahoma South Carolina Ohio Michigan Vermont Iowa Arkansas Arizona Nevada ‡

Beds per 100,000 population 1955 250.8 236.8 359.9 410.7 599.5 360.7 310.4 386.8 214.1 119.5 315.8 237.3 214.6 347.4 291.2 303.2 346.7 282.6 257.5 292.8 296.9 366.7 323.1 225.1 285.5 490.7 232.4 369.3 462.1 256.2 404.7 280.7 171.2 NA 405.5 331.0 407.3 232.5 192.0 200.5 NA 369.6 264.7 319.7 301.2 342.3 198.2 284.3 172.4 195.6

Beds per 100,000 population 2004–2005 49.7 40.3 33.8 32.4 27.4 26.8 25.9 25.4 24.1 22.3 22.2 22.1 21.7 21.6 21.5 20.9 20.7 20.2 19.3 19.2 18.9 18.9 18.5 18.1 17.5 17.2 17.1 16.9 15.8 15.6 14.3 14.2 13.8 13.5 13.0 12.6 12.5 12.1 12.1 11.3 11.3 11.0 10.6 10.6 9.9 8.9 8.1 6.7 5.9 5.1

2004–2005 beds as percentage of 1955 beds 19.8% 17.0% 9.4% 7.9% 4.6% 7.4% 8.3% 6.6% 11.3% 18.7% 7.0% 9.3% 10.1% 6.2% 7.4% 6.9% 6.0% 7.1% 7.5% 6.6% 6.4% 5.2% 5.7% 8.0% 6.1% 3.5% 7.4% 4.6% 3.4% 6.1% 3.5% 5.1% 8.1% NA 3.2% 3.8% 3.1% 5.2% 6.3% 5.6% NA 3.0% 4.0% 3.3% 3.3% 2.6% 4.1% 2.4% 3.4% 2.6%

* The District of Columbia was not included, since its public psychiatric hospital was used for many years for admissions of non-District residents and its data are not comparable with the states. Data are not available for Alaska and Hawaii in 1955, since they were not states at that time. † Rhode Island has no state or county psychiatric hospital but maintains psychiatric beds in a general hospital. Source: Treatment Advocacy Center.

RIPON FORUM Winter 2014

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care is because they are so asymptomatic that the public that won’t happen again. needs special training to identify them, and that -- once n Create an Assistant Secretary for Mental identified -- treatment will be available. Neither is true Health and Substance Abuse Disorders – More than for the seriously ill. As Creigh Deeds learned, families anything, this individual is needed to end missioncan -- and do -- beg for treatment for loved ones already creep, reduce duplication, coordinate piecemeal federal identified as being ill. And yet they still can’t get it. agencies and stop the federal funding of non-evidenced If Congress wants to improve care, save money and based programs. But beyond that, the new Assistant reduce violence by the seriously ill, it should decrease Secretary would also be a champion of programs mental health funding and increase mental illness that help the most seriously ill, and help disburse funding. Replace mission creep with mission control. mental health block grants previously distributed That’s the idea behind the legislation that Pennsylvania by the Substance Abuse and Mental Health Services Rep. Tim Murphy introduced this past December, the Administration (SAMHSA) in order to free states Helping Families in Mental Health Crisis Act. Among from SAMHSA policies that prevent those funds from other things, Murphy’s proposal would: reaching the most seriously ill. n Get treatment to people who n Require SAMHSA and are too sick to accept voluntary CMHS to focus on serious mental treatment -- HR 3717 funds illness -- HR 3717 makes what demonstration Assisted Outpatient should be non-controversial reforms Treatment (AOT) projects. AOT to SAMHSA and CMHS. Among is limited to the most seriously other things, it requires all grants ill who have a past history of to be evidence-based, reviewed by violence, incarceration or needless persons with clinical experience hospitalizations caused by going in mental health treatment, and off treatment. It allows courts, prohibits SAMHSA from making after extensive due process, to grants not authorized by Congress. order them to stay in mandated and These reforms are needed because monitored treatment as a condition SAMHSA and CMHS fail to focus of living in the community and, on serious mental illness, fund equally important, order community programs that lack independent programs to provide the care rather evidence of effectiveness, and award than turn them away. New York’s DJ Jaffe taxpayer money to organizations that AOT program (also known lobby against treatment for as “Kendra’s Law”) reduced the most seriously ill. For Money is not the problem… homelessness, arrest, and example, in spite of the incarceration in excess of fact that getting the correct The elephant in the room is 75% each and cut costs in diagnosis is key to getting the getting treatment to the half by reducing the use of right medication, SAMHSA more expensive incarceration distributes millions to most seriously ill. and hospitalization. The “peer” groups that believe Department of Justice “psychiatric labeling is a certified AOT as an “effective crime prevention pseudoscientific practice of limited value in helping program.” people recover.” n Free parents of seriously mentally ill from n Preserve psychiatric hospital beds -- HR HIPAA Handcuffs -- Parents need information about 3717 rejects the mental health industry shibboleth the diagnosis, treatments and pending appointments of that everyone can survive safely in the community by their children in order to facilitate care. But doctors preserving a few inpatient psychiatric beds for those hide behind federal privacy standards passed as part who can’t. of the Health Insurance Portability and Accountability n Increase the role of the criminal justice system Act (HIPAA) and patient confidentiality laws included in setting mental health policies -- Many of the policies in the Family Educational Rights and Privacy Act espoused by the non-profit mental health industry, like (FERPA) to prevent parents from receiving it. School closing hospitals and making civil commitment more authorities identified Jared Loughner as being mentally difficult, increase the incarceration of people with ill and potentially dangerous before he shot Gabrielle serious mental illness. HR 3717 gives criminal justice Giffords, but HIPAA and FERPA laws kept his family powerful representation on federal advisory boards so in the dark. HR 3717 writes exceptions into the law so they can prevent these policies from being adopted.

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n Refocus PAIMI – PAIMI stands for the Protection and Advocacy for Individuals with Mental Illness Program. Established with the noble purpose of providing representation to persons with serious mental illness who were being abused, the program has morphed into a political advocacy machine that ignores the psychotic and assumes all persons with mental illness are well enough to “self-direct” their own care.

PAIMI lawyers “freed” William Bruce from involuntary hospital care over the objections of his Mom and Dad. William then killed his Mom. HR 3717 returns PAIMI to its original focus of helping people who need help, and prohibits PAIMI groups from using federal funds to lobby for other agendas. n Empower NIMH -- Under Dr. Thomas Insel, the National Institute of Mental Health has forsaken mission creep and now focuses on serious mental illness. HR 3717 turns over certain funds that were misspent by SAMHSA to NIMH, so they can find cures for serious mental illness.

HR 3717 is supported by mainstream mental health organizations like the American Psychiatric Association, American Psychological Association, and Treatment Advocacy Center. It is supported by major law enforcement organizations including the National Sheriff’s Association, and New York State Association of Chiefs of Police. And it has passionate support among families of the seriously mentally ill. The only opposition comes from those who have benefitted from the mission creep or run programs that lack evidence of efficacy.

There is a crisis. It involves people with untreated serious mental illness, not all others. Throwing money at mental health as Congress has done will not help those with serious mental illness. Passing HR 3717 is the best chance Congress has at addressing the real problem.

RF DJ Jaffe is Executive Director of Mental Illness Policy Org., a non-partisan, science-based think tank focused on serious mental illness (not mental health).

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The Wisconsin Example How one state is tackling the mental health crisis ROBIN VOS A package of bills that garnered overwhelming n Improving coordination of care among those who bipartisan support in the Wisconsin State Legislature this treat people with mental illness. session addresses an important issue in our state and country. n Increasing awareness and reducing the stigma that Mental health disorders affect millions of people every often accompanies mental health diagnoses. year, including an estimated 22 percent of adults. It can n Identifying and promoting best practices for take a toll on personal relationships, families and even the addressing the link between mental illness and substance economy. It is estimated that dependence and abuse. mental illness costs the United n Addressing mental illness States billions in lost productivity in the prison population. every year.

The Speaker’s Task Force With reportedly half of on Mental Health held five public all lifetime cases of mental hearings around Wisconsin. illness beginning by age 14, Legislators heard from more than early intervention is essential.

70 experts and the public. After However, the stigma often weeks of deliberation, the task associated with mental illness force proposed reforms that were keeps people from seeking drafted into more than a dozen treatment; the median delay bills. One piece of legislation between the onset of a disorder creates a child psychiatry access and treatment is about ten years. line to help connect pediatricians The facts are daunting, but they with psychiatrists since many illustrate the need to take action. counties in Wisconsin lack even In Wisconsin, Republicans a single child psychiatrist.

Speaker Robin Vos and Democrats agreed that our In order to attract doctors state’s system for treating those to underserved areas, one bill with mental illness was simply provides grants to doctors in In Wisconsin, Republicans not getting the job done. Last primary care or psychiatry to get and Democrats agreed that February, I created the Speaker’s them to practice in rural areas of Task Force on Mental Health our state’s system for treating the state. Another bill establishes and charged its chair, Rep. Erik those with mental illness was a new Treatment Alternatives Severson (R-Osceola), and and Diversions program simply not getting the vice-chair, Rep. Sandy Pasch for offenders with mental (D-Shorewood), with finding health disorders to promote job done. ways to increase access to care treatment over incarceration and improve the coordination of and hopefully reduce recidivism treatment. rates. In addition, there’s legislation that allows for more I wanted legislators to take a comprehensive look at communication between primary care physicians and mental mental health issues, which would lead to legislation to health professionals so doctors can work together in a patient’s address some of the main concerns. I tasked the 11-member best interest. When it comes to emergency treatment for a committee with recommending improvements in the loved one, a separate bill guarantees that interested parties following areas: have a right to have a judge review a three-party petition. n Eliminating barriers to treatment, and promoting Legislation also addresses the employment of individuals early and voluntary intervention for juveniles and adults in experiencing mental illness by creating five regional centers need of mental health services. around the state that will help with placement and support.

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Wisconsin’s two year budget also provided an increase of the Speaker’s Task Force on Mental Health and the in funding for mental health care. Nearly $30 million is Wisconsin State Legislature. The legislative package allocated to help meet the needs of individuals with mental and our budget initiatives are considered one of the most health concerns. Nearly $4 comprehensive packages million of that is invested in of mental health reforms The Speaker’s Task Force on Coordinated Services Teams Wisconsin has ever seen. that deal with communityMental Health held five public Lawmakers not only increased based care for juveniles. More awareness of mental illness, hearings around Wisconsin … than twice that amount is going but we also addressed After weeks of deliberation, to the state’s Comprehensive problems relating to the access Community Services that to and coordination of care. the task force proposed help those with severe mental However, we know that reforms that were drafted into illness. To help integrate more needs to be done. In services throughout all aspects the future, we will continue to more than a dozen bills. of state services, the new look for additional avenues for Office of Children’s Mental improvement. I look forward Health is being created. In-home counseling for children to working with my colleagues on both sides of the aisle under the Medicaid program and peer-run respite centers to make further reforms and hopefully, provide a model for are both getting an increase in funding as well. Finally, the rest of the country to follow.

RF approximately $12 million is being used for additional forensic units at the state’s Mendota Mental Health Institute Speaker Robin Vos is the 75th Assembly Speaker in to reduce wait times of patients and provide for timely Wisconsin. He is currently serving his fifth term in the treatment.

Wisconsin State Assembly. Speaker Vos represents a I am proud of the work that was done by the members portion of Racine County in southeastern Wisconsin.

A HEALTHIER FOUNDATION FOR AMERICA The American Medical Association is working to improve the health of the nation and to build a better health care system for our country.

In this system patients, physicians, businesses and government will all enjoy the rewards of high-value care. Physicians would have the opportunity to choose a payment model that reflects their specific practice setting. And this new system would foster innovation.

Eliminating the sustainable growth rate formula and replacing it with a high-performing Medicare program is an essential step.

This will happen. This must happen. Our patients—the 315 million people of America—are counting on it. ama-assn.org/go/bettersystem

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“This is an issue that found me -- I didn’t find it.”

A Q&A with Gordon Smith On the night of September 8, 2003, Senator Gordon Smith (R-OR) was getting ready for bed in his suburban Washington home when he heard a knock at his door. It was the police. They were there to inform Smith and his wife that their son Garrett, a 21-year old college student in Utah who had been struggling with depression, had committed suicide.

“Shock and numbness held me for a moment above what looked to be the blackest depths of sorrow and failure,” Smith would later write in his 2006 book, Remembering Garrett. “Joy vanished and years of striving and achieving now appeared as ashes to me. Success in business, service in church, election to the United States Senate – in an instant, it all seemed meaningless, even vain. I had failed to save my own son.”

For Smith, the day was both a tragedy and turning point – a day when he lost a child and gained a cause. In the years since, he has become one of America’s leading advocates for ending the stigma of mental illness. Through his current position as President and Chief Executive Officer of the National Association of Broadcasters, he is spearheading a campaign to raise awareness of the disease and provide assistance to those who need it the most.

The campaign is called “OK2TALK.” Since its launch last July, local TV and radio stations across the country have provided over $35.5 million in free airtime for ads and other messages intended to make sure people have a better understanding about mental health and mental illness.

The Forum recently spoke with Smith about this campaign and his experience as a former legislator and parent who has been personally affected by this disease.

GS: The role of Congress is to think differently about RF: How has America’s mental health care system mental health. In the past, this issue has been put in the attic. changed over the past 11 years?

GS: It has been improving, but it has a long way to go. But it needs to be given as much attention as issues related Progress was made during my time in public service with to physical health because mental health is really a physical Senator Wellstone and Senator Domenici. Additionally, illness of the brain.

If you don’t have mental I authored a significant piece of health, but seem otherwise the legislation that was passed What I learned after my physically healthy, you do not unanimously by the United in fact have health. The keys are States Senate -- The Garrett Lee son’s death is that mental early identification, and making Smith Memorial Act -- that led to illness touches nearly every sure treatment is available and additional legislative progress. affordable. And I think that, in the Health insurance policies person and every family end, Congress should make sure now provide somewhat greater either directly or through that as part of the mental health parity for mental health insurance associations of relatives offering, or as part of the health benefits.

And the Veterans offering to our citizens, mental Administration, because of our and neighbors. health occupies an equal place with foreign wars, has stepped up all other kinds of health care. its response to mental illness.

Additional research dollars and heightened awareness -RF: Could you tell us about the mental health these things are improving.

But the safety net of mental health in our country still awareness campaign you’re spearheading as President needs a lot of improvement, as instances like Sandy Hook of the National Association of Broadcasters? make clear. We’ve got a long way to go.

GS: This was the outgrowth of the terrible tragedy at Sandy Hook. Vice President Biden called all of the RF: As a former legislator, what is the role of entertainment industry in to talk about what we could do in Congress in improving the mental health care system? response.

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The National Association of Broadcasters volunteered, with my urging, to produce a public awareness campaign.

We did so, raised the money, and produced the “OK2TALK” campaign.

It has been a spectacular success. The PSAs suggest four things in 30 seconds -- that it’s okay to talk about mental health; that help is available and effective; that if you need help, you should get it; and, that if you know someone who is struggling, help them to get help.

As a result of this campaign, broadcasters have provided over $35 million in free airtime around the country. The response on our Tumblr page has been overwhelming, which makes clear how serious a problem this is in our society.

RF: Which is more important at this point -education or funding?

GS: They really can’t be separated. Education is critical, but education takes resources. We have to take the messages of the OK2TALK campaign, and we need to spread them far and wide.

We need to train health care professionals, educators and parents to recognize the signs of mental illness and do something about it, whether it’s in their families, with their loved ones, or among their neighbors. So I really think it’s a mistake to separate education from funding -- they go hand-in-hand.

belong to a “fraternity of suffering.” Could you talk for a moment about this “fraternity” and how parents and family members are particularly impacted by this disease?

GS: What I learned after my son’s death is that mental illness touches nearly every person and every family either directly or through associations of relatives and neighbors.

Those who have survived the suicide of a loved one are victims as well.

What I found when the news of our son’s death began to spread is that people from every imaginable walk of life could relate to it and had some experience with a friend or loved one who suffered from mental illness. The fraternity of suffering – the fraternity of survivors of mental health -- is enormous in this country.

So we all have a stake in making sure that the safety net of our country includes and keeps a prominent place for mental health care.

RF: Looking back on your son’s struggle with mental illness, and looking at your own efforts to combat the disease now, what do you hope your legacy will be when all is said The role of Congress is and done?

GS: I would hope that people to think differently about would know that this is an issue that mental health. In the past, found me -- I didn’t find it. But it is this issue has been put in an issue on which I’ve labored long and, I hope, well. I also hope I’ve the attic. made a positive difference in the lives of those who suffer like my son RF: Are there any specific changes in current law that you believe should be did. I hope that many lives of our fellow citizens can be saved and made better with the knowledge that mental health cannot made to strengthen mental health care?

GS: All of the laws that Congress has already passed only be restored, but that healing is possible.

I think that one of the things we need to understand in our should be fully implemented by the Executive Branch. And however the Affordable Care Act is ultimately resolved, society is that mental illness is a physical illness. If we regard mental health must retain a place equal to physical health it as the physical manifestation of an illness of the brain, the in the health care delivery system of our nation -- that’s the stigma could go away. We should have the same empathy for those who suffer mental illness as we do when loved ones suffer bottom line.

RF: You’ve said that you and your wife now other physical illnesses. They really are the same in the end. RF

QUICK FACTS: Since July 2013, America’s broadcasters have set aside over $35.5 million in free airtime for the OK2TALK campaign. This includes over 293,380 TV and radio airings in English and Spanish. The TV spots are airing in all 210 television markets. The OK2TALK tumblr page has received 25,374 followers, 5,600 personal submissions, more than 62,000 engagements, 488,000 total visits (316,000 unique), more than 1 million page views, and more than 102,000 clicks on the "Get Help" button, that takes you to mentalhealth.gov/suicide prevention resources.

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The Invisible Wounds of War PATRICIA DRISCOLL Our nation has been at war for more than 12 years. troops and veterans who have suffered these hidden Since September 11, 2001, we have sent more than 2 wounds. The ultimate goal of Help Save Our Troops million of our sons and daughters into harm’s way. is to reduce military suicides. Through this campaign, These patriots have selflessly volunteered to defend the the AFF provides counseling services for military freedoms we hold dear as Americans. families, including children, grants for therapy and As more and more of our service members return addiction counseling, and runs a variety of recreational home, the responsibility of our nation to live up to group therapy programs to boost morale among service promises made is getting more difficult. members, veterans, and their families.

One of the greatest challenges facing service Tragically, for some families, it is already too late. members and veterans In 2012, there were 349 suffering from Postsuicides among active Traumatic Stress duty service members, Disorder (PTSD) and which is more than Traumatic Brain Injury were killed in action.

(TBI) is the stigma Currently, one veteran associated with these commits suicide every diagnoses. These heroes 65 minutes, up from are suffering internally one every 80 minutes through no fault of their during 2012. This, own. It is easy to see too, is an epidemic the physical wounds, but that deserves national it’s impossible to look attention and needs to inside the mind of a man end. or woman who needs The Help Save Our help.

Troops campaign also Patricia Driscoll speaks at a Ripon Society breakfast According to the seeks to alter the way discussion on September 11, 2013.

National Institutes of that the military health Health, there are more care system deals with than 600,000 veterans the repercussions from In 2012, there were 349 suicides with PTSD. In 2012, the invisible wounds there were 50,000 cases of war. The AFF is among active duty service members, of PTSD diagnosed, and advocating for an which is more than were killed some estimate 184 new 18-month extension in action. cases are diagnosed each of TRICARE mental day. Since 2001, there health benefits, which have been more than would allow service 230,000 cases of Traumatic Brain Injury. members and veterans to access the care they so These numbers are staggering. Unfortunately, urgently need, even if the problems take root long after they’re also increasing each year. This is an epidemic. the initial injury is sustained.

Now, as citizens, it’s our turn to act. This is why Another step that Congress can take is passing the we have launched the Help Save Our Troops campaign reauthorization of the TBI Act, which would allow for at the Armed Forces Foundation (AFF). grants to be extended through 2018 to provide better The Help Save Our Troops campaign proactively access to rehabilitation services. educates Americans about the invisible wounds of The AFF has also partnered with USC’s Center war, including PTSD and TBI, and advocates for those for Innovation and Research on Veterans and Military RIPON FORUM Winter 2014

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Families in an effort to provide veterans with counselors effectiveness of hormone treatments that could improve who have served in combat situations themselves. the outcomes of people suffering from TBI. Additionally, the AFF established a partnership with These efforts rely on modest financial support the Johns Hopkins University Military and Veterans from Congress, but have the potential to drastically Health Institute to work on innovative research in tissue impact treatment for these invisible wounds. The AFF regeneration, PTSD and TBI therapies, and better ways is committed to raising awareness for these programs to diagnose these wounds. and advocating for more Doctors from Johns Hopkins research into healing the According to the National have participated in the long-term impacts.

Foundation’s Congressional The AFF prides itself Institutes of Health, there Lecture series and other on returning 95 cents of are more than 600,000 programs discussing PTSD every dollar raised to veterans with PTSD. and TBI and the innovation help service members, being conducted at the veterans, and their Institute. Since 2011, the AFF has partnered with Johns families cope with the invisible and physical wounds Hopkins University School of Medicine’s Department and ensure we truly live up to our motto of “Serving of Plastic Surgery on an awareness effort for their those who Serve.” innovative hand and face transplant program.

We don’t want anyone to become a statistic. We’re There are many promising advancements being here to help. RF pursued in the medical treatment of invisible wounds.

A blood test is being developed in order to more accurately diagnose the severity of a TBI soon after Patricia Driscoll is President and Executive Director the injury. Research is being done to determine the of the Armed Forces Foundation.

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The Cost of Doing Nothing Why investing in mental health care saves money – and lives MARY GILIBERTI From 2009-2012, states cut $4.35 billion from their mental mental illness. The goal should be to divert individuals from health care budgets. Cost-cutting strategies mostly occurred incarceration into treatment and to provide supports and services without regard to cost-effectiveness or the need for strategic so they don’t enter the criminal justice system in the first place. reorientation of the mental health system.

Police Crisis Intervention Teams (CIT), mental health Last year, 37 states began reversing the trend, but the courts and community services like assertive community damage has been done. It will be a long time before what was treatment (ACT) serve both diversion and prevention purposes. lost will be regained. The challenge now is to transform the With ACT, teams of mental health professionals visit individuals system while rebuilding it. One in four adults experiences a where they live rather than expecting them to come to an office. mental health problem in any given This proactive approach helps year. One in 17 lives with the most people stay on a path to recovery serious conditions. As many as one -- and protects against relapses. in five children also experience ACT programs in the Chicago mental disorders. and Rochester, NY areas have Unlike many other chronic shown savings up to $20,000 conditions, mental illness begins and $40,000 per person over the at an early age. Fifty percent of cost of hospitalizations or jail lifetime cases of mental illness sentences. begin by age 14 and 75 percent by Pre-booking diversions, age 24. Treatment from the time of including CIT, can reduce reonset is delayed on average eight arrests by approximately 60 to 10 years. The mental health percent. In the juvenile justice care system is rigged to respond to system, services such as functional crises, rather than early screening, family therapy (FFT), a short-term sustained treatment and social intervention that focuses on family supports. Structural choices involve interaction patterns, reduce crime costs, but instead of providing and recidivism. Savings with FFT continuity of care, the system is are approximately $32,000 per Mary Giliberti fragmented and uncoordinated. person, but few communities offer Policymakers often lack The mental health care system such services. information for making sound Without early identification is rigged to respond to crises, choices. Hard data is elusive. and treatment, childhood mental Returns on investment — outcomes disorders affect how children rather than early screening, — are not accurately measured. learn and behave. In turn, school sustained treatment and Analyses across different budget systems confront higher special social supports. sectors are difficult or non-existent. education costs, increased The system begs for integrated, disciplinary issues and lost uniform, and transparent data. education time. At the same time, schools can play an important When taxpayer dollars aren’t spent on evidence-based, role in community mental health partnerships. In Minneapolis, cost-effective programs, cost-shifting occurs across different community mental health services are delivered in school systems. The criminal justice system is one of the most dramatic facilities. For families, the arrangement is convenient, requiring examples. Investing in mental health care at the front end can less time away from work. Local agencies engage young result in cross-system savings overall. In state prisons and people more effectively, and students are better able to integrate local jails, 20 percent of inmates live with mental illness. In the learning and coping strategies for school and home. juvenile justice system, the prevalence is 70 percent.

Supported housing and supported employment services can Correction facilities are probably the worst places to treat also reduce cost-shifting. Supported housing costs significantly RIPON FORUM Winter 2014

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less than homeless shelters or jails or hospitals. Louisiana, that states will gain resources from expansion and individuals Tennessee and Utah are among states with model programs. with mental illness will be able to get care earlier.

Even in states that have expanded Medicaid, it is critical to Large, urban states do not have a monopoly on innovation. keep co-pays low, since Only about 20 percent they otherwise serve as of individuals living with Only about 20 percent significant disincentives mental illness are employed. for people seeking help About half of these work of individuals living with mental when they need it. Mental full-time. The vast majority illness are employed … The vast illness and poverty make want to work and would be majority want to work and would be it very difficult for some successful with supported employment services, but successful with supported employment individuals to obtain continuous treatment. It is only two percent receive services, but only two percent important to eliminate any them. Communities lose financial barrier to getting economic earning power. receive them. care. Failure to do so Costs increase for programs such as Supplement Security Income (SSI), Social Security will result in increased costs to criminal justice and emergency providers.

Disability Income (SSDI), Medicaid and Medicare.

Investing in evidence-based services and supports and Medicaid is the single largest payer for state mental health services and tends to serve those people with the most severe providing accessible early care will yield long term benefits. illnesses. However, many individuals with serious mental illness Our current system is spending significant resources for poor RF have difficulty completing the process for obtaining SSI, which is outcomes. We can do better. a pathway to coverage under Medicaid. Overall, almost 40 percent of people living with mental illness are uninsured. Expanded Mary Giliberti is the Executive Director for the National coverage will help many of them get care. Cost studies indicate Alliance on Mental Illness (NAMI).

Retail’s Leading Brands

Speaking with One Voice 24 Hour Fitness Worldwide, Inc. 7-Eleven, Inc. Abercrombie & Fitch, Co. Advance Auto Parts, Inc. American Eagle Outfitters, Inc. American Signature Furniture Apple Inc. AutoZone, Inc. Belk, Inc. Best Buy Co., Inc. Big Lots Stores, Inc. Blain’s Farm & Fleet, Inc. Cabela’s Canadian Tire Corporation, Limited CarMax, Inc.

Christopher & Banks Corporation Claire’s Stores, Inc. Costco Wholesale Corporation Crate & Barrel CVS Caremark Corporation Delhaize America Dick’s Sporting Goods, Inc. Dollar General Corporation Dollar Tree Stores, Inc. Express, LLC Family Dollar Stores, Inc. Foot Locker, Inc. Gabriel Brothers, Inc. GameStop

Gap Inc. Giant Eagle, Inc. H-E-B The Home Depot, Inc. Hy-Vee, Inc. IKEA North America Services, LLC J.C. Penney Company, Inc. J. Crew Group, Inc. Jo-Ann Stores, Inc. L Brands, Inc. Lowe’s Companies, Inc. Meijer, Inc. Michaels Stores, Inc. NEXCOM

NIKE, Inc. Oriental Trading Company, Inc. Payless ShoeSource, Inc. The Pep Boys – Manny, Moe & Jack PETCO Animal Supplies, Inc. PetSmart, Inc. Publix Super Markets, Inc. RadioShack Corporation Recreational Equipment, Inc. (REI) Regis Corporation Rite Aid Rooms To Go, Inc. Ross Stores, Inc. Safeway, Inc.

Save Mart Supermarkets Sears Holding Corporation Signet Jewelers, Ltd. Staples, Inc. T-Mobile USA Inc. The TJX Companies, Inc. Target Corporation Tractor Supply Company Ulta Salon, Cosmetics & Fragrance, Inc. Unilever VF Corporation Walgreen Co. Wal-Mart Stores, Inc. Whole Foods Market, Inc.

To learn more about RILA, visit www.rila.org/agenda.

Retail Industry Leaders Association • 1700 North Moore Street • Suite 2250 • Arlington, VA 22209 • www.rila.org • 703-841-2300

RILA is proud to support the Ripon Society.

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we can prevent traffic deaths why not diabetes?

If we can use public policy to change attitudes and behavior around using seat belts, we can use it to limit the societal costs of type 2 diabetes. Right now, 11 million older adults in Medicare have diabetes and another 20 million – 50% of the age 65+ Medicare population – are at risk of developing diabetes. Implementing evidence-based prevention methods could reduce the rate of diabetes and its complications, which would save thousands of lives and billions of dollars annually. Diabetes prevention is a smart investment.

Support the Medicare Diabetes Prevention Act, S. 452/H.R. 962.

Make the National Diabetes Prevention Program a covered benefit for Medicare enrollees at risk for diabetes. Personal responsibility, the private sector and the federal government working together will make a difference.

The National DPP is a public-private partnership overseen by the Centers for Disease Control and Prevention to bring proven diabetes prevention programs to communities across America. To learn more, visit www.DiabetesAdvocacyAlliance.org and click Policy Priorities.

The Diabetes Advocacy Alliance™ (DAA) is a coalition of patient, professional and trade associations, nonprofit organizations, and corporations united in their effort to elevate diabetes higher on the national agenda.

RIPON FORUM Winter 2014

Diabetes Advocacy Alliance TM

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Politics & Perspective

A Proactive Step Toward Better Cyber Security PATRICK MEEHAN Congress is a reactionary body. In my time in shopping season, sophisticated hackers gained access the House of Representatives, I’ve experienced both to the payment and order processing systems of retail the frustration of gridlock and the joy of substantial giant Target. The personal information of as many as legislative progress. In most cases, regardless of 110 million Americans may have been victims of the the outcome, the challenges we’ve embraced as a cyber attack. lawmaking body have been largely driven by events.

Virtually overnight, the personal financial data It is rare indeed that Congress addresses a of nearly one out of every three Americans was problem before an event occurs. However, over the compromised. Names, credit card numbers, addresses, past year, the House Committee on Homeland Security phone numbers and e-mail addresses -- all are at risk. has been doing just The thieves who stole that. Together with this information may Committee Chairman not use it right away. In Michael McCaul, we fact, the lasting effects have orchestrated of the data breaches will over 300 meetings, not be clear for months events, and hearings and even years. Families with government, hoping to apply for a industry, and privacy mortgage or buy a car stakeholders and will find their credit in experts to help form tatters. Others will learn comprehensive, levelthat credit cards and headed legislation that bank accounts had been will help to mitigate, opened in their names, or and more importantly, that criminals had used prevent, a cyber attack their identity as an alias on our nation’s critical after being arrested. infrastructure.

Savings accounts and I am pleased to retirement funds could say that in February, be drained long after A recent poll of national security the Committee the initial data was experts by Defense News ranked u n a n i m o u s l y compromised. cyberwarfare – not terrorism, a passed the National As frightening as Cybersecurity and these consequences nuclear Iran or a rising China – as Critical Infrastructure may be, the threat of the greatest threat to the United Protection Act cyber attack could lead (NCCIP).

This to far greater disasters.

States and its interests. important bipartisan State-sponsored hackers legislation will supported by countries protect America from a cyber attack on our critical like Iran and China could hobble our power grids, infrastructure, while prohibiting any new government communications networks and financial systems. It’s regulations. no surprise then that a recent poll of national security This is an issue that Congress must address before experts by Defense News ranked cyberwarfare – not an attack happens. As we all know, this past holiday terrorism, a nuclear Iran or a rising China – as the 20

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greatest threat to the United States and its interests.

Homeland Security Committee, but enjoys another Federal policy should encourage collaboration rarity – the support of both industry and privacy between the private sector and law enforcement, and advocates. The ACLU called NCCIP “both pro-security it should do it in a way that builds trust and fosters and pro-privacy.” information sharing between government and industry.

As Chairman of the Cybersecurity Subcommittee, This is the strategy that I am unwilling to stand the NCCIP Act seeks speechless when asked to employ – without “what did you do to Federal policy should encourage compromising the prevent an attack?” collaboration between the private privacy of American Let us take this unique sector and law enforcement, and it citizens, or imposing opportunity to be a expensive and proactive, productive, should do it in a way that builds burdensome mandates and protective Congress. trust and fosters information sharing Together, we can unite on job creators.

With NCCIP, our nation against those between government and industry.

Congress has a rare who wish to do us opportunity to show harm.

RF foresight, and act in a responsible manner to protect our nation. Furthermore, as a recent column in The Patrick Meehan represents the 7th District of Hill put it, “cybersecurity could be the next bipartisan Pennsylvania in the U.S. House of Representatives. breakthrough.” The NCCIP Act not only garnered He serves as Chairman of Homeland Security support from every Republican and Democrat on the Subcommittee on Counterterrorism and Intelligence.

National Cybersecurity and Critical Infrastructure Protection Act of 2013 Summary of Key Provisions

•

Prohibits new regulatory authority at DHS and is budget neutral;

•

Codifies and strengthens the National Cybersecurity and Communications Integration Center, a federal civilian, transparent interface to facilitate real-time cyber threat information sharing across critical infrastructure sectors;

•

Establishes an equal partnership between private industry and DHS, and ensures that DHS properly recognizes industry-led entities to facilitate critical infrastructure protection and incident response;

•

Codifies and strengthens the successful aspects of the National Infrastructure Protection Plan, a public-private partnership framework that has been supported by the private sector since 2003;

•

Codifies the Cyber Incident Response Teams to provide timely technical assistance, crisis management, and actionable recommendations on cyber threats to critical infrastructure owners and operators on a voluntary basis;

•

Ensures that the National Cybersecurity Incident Response Plan is regularly updated and exercised in coordination with federal, state, local, and private sector stakeholders;

•

Codifies DHS operational information security activities to protect and ensure the integrity and resiliency of all federal civilian information systems and networks (.gov); and,

•

Amends the SAFETY Act to establish a threshold for qualifying cyber incidents so private entities can voluntarily submit their cybersecurity procedures to the SAFETY Act Office to gain additional liability protections in the event of a qualifying cyber incident.

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In Pursuit of the American Dream GREG SMITH AND ROGER FORTIN The ADCI is comprised of 35 unique “dreams The concept of the American Dream has unique and within the Dream,” with each being measured and scored ongoing relevance to our nation’s history. The individual separately. These dreams range from conventionally defined dream for a freer, better, and more fulfilled life was present American Dream aspirations such as home ownership and from the start. It evolved from the hearts and souls of the attainment of a good job to other concepts not often millions of people who built this country. The Dream has included in the American Dream discussion such as social lured tens of millions of people of all nations to America. In status and safety in travel. Collectively these unique dreams many ways, the study of America is a story of individuals of are categorized into five unique American Dream subdifferent creed, race, gender, ethnicity, and class attempting indices which represent an individual’s personal economy, to pursue their dreams. well-being, trust in institutions, attitudes towards diversity, So, with this individual pursuit of a better life as the and physical environment. Though one sub-index is not held back drop, researchers at Xavier University in Cincinnati, to be more important OH, set out to quantify than another in the ubiquitous concept survey development, of the American the fact remains that Dream. After 3 years the sub-indices are of research and testing, unevenly balanced. they established the The overarching American Dream dream of a healthy Composite IndexTM personal well-being (ADCI) in July 2011. is the largest subThis instrument index based on the was built on public number of unique views and opinions dreams that it reflects, about the American which is followed, Dream. Created from in descending a statistically validated order, by personal survey instrument, economy, trust in the ADCI gauges the institutions, diversity, country’s current and Fundamentally, the American Dream and environment. collective sentiment is about hope – the hope that every Therefore, as we regarding the extent look for the largest to which people living individual of whatever status has the driver of the Dream, in the United States chance to be all that he or she can be. we find it exists in are achieving their one’s contentment, American Dream. The health, and prosperity in life. It is important to note that 139 question survey reaches at least 1,000 respondents this hierarchy was not built deterministically. It is the direct each month from across the nation using the demographic result of the sentiment of people pursuing the American spectrum of the most recent United States Census. Each Dream. survey question response is scored on an increasing sentiment One of the more interesting findings from the ADCI is scale from 0 to 100 and averaged across all responses. The that Americans consistently rate attitudes towards diversity outcome is a personal American Dream score that indicates higher than all other sub-indices. As such, assimilation of how far along, as a percentage, individuals are in achieving differences with others and attitudes towards diversity is the their American Dream. The monthly volume is aggregated area where Americans are furthest along in their Dream quest. and scored on the same scale to create the ADCI. 22

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Respondents also exhibited very positive sentiment regarding their personal well-being. Unfortunately, the dreams of having a strong personal economy and a society where one can trust institutions lag significantly behind. They are currently the largest American Dream inhibitors for people living in the United States. Within these broad segments, respondents have indicated that they struggle the most with financial security, trust in government, and trust in business. Improvement in these three domains will most quickly and effectively improve the quality of life of people living in America and better enable the pursuit of the American Dream by everyone.

As of January 2014, the ADCI stands at 65.17. This means that, as a nation, we are 65.17% of the way to fully achieving the American Dream. There is both good news and bad news in this reading. To begin, the average ADCI score from 2011 to the present has increased each year. Thus, the overall quality of life of people in America is steadily improving. Moreover, their personal economies have improved in near lockstep with the overall quality of life during this time and serve as a key driver of the ADCI increase. Unfortunately, the other overarching sub-indices are not behaving in the same manner.

The trust Americans have in institutions has regressed over the last year and a half, largely driven by the lack of trust people have in government. The trust in government measure stands at 38.74, which indicates that Americans believe they

are only 38.74% of the way to living in a society where they can fully trust the government. Prospectively, this can be viewed as good news as there is plenty of room to grow in this area.

Fundamentally, the American Dream is about hope -- the hope that every individual of whatever status has the chance to be all that he or she can be. It is America’s highest aspiration and promise and is inextricably bound to our nation’s ideals of freedom, equality, justice, and opportunity for all people.

Individuals’ pursuits, collectively, constitute the moral and economic engines that drive this nation forward. As the ADCI surveys show, there is a direct relationship between the number of individuals who pursue the American Dream and the health of society.

The greater the number of people who pursue their dreams, the healthier America’s economy is. Therefore it is not surprising that the ADCI has proven to be an excellent predictor of key economic activity. Ultimately, if our nation can effectively address the lack of trust we have in our institutions, individual economies will improve and so too will the quality of life of people living in America.

RF Greg Smith is the Chair of the Management Information Systems Department, and Roger Fortin is the Academic Vice President and Provost for Xavier University.

The Ripon Society

Ideas that matter since 1962.

“Over the course of the 50 years that Ripon has existed, it really has been very helpful in terms of shoring up our party – frankly helping to broaden our party.”

Speaker John Boehner January 22, 2013

Founded 1962.

www.riponsociety.org RIPON FORUM Winter 2014

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The New Politics of Evasion New thinking and favorable demography have largely addressed the Democrats’ old problems. Now it’s the Republicans who can’t face reality.

WILLIAM A. GALSTON & ELAINE C. KAMARCK As veterans of an eight-year struggle to reimagine for whom “Back to Reagan” is a mantra that soothes and reinvent the Democratic Party, we look at today’s and cures. But we are as far away from the end of the Republicans with a wry sense of recognition. Much of Reagan Administration as Democrats were from FDR at what we wrote about our party a quarter of a century ago the beginning of the Nixon Administration. Reaganism applies with only minor modifications to the contemporary applied conservative principles to a specific historical GOP: an unattractive message, outdated policies, adverse situation. If Reagan reappeared today, his principles demographics, and a fatally flawed political strategy, would be the same, but many of his proposals would not. among other similarities. Now as then, the losing party is As long as Republicans imagine that the party’s 1980 talking to itself more than it is listening to the people. Now platform will solve either today’s public problems or their as then, a party wrestling with defeat is hampered by an own political problems, they’ll continue to struggle. entrenched base that Another popular resists change and but counterproductive punishes those who tendency is to blame try to bring it about. the messenger rather In our experience, than the message. successful reform of a Throughout the New political party requires Deal, Republicans a number of difficult c o n v i n c e d steps: diagnosing themselves that the party’s ills; Franklin Roosevelt discarding backwardwas a snake charmer looking policies; who had bewitched restating the party’s the people and that all principles in terms would be well once that attract rather than he passed from the repel skeptics; and scene. It took Harry crafting proposals Truman’s unexpected Reagan was to Democrats as FDR was that address the broad victory over Tom population’s problems Dewey to convince to Republicans — a great communicator and concerns, not Republican leaders whose rhetorical gifts sugar-coated a pill just those of core that their problems supporters. Reform went deeper, that they believed the people otherwise requires, as well, setting the stage would not have swallowed. an organization that for Eisenhower’s serves as a focal point successful battle for reformers, helps incubate new ideas, and leads the battle against Robert Taft. Ike’s program of “Modern Republicanfor their adoption by the party. And it requires, finally, ism” ended the party’s battle against the New Deal and standard-bearers who understand the reform agenda and restored it as a serious national competitor. can explain it clearly to party leaders, to the rank and file, Reagan was to Democrats as FDR was to Republicans and ultimately to the entire electorate. Money, technology, — a great communicator whose rhetorical gifts sugarand tactics matter, of course, but only within a broader coated a pill that they believed the people otherwise would reform strategy. not have swallowed. Not until Michael Dukakis’ startling Judged against this template, the reform of the defeat at the hands of George H.W. Bush did Democrats Republican Party is taking, at most, its first halting steps. begin to realize that their problems might be more than A politics of nostalgia still attracts too many Republicans, cosmetic.

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Once again, the same drama is playing itself reservations about the Republican Party begin with social out. Many Republicans (including their presidential issues such as same-sex marriage, they hardly end there. nominee) believed up to Election Day that victory over These voters also believe that the wealthy should pay higher Obama was assured. Recovery from recession was slow; taxes; that Republicans don’t want to help them pay their unemployment remained high; household incomes were student loans; that reducing the size of “big government” is depressed; the President’s approval ratings hovered around much less important than attacking entrenched interests on 50 percent. As the returns rolled in, recriminations began: a broad front; that they will be better off under Obamacare; The wealthy Mitt Romney was miscast in hardscrabble that the wars in Iraq and Afghanistan were mistakes that the populist times; he stood mute in the face of the Obama United States should not repeat; and that, along with samecampaign’s summer onslaught; and he destroyed himself sex marriage, immigration reform functions as a “gateway with his “47 percent” video, the economic equivalent of issue.” Even when they disagree with Obama’s policies, Todd Akin’s remarks on rape. most young voters at least give him credit for trying to fix There is some truth to all this, of course, but it was problems, while Republicans are seen as mostly negative, mostly a diversion from the basic point: The Reagan often harshly so. agenda was played out, and the Tea Party’s Wahhabi-style Toward the end of the CRNC report, the authors drive to restore pure, uncompromised conservatism had implicitly question their party’s dominant narratives. led the party away from, Their most recent rather than toward, commissioned survey an electoral majority. compared a wide range Tacitly acknowledging of broad narratives this reality, party leaders that Republican began to think out loud. candidates could use.

While a report from the The winners among Republican National young voters: creating Committee focused jobs and economic mainly on mechanics, growth, tackling the its authors forthrightly tough problems that stated that “America will face the next looks different” and generation, and giving drew some obvious hardworking people the policy implications. opportunity to advance.

In particular, they The losers: protecting stated, “We must Americans’ liberty Not until Michael Dukakis’ startling embrace and champion and the principles defeat at the hands of George H.W. comprehensive of the Constitution, immigration reform. If promoting liberty Bush did Democrats begin to realize we do not, our Party’s and reducing the role that their problems might be appeal will continue of government, and to shrink to its core protecting families and more than cosmetic. constituencies only.” core American values.

The authors also While the authors don’t acknowledged the force of generational change: “[T] spell it out explicitly, the conclusion is inescapable: The here is a generational difference within the conservative messages that have dominated the Republican Party since movement about issues involving the treatment and the the beginning of the Obama Administration are turning off rights of gays—and for many younger voters, these issues young adults. (The attack on big government is especially are a gateway into whether the Party is a place they want unpopular with Hispanics.) To summarize the report in to be.” language that its authors would surely reject, George W. A subsequent report from the College Republican Bush was more right than wrong, and the Tea Party is more National Committee (CRNC) underscored this point. In wrong than right. findings based on two commissioned surveys and other data, the report documented the sizeable gap between Reform on the Horizon?

In this context, it is hardly surprising that the party’s young voters’ perceptions of the Republican Party and their own preferences and beliefs. While not ignoring problems leading thinkers are beginning to weigh in. In an article rooted in technology and branding, the report paid the most entitled “Reaganism After Reagan” published in February attention to policy-based difficulties. While young voters’ 2013, National Review’s Ramesh Ponnuru commented, RIPON FORUM Winter 2014

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“Today’s Republicans are very good at tending the fire of ers, whose antipathy to Obama spilled over into a general Ronald Reagan’s memory but not nearly as good at learning anti-government stance. Pawlenty’s candidacy quickly from his successes. They slavishly adhere to the economic collapsed, but the woes of the working class remain, program that Reagan developed to meet the challenges of offering opportunities to conservative reformers willing the late 1970s and early 1980s, ignoring the fact that he to challenge entrenched economic orthodoxies. largely overcame those challenges, and now we have new A third strand of conservative reform, mainstream ones.” Ponnuru concluded with a flourish that verged on rather than populist, tries to build on what George W. heresy: “In his first Inaugural Address, Reagan famously Bush got right. In March 2013, two veterans of the Bush said that ‘government is not the solution to our problem; Administration, Peter Wehner and Michael Gerson, government is the problem.’ The less famous yet crucial published a lengthy essay, “How to Save the Republican beginning of that sentence was ‘in our present crisis.’ The Party—A Five-Point Plan.” They began by noting question is whether conservatism revives by attending to key shifts in the country since Reagan: Demographic today’s conditions, or becomes something withered and changes were working in favor of Democrats, and the dead.” end of the Cold War reduced the credibility of the classic If “Back to Reagan” Republican “tough won’t do as a strategy on defense” stance. and budget cutting has Echoing Ponnuru, they hit a political wall, commented: “[I]t is no what comes next? wonder that Republican Since Romney’s defeat, policies can seem stale; several strands of they are very nearly conservative reform identical to those have emerged and offered up by the party gotten a new hearing. more than 30 years Rand Paul is trying to ago. For [today’s] move libertarianism Republicans to design into the Republican an agenda that applies mainstream, and recent to the conditions of controversies over 1980 is as if Ronald drones and surveillance Reagan designed his have given him the agenda for conditions opportunity to enhance that existed in the Once again, the same drama is his national visibility.

Truman years.” playing itself out. Many Republicans For conservatives, the Gerson and road to reconnecting Wehner went on (including their presidential nominee) with young adults starts to propose new believed up to Election Day that with libertarian-leaning approaches in five stances on social and areas: focusing on the victory over Obama was assured. national-security issues. economic concerns Another brand of of workingand conservative reform tilts toward economic populism. A middle-class Americans; welcoming rising immigrant large piece of the Republican base has only modest levels groups; pushing back against hyper-individualistic of education and income. Mitt Romney had nothing to say libertarianism by demonstrating the party’s commitment to them, which helps explain why millions of white voters to the common good; engaging social issues in a manner stayed home last November. Back in 2008, however, two that is aspirational rather than alienating; and harnessing young conservatives, Ross Douthat and Reihan Salam, their policy views to the findings of science. While they had already diagnosed the problem. In Grand New Party: aren’t always clear about the specific policy implications How Republicans Can Win the Working Class and Save of these approaches, they do endorse breaking up the big the American Dream, they advocated the selective use banks and enacting comprehensive immigration reform. of government to reweave the fabric of civil society Describing opposition to gay marriage as a “losing battle,” and address the neglected economic needs of downscale they note tartly (and correctly) that “it is heterosexuals, Americans. Former Minnesota Governor Tim Pawlenty not homosexuals, who have made a hash out of marriage,” took up their cause under the banner of “Sam’s Club and they suggest that Republicans and conservatives conservatism” during his brief 2012 campaign, but he might more usefully focus on strengthening marriage in could not channel the anger of Republican primary votall its forms.

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Gerson and Wehner offered not only policies, but a a quarter of a century ago, but it was necessary for us to theme as well: “The Republican goal is equal opportunity, say it. We’re waiting for our counterparts among today’s not equal results. But equality of opportunity is not a natural Republicans and conservatives to do the same. state; it is a social achievement, for which government shares There’s something else missing as well – a focal some responsibility. The proper reaction to egalitarianism institution that brings reformers together to craft new is not indifference. It is the promotion of a fluid society in policies and the political strategies needed to make them which aspiration is honored and rewarded.” effective, first within the party, and then for the entire If there were a political equivalent of intellectual country. So far, the Republican intellectuals seem to operate property, we could sue for patent infringement, because in a vacuum. They have little formal connection to the these sentiments can be found, party’s elected officials or nearly verbatim, in numerous its organizations. It will be DLC documents from the late a sign of seriousness when 1980s on. The resemblance is Republican dissidents are no coincidence: Along with willing to devote their energies Tony Blair’s New Labour, and resources to creating an Gerson and Wehner cite the organization devoted to party DLC and Bill Clinton as their reform and protecting it from models of successful party being strangled in the cradle, reform. Not surprisingly, we as the defenders of entrenched think they’re on to something. arrangements will surely try Despite this intellectual to do. If Republican leaders ferment, the transformation and candidates try to improve of the Republican Party has their party’s fortunes without barely begun. There’s no changing its orientation, they substitute for a leader with the will surely fail. guts to break with outdated Much is at stake, not just party orthodoxy, as Clinton for Republicans, but for the did on trade, fiscal policy, entire country. The polarization welfare, and crime, among of our party system has other issues. And he did more thwarted action on critical than that: In the famous Sister challenges and has exacerbated Souljah episode, he spoke public mistrust. As long as our out against a tendency in parties remain at roughly equal There’s no substitute for a the party’s base that crossed strength, our institutions can the line from protest to only work when adversaries leader with the guts to break extremism. Mitt Romney are willing to debate fiercely— with outdated party orthodoxy, and the other contenders and then reach honorable as Clinton did on trade, fiscal for the 2012 Republican compromises. A Republican nomination had numerous Party dominated by a new policy, welfare, and crime, opportunities to do just that, generation of reform-minded among other issues. and they ducked them all. The conservatives who care more incredible statements about about solving problems than women and rape by two Republican Senate candidates scoring points would be a huge step toward restoring a federal could have served as a Sister Souljah moment for Romney. government that can govern.

RF But rather than using these to mount a full-throated protest against extremism in the Republican Party, he offered William A. Galston is the Ezra K. Zilkha Chair and a mild rebuke that did nothing to undo the damage or to Senior Fellow in the Governance Studies Program at change the trajectory of the campaign. As long as aspirants the Brookings Institution and College Park Professor for party leadership flinch from confronting their angry at the University of Maryland School of Public Policy. base, the American people will continue to see Republicans Elaine C. Kamarck is a Senior Fellow in the Governance Studies Program and the Director of the Management as an uncompromising, uncaring, and retrograde force.

And until party intellectuals are willing to go beyond and Leadership Initiative at Brookings. This is an policy prescriptions and call extremism by its rightful name, excerpt of an essay that originally appeared in the Fall it is unlikely that any candidate will be willing to do so. 2013 edition of Democracy: A Journal of ideas (www.

The phrase “liberal fundamentalism” made us few friends democracyjournal.org).

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News & Events

“The Numbers Don’t Lie”

Ripon Society hosts Pew Research for Discussion on American Electorate WASHINGTON, DC -- With the mid- 2). As an example, he pointed to a Republican Party during this time term elections less than seven months December poll which revealed that 42 and feel that, in many ways, the away, The Ripon Society hosted a percent of Republicans disapproved party is not conservative enough. luncheon discussion on February 19 of the job their party’s leaders were Although they still vote fairly reliably to look at the American electorate and doing in Congress. By contrast, Republican, they now call themselves how political trends may impact the 68 percent of Democrats approved independents, and express a lot of prospects of the Republican Party in of the job their leaders were doing. criticism of Republican leaders.”

November.

Similarly, 70 percent of DemocraticDespite this deficit, Dimock The discussion was stated that there were entitled, “The Numbers still several areas in Don’t Lie.” It featured which Republicans hold a presentation by Dr. a clear advantage over the Michael Dimock, Democrats. For instance, the Vice President more Americans (45of Research for the 35 percent, to be exact) Pew Research Center, think the GOP does a who, among other better job of dealing topics, discussed the with the federal budget GOP’s image among deficit than Democrats Americans, the issues do.

Republicans also in which Republicans hold an advantage (42-38 are viewed favorably, percent) in dealing with and how young people the economy.

Despite view not only the party, the fact that the party but government. has spent so many years “The basic political pushing to keep taxes low, Michael Dimock. landscape right now the GOP is surprisingly still has a bit of a tied with the Democrats Democratic tilt to it,” (41-41 percent) on which “The basic political landscape right party is better able to deal Dimock stated (see next page, Figure 1). “While with the issue of taxation. now still has a bit of a Democratic the trend is toward On the issue of health tilt to it.” independents, you’ve care, Dimock noted that still got about an 8-point although public support Democratic edge in of the Affordable Care party identification. I think some leaning independents had a favorable Act is falling, Republicans continue of this reflects the fact that the view of the Democratic Party, to lag behind Democrats (37-45 Republican Party’s brand in the while barely half – 53 percent -- of percent) when it comes to which public eye remains meager. There is Republican-leaning independents had party is better able to deal with the less confidence in the party, and more a favorable view of the GOP. issue. This is especially true among negative perceptions of Republicans “This deficit reflects a dynamic young Americans, whose increasing than Democrats.” that has been going on since the skepticism of Obamacare is matched Dimock noted that some of the second term of the Bush Presidency,” by their skepticism of the Republican deficit that the GOP faces in this Dimock observed. “It involves what brand. regard is internal and comes from we refer to as ‘lapsed Republicans’ “I don’t think it will surprise within the party itself (see Figure – people who got frustrated with the anyone to hear that the political RIPON FORUM Winter 2014

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Michael Dimock, VP-Research Presentation to the Ripon Society and RAMS, Capitol Hill Club, Washin

PAGE ONE: PARTY IMAGES, LEADERSHIP AND ISSUE

Section One Diversity & Religion

leanings of the Millennial generation are very Democratic,” Dimock Figure 1: Party Identification Trends Figure 2: Party Fa stated. “This is a generation that is 45 % very diverse – 41 percent are nonwhite. This is also a generation that 40 is not as skeptical of government as I 38 Favorable view of… other generations. In fact, when you 35 D The Republican Party talk about the generational divide in 32 30 politics, we’re at an unusual moment The Democratic Party where we have an older generation R 25 that has been consistently anti24 Approve of the job each is d government and a younger generation 20 that is unusually pro-government.”

Republican leaders in Cong To that end, Dimock pointed to a 15 Democratic leaders in Cong survey last fall that asked Americans 10 whether they favored a bigger NUMBERS, FACTS AND TRENDS SHAPING THE WORLD PEW RESEARCH CENTER/USA government that provided more 5 services, or a smaller government that Michael Dimock, VP-Research provided fewer services (Figure 3).

0 PresentationMillennials to the Ripon Washington DC Feb 19, 2014 were Society the onlyand age RAMS, group Capitol Hill Club, 1992 1996 2000 2004 2008 2012 where a majority (55 percent) favored PEW RESEARCH CENTER Aggregated surveys from each year. having a bigger government.LEADERSHIP That PAGE ONE: PARTY IMAGES, AND ISSUES Based on general public. said, Dimock also pointed to another poll which revealed that Millennials, Figure 1: Party Identification Trends Figure 2: Party Favorability and Leadership Approval for all their pro-government leanings, Figure 3: also have an entrepreneurial spirit and Figure 4: 45 % Among inds appreciation of the private sector, with Democrats Have Image Advantage Lean Lean Republicans Ho 76 percent agreeing that, “The strength Ind Rep Dem 40 % saying each party … Total Rep Dem % saying each Diff party c of America is mostly based on the 38 SHAPING THE WORLD Favorable view of… NUMBERS, FACTS % AND TRENDS % % Both/ % % % between success of American business.”

35 Rep Dem Neither/ R-D 35 13 Party 74Party12 DK31 diff53 Young vs.

Dimock made his remarks 32 The Republican Party 30 % 39 50-64 a crowd of over 150 Ripon Total Total47 % 18-29 65+ The Democratic Party 7 % 8730-49 17 70 PAGEbefore 3: GENERATIONAL DIFFERENCES Society members and Congressional Is more willing to work 25 Federal with other party D+25 Favorofgay marriage 51 27 6552 21=100 54 45 39 budget Chiefs Staff.

He (May will 13) make a 24 +14deficit Approve of the job each is doing Economy similar presentation at The Ripon 20 more concerned with More people of different races eachIs other is in a Congress 29 Republican leaders 12 17 11 Society’s 4th Annual Legislative andmarrying needs of people like me 43 2132 42 52 16=100 D+20 Taxes 60 47 36 29 +17 change for the better (Sep 11) 15 Communications Directors Symposium Immigration Is more extreme in its Democratic leaders in Congress 34 9 68 20 4 42 on Leadership, which is scheduled positions 54 8235 12=100 R+19 Health 10 More women in the workforce change for the better (Sep 11) 73 73 72 62 care+9 to be held on March 7th at George PEW RESEARCH CENTER/USA TODAY Dec. 3-8, 2013.

Poverty Is more influenced by Diff Diff Washington’s Mount Vernon.

RF 5 0 1992

Immigrants strengthen our society (Nov 13)

lobbyists

47 23=100 R+17 NUMBERS, NUMBERS, FACTS FACTS AND TRENDS TRENDS SHAPING THE WORLD WORLD 49 AND 5730 SHAPING 55 THE 41

Figure 3: Generational PAGE PAGE 3: 3: GENERATIONAL GENERATIONAL DIFFERENCES DIFFERENCES Toward Government No religious affiliation (2012)2012 1996 2000 2004 2008

Governs in a more honest Differences and ethical way 20

Total Total

Can better manage federal

31

D+10 3241 28=100 21 15 18-29 18-29 30-49 30-49 50-64 50-64

39

+8

9 65+ 65+

+12 Total Total

between between PEW RESEARCH CENTER J FiguresYoung may not vs. add Young vs. to 10

40 40 65 5541 20=100 42 32 D+1 51 51 65 54 54 45 45 Smaller govt providing fewer services (Sep-13) 51 15-19, 2014.

37 49 60 RESEARCH CENTER Jan. More More people people of of different different races races marrying marrying each eachPEW other other isis aa Figures may not add to 100% of 43 43 because 60 60rounding.47 47 36 36 change change for for the the better better (Sep (Sep 11) 11) 12 24 11 8 Figure 3: View of federal govt … Basically content Figure 4: More More women women inAdvantage the the workforce workforce change change forRepublicans the the better better (Sep (Sep 11) 11) 73 73 82 73 72 72 Democrats Have Imagein Hold on Issues73 Angry (Oct 13)for 30 Many82 17 29 39

26 39 39 61 29 29 5 62 62 37

+15 +14 +14

% saying each party …

39 39 40

+8 +8 +7 +12 +12 0 +15 +15

Section SectionOne Two & Religion Diversity Views of Government

EW RESEARCH CENTER Aggregated surveys from each year.

Prefer…

Bigger govt providing more Favor Favor gay gay marriage marriage (May (May 13) 13) ased on general public.

servicesgovernment

% saying each party could do a better job dealing with …

Immigrants Immigrants strengthen our our society society (Nov (Nov 13) 13) 49 49 57 57 55 55 41 41 Priority… strengthen Spending to help the economy recover 45 52 46 41 Both/

wo rnment

Rep Dem Neither/ R-D Partyaffiliation Party (2012) DKbudget diffdeficit (Dec 12) Reducing the No No religious religious affiliation (2012) % % % Health Care law govt Approve s more willing to work Prefer…

Prefer…

Bigger Bigger govt providing providing more more services services Federal budget deficit with other party 27 52 21=100 D+25

30

s more concerned with eeds of people like me

Rep 49 20 20 Party %

41 40 40 45 RIPON FORUM Winter 201454 Disapprove (Dec 12) Smaller Smaller govt govt providing providing fewer fewer services services (Sep-13) (Sep-13) 51 51 Economy 42

32

52

16=100 D+20

Taxes

41

Both/ Dem 44 Neither/ 47 R-D 32 32 21 Party DK21 diff % %

52 15 15

52 99

41 41 43 55 55 42 42 32 32 20=100 R+10 54 20=100 56 R+4 60 52 37 37 49 49 60 38

38 26 26 54 61 61

35 41

17=100 Even

+17 +17 +12 +9 +9

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Name: Adam Kinzinger Occupation: U.S. Representative, Illinois’s 16th District

You became an elected county official at the ripe old age of 20. What did this early experience teach you? Being elected to a local office at such a young age taught me the importance of being accessible to my constituents. I saw just how important it is to bring the government back to the people and to be a valuable resource for the same folks who elected me. I believe this philosophy allows me to make a positive difference in people’s lives and enables me to well serve the people of the 16th District.

Your desire to serve others is evident in your distinguished public service and military record. What advice would you give to those seeking to give back to their country? If you believe in what you’re doing, it’s worth it. Giving back to your country, or community, is simply one of the most rewarding experiences one can do with their time and energy. When I speak to high school students trying to figure out what to do with their lives, I always tell them to chase their passion, not a paycheck. I hope everyone can find it their duty to in some small way improve the lives of those around them.

With 24/7 news coverage and social media everywhere in our lives, why do you think Americans feel so disconnected from Washington these days? What can be done to reverse that trend? You’re right. It seems that we are more heavily bombarded with information these days than ever before. With one news story after the other focused on the latest crisis, it is easy for the average person to feel disconnected and disenchanted with Washington. But, I hope people can find optimism in their own representatives; to know that they are being heard and that it is worth being engaged. I think a way to reverse the trend is to be more selective of the information one consumes. I promise not every headline is bad, and there are plenty of good people doing great things out there. If you look for the good, you’ll find it.

A question about foreign policy -- amid increasing violence and reports of a resurgent Al-Qaeda in Iraq, what do you believe America’s role in that country should be moving forward? Al-Qaeda is the #1 enemy to the United States; as such we need to ensure that Al-Qaeda does not feel safe wherever it operates. Our country has sacrificed a lot in order for a free Iraq, and now we must protect it. If we are going to live up to our commitments, we need to push Al-Qaeda back. I believe by using limited airstrikes, and by allowing our strong intelligence assets to work with the Iraqi government, we can ensure Al-Qaeda has no significant presence in Iraq again. As Americans, we must keep our commitments to the world to regain the trust of our allies, and for our enemies to fear us.

You have been targeted by some special interest groups for not being conservative enough. Yet, in a divided government, the need for compromise has never been greater. How have you tried to strike this careful balance? I serve the people of the 16th district, not special interest groups. As representative for the people of the 16th district, I try to serve as humbly and honorably as I can, regardless of politics. I believe we can stand firm in our principles while also recognizing the need for incremental progress. No deal will ever be perfect.

In divided government, it is easy to vote no; getting to yes is the hard part.

Finally, many have tabbed you as an up-and-comer in the conference. How do you manage these lofty expectations with the basic challenges of a second-term Member? My focus in Congress is getting the folks of the 16th District back to work, reigning in government spending, and ensuring we pass down to the next generation a country stronger and more free than the one we were given. I believe that if I stay focused on those important issues and vote my conscience, I will be able to consider my time in politics a success, no matter what happens.

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