entertainment industry. . supports that as well. there have been some really great tenants at the port. we wanted to make sure we announced the initial moves as a signal that while we have other tenants to work with, these two were complex. they needed assurances. i remember as a city administrator with jennifer and monique walking the parameters trying to figure out which offices would be the best. today we're standing on the option we chose would be the best for lozani's for their hopefully permanent home. it will make a great investment. bower will be moving to.

pier 50 along with other tenants and other things kept in storage. these are two significant moves. they demonstrate the level of cooperation we have always wanted to have with our tenants at the port. we need to move them in a sensitive way. they are moving to new places. i think when you talk to them and into the details of this site and. pier 50, they're going into better sites that will allow them to grow and serve our city and visitors in great foer ways.

i want to thank you for your wonderful stewardship of your companies and employees, working together with the port, our office, our event authority, and organizing committee to make this even successful and do so in a sensitive and smart way. these are great, solid businesses for the city. they employ a good number of people. we want to keep the entertainment and transportation going. thank you for your cooperation. thank you to the port for their leadership on this. [applause] >> we would like to invite gary bauer to say a few words. >> i appreciate the kind words. we could not make this happen without the mayor and the rest of the port. we have been a tenant here for over 14 years. we have over 200 employees.

if we were to move, we would be putting those people out of work. we just finished a few weeks ago in san diego. this is a great thing for the city. it is a great opportunity. we think it is a great opportunity with the cruise ships coming in. we're looking forward to our new location at pier 50. thank you so much. [applause] >> now i would like to invite norm to say a few words. >> i would like to thank mayor

lee, the former mayor, and others for all the hard work they have done in the city. it cannot happen, these kinds of activities, unless we have help from downtown. we really appreciate that a lot. we're really excited about the new location. [applause] it is terrific for us. this was the city gate to san francisco. you are standing on what was called the clark. point pier, it was the beginning of the barbary coast. teatro zinzanni is proud to carry on the prague tradition of music in this city for many years to come. -- the proud tradition of music in the city for many years to

come. there's a special order we have. it is the order of zinzanni. >> i am going to pin that on. do not bend down too quickly. [laughter] [applause] >> thank you. congratulations to everybody. >> i guess that is it. [laughter] it is the beginning of a new day. we look forward to being here. we look forward to the mayor joining us. >> use gary bauer's transit and come to teatro. [applause] thank you.

>> hello. 9 judge terri l. jackson. the court is now recruiting prospective civil grand jurors. our goal is to develop a pool of candidates that is inclusive of all segments of our city's population. >> the jury conducts investigations and publishes findings and recommendations. these reports them become a key part of the civic dialog on how we can make san francisco a better place to live and work.

>> i want to encourage anyone that is on the fence, is considering participating as a grand jury member, to do so. >> so if you are interested in our local city government and would like to work with 18 other enthusiastic citizens committed to improving its operations, i encourage you to consider applying for service on the civil grand jury. >> for more information, visit the civil grand jury website at sfgov.org/courts or call

>> the public wants to access particular information about your house or neighborhood we point them to gis. gis is a combination of maps and data. not a graphic you see on a screen. you get the traffic for the streets the number of crimes for

a police district in a period of time. if the idea of combining the different layerce of information and stacking them on top of each other to present to the public. >> other types of gis are web based mapping systems. like google earth, yahoo maps. microsoft. those are examples of on line mapping systems that can be used to find businesses or get driving directions or check on traffic conditions. all digital maps. >> gis is used in the city of san francisco to better support what departments do. >> you imagine all the various elements of a city including parcels and the critical infrastructure where the storm drains are. the city access like the traffic lights and fire hydrants.

anything you is represent in a geo graphic space with be stored for retrieval and analysis. >> the department of public works they maintain what goes on in the right-of-way, looking to dig up the streets to put in a pipe. with the permit. with mapping you click on the map, click on the street and up will come up the nchgz that will help them make a decision. currently available is sf parcel the assessor's application. you can go to the assessor's website and bring up a map of san francisco you can search by address and get information about any place in san

francisco. you can search by address and find incidents of crime in san francisco in the last 90 days. we have [inaudible] which allows you to click on a map and get nchldz like your supervisor or who your supervisor is. the nearest public facility. and through the sf applications we support from the mayor's office of neighborhood services. you can drill down in the neighborhood and get where the newest hospital or police or fire station. >> we are positive about gis not only people access it in the office but from home because we use the internet. what we used to do was carry the large maps and it took a long time to find the information. >> it saves the city time and money. you are not taking up the time

of a particular employee at the assessor's office. you might be doing things more efficient. >> they have it ready to go and say, this is what i want. >> they are finding the same things happening on the phone where people call in and ask, how do i find this information? we say, go to this website and they go and get the information easily. >> a picture tells a thousand stories. stories. some say a map [music]

hello, i am ivette torres and welcome to another edition of the road to recovery . today we will be talking about health reform and what it means to people with substance use and mental disorders. joining us in our panel today are deb beck, president drug and alcohol service providers organization of pennsylvania; dr. richard frank, professor of health economics, department of healthcare policy, harvard medical school; patrick hendry, senior director of consumer advocacy,

mental health america; john o'brien, senior advisor for behavioral health financing, substance abuse and mental health services administration, u.s. department of health and human services. john, healthcare reform, why was it necessary? what benefits are we going to see out of it? well, ivette, we have about 50 million individuals in this country who don't have any insurance at any given point in a year. a number of them use emergency rooms and/or hospitals and that has a very significant cost for both people who have insurance, as well as employers who pay for insurance. we spend about $17.2 billion dollars on uncompensated care for those individuals. we also know that there is a significant number of people with substance abuse disorders who have benefits and

don't access care, but there are a significant number of individuals who can't access care because they don't have insurance benefits. and richard, what are the major ways the affordable care act will affect the behavioral health system? the affordable care act, the behavioral health aspects of the affordable care act are based on sort of three principles. one is coverage and parity, two is integration of behavioral health and health care and the third is prevention. and in part because the people with behavioral health disorders have had a much higher rate of being uninsured than the rest of the population, you can expect a disproportional impact on the behavioral health community because of the coverage expansions coupled to parity. okay, and let's talk a little bit more about that health parity and addiction equity act, the mental health parity and addiction equity act, richard.

expand a little bit on, particularly the types of links that are going to be made with the aca. the wellstone-domenici parity act, which was passed in 2008, went into effect in early 2010. and what it does is it really provides fairness and coverage along two dimensions. first, it requires that the standard benefits in an insurance plan be the same for the medical surgical side as it is for the behavioral health side. and so right away that means that copayments, deductibles, limits will be the same. it does a second thing, which is equally important, which is it says that if you are going to manage care, that is

okay and you can manage it differently, but you have to base it on the same clinical criteria, the same evidence, and the same logic that you use to make all your other management decisions. and in that sense, what it is doing is it's demanding fairness on the management side, as well as on the benefits side, which is really revolutionary. and the affordable care act adopts parity as one of its key principles that connects throughout the act. it connects in the exchanges, it connects in medicaid expansion, it connects in the essential benefits part of the affordable care act. and patrick, what does that mean for the consumer? that is the big question, really, i think. we are still discussing that throughout the country. we know that parity is something that we have worked hard for a long, long time and we assume that as it becomes

more prevalent and really fully enacted, that that will be a great benefit to people receiving health care. i mean, for years we had people receiving medicare without parity, where they paid a higher rate for mental health care than they did for their traditional healthcare rates. but as far as how the aca is going to play out in terms of improving mental health care and substance abuse, too, i think we are still trying to figure out where we are at the table. i just came from louisiana yesterday and we had a several-day discussion about how do, especially in the smaller states that are not so well organized, how do we get to the table to work out these details about how under-integrated health care, that mental health is not going to still be kind of a stepchild.

and deb, for someone in the community that is working with the individuals that need to get into recovery and that are currently in a treatment program or that are in recovery from substance use or mental disorders, what is the major point that we need to share with those individuals? well, i just have got to start by saying one in four families has somebody with a drug and alcohol problem and this is a fatal, it's a progressive, always fatal illness if it goes unchecked. so trying to begin to deal with this issue in a larger way through insurance is literally life and death important. i kind of want to sidestep a bit your question because i think there are several features of the affordable healthcare act that hold out a lot of hope. now we are worried, as you are, on how do consumers access some of these things. that pathway is not entirely clear to us at this point.

but pre-existing conditions, the elimination of pre-existing condition clauses has been an issue and a nettlesome one for our population. also the issue of you can't get thrown off your insurance if you start to use it was something we have seen in the drug and alcohol field. those two changes alone i think are extremely helpful. john, it seems like there are a lot of moving parts to this effort and what is samhsa doing to basically get the word out so that people are connected to what is going on and they really take action when they are supposed to? good question. we have been doing a number of things over the last 18 months, specifically around infomercials initially around parity before the regulations came out. and then as the regulations came out last year, we provided more detailed information, both in terms of traditional ways, webinars and presentations, as well as tip sheets around parity to try to get the information out.

we have a 140 million people who are affected by parity. that's good. what is a little challenging is how to reach a significant portion of those individuals who for most, parity is probably too technical of a term for them. and generally when we talk to employers, especially large employers, they say they have done a lot of effort to try to educate folks about parity, but the fact remains is that people really don't pay attention to these benefits until they almost have to use them, in most cases. so we are working with employers, we are working with our internal communications staff, external communications staff, to try to really figure out what is the best way to be able to get as much information to as many people around parity as possible. as we continue to really unveil all of this, the aca will increase access to behavioral health by expanding medicaid.

how will that work? as i said, in a sense, there are three large over-arching principles in the affordable care act. one is coverage expansion through medicaid, which you just mentioned, and the other one is insurance market reform, which deb referred to a little bit, but there is more to it than that. and then finally there is delivery system and payment reform, and they all work together, they all fit together. and so in fact, the medicaid expansions go to cover anybody with an income below 133 percent of poverty line. and that coverage will include mental health- which is approximately, what is that level? $10,000, $11,000 for an individual. and then $28,000, $29,000 for a family of four. yes. and so in fact for the first time, medicaid becomes a simple means tested program as opposed to something complicated where you have many different criteria that you have to meet.

so it's just for low income people now. and then picking up at that 133 percent level are subsidies to help you buy private insurance under these new organizations called health insurance exchanges, which is a way of giving individuals and small groups the same purchasing power that somebody who works, say for the federal government or ibm would get. and that is coupled with some new regulatory rules such as the ones that deb mentioned around pre-existing conditions and the like. there are lots more that we need to learn about this effort and we will be right back. [music] samhsa is playing a huge role in helping to implement the affordable care act.

first of all, we are trying to make sure that behavioral health is considered in every decision that is getting made, whether it's about the exchanges or whether it's about the rules that medicaid or medicare put out or whether it's about the information that goes out to the public about the kinds of things that are covered or whether it's about the preventive services that will get coverage without a copay, for example, or screenings or meaningful use activities. there's a whole bunch of stuff going on and we're trying to make sure behavioral health is at every one of those tables, so that is part of samhsa's role. one of the most important things to remember is that the affordable care act will offer services to a larger number of people that who were previously without such services. and it will treat behavioral health service needs on par with the general health service needs. it will foster an integration of care so that we can address

both the physical health, as well as behavioral health components, of the whole person. it will encourage the integration and comprehensive approach to dealing with a person's behavioral health issues, as well as their physical issues. recovery benefits everyone. i started my own company. i got my dad back. my friends believe in me. daddy's home. hi, dad. substance use and mental disorders can be treated. it all starts on day 1. join the voices for recovery. for information and treatment referral for you or someone you love, call 1-800-662-help. brought to you by the u.s. department of health and human services. before, addiction and depression kept me from living my life. now, every step i take in recovery benefits everyone.

there are many options that make the road to recovery more accessible. it begins with the first step. join the voices for recovery. for information and treatment referral for you or someone you love, call 1-800-662-help. brought to you by the u.s. department of health and human services. [music] like a lot of people experiencing mental illness kind of later in life, i really, my symptoms became profound in my 30s. i started having these mood swings, so i decided i should go see a doctor. and i went to my regular doctor, who examined me, but he was not really familiar with psychiatrics and he just said you need a vacation. so i minimized the whole idea in my mind and i continued to

get worse and eventually really destroyed my company that i owned at the time. my next step into mental health was that i ended up in a psychiatric hospital. and if we had had the type of care that we are working towards now where all care is integrated and you walk in one door and you can see all the different types of people you need to see, i wouldn't have to go through those extra 4 years of agony and destruction and then changes to my family and all of that. let's talk a little bit about how many people-we had mentioned it earlier, deb-but how many people are actually uninsured? and let's talk a little bit more about specifically in the behavioral health area. the data coming from the federal government points to 50 million people not having any kind of coverage. and people with untreated drug and alcohol problems or unaddressed mental illnesses have a hard time accessing benefits or thinking that through.

if i am really in the throes of an active addiction, i may not think about how to sign up for medicaid or how to sign up for the health exchanges. so there's this big group we've got to do something with. we are really concerned about it. i think the good news is the affordable healthcare act includes drug and alcohol and mental health, both. the problem is we're going to have to do a lot of work to help this particular population access the coverage. the coverage is there, no question, but we're dealing with a patient population that has a very difficult time getting through the hoops. and the intended goal of that is that there will be 32 million more americans that will actually have coverage, either through medicaid or private insurance. so that's about two-thirds of the 50 plus million that aren't insured at this particular point in time. the best guesses, and actually they are more than just guesses, is that anywhere from 20 to 30 percent of