Problem Gambling Efforts: Who is responsible? Elizabeth Lanza, Director of the Office of Compulsive and Problem Gambling PA Gaming Control Board

Problem Gambling Efforts: Who is responsible? Elizabeth Lanza, Director of the Office of Compulsive and Problem Gambling PA Gaming Control Board

History of Problem Gambling * Moral issue/weakness * Impulse Control Disorder * Addiction like substance abuse

History of treatment * Self-Restraint- pick yourself up by the bootstrap * 12 step GA * Mental health/addictions counseling * Individual s pay * State funded * Insurance * Holistic approach- * Prevention * Responsible gaming * PG recognition * PG treatment

Who s responsible for what? * Individual * Legislature * Treatment services * Gaming providers- casinos, lotteries * Non-profits * Regulators

Individual * Ultimately, responsibility lies with individual * Participate in responsible gambling or abstinence * Recognizing the signs of disordered gambling * Reaching out for assistance * Entering treatment * Continuing treatment * Maintenance

Legislature * Legislation should include- * Funding for PG treatment, prevention, education/ outreach * Pinpoint responsibilities of each agency * Treatment and PG programs * Helplines * Other legislation * Therapeutic justice

Treatment Services * Higher level- Departments of Health, Human Services * Prevalence study, if possible, prior to commencement of new gambling activity in order to better measure PG prevalence before vs. after legalized gambling. * Jurisdiction-wide certification for providers * Training network * Reimbursement plan * Including incentives to become a treatment provider * Helpline * Treatment options- inpatient and outpatient, screening, short term interventions, long term treatment options

Treatment Services * One-on-One level- treatment providers * Trained on gambling disorders * Screen for PG at intake for all patients

Casinos/Lotteries * Promotion of responsible gaming * Employee training * Signs and symptoms of problem gambling training * Responsible alcohol service * Identification of underage, self-excluded individuals * Self-banning programs in jurisdictions that do not offer such programs. * Active in state/nationwide groups like the CCGP and NCPG * Responsible advertising * Sponsorships of problem gambling groups and/or programs.

Non-Profits (CCGP, NCPG ) * Helpline * Outreach * Training * TOT * Training of providers * CAP training * Network * Conferences * Active in jurisdiction

Regulators * Problem Gambling/Responsible Gaming regulations * Employee training * Training performed by expert * Training materials approved by regulator * Require regularly updated training * Require annual refresher training * Require specifics

Specific employee training requirements in PA * Characteristics and symptoms of compulsive behavior, including compulsive and problem gambling. * The relationship of compulsive and problem gambling to other addictive behavior. * The social and economic consequences of compulsive and problem gambling, including debt, treatment costs, suicide, criminal behavior, unemployment and domestic issues. * Techniques to be used when compulsive and problem gambling is suspected or identified. * Techniques to be used to discuss compulsive and problem gambling with patrons and advise patrons regarding community, public and private treatment services. * Procedures designed to prevent serving alcohol to visibly intoxicated gaming patrons. * Procedures designed to prevent persons from gaming after having been determined to be visibly intoxicated. * Procedures for the dissemination of written materials to patrons explaining the self-exclusion program.

Specific employee training requirements in PA * Procedures for removing an excluded person, an underage individual or a person on the self-exclusion list from a licensed facility including, if necessary, procedures that include obtaining the assistance of appropriate law enforcement personnel. * Procedures for preventing an excluded person or a person on the selfexclusion list from being mailed any advertisement, promotion or other target mailing no later than 5 business days after receiving notice from the Board that the person has been placed on the excluded person or self-exclusion list. * Procedures for preventing an individual under 21 years of age from receiving any advertisement, promotion or other target mailing. * Procedures to prevent an excluded person, an individual under 21 years of age or a person on the self-exclusion list from having access to or from receiving complimentary services, or other like benefits. * Procedures to prevent an excluded person, an individual under 21 years of age or a person on the self-exclusion list from cashing checks.

Advertisements * Regulations requiring advertising of helpline # * Require all advertisements (print, radio, video, billboards) to have helpline info (ie- If you or someone you know has a gambling problem, help is available. Call 1-800-GAMBLER.) * Require specific size requirements * 2% of height or width of the advertisement, whichever is greater.

Required Handouts * Policies requiring specific handouts made available to patrons at each casino * Self-Exclusion Program info * Voluntary Credit Suspension info * Contact info on area treatment providers * Responsible gaming info

Outreach * Advertise programs * Brochures and handouts * Press releases * Ads in publications (several languages) * Media campaigns * Senior/Health fairs * PGAM * What s really at stake?

Enforcement * Impose enforcement actions for allowing underage gambling, excluded and self-excluded gambling * Consent agreement * Fines

Jurisdiction-wide Self-Exclusion Program * Voluntary self ban from all gambling establishments within territory. * Utilize a strong deterrent * Individual responsibility * Ban length options * Gateway to treatment * Active removal process * Data collection

Self-Exclusion * Voluntary * No 3 rd party exclusions * Must acknowledge that they are not being coerced if a 3 rd party is present * Will be turned away if administering employee believes or individual admits that they are being coerced, under the influence of a substance or not of sound mental capacity

Self-Exclusion * Strong deterrents * Violators * Will have their winnings confiscated * May be cited with a trespass charge

Self-Exclusion * Individual responsibility * Staying out of casino * Recognition of gambling problem

Self-Exclusion * Ban lengths * One year * Five years * Lifetime

Self-Exclusion * Gateway to treatment * DDAP treatment provider list * GA and Gam-ANON meetings * Self help tools

Self-Exclusion * Active removal process * Must appear in person to remove from the list * Opportunity to offer info on treatment * Data collection * Burden on those who choose to remove, not those who choose to remain banned

* Data Collection Self-Exclusion

As of January 31, 2017 * There have been 10,975 Voluntary Requests From Individuals For Placement on the PA Self-Exclusion List.

Gender 7000 6000 5000 4000 3000 2000 1000 0 Male Female

Self-Exclusion Intakes By Year 1800 1600 1400 1200 1000 800 600 400 200 0 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017

Duration Lifetime 2,368 22% 20% 58% Five Years 2,231 One Year 6,376

Race 9000 8000 7000 6000 5000 4000 3000 2000 1000 0 Asian Black Caucasian Hispanic Indian Middle Eastern Multi-Racial Native American Other

Age 3000 2500 2000 1500 1000 500 0 21-25 26-34 35-44 45-54 55-64 65+

Type of Gambling 3000 2500 2000 1500 1000 500 0 Casino Gaming Horseracing Slots Sports Betting Table Games Numbers based on voluntary answers given at time of intake Casino Gaming included 2 or more different types of gambling (Table Games, Slots, etc. )Table Games include but not limited to poker, blackjack, Roulette, etc.

Length of Gambling Problem 1400 1200 1000 800 600 400 200 0 Less than 1 year 1-3 years 3-5 years 5-10 years 10-20 years 20-30 years 30+

Intake by State of Residency Alabama - 1 Kansas - 1 Ohio - 175 Arizona - 3 Kentucky - 1 Oklahoma - 2 California - 3 Louisiana - 2 Pennsylvania 9,283 Canada - 6 Maryland - 68 South Carolina - 3 Colorado - 5 Massachusetts - 1 Tennessee - 1 Connecticut - 8 Michigan - 2 Texas - 8 Delaware - 118 Minnesota - 2 Virginia - 29 Florida - 15 North Carolina - 8 Washington - 2 Georgia - 3 New Jersey - 851 Washington DC - 2 Illinois - 2 New Mexico - 1 Wisconsin - 1 Indiana - 1 New York - 351 West Virginia 15

Found out about SE Program 2500 2,364 2000 1500 1000 500 0 412 55 993 45 522 254 646 129 56 575 87 139 149 39

More PA SE Stats * Self-excluded individuals who reported to have sought treatment prior to self-exclusion in PA: 18% or 1,921 individuals * Self-excluded individuals who reported to have self-excluded in other jurisdictions prior to self-exclusion in PA: 5.8% or 629 individuals * Self-excluded individuals who reported to have gambled in PA facilities prior to self-exclusion in PA: 55% or 5,910 individuals * Age range of self-excluded individuals: 21-95 years Percentage is based on voluntary answers given at time of intake *Age at intake

Violations Lifetime - 794 25% 53% 22% Five Years- 698 One Year 1,689 3,181 known violations of the terms of self-exclusion

Multiple Violations 6% 4% 5% Twice - 369 19% Three - 106 66% Four - 34 Five - 21 More Than 5-25 556 multiple violations

Removal Stats * As of January 31, 2017, there have been 3,443 requests for removal from the Self-Exclusion List. * 614 individuals or 18% who have removed themselves from the Self-Exclusion List have voluntarily requested to be placed back on the list. * 136 or 22% of the 614 individuals that placed themselves back on the Self-Exclusion List chose a lifetime ban. * 2,716 individuals whose term of self-exclusion has concluded have not removed themselves from the Self- Exclusion List. Individuals who have been placed back on the PGCB self-exclusion list after removal will likely be counted more than once, but at this point it is not enough to skew the numbers

Removal Stats, cont. * 1,170 individuals reported gambling in other jurisdictions while on the Self-Exclusion List. * 297 individuals reported gambling in Pennsylvania while on the Self-Exclusion List. * 372 individuals reported seeking treatment while on the Self-Exclusion List. * 164 individuals reported to be self-excluded in other jurisdictions.

Questions? Liz Lanza, Director Office of Compulsive and Problem Gambling PA Gaming Control Board