what we are talking about is preventing people going into crisis, generally, and into a deeper end of services. so it's really, really critical that we put a lot of emphasis on prevention and recovery, resiliency based programs in mental health because the difference in cost and services between somebody coming into a system and receiving the aid they need at the beginning that will help keep them out of the hospitals and the crisis units can be as high as 10 to 1. i mean, in some states, the cost of keeping a person in a state psychiatric hospital for a year is $120,000 dollars. whereas the cost for keeping somebody in the next highest level of service, which is generally considered to be our sort of community treatment teams, act teams, is about $12,000 dollars. so it's 10 to 1. and we have seen the exact opposite happening with all the cuts going on the state levels because they are cutting the front end first.

it is easier to cut these recovery-based programs because they know they need to keep those hospital beds. the problem is that every time they do that, they need to keep more hospital beds. can i jump in here? sure, i was just going to go to tell us because part of the act talks about no-cost sharing and i am hearing all of these ka-ching, ka-ching, ka-chings up here. let me just say a couple of points that builds on patrick's point. i think the science, we are a point right now where the science has taken a major leap. and so recently the institute of medicine has come out with several reports on preventing behavioral health problems in children and adults. the scientists at the nimh and niaaa all have early intervention studies going on that are extraordinarily promising. and i think that actually the science should make us a little bit more optimistic

about our ability to actually prevent disorders. so, for example, the affordable care act has a nurse-home visitation program as part of it. and that has been studied for 30 years. the first randomized trial was 33 years ago and it showed that you could actually prevent lots of bad things from happening to children as they grew when they lived in at risk households. and similarly, if you treat mothers' depression, mothers of young children, you do things to prevent both substance use disorders from developing, but also a variety of behavioral problems and early schooling. and so i think there is a lot of promise here and i think that that promise is what prompted the act to put in the provisions to make it really easy to access those types of services. also the untreated alcohol and drug problems drive medical costs in unwanted ways. they just drive up all kinds of healthcare costs.

this illness is so co-occurring with a whole host of very expensive medical conditions. so once you develop a plan where there is benchmark coverage in every area of insurance, whether it's medicaid, the exchanges, the group health plans, you are raising the possibility of cutting down on an enormous amount of unwanted healthcare spending. just think one fetal alcohol syndrome birth that was preventable. the acoa is also sprinkled with screening, early screening, and that's how we get out the population who is currently uninsured is to do the early screening and intervention, catch people's addiction earlier in the disease and then the benchmark plans provide for the treatment of it. we should be, if we did this thoroughly, able to cut down on other medical spending. that is major prevention stuff, in my book. that's just true also for mental health. early screening is the best tool we have, really, for prevention, i think.

john? i think screening is incredibly important. however, i think trying to get primary care professionals to do screening in a way that really allows them to identify substance use or mental health conditions is critically important. i will just tell you this personal story and that is that i went in for my primary care visit, the nurse came in, did a screening, asked me about drug use and i asked her how many people in the 10 years that she had been there had actually said yes and she said one. and she works for a very, very large healthcare organization. it is certainly something that will need further study and implementation actually, for people to actually do it. i know that sbirt, we have sbirt that does a great job of screening patients at every sector of the healthcare system

for mental health and for addiction treatment. there's also another program that we have, which is the community transformation grants. john, do you want to talk a little bit about that and what they will do? sure, and they were released in may of this year. they are for states and local communities. their primary focus obviously is on prevention, prevention of a variety of activities. one of those activities is around prevention of -sorry- focus on emotional health. within the emotional health category, there are a number of activities that are specifically focused on preventing alcohol use, substance use, and to promote emotional wellness. so will samhsa continue to do programs that will help

communities integrate into these new aca framework? yes. as a matter of fact, we provided, as soon as they came out, information to our stakeholders that are representative of states and local communities in order for them to take advantage of those grant programs. and just so that we have touched base, let's review some of the places where individuals can go and get help because there are so many pieces to this. richard, you were talking about the office of national coordinator? yes. inside of the department of health and human services there's an office that is in charge of all the health information technology and they give grants to states and they have worked with individual providers to sort of really bolster the expansion and the responsible use of health information technology.

and they are very sensitive to the issues of behavioral health consumers that were brought up. and so it is really that office, the office of national coordinator for health information technology where people should contact with these issues. but john, there is also other offices that provide the consumer with information as to how to reach the exchanges, talk about the health homes, talk about all of the other components, correct? yes. out of the office of the secretary, out of hhs, there is a web site, a very good web site around the affordable care act. and it is incredibly user friendly, provides information about the act. it is also being populated now with information that is state specific about what is being covered and insurance companies within those states. it's a rolling implementation so that as the secretary gets additional information,

that information is put into that web site. incredibly interactive. samhsa also has a web site on health reform and within that web site we talk about parity, we talk about the health homes, we talk about the grant opportunities that i just talked about and a variety of other issues as well. final thoughts, deb, in terms of what consumers need to know and what they need to do? well, the opportunity here is huge, but the challenge is how do we set it up so the law is enforceable? again, i am looking at benefit books that don't reflect the parity act yet and the aca is coming down the pike soon. well, it's already here. we have to find some way to catch all of this and put it down where the consumer opens a benefit book and there it is. patrick? and i think it actually even goes beyond that. i mean, i think in, and probably in the substance abuse community,

but also in the mental health community, word of mouth is probably one of the best ways we have of getting information out. again, because we have these problems of- for instance, i worked in florida for a number of years and we knew that we only served about 49 percent of the people who really needed our services in the state and the rest were untreated completely. so how did we have access to even get a book to them? so we have got a long way to go to really find a way to communicate with the people who need it. richard, final thoughts? i think this is a historic opportunity. i think that 10 years from now when we look back, we'll say that this was bigger, particularly for the substance use disorder community, than the creation of medicare and medicaid. that this is really huge. and i know it's a well worn cliché at this point, but it really is a game changer. and i want to thank you for being here. i want to remind our audience

that national recovery month is every september. our information package this year is on healthcare reform issues, so i hope that the leaders in communities take a look at it and organize events and activities around getting information out to the public about the new healthcare reform and the aca. thank you for being here. for a copy of this program or other programs in the road to recovery series, call samhsa at 1-800-662-help or order online at recoverymonth.gov and click multimedia. every september national recovery month provides an opportunity for communities like yours to raise awareness of substance use and mental health problems to highlight the effectiveness of treatment and that people can and do recover.

in order to help you plan events and activities in commemoration of this year's recovery month observance, the free recovery month kit offers ideas, materials, and tools for planning, organizing, and realizing an event or outreach campaign that matches your goals and resources. to obtain your copy of this year's recovery month kit and gain access to other free publications and materials related to recovery issues, visit the recovery month web site at www.recoverymonth.gov or call 1-800-662-help. [music]

>> thank you for your patience. i m leader pelosi's district rector in san francisco. i've been with the for about nine years, and we are excited

to put on this forum today to help people learn how they can access credit and capital for their small business. click background on some of what was accomplished in the last congress when later closing was speaker of the house. she had had 16 tax cuts signed into law to help small businesses grow and thrive. as we know, during the last 15 years, small businesses account for about 2/3 of the job growth in our country, but when the bush recession hits in 2009, 2010, small businesses were hit particularly hard. small businesses are the center of her agenda. congress under her leadership gave 27 million small businesses tax cuts. two main pieces of legislation -- the small businesses jobs act in the information you have,

will create a total of 500,000 jobs and create eight tax cuts. they are all described in the packet you have. also, unleashing up to $300 billion in credit for small businesses to access. there are another eight tax cuts that were passed through a number of different laws. some of our panelists will address those. even though now we are in an environment where there is a republican majority in the house and a slimmer majority in the senate, please note that the leader and democrats are going fight hard to keep their agenda and restart our economy, and there will be more work to be done. i would like to hand over the podium to nicole rivera, who put this together. she will introduce the panelists and go over some logistics. i want to point out quickly that we are being recorded by san francisco government tv. the camera in front is only

aimed at the podium. it is not taking shots of the audience, only the podium for people who want to ask questions. so do not worry, you are not on tv if you do not want to be. >> thank you for your patience. i am a representative with leader pelosi, and i'm thrilled to have you today to learn more of our best practices for accessing credit. it is a priority for our office. we are very well aware of how small businesses are running up against the wall right now in terms of trying to get the credit and loans they are looking for, so i will try hard to bring the brightest minds in this room so you can effectively fix their range and learn more about what you can do better to fix your business plan and what it is they are looking for. first of all, i will introduce everyone. mark quinn is the san francisco

district director of the u.s. small business administration. the small business administration covers not only san francisco proper but the bay area. the severed his third district is responsible for a business loan portfolio of 12,000 loans worth $4.2 billion. in 2009, the sba approved $500 million in lending. next, we have the executive director of the san francisco small business office. she was in san francisco in 1986 to open the buffalo exchange limited store, and in the 13 years she worked for buffalo exchange, tennis district manager, she held her open the company from four to 11 stores. in 2009, the mayor appointed her as executive director to the office of small businesses. next, we have the ceo of

opportunity funds. he has combined his background as a community organizer with an education from stanford to develop an innovative, not-for- profit financial incision that uses market principles to affect systemic change. it operates one of the nation's largest individual development, programs, a leading provider of micro loans in california, and has a robust community real estate finance unit. next, we have the ceo of ne community federal credit union. since 1988, she has been the ceo of northwest community federal credit union. under her watch, the credit union group to over 1600 members. it has become the national model for institutions seeking to provide financial education and banking services to the low- income communities. last but not least, we have our conditional lender represented here by wells fargo. mark cyrus is the senior fda

banker for the region -- the senior sba banker. he held businesses choose the best loans for the growing business and focus on a comprehensive understanding of their goals for their business. mark is responsible for helping entrepreneurs with sba loans every step of the way. i would like each of you to speak a little bit about what your organization does and, more importantly, address the audience here and let them know what your looking for when you are hoping to fund their loan. we will start with you, mark. >> absolutely. thank you. i want to thank speaker pelosi for putting this together. i want to thank all of the of for coming out on a smell it -- snowy san francisco date.

[laughter] we've been told we should get us know when we go back outside. not sure what to expect. second, i thank speaker pelosi for all the work she did to support the jobs act and before that, the stimulus bill, the original american recovery act bill that allows sba to be able to besba landing more available to small businesses. very important piece of our tools that we have in this really very difficult time for small businesses to get access to credit. finally, i want to find the rest of the folks here, my colleagues on the panel. it is the case that sba works with these organizations to try to help small businesses understand how to get credit and fine tools to be able to do that. sba programs cover a wide range, and i will talk about this range

of lending and the kinds of things we do, but in many ways, we do not do it alone. we do it with partners, and that is the takeaway message, the sba lending activity, while would guarantee loans through a number of lenders, we do it with a lot of other partners as well. let me give a little bit of a sense of what the small business administration does and is. we in san francisco covered the bay area and north coast counties, and we do a variety of things. i will come back to the credit card because i know that is what this session is about, but before i do that, there's two other roles we play that are important as well. one is about helping small businesses understand how to start businesses, getting good technical assistance, getting good advice about starting and managing your business. equally important is being prepared for credit. one of the things we tried to do is work with small businesses to understand how to be ready for

credit. a lot of that is helping folks that are interested in starting a business understand how to develop a business plan, how to get good advice about starting and managing a business. we see a lot of small businesses interested in starting a business, and they have a talent or skill or craft, and they know what they want to do, but they really need to structure a rounded to do it. part of what they need, through partners, through score, through our business centers that we have in san francisco, and through the small business development center we also have here, really help small businesses understand how to get started in business, how to develop business plans, how to be able to put yourself in a position of planning for your business as much as running your business. a big part of what we do is the technical assistance and counseling work we do for folks interested in starting a business or those in the early stages who really need advice about where to go when you run into the wall, about financing,

marketing, managing your business. that is an important role we play as well. another role we play is helping small businesses understand how to do contract thing, particularly with the federal government, but in a more general way, with all the public sector players. one of the things that small businesses always need is customers. one of the big customers out there is the public sector, but one of the challenges is the public sector on every level, federal, state, and local, are always difficult for small businesses to understand how to navigate the process of getting certified to do business, finding the right sources to be able to talk to and understand how to navigate getting into the contract thing rolls with public sectors, so we try to help small businesses understand that, and we partner with a lot of organizations -- the city, the state of california, and now federal agencies, to be able to take advantage of a huge buying

opportunity for small businesses, but one that they find very intimidating. sometimes it takes too long. it is too complicated. for real red tape of process is something less certainly exists with small businesses try to get into public contracts the work. those are two roles we play, separate from the access to credit roll. on the financing side, sba plays a role across a wide spectrum in terms of who we partner with and what kinds of loans sba is able to guarantee. we are not a direct lender or guarantee lender. we have a couple of program he says, just to give you a sense, and i will let eric talk about the microlending side, but we have a microloan program to deal with the early stage client looking for a small loan under $50,000, down to, really, $10,000. for those businesses that are not viable in any real way but have a great idea, have some

abilities to show that they have a good plan and really need to be able to get some early stage financing. that is kind of a non- traditional source of capital that exists out there. the main sba programs are guaranteed loan programs, and we act essentially as a guarantor, insuring the bank that if you make a loan to a small business, the business is not able to pay the loan, the sba will pay the bank a share of that long, typically 75% or 80%. a bank like wells fargo, for example, which is the largest sba lender in the country. when the lender makes the loan to you, they come to us and say that your business, for a variety of reasons, may not be strong enough to get a loan without a guarantee. it might be a business that is too young or is a type of business -- say, restaurants -- that are a little riskier than they want to deal with, or you do not have the kind of

collateral a lender is looking for. "an sba lender will be able to make the loan with a guarantee that sba will be able to provide. we probably will about 225 sba loans this year. at any point in time, we have about 1500 loans in san francisco that are sba loans. a lot of them are restaurants because that is one of the areas that is very typical because it is a riskier business. but a lot of people in san francisco see that as an opportunity for them as well. we also partner with the golden gate restaurant association to help people understand how to do financing for restaurants. a lot of what we do is helping small businesses get access to credit. the sba loan program covers a range of small loans down to $25,000 and large loans up to $5 million, so it is a very wide range. can be used for a variety of

uses -- debt refinancing, building acquisition, working capital, so it can be used for a wide range of things from a small business point of view. as you heard, we do guarantees for about 90 or 100 banks in the country -- or in the bay area. about 3000 nationwide. there is a lot of lenders that do some sba lending. first thing you want to do is deal with the bank. if they are not able to make the loan by themselves, then go to our website, which is www. sba.gov, and look for the local page to see the local san francisco financing sources. but before you do that, the takeaway message here is that before you go to a bank, make sure you are cleared to do that. you do not want to go to a bank

looking for financing for your business and ask them a question that will immediately give them a sense that you are not ready. you go to a bank and say, "how much can i borrow?" they will tell you, "i do not know, but probably not from us." you need to know exactly what you're looking for, how you are going to use the money, and how you will be paid the bank. part of the process is make sure you are prepared. the first thing you need to do is take a advantage of the resources that can help you develop your business plan and really be prepared to go to a lender. being able to answer the questions you know that they will be asking is part of what we do as well. i'm sure we will have lots of time for questions, but i will send it back to you. >> director of the office of small business with the city and county of san francisco. again, i also want to thank congresswoman pelosi for hosting this event, and with her staff,

and her leadership around all the work she has done supporting small businesses. because she comes from san francisco, and, by our definition, is small business is a business with under 100 employees. that is almost 85% of all businesses in the city. because she is from here, she really understands what small businesses are about, and she articulates your needs in washington, d.c. in may 2008, san francisco opened the office of small business, under the leadership of gavin newsom, under the urging of our small business leaders. the mayor heard there was a need for the community to have a small office to help the needs of our small businesses in san francisco, help them understand and navigate the complex structure in getting a business