Missouri Alliance to Curb Problem Gambling

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Missouri Alliance to Curb Problem Gambling 2001 Annual Report ALLIANCE MISSION The Missouri Alliance to Curb Problem Gambling 9s mission is to heighten public awareness for the dangers of problem gambling; develop prevention and education programs for gamblers of all ages; and direct problem gam- blers and their families to the 1-888-BETSOFF helpline and free treatment. ALLIANCE GOALS " To raise awareness of the dangers of problem gambling and direct compulsive gamblers and their families to free treatment. " To develop and implement prevention and education programs for all ages.

" To ensure access to and availabilit y of quality assistance and treat- ment. TABLE OF CONTENTS Alliance Mission and Goals Inside front cover Introduction 1 Participating Memberships 2 Speakers 9 Bureau 2 Underage Gambling Prevention 3 Helpline - 1-888-BETSOFF 5 Senate Bill 902 6 Responsible Gaming Education Week 7 Member Roles MO Department of Mental Health 8 MO Council on Problem Gambling Concerns Inc. 9 MO Gaming Commission 10 MO Lottery 11 MO Riverboat Gaming Association 13 Alliance Member Representatives and Contacts 15 Important Web Sites 16 INTRODUCTION 2001 Brought Added Improvements to Problem Gambling Programs in Missouri Missouri is recognized as an innovative leader in the United States on ... more. less.

addressing problem gambling issues. 1 The growing success of Missouri 9 s public awareness program is largely due to the efforts of the Missouri Alliance to Curb Problem Gambling (the Alliance). Formed in 1997, the Alliance brings together diverse groups that have the common inter- est of working on issues relating to problem gam- bling. The Alliance consists of both governing members and participating members. 2 Governing members share the responsibility of administering the Alliance programs and include: the Missouri Council on Problem Gambling Concerns Inc., a non-proA t advocacy group for problem gamblers; the Missouri Department of Mental Health; the Missouri Gaming Commission; the Missouri Lottery; and the Missouri Riverboat Gaming Association, a private trade orga- nization representing riverboat casino operators. The Alliance continues to expand its pro- grams to help educate Missouri residents on respon- sible gaming and how to A nd help for gambling problems. The year 2001 has been an exciting year for the Alliance and its initiatives. During early spring of 2001, the problem gambling helpline enhanced its services when it transferred responsibility for answering the 1-888- BETSOFF calls from its helpline operators to its staff of trained counselors. These counselors subsequently attended the 60-hour training program that is a criti- cal component for attaining state certiA cation as a compulsive gambling counselor. With the beginning of the state 9s new A scal year on July 1, 2001, the Missouri Department of Mental Health and the Missouri Gaming Commis- sion were able to utilize funds provided through the passage of Senate Bill (SB) 902 by the Missouri Gen- eral Assembly during the 2000 legislative session. This is proving to be one of the most signiA cant steps toward the development of a comprehensive problem gambling program in Missouri. The bill provides a mechanism for funding problem gam- bling treatment, education and prevention programs. More information about SB 902 can be found on page 6 of this report. In August, the Alliance sponsored its third annual Missouri Responsible Gaming Education Week. Educational seminars were held in Kansas City and St. Louis featuring nationally renowned speakers on problem gambling. During this year 9 s events, the Alliance also introduced its third educa- tion and awareness campaign 3 an older adult aware- ness campaign. This campaign, which includes post- ers and brochures, was designed with guidance from the Missouri Division of Aging (now part of the Mis- souri Department of Health and Senior Services) and the Governor 9 s Advisory Council on Aging. The Alliance also further augmented its underage gambling prevention campaign through sponsorship of a new interactive workshop on addic- tions, including gambling. The Alliance and Second Chance Foundation, a non-pro A t organization from Jefferson City, conducted a pilot program of c All Bets Off d in September. More information on this exciting new program can be found on page 3. Additional new programs and initiatives of the Alliance and its members include: " Placement of 1-888-BETSOFF helpline bill- boards in Kansas City and St. Louis; " Strengthening of the nationally recognized Voluntary Exclusion Program through the adoption of a new rule; " Expansion of the Alliance speakers 9 bureau; and " Creation of additional educational exhibits for participation in various related confer- ences and meetings. 1 Missouri Alliance to Curb Problem Gambling representatives were asked to be presenters at a variety of conferences and annual meetings throughout the year, including the National Council on Problem Gam- bling, the World Gaming Expo, Global Gaming Expo and the North American Gaming Regulators Association. 2 Participating members are nonvoting members who wish to par- ticipate in Alliance activities. For more information on becoming a participating member, please visit the website at http://www.888BETSOFF.com/alliance/app.htm 1 . ALLIANCE GROWS THROUGH PARTICIPATING MEMBERSHIPS Membership in the Missouri Alliance to Curb Problem Gambling continues to grow through the Alliance 9 s Participating Membership program. Membership is both free and open to any individual or organization with an interest in helping to heighten public awareness of the dangers of problem gambling and promoting the availability of treatment in Mis- souri. Participating members are informed of Alli- ance activities and events, invited to attend Alliance meetings and are encouraged to provide input to help the Alliance further its goals. The participating membership application can be found on the Alliance 9 s web site at www.888BETSOFF.com or by writing to MACPG at PO Box 104591, Jefferson City, MO 65110. Current participating members include: " Missouri Department of Elementary & Sec- ondary Education " Life Crisis Services " Linda Cottler, Ph.D., MPH " Renee Cunningham-Williams, Ph.D., MPE " Stan Landon " Lia Nower, J.D., Ph.D., NCGC SPEAKERS 9 BUREAU During its A rst full year of availability, the Alliance 9 s speakers 9 bureau delivered more than 50 presentations on problem gambling issues to more than 3,200 participants. Alliance representatives also participated in several radio shows and provided an informational exhibit at four statewide conferences during 2001. The Alliance has speakers available to give presentations on a variety of problem gambling topics for any group or organization, anywhere in the state, free of charge. These speakers help to better educate Mis- sourians about guidelines for responsible gambling, common gambling misconceptions, prevalence rates, risk factors and warning signs of problem gambling, prevention of underage gambling, older adult issues, and the resources available for prevention and treat- ment, including the free treatment for both the prob- lem gambler and her/his family members. For more information about the speakers 9 bureau or to arrange a free presentation, please call (573) 526-4083 or (573) 526-7467. Keith Spare, Missouri Council on Problem Gambling Concerns Inc., speaks at the Governor 9 s Conference on Aging in November 2001. 2 UNDERAGE GAMBLING PREVENTION Missouri Kicks off Youth Addiction Awareness Program c All Bets Off, d an interactive workshop for youth concerning addictions, including gambling, is proving to be a success among teachers and students. The in-school awareness program, which is the A rst of its kind offered in Missouri, is a one-hour seminar that presents facts about addictions and the risk fac- tors associated with them. The seminar is sponsored by the Missouri Alliance to Curb Problem Gambling and is pre- sented by the Second Chance Foundation, a non- pro A t organization from Jefferson City. c 8 All Bets Off 9 was created by the Second Chance Foundation to help the Alliance further its youth gambling addiction awareness efforts, d said Gary Gonder, chairperson of the Alliance and direc- tor of communications for the Missouri Lottery. c There are so many programs in our schools that help to educate youth on the dangers of alcohol and drug abuse, but very little about other addic- tions, including gambling. 8 All Bets Off 9 addresses all addictions, risk factors and good decision-making. d The program, which is targeted toward youth in grades 7 through 9, is being presented at various schools throughout the state. During October, November and December 2001, the Second Chance Foundation presented 24 sessions of c All Bets Off d to six schools in Missouri. Beebe Heil presents a workshop for c All Bets Off d program. c I thought the program was really good, d said one student who participated in the program. c It provided us with a new meaning of addiction and how it could affect a family. d Goals of c All Bets Off d include: " To educate youth about the dangers and risk factors of addictions, including gambling. " To raise awareness among educators and par- ents about the dangers of addictions, includ- ing gambling. " To raise awareness of the helpline phone number 3 1-888-BETSOFF 3 and the avail- ability of free treatment. Problem Gambling Not Restricted to Adults Problem gambling is not restricted to adults. According to the National Gambling Impact Study Commission (NGISC), the number of youth at-risk of becoming problem gamblers is more than double that of adults. It is estimated that 85 percent of youth (ages 12-20) have gambled sometime during their lives. Between 2.9 and 5 percent of these youth are problem gamblers. The most common forms of gambling among youth are sports betting and card games, with interest in Internet gambling on the rise. This year, the Alliance continued to expand the underage gambling prevention campaign that was A rst launched in August 2000 during its second 3 annual Responsible Gaming Education Week. This campaign helps to educate youth, parents, school counselors and of A cials, and the general public about the dangers of gambling at a young age. The A rst phase of the program included posters, brochures, speaker presentations, traveling exhibits and an infor- mational mailing to middle, junior high and high schools in each school district. The posters and brochures were designed with guidance from the Missouri Department of Elementary and Secondary Education 9 s Division of Guidance and Placement. Alliance representatives gave presentations on youth gambling issues at numerous school coun- selor conferences throughout the academic year, including presenting a workshop at the fall confer- ence of the Missouri School Counselors Association. Representatives also attended three educational con- ferences during 2001 to provide an exhibit and infor- mation to conference attendees. Willie Taylor, 2001 Missouri Riverboat Gaming Association Responsible Gaming Committee chairperson, greets visitors at the Missouri School Counselor Association 2001 Fall Conference. The youth prevention and awareness pro- gram also includes activities conducted through indi- vidual members of the Alliance. The Missouri Riverboat Gaming Associa- tion (MRGA) awards college scholarships each year through its Project 21 Scholarship Program. These scholarships are awarded to high school students whose posters, essays or video presentations best convey a message deterring underage gambling. MRGA awarded A ve scholarships in 2001. The goal of the Project 21 Scholarship Pro- gram is for youth to educate their peers that anyone under the age of 21 is not allowed to gamble at a riverboat casino. MRGA members are also diligent in checking for underage persons who may attempt to enter riverboat casinos. All casinos have an estab- lished protocol regarding the issue of unattended minors on-site. Missouri casinos have a no tolerance policy for unattended minors in unsupervised areas of the casino property. The Missouri Lottery also works to keep retailers aware that underage persons may attempt to purchase lottery tickets. It encourages its retailers to ask for identi A cation when they are in doubt of a customer 9 s age. Both MRGA and Missouri Lottery utilize sign programs to remind their personnel and the public about the legalized ages to gamble. 4 HELPLINE 1-888-BETSOFF Toll Free Helpline Enhances Services To Problem Gamblers The 1-888-BETSOFF gambling helpline underwent a number of exciting changes that have enhanced its services to Missouri 9 s problem gam- blers. In 2001, under the management of Life Crisis Services (LCS), the helpline received 2,846 calls from individuals looking for assistance and/or information about problem gambling. This is an increase of more than 53 percent over last year. c The most exciting development is that the 1-888- BETSOFF helpline is now answered by our paid staff, all of whom are master 9 s-level clinicians and trained as compulsive gambling counselors, d said Lee Judy, executive director of Life Crisis Services. This is an important step forward in enhanc- ing services . c Calling 1-888-BETSOFF is often the A rst time a problem gambler reaches out for help, d said Sue Self, the helpline 9 s program director. c We believe that the higher level of education and training of those who are on the frontline increases the likeli- hood that problem gamblers and their family mem- bers will receive the help they need. d The change from volunteer staff to paid, clinical staff members took place in March of 2001. The certi A cation training for staff was completed in June. Since then, there has been an increase in the number of individuals taking advantage of the pro- grams Missouri has to offer, such as the Voluntary Exclusion Program and Free Counseling Services. Life Crisis Services of St. Louis operates the statewide problem gambling helpline with fund- ing from the Missouri Riverboat Gaming Associa- tion. LCS is a crisis intervention agency with more than 35 years experience in helping callers with a wide range of problems. In recognition of the agen- cy 9 s excellence as a crisis-intervention hotline, Pres- ident George Bush named Life Crisis Services the 418 th Point of Light in 1991. The American Asso- ciation of Suicidology awarded its A rst A ve-year cer- ti A cation to LCS, making it one of the nation 9 s pre- mier suicide intervention hotlines - the standard is a three year certi A cation. This history of delivering high quality services to people in crisis is carried on through the 1-888-BETSOFF gambling helpline. In July and September the helpline under- went an evaluation of services, overseen by the Mis- souri Department of Mental Health. Blind test calls to the 1-888-BETSOFF helpline were made by licensed clinical social workers and certi A ed compul- sive gambling counselors. The helpline staff met or exceeded all of the performance standards estab- lished. The evaluation summary comments, written by Dewey Price of the Department of Mental Health include: c& the counselors at Life Crisis Services were helpful and professional. d Counselors were c knowledgeable of the behaviors associated with pathological gambling and the different types of gambling addicts. d Callers who dial 1-888-BETSOFF seeking assistance are assessed by a clinician to help reveal the extent of the problem. Callers are given refer- rals to appropriate agencies, and the worker helps them develop a plan for getting help. Sometimes that plan includes talking with friends and family members about the problem and enlisting their sup- port as well. A worker may arrange for a follow-up call to further lend support and encouragement to the problem gambler or a family member who is uncertain how to proceed. All callers are told about the free counseling 5 services provided by the Missouri Department of Mental Health, and all casino gamblers are given information about the Voluntary Exclusion Program. Other referrals include Gambler 9 s Anonymous, Con- sumer Credit Counseling and the Self Transaction Exclusion Program. SB 902 Senate Bill 902 Continues to Bene) t Problem Gambling Programs Missouri has been recognized throughout the world as an innovative leader in addressing problem gambling issues. However, the lack of a consistent allocation of state funding for problem gambling had been a weakness in the Missouri program until the passage of Senate Bill 902. Senate Bill 902 became effective August 28, 2000. It addressed the lack of state funding for prob- lem gambling programs by providing a mechanism for funding problem gambling treatment, education and prevention programs. The bill amended Sections 313.820 and 313.835, RSMo, to allow up to one cent of the state 9 s portion of the admission fee to be allocated to the Compulsive Gamblers Fund. To ensure the best possible allocation of the funding, problem gambling advocates must appear each year to justify their ongoing and proposed pro- grams in order to obtain appropriations for their problem gambling efforts. Unutilized funding for each year is transferred to early childhood educa- tion. Senate Bill 902 also expanded the use of the Compulsive Gamblers Fund found in Section 313.842, RSMo, allowing it to be used for preven- tion and education programs in addition to treat- ment services. These funds became available with the start of the new state A scal year on July 1, 2001. The Missouri Gaming Commission (MGC) received an appropriation of $40,000 from the Compulsive Gamblers Fund for research, education and out- reach efforts. The Missouri Department of Mental Health (DMH) received an initial appropriation of $190,110 for treatment and prevention services. Due to a signi A cant increase in the utilization of the free treatment services, DMH requested a supplemental appropriation of $207,964 that will be reviewed during the second regular session of the 91 st General Assembly in 2002. Senate Bill 902 added Section 313.843, RSMo, which restricts childcare programs offered to casino patrons to only those facilities that are licensed by the Missouri Department of Health, have a min- imum of 8,000 square feet, and are not open past 11:00 p.m. on school nights and 1:00 a.m. on other days. Finally, the bill made it a misdemeanor for persons under age 21 to enter an excursion gambling boat or attempt to make a wager. Section 313.830, RSMo, makes it a misdemeanor for a minor to access or attempt to access a casino or to assist a minor in doing so. It is a class B misdemeanor for the A rst offense and a class A misdemeanor for the second and subsequent offenses. The bill also amended Sec- tion 313.830 to make it a felony to knowingly make a false statement to the MGC. Current research indicates youth are at the greatest risk of becoming problem gamblers. Thus, the inclusion of this language provides a necessary deterrent to underage gambling. These provisions become particularly important when one considers the array of college and university campuses in rela- tively close proximity to casinos in Boonville, Kansas City, La Grange and St. Louis. 6 RESPONSIBLE GAMING EDUCATION WEEK Entertainment can come in a variety of different forms 3 exercising, visiting family and friends, traveling and gambling. While most forms of entertainment are harmless, some activities, such as gambling, can be devastating if done to excess. The social acceptability of playing the lot- tery, visiting the riverboat casinos and playing bingo, along with the increased accessibility to gambling venues, have helped to create an atmosphere in Mis- souri that could be detrimental to those individuals at risk of becoming problem gamblers. Education is key to helping anyone who may be at-risk. Governor Bob Holden proclaimed August 6-10, 2001, as Responsible Gaming Educa- tion Week in Missouri. Since 1999 the Missouri Alli- ance to Curb Problem Gambling has used the A rst week in August to call attention to potential gam- bling problems. The 1999 statewide event was the A rst of its kind in the United States. Older Adult Awareness Campaign The week 9 s focus this year was the effect of gambling on senior adults. Seniors are in a special time of their lives and, like the vast majority of other adult gamblers, they can enjoy gambling for what it is 3 entertainment. However, about one percent of the adult population can experience serious prob- lems due to gambling. Problem gamblers who are retired may suffer more severe consequences because they may not have the ability to recover A nancially. According to a report issued in 1999 by the National Gambling Impact Study Commission, senior adults are gambling in record numbers 3 more than double compared to 20 years ago. The report concludes: " Seniors are less likely to seek help because they were raised in an era of self-reliance. " Access to treatment for seniors may be lim- ited due to a dependence on others for trans- portation. " Many individuals, including seniors, may have physiological disorders or diseases that increase the risk of pathological gambling. " Seniors who don 9 t gamble can be negatively affected by friends and family members who have gambling problems. The campaign on seniors and gambling was introduced through two seminars. Joanna Franklin was the featured speaker in Kansas City. She has worked in the addictions A eld for more than 25 years and serves on the board of directors for the National Council on Problem Gam- bling. Dennis McNeilly was the featured speaker in St. Louis. He is a clinical psychologist and researcher specializing in older adult issues, and is Assistant Professor of Psychiatry at the University of Nebraska Medical School 9 s Department of Psychia- try in Omaha. Left to right: Gary Gonder, Missouri Lottery; Melissa Stephens, Missouri Gaming Commission; Shelly Perez and Jim Scroggins, Missouri Lottery; Gov. Bob Holden; Dewey Price and Jeanne Galliher, Missouri Department of Mental Health. 7 MEMBER ROLES MISSOURI DEPARTMENT OF MENTAL HEALTH Experiences Steady Growth Of Counseling Program Since 1996, the Department of Mental Health 9 s Division of Alcohol and Drug Abuse (ADA) has administered the Compulsive Gambling Coun- seling Program for pathological gamblers and their family members. Family members can receive help whether or not the gambler is in treatment. The counseling program has grown steadily since its inception while continuing to provide free treatment. In calendar year 2001, 335 compulsive gambling cli- ents or family member clients received individualized treatment for their gambling problems through indi- vidual and group counseling, family therapy and/or codependency counseling. Another administrative component is the credentialing program for Certi A ed Compulsive Gambling Counselors (CCGCs). Candidates for certi A cation must successfully complete an ADA approved, 60-hour course on problem gambling and its impact, effective treatment strategies and the importance of education and prevention. In addi- tion, they must possess a credential in a related help- ing profession such as substance abuse and drug treatment, social work or psychology. To remain certi A ed, the counselors must meet speci A c renewal requirements for continuing education and maintain their prior credential in good standing. In May 2001, ADA sponsored continuing education for CCGCs at its spring training institute. Other training opportunities were provided by train- ing professionals as well as at state and national con- ferences and during Responsible Gaming Education Week. ADA continues to utilize program provid- ers from its existing network of treatment facilities and currently contracts with 15 agencies. These pro- viders must employ a Missouri certi A ed compulsive gambling counselor. Current providers are: " Bridgeway Counseling Services - St. Charles and Troy " Community Treatment, Inc. (COMTREA) - Festus " Family Counseling Center - Kennett and Hayti " Family Guidance Center - St. Joseph and Maryville " Hannibal Council on Alcohol and Drug Abuse - Hannibal " Missouri Valley ADP - St. Louis City, St. Louis County and St. Peters " Pathways Community Behavioral Health - Clinton " Phoenix House - Columbia " Provident Counseling - St. Louis " Renaissance West - Kansas City " Research Mental Health Services - Kansas City " Rodgers South - Kansas City " Sigma House - Spring A eld " Southeast Missouri Community Treatment Center (SEMO) - Farmington " Tri-County Mental Health Services - Kansas City Funding for the Compulsive Gambling Counseling Program is derived from a portion of the admission fees paid by the riverboat casinos to the state and then appropriated annually to ADA. This allows for the provision of free treatment. Providers are reimbursed for treatment services through the program of A ce in Jefferson City. All services must be preauthorized and reimbursement rates are pre-set. Clients must meet diagnostic criteria for pathologi- cal gambling. A primary reviewer, who is also a Mis- souri CCGC, conducts a clinical review process for authorizing provider requests. Gambling clients and family member clients must be Missouri residents. ADA maintains a list of agencies that employ certi A ed compulsive gambling counselors, including state facilities that provide the free counseling to Missouri residents. The list is distributed to callers, other Missouri Alliance members and to the 1-888- BETSOFF helpline to assist them in making appro- priate referrals. The list is also available on the Department of Mental Health 9 s (DMH) Web page at www.modmh.state.mo.us/ada/treatment.htm DMH also prepares the annual budget esti- mates for program funding, reimburses outpatient providers for services rendered and monitors the quality and utilization of treatment services. 8 ADA 9 s c Harmless Fun? That 9 s How Addic- tions Can Begin d campaign continued throughout 2001 with billboards, brochures and posters high- lighting tobacco, alcohol and gambling as areas that might begin as harmless activities, but that may prog- ress to addictive behavior. The campaign was devel- oped by the Department 9 s Of A ce of Public Affairs and is made possible through block grant funds. DMH and other members of the Missouri Alliance joined with the Second Chance Founda- tion of Jefferson City to provide an in-school, addic- tion-prevention awareness program with an empha- sis on gambling. Missouri 9 s seventh through ninth grade students are the target audience. The program is described on page 6. DMH contributed $7,000 from a prevention block grant to assist with the pro- gram development and program presentations. 9 MISSOURI COUNCIL ON PROBLEM GAMBLING CONCERNS INC. The Missouri Council on Problem Gam- bling Concerns (MCPGC) was founded in 1995 and became an of A cial member of the National Council on Problem Gambling in 1996. MCPGC is a 501(c)(3) non-pro A t organization incorporated in the State of Missouri with its principal of A ce at 5128 Brookside, Kansas City, Missouri. Founded in 1972, the National Council on Problem Gambling is the oldest and largest organi- zation dedicated to addressing the issues of problem and pathological gambling. MCPGC 9 s continued membership brings to Missouri the full scope of cur- rent national information and treatment resources on problem and compulsive gambling. MCPGC 9 s vision is: c Missourians working to advocate a gaming neutral response to problem and compulsive gambling concerns. d Their mission is to address problem and compulsive gambling through prevention, harm reduction and increased awareness of its impact. Further, MCPGC is com- mitted to assisting those who are impacted by prob- lem and compulsive gambling through promoting and providing quality education, service referrals and accessible treatment. In service to these goals MCPGC provides public education on problem gambling concerns. During 2001 presentations were made to churches, credit union associations and national meetings held in Missouri. In addition, MCPGC helped con- cerned citizens in Kansas establish a council and con- duct their A rst counselor training program. MCPGC works with the media to provide information on gambling concerns from the indi- vidual and family points of view. Their continued emphasis is that changes in gaming regulations and increasing gambling opportunities carry with them the public responsibility of increasing dedicated funding that insures the community is fully edu- cated about the gambling prevention, intervention and treatment. MCPGC maintains that while we have been a leader in making treatment available, Missouri has not yet provided an informational safety net that ade- quately provides for the individuals and families that are negatively impacted by gambling. The Council continues to advocate for a Missouri system that models the c best practices d guidelines of responsible gambling modeled in other states. MCPGC has partnered with Tri-County Mental Health and the Kansas City Port Authority to organize a 2002 Compulsive Gambling Counselor Training Program that will begin in the spring of 2002. MISSOURI GAMING COMMISSION Re' nes Problem Gambling Programs The Missouri Gaming Commission (MGC) administers a voluntary exclusion program for prob- lem gamblers. 1 This unique program, created in 1996, provides problem gamblers with a method to acknowledge that they have a gambling problem and take personal responsibility for it by agreeing to stop visiting riverboat casinos. The exclusion is for life. Research indicates that problem gambling is a lifetime condition and those who suffer from it are never cured but are constantly recovering. In order to assist problem gamblers with their self-imposed ban, the Commission requires casino operators to cease all direct-marketing efforts to people in the voluntary exclusion program. Casi- nos are required to block all direct mailings and other promotional enticements to people in the pro- gram. This policy ensures that people in the pro- gram do not receive invitations for free nights in the casino 9 s hotel, free dinners, match play coupons or other inducements to visit the casino. In addition, the Commission requires that casinos refuse to allow people in the program to cash checks or participate in player 9 s club programs. If a problem gambler who has requested to be excluded chooses to violate her/his agreement and visits a Missouri casino, she/he is arrested for tres- passing upon discovery. As a method of enforcing these policies, the Commission requires casinos to refer to the list of people in the program before issu- ing new player 9 s club cards, cashing checks or paying out large jackpots ($1,200 or more). State law provides that a self-excluded person may be charged with trespass if that person enters an excursion gambling boat. 2 The Commission uses the trespassing arrest as a way to call attention to the problem gambler 9 s destructive behavior in the hope that it will encour- age her/him to enter a treatment program. After receiving notice of the arrest of someone who is vol- untarily excluded, the Commission sends a letter reminding the disassociated person of her/his commitment to refrain from visiting Missouri casi- nos as well as the availability of free treatment. The Commission also provides the person with both a listing of certi A ed compulsive gambling counselors and a schedule of Gamblers Anon- ymous meetings in the community. VOLUNTARY EXCLUSION PROGRAM The Commission adopted a rule that took effect May 30, 2001, allowing disassociated persons to enter an excursion gambling boat for the purpose of carrying out bona A de duties of their employment. This new rule provides the problem gambler with the ability to both utilize the voluntary exclusion program in her/his recovery plan as well as maintain a current source of income when it is most critical due to the A nancial distress created by the destructive gambling behavior. 3 The voluntary exclusion program is not for everyone. It is not a panacea or a quick A x for prob- lem gamblers. The vast majority of people who suffer from problem gambling need counseling or group therapy such as Gamblers Anonymous. However, the voluntary exclusion program can be an important part of an overall recovery program. 1 The program is formally called the List of Disassociated Persons. The provisions of the program can be found at 11 DSR 45-17, et. seq. This rule is also available on-line at http://mosl.sos.state.mo.us/csr/11csr/ 11c45-17.pdf. You will need Adobe Acrobat to view this document. 2 Section 313.813, RSMo. 3 The provisions of this rule can be found at 11 CSR 45-17.015. 10 Many problem gamblers A nd that blocking the direct marketing efforts of the casinos and the consequence of being arrested for trespassing are helpful components in their ongoing recovery. Fur- thermore, applicants to the program can request a referral to free counseling. The MGC employs a full-time Problem Gambling Programs administrator to act on behalf of problem gamblers, their families and friends. Mis- souri is believed to be the only state in the nation whose gaming regulatory agency staffs a full-time problem gambling advocate. During 2001, the MGC delivered presenta- tions throughout the state to heighten awareness of the warning signs and risk factors of problem gam- bling, as well as the resources available in Missouri for problem gamblers and their loved ones. MGC staff members also provided exhibits at workshops and conferences throughout the year to distribute informational material on the Alliance 9 s programs. Throughout the year, the MGC provided assistance in funding, researching and developing the exciting new c All Bets Off d in-school addiction awareness program, as well as the older adult awareness campaign that was formally launched in August. MGC 9 s redesigned Web site features expanded information on problem gambling and the voluntary exclusion program. The site includes the history of the program, frequently asked ques- tions, information on how to apply to the program, a sample application for placement on the List of Disassociated Persons and links to the list of cer- ti A ed compulsive gambling counselors in Missouri and other problem gambling Web sites. The MGC is a member of the National Council on Problem Gambling as well as a charter member of the Missouri Council on Problem Gam- MISSOURI LOTTERY Heightens Role In Alliance Senior adults are the targets of a new aware- ness program introduced by the Missouri Lottery during Responsible Gaming Education Week activi- ties in August. The new campaign is the third such program produced by the Lottery in its efforts to increase awareness of the helpline number and the availability of free treatment. In its role as a founding member of the Missouri Alliance to Curb Problem Gambling, the Lottery has taken on the responsibility of building public awareness of the Alliance 9 s various programs. Each year since the Alliance began in 1997, the Lot- tery has expanded its problem gambling awareness program. c We 9 re proud to be playing such a vital role as a member of the Alliance, d said Gary Gonder, director of communications for the Lottery and chairperson of the Alliance. c We 9 re constantly look- ing for ways to help enhance the Alliance 9 s programs and increase awareness. d In A scal year 2002, the Lottery 9 s responsible gaming awareness budget is expected to increase by more than 10 percent over the prior year 9 s budget. During 2001, the Missouri Lottery was instrumental in creating and implementing the in- school youth addiction prevention program c All Bets Off. d The Lottery continues to serve as the pro- gram 9 s coordinator for the Alliance. 11 Melissa Stephens and Annette Turner, MGC staff, working a booth during the Governor 9 s Conference on Aging. Also during 2001, the Lottery updated per- manent billboards in Kansas City and St. Louis that publicize the 1-888-BETSOFF helpline number. Other billboards in both cities will continue to carry the helpline message on a rotating basis. The new senior adult awareness program was created by the Missouri Lottery with input from members of the Alliance and the Missouri Division of Aging. The campaign includes posters and bro- chures. The Missouri Lottery also continues to maintain and update the Alliance 9 s Web site, which was created last year by the Lottery. The Web site at www.888BETSOFF.com provides Internet users with information on how to seek help for gambling problems, along with information about the Alli- ance and its activities, frequently asked questions, resources and links to other problem gambling sites and organizations. The Lottery also paid radio and television stations to play the 30-second informational public service announcement during Missouri Responsible Gaming Education Week 2001 in August and at var- ious other times during the year. The Lottery 9 s responsible gaming program also includes: " Placement of stickers stating c Players must be 18 or older d are on all numbers terminals and Instant Ticket Vending Machines at retail loca- tions; " Printing of c Players must be 18 or older d mes- sages on the back of Numbers Game tickets and Scratchers tickets; " Promoting the 1-888-BETSOFF helpline number through placement of posters and bro- chures in 5,000 retail locations; " Printing reminders that players must be 18 or older and play responsibly messages in the Lot- tery 9 s publications, including a player newslet- ter, a retailer publication and the Lottery 9 s fact book; " Attending conferences and workshops to raise awareness of problem gambling issues and the free help available to problem gamblers and their families; " Creation of and maintaining adequate supply of public awareness posters and brochures for Alli- ance members; 12 " Creating and producing an informational video for the Alliance; " Exhibit and present at conferences and work- shops; " Conducting problem gambling sensitivity train- ing for Lottery employees; " Featuring the helpline number and responsible gambling messages regularly on the Lottery Minute, which is broadcast on more than 70 radio stations throughout the state; " Featuring the problem gambling helpline and responsible gaming on the Lottery 9 s game show, c Fun & Fortune d ; " Include a c Play Responsibly d message on all Lot- tery products; " Development of a Code of Ethics for Lottery advertising; and " Continued charter membership in the Missouri Council on Problem Gambling Concerns Inc. to further promote problem gambling education to anyone who gambles in Missouri. MISSOURI RIVERBOAT GAMING ASSOCIATION Bolsters New Helpline and Adds New Programs The Missouri Riverboat Gaming Associa- tion (MRGA) funds 1-888-BETSOFF, a statewide telephone crisis line and referral service for problem gambling. The telephone line provides immediate crisis response and referral to the statewide network of outpatient gambling clinics and certi A ed compulsive gambling counselors. The telephone line is managed by Life Crisis Services, a provider of quality interven- tion services, primarily by telephone, with emphasis on caring support for callers and treatment referrals. The MRGA is the trade association of the commercial gaming industry in Missouri. MRGA 9 s casino membership is: Argosy Casino in Riverside, Casino Aztar in Caruthersville, Harrah 9 s St. Louis in Maryland Heights, Harrah 9 s North Kansas City, Mark Twain Casino in La Grange, Isle of Capri Casino Boonville, Isle of Capri Casino Kansas City, President Casino on the Admiral in St. Louis, St. Jo Frontier Casino in St. Joseph, Ameristar Casino Kansas City and Ameristar Casino St. Charles. Each of these facilities is licensed by the Missouri Gaming Commission to conduct casino-style gambling. MRGA member A rms have speci A c pro- grams designed to address responsible gaming issues at their facilities. All Missouri riverboat casino companies have an employee designated as director of responsible gaming programs. MRGA 9 s Responsible Gaming Program is comprised of three components: " Project 21, which addresses underage gam- bling; " Operation Bet Smart, which focuses on compulsive gambling; and " Alcohol awareness programs to promote responsible consumption of alcohol. The goals of these components are to create awareness inside the various casinos, get employees involved in addressing the issues, create awareness outside the casino and in the communities and pro- vide resources for those who need help. There are a variety of tools used by MRGA member A rms to create awareness of responsible gaming issues. 1-888-BETSOFF is displayed on MRGA casino posters and pamphlets produced by the Missouri Lottery in strategic locations through- out the property. All Missouri casinos display post- ers communicating key messages in high traf A c, customer areas and employee back-of-house areas. These areas include casino entrances, ticket counters, cashier cages, cash access machines and employee break rooms and time clocks. Additionally, depend- ing on appropriateness, responsible gaming messages are communicated on boarding passes, electronic advertising, newspaper advertising, telephone hold messages, hotel television (in-house channel), video wall messaging and promotional offers. All Missouri casinos participate in innova- tive new self-exclusion programs being offered by companies that own the free standing kiosks that are generally recognized by gaming patrons as c cash advance d machines. These programs allow guests to exclude themselves from obtaining a cash advance through the company 9 s cash devices. Casinos have developed programs that allow patrons the option to prohibit the gaming company from using identifying information for marketing purposes. All casinos provide employees with infor- mational training on responsible gaming subjects. Missouri casino companies have a mission statement illustrating the purpose in deterring problem and underage gambling. Recognizing the importance of 13 getting employees involved early, responsible gaming is part of orientation for all new hires. The training programs teach a wide range of responsible gaming issues, including how to identify the signs and symp- toms of problem gambling, tips on spotting under- age customers and ways to prevent intoxication in the serving of alcohol. All casinos participate in initiatives to inter- vene with intoxicated guests. Each property partici- pates in a designated driver program or arranges cab rides as needed. Several companies have extended their server-training programs to valet parking employees. As a last step for patrons who refuse inter- vention, local police authorities are noti A ed. Unlike many other gaming jurisdictions, Missouri casinos do not serve free alcoholic drinks on the casino B oor. Furthermore, all alcoholic beverages must be purchased with cash, which results in a transaction that assists the server in assessing the sobriety of the guest. A variety of other methods are utilized to communicate responsible gaming issues to employees including employee newsletters, B iers and employee contests. The American Gaming Association (AGA), a national trade association of the gaming industry, publishes the Responsible Gaming Resource Guide and PROGRESS (Promoting Responsible Gaming Resources and Education Standards) kit, which encourages the development of industry-wide pro- grams and policies. In response, MRGA has adopted the AGA 9 s voluntary advertising guidelines. Materials such as the Responsible Gaming Resource Guide and the PROGRESS kit are incorporated into the train- ing provided to all casino employees. Additionally, AGA promotes research in dis- ordered gambling and underage gambling through the National Center for Responsible Gambling. Sev- eral Missouri casinos provide ongoing A nancial sup- port for the research by the National Center. Mis- souri casinos recognize that dealing with disordered and underage gambling is not only the right thing to do, it is also good business. Finally, MRGA encourages patrons to estab- lish their own limits and provide direction to others by developing a set of personal guidelines to deter- mine whether, when and how much to gamble. Per- sonal guidelines should be developed with the fol- lowing precepts in mind: " The decision to gamble is a personal choice; " Gambling is not essential for having a good time; " What constitutes an acceptable loss needs to be established before starting to gamble; and " There are times when people should not gamble. 14 Alliance Member Representatives and Contacts Chairman: Gary Gonder, Missouri Lottery Vice-Chairperson: Mike Ryan, Missouri Riverboat Gaming Association Secretary: Melissa Stephens, Missouri Gaming Commission Missouri Alliance to Curb Problem Gambling PO Box 104591 Jefferson City, MO 65110 www.888BETSOFF.com Missouri Council on Problem Gambling Concerns Inc. Keith Spare Director 5128 Brookside Blvd. Kansas City, MO 64112-2736 Phone: (816) 889-4662 Fax: (816) 861-5087 E-mail: keithspare@aol.com Missouri Department of Mental Health: Division of Alcohol & Drug Abuse Dewey Price Jeanne Galliher Mental Health Manager, Clinical Review Program Specialist 1706 E. Elm St., PO Box 687 1706 E. Elm St., PO Box 687 Jefferson City, MO 65102-0687 Jefferson City, MO 65102-0687 Phone: (573) 751-4942 Phone: (573) 751-4942 Fax: (573) 526-5950 Fax: (573) 526-5950 E-mail: mzpricd@mail.dmh.state.mo.us E-mail: mzpricd@mail.dmh.state.mo.us Missouri Gaming Commission Kevin Mullally Melissa Stephens Executive Director Problem Gambling Programs Administrator 3417 Knipp Dr., PO Box 1847 3417 Knipp Dr., PO Box 1847 Jefferson City, MO 65102-1847 Jefferson City, MO 65102-1847 Phone: (573) 526-4080 Phone: (573) 526-4080 Fax: (573) 526-1999 Fax: (573) 526-1999 E-mail: kmullall@mail.state.mo.us E-mail: mstephen@mail.state.mo.us Missouri Lottery Gary Gonder Shelly Perez Director of Communications Responsible Gaming Program Coordinator 1823 Southridge, PO Box 1603 1823 Southridge, PO Box 1603 Jefferson City, MO 65102-1603 Jefferson City, MO 65102-1603 Phone: (573) 751-4050 Phone: (573) 751-4050 Fax: (573) 751-5215 Fax: (573) 751-5215 E-mail: gondeg@molottery.com E-mail: perezs@molottery.com Missouri Riverboat Gaming Association Mike Ryan Adoria Adair Executive Director Chairman, MRGA Responsible Gaming Committee 6609 Clayton Road Suite 2 West IOC 3 Kansas City, 1800 E Front St St. Louis, MO 63117 Kansas City, MO 64120 Phone: (314) 721-7704 Phone: (816) 855-4203 Fax: (314) 721-1717 Fax: (816) 855-4247 E-mail: mrga@swbell.net E-mail: Adoria_Adair@islecorp.com 15 Important Web Sites Missouri Alliance to Curb Problem Gambling www.888betsoff.com Missouri Department of Health and Senior Services www.modmh.state.mo.us/ada/facts/gambling.htm Missouri Gaming Commission www.dps.state.mo.us/mgc/index.htm Missouri Lottery www.molottery.com Missouri Riverboat Gaming Association www.mrga.org National Council on Problem Gambling www.ncpgambling.org National Institute of Mental Health www.nimh.nih.gov/ Gamblers Anonymous www.gamblersanonymous.org Gam-Anon www.gam-anon.org Responsible Gambling Council (Ontario) www.responsiblegambling.org Women Helping Women Recovery Newsletters www.femalegamblers.org National Senior Problem Gambling Task Force www.seniorproblemgambling.org Institute for Research on Pathological Gambling and Related Disorders www.hms.harvard.edu/doa International Center for Youth Gambling Problems and High-Risk Behaviors www.education.mcgill.ca/gambling The WAGER (Weekly Addiction Gambling Education Report) www.thewager.org 16 Missouri Alliance to Curb Problem Gambling PO Box 104591 Jefferson City, MO 65110 www.888BETSOFF.com

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