All right. Good morning everybody. My name is Enrique Suniga and this is a meeting of the Gaming Commission. Today is July 26, 2018, and this is meeting number 248. Chairman Crosby and Commissioner Cameron are away in what turned out to be a working vacation, but we have them dialed into the phone. I need to establish that you can hear us okay. Chairman Crosby, can you hear me? I can hear you fine, but I don't see the light stream up. Is it on? Oh, here it is. I got it. It's a delay. It will be on a delay for about 30 seconds. Yes. It's running for the line. The video streaming has a few seconds of delay, so our advice, Chairman, is that you listen to the conversation on the phone and mute the stream. Commissioner Cameron, can you hear us okay? I can hear you loud and clear, Commissioner Suniga. Very good. Commissioner Stebbins, can you speak into the microphone to see if they can hear us okay? Probably can. I think they can now. Okay. All right. Okay, so we've established that you can hear us all votes. If we have any votes as the regulations require, we'll be taken by roll call, and we'll proceed accordingly. Okay. So first, the second order of business is, I suppose, administrative update. We don't have minutes for this meeting? No, because we just did a meeting last week. Last week, okay. All right. So the item on the agenda begins with Director Petrosian. Good morning, commissioners. Good morning. So my general update, I will tell you there is no other update right now other than the MGM opening. And staff continues to work diligently. I think staff is starting to spend, I will start to spend more time out in Springfield, certainly as August rolls around. I anticipate that we will have a meeting next week out in Springfield. And that meeting will, I hope, culminate in a potential vote by the commission to delegate commissioner Stebbins with the authority to issue a temporary certificate of occupancy later in the month when certain preconditions are met by MGM. But so just to give you and the public a heads up, I anticipate next Thursday, August 2nd, a meeting potentially starting early afternoon around lunchtime. That will be the culmination of staff's presentation work on checking on license conditions, RFA-2 conditions, regulatory gaming competitions, all those, the commission that would give them, empower them, hopefully to delegate to commissioner Stebbins, that authority. And do you want to clarify for the record the certificate of operations is what you meant to say? Yeah, did you say occupancy? Yeah, no occupancy. Occupancy is by the city of Springfield. Good news is we're not in that business. Yeah, you're right. Operations, gaming operations. We will issue the certificate of operations. Absolutely. Thank you. Can we take a second? Yes, go ahead, chairman. I can't hear that very well. Is there any way that can be... Can you hear it? It's not as clear as the commissioners, but I can't hear it. They need that... Hold on one second. Yes. I think we discovered the source. It's the speaker of the phone. Try that now. Without paraphrasing the commercial, can you hear me now? Yeah, that is much better. Okay. I will very briefly go over what I said, which is staff is working hard and we're spending a lot more time out in Springfield. And we anticipate a meeting next Thursday, which staff would present to the commission all the regulatory license conditions, commitments, regulatory gaming preparations and everything which we anticipate would empower the commission to make a decision to delegate to commissioner Stebbins, the authority later in August to issue a temporary certificate of operations for the gaming establishment at MGM Springfield. So that's what we anticipate happening next Thursday, August 2nd. Thank you, director. I actually... We have a practice of recognizing our elected officials whenever they attend our meetings. Yeah, so there are representatives from Senator Brady's office here today. Excellent. Thank you very much. Thanks for reminding me of that. Thank you. Yep. So, which leads me to the next item, which is the... We had received a letter from representatives of MG&E, which you remember was an applicant for the Region C commercial license. I think I had updated the commission that we had received that letter in June. I anticipated potentially addressing it sometime later, sometime in July. I know for the calendar we're still in July. And what I had done is I had asked staff, when I say staff, I mean the legal department to look at both the legal, some of the legal and policy issues involved in that direct letter's request and sort of the implication of Region C again. So what I'd like to do is you have a memo in your packet from our legal counsel. I'd like to turn it over to General Counsel Blue to explain some of staff's thinking at this time. Good morning, commissioners. You have in your packet a memo from me and my team. In the memo outlines the process by which Region C was considered. It was very instructive to go back and look at some of that to realize how long we considered Region C. And then attached to the memo is a list of items that the commission may want to consider. I think just as a practical matter, the way the commission awards a Category 1 gaming establishment license is in our regulations. It's very specific. The regs are drafted to require a competitive, open kind of process with an evaluation of the long and detailed application that we have. We do not at this time have a process in our regulations for a reconsideration or the award of a license in a process that may be different from what we already have. So that's kind of the fundamental starting place. Other than that, you'll see from our memo there are a lot of things that have changed in the region. There's a lot of things that we understand a little bit better or differently now that we've been through the process of opening PPC and now getting close to opening MGM. So I put that out there for your consideration. Whatever you determine you'd like staff to do and you'd like us to proceed, we would be happy to do that. Thank you. Yeah, we have received that letter from MGE that you outlined, Director. I found your memo very helpful. I want to go around and get comments from my fellow commissioners on this matter. Commissioner O'Brien, do you have some thoughts on these documents? In terms of where we stand today and in light of the memo, my recommendation would be to set this for a time in the fall when we can truly ask questions of the process and come up with a plan for how to go forward. I didn't quite hear that question. My recommendation with everything that the commission has before it for the summer would be that we set a date to have a further discussion on process about this letter in the fall. Sometime in September would be my suggestion. In other words, start thinking about a process at a later time. A process or a response. Or a response. Commissioner Stevens, do you have any thoughts on the contents of the memo or the letter? It was an interesting letter for us to get. Certainly, I don't think the message has been lost on us. I know former Commissioner McDonald, being a Southeast Native, would continue to raise the question with us of what about the Southeast region of Massachusetts and, again, not being left behind. I think we all take that into consideration. I know this is not up for a vote, so I think to Commissioner O'Brien's point, there's no action we can take on either the request or future steps for us to take without, again, kind of shifting this down the road to another meeting. And, again, hopefully after we can move past the opening of MGM so that staff can turn their attention to a lot of the work and questions that were raised in General Counsel Blue's memo. Personally, I have several areas of concern within the request that we got from MGMU's legal counsel. You know, I'm more than happy to take those up at the appropriate time. I don't think there's any harm with raising whatever issues are on your mind. I think it clearly makes sense. We've got our hands full till September for any significant work having got cleared. But it was only wrong with doing whatever, but we've got some of the issues now. Commissioner Cameron, do you have other comments in addition to what, do you have comments on this matter? I do, Commissioner. Like you, I found the staff memo helpful and I certainly, I know that we're not voting on any of this, but I certainly agree with many of the recommendations. You know, it's been a number of years and I certainly think that would lend itself to a new gaming market analysis of the region as well as the analysis of what is happening here in Massachusetts. So, I mean, I suppose through a number of these issues that they recommended, but I certainly agree with most of them. Many, many things have changed. The environment has certainly changed. The gaming environment, and I think a review would be a very good place to start. Overall, I don't think the many of the circumstances that caused us to deny that license have changed from now. So I'm just giving that as a thought that I just, you know, the saturation point is always something we're looking for and what's best for the Commonwealth. And as we all know, we did not have a competitive environment in Regency and there were many factors for that, but I think doing this analytical work will help us form an opinion on how to move forward in Regency. So I think many of those steps would be necessary for us to have a better view of the environment now. Right. There's certainly a lot of things that have changed outside, even outside of the gaming region of Massachusetts, but in our contiguous states that bear into a lot of these, the discussions that we had back then. So I just want to back up a little bit. The people from MG&E do say, we do point out that we had issued a public statement relative to having a public discussion on this matter later time, which is what they're asking us to do now. Do I get a sense from commissioners that this is something that we would want to schedule for a later time, like in the fall, we could conduct a public hearing, for example, like we've done in the past. We could also ask for public comment, like we have done in the past. Is this something that any of the commissioners would agree with? Commissioner Stebbins, before we go into the phone, Commissioner Stebbins? Yeah, I certainly look at this request is generating, this request generates two questions for us. I think there's a separate track of how do we reply to legal counsel from MG&E's request, and then secondly, how the commission moves forward and reconsider a lot of the questions again raised in General Counsel Blue's memo about Region C, things that may have changed, things that might be different. Certainly a public hearing or a public meeting opportunity to get some feedback and input would be merited. So there's kind of dual paths of decisions I think we need to consider. Is that along the lines of what you were also pointing out, Commissioner O'Brien? Yes, I think that as you said, there's two issues. One is a sort of discrete response to the letter, and then the other one is what if any process follows independent of that response? Absolutely, I think it's something that should be addressed at a later time with a little more definition in our part about what that conversation entails. But absolutely, public comment is always welcome. Okay, Chairman Crosby? Yeah, I had a couple of thoughts related to that. I think the idea of doing the back, the sort of the environmental scan makes sense. I don't think it would make sense to get that started at that point, putting that off. If we wouldn't use HLT, who's always done our analysis before, we could claim the question, Commissioner Zinni, who in particular are good at that, and that kind of managed the relationship with HLT. And I would think it would make sense to go off and talk to them and have them send us a proposed scope on how they would look at the issues that are raised in items one and two and get that going. There's no point in waiting until September to get that started. Maybe they could be ready by September, so we'd have that for us. Similarly, I think asking for comment now, I think the idea probably of holding a hearing is a good idea. We might want to go out in the community to do one or more as we have in the past, but I think it would be great to act, to ask for feedback now. We have a letter from Senator Brady, and we have a letter from one of the churches, but that's the only direct connection we've had other than the letter from Ask Amy, and I think it would be good for us to ask for that now. So we've got a bunch of what's going on out there. And then I talked with Catherine and Todd about this, but I think it's much worth taking a shot at seeing whether there's other commercial interests. And as everybody knows, when we spent, I guess, practically years, the last time around, trying to encourage commercial applications. And at the end of the day, there was only one company and one community that could get together and actually make an application. I had asked Todd to think about whether would there be some screener questions? Could we now simply ask for statements of interest with enough substance in the request that we could screen out the complete Mickey Mouse poses? I'm not sure we can do this. As I said, I talked about this with Catherine and Todd, and I asked Todd to think about the kinds of questions we might ask, but it would be useful for us to be determined out hypothetically. This was not necessarily the case at all. But if we turned out hypothetically that there were no other parties we expressed interest, then we might want to rethink whether we want to go through the whole R-A-T process over again with only one party interested, which would be MGMD. So that would be a third thing that if we could request statements of interest with some degree of substance, that would also prepare us for September when we get around to dealing with this. Let me just react quickly to that because this is a little bit what Council Blue was saying initially that our regulations, actually the statute, does not really contemplate for what you seem to be alluding just simply asking a statement of interest or just a flat-out reconsideration of an applicant in the past. So while the statement of interest or the scanning, the market scanning is intriguing, I would be a lot more comfortable finding a way to first analyze whether it fits with first the statute and if necessary whether we would need to change regulations to accommodate that. I mean, I think the idea is intriguing but I go back mostly to how this was set up initially and that was a competitive process that Council Blue was referring to. I want to make sure I go in the same order. I'm sorry, Chairman, did you have a response to that? Yeah, I just want to make sure I understood. Were you saying that you didn't think we could ask the requests for statements of interest within our existing rights? No, I'm saying I would first want to make sure that our legal department thinks that it fits within the confines of the statute and our regulations to do that. Okay, well that's fine. I mean, I can't see why asking for a statement of interest would be an issue we certainly as a part of our matter have that going on, you know, before we were all going around the Commonwealth asking for people to express interest in the various regions. Well, before we began the RFA-1 process I don't have any problem with checking with Catherine to make sure that fits. We will. I mean, my sense is that that expression of interest was the RFA-1 per se and the 400,000 non-reimbursable fee that the statute provided for. But the point is well taken. And we'll check with staff on that. Commissioner Cameron? Could I just finish up? I'm sorry to interrupt you, but I just had a couple of other thoughts. One was I thought that there was kind of a misimpression in the NG&E letter that was worth addressing. The letter made it sound as if the only issue that the commissioners dealt with or the principal issue by far, the controlling issue that the commissioners dealt with when we decided not to award the license was the possibility of a tribal casino. And I made a point of going back and reading our decision, and we certainly made reference from time to time to the tribal issue and whether or not the NG&E proposal properly accommodated the potential financial impact of that. But we were way, way more comprehensive in our concerns than simply the tribal issue. So I just wanted to put that on the record. That was an important... That is very important. I was going to make actually that point myself, but it bears repeating that from the letter, the NG&E people make it seem as though the only or certainly the most important factor in there not being awarded the license was the status of the tribe. And there was indeed a lot of other factors into ultimately the 401 decision not to award the license. And that's an important point of clarification for the record. I just have one more, sorry. The point that I'm trying to make is I think we can... I agree with everybody that we can't really deal with this right now in any substantive way, but we ought to get as much preparatory work done as we can between now and mid-to-late September when we can turn our attention to this full board. And that's why I'm recommending that the suggestions, one and two, we try to get that underway. But also recommendations six, seven, eight and nine are things that I think that we, the department and staff can be looking at so that there are suggested answers to those questions when we're ready to go come, say, mid-September. We're sitting in community support thinking about whether it's proper and reasonable to ask for statements of interest. Doing the recommendations one and two, getting those going, and that going as quickly as we can. Probably staff follow through on recommendations six, seven, eight and nine. I think we'd make a lot of sense. And I would put us in a position to have a really, really robust conversation when we get started rather than starting from ground up. Yeah, there's a lot that the staff can undertake. My, we'd have to check, for example, things how, whether we're still on their current contract with our consultants, for example, whether we can just extend them or we need to conduct another solicitation, for example, to do that market scan or market assessment. And, but that's, your point is well taken, that that's work that we could undertake now. So we'll turn to staff to see how we can start implementing the tasks that are more feasible to do in the short term. Commissioner Cameron, did you want to react to any of these comments or make a final point? Yes, Commissioner. I just, I guess my question is more about process here. And consensus of the commission members with regard to any work now. Is it the right time to move forward with some of this work? I think we're talking about, and maybe there will be, but there is nothing for a vote on today's schedule. But for example, a market analysis is really an expensive proposition to do it properly. And I'm just, maybe we do have a consensus to at least move forward with something like that. But I think several of these steps require, you know, a good amount of work from staff. And do we have a consensus among the five of us to move forward with that? Or would those steps be needed to discuss in a meeting?  But I'm just wondering if we're, if we really do have a consensus for timing, is this the right time to move forward with all of these steps? And I just haven't heard that from my fellow commissioners. And I'm weighing in my own mind what I think is appropriate right now. Even public comment, does the public have enough information to comment wisely or would it be appropriate for us to say, for example, you know, conduct the market analysis and then ask for, you know, public comment? I'm just, I'm just trying to figure out the process here. And what is, what is your sense relative to your, weighing into that consensus question? What is your feeling about the timing for moving on any of these all things being equal? Well, I, I frankly think staff in particular probably has lots to do between now and September. And, you know, I'm just wondering if, if, if it makes any sense to move forward right now trying to get some of these, some of these issues addressed, or if it would make more time, allow, if, if we should wait until say September after we open and then address some of these issues. I'm just, I'm just trying to be cognizant of everybody bandwidth and, you know, what the consensus is among the five of us. And I'm just, you know, I'm just not sure, you know, how I feel about it without more discussion with the five of us. Well, there seems to be one, I'm sorry, go ahead, Chairman Crosby. I just, you know, obviously I agree with Mr. Cameron, but if the staff doesn't feel like they've got the bandwidth to do like items 6-10 or 6-9, I would obviously agree with that. You know, what I'm, what I'm thinking is to the extent that we can get ourselves ready, appropriately, I think that's constructive. You know, if, if we, everything always takes longer than you think, than you think it does, I think it's a fair question, not just from the standpoint of MGE, but from the standpoint of everybody in Southeastern Mass. It's a fair question about, is it time for us once again to take a look at this? I have no opinion on it, frankly, at this stage of the game, but I think it's perfectly legitimate. And I was going to, I would have brought this up, but then, Jim, you haven't written this. I was, I was going to again take a look at that region and see and figure out what we do. So to the extent that we can prepare ourselves to be ready to go in September. Okay. Other reactions from commissioners in the room? I, I, I'd want to follow up on what Commissioner Cameron said and maybe to clarify my initial statement, which was there are two issues on this agenda item. One is the response to the letter. Two is what if any process follows. And I do think moving in depth on anything beyond what is the response to the letter prior to September is premature and presupposes something will occur. And I think the appropriate step in September is to Cameron, Commissioner Cameron's point is we come up with our response to that letter and then some consensus about what if any process follows before we're sending other things out, forbidding and other contract things about testing the market. That's, that's where I stand. Yeah, actually, and that's where I stand as well. And that probably is the beginning of that consensus emerging that Commissioner Cameron was alluding. I think you've, you've put it well, Commissioner O'Brien. Let's, let's figure out the short run is a response to the letter and let's turn it back to staff to, to do that. And, you know, we can do that in, in, in short order. But the, the way they are, the issue that is more of careful consideration. And I understand Commission Chairman Crosby's point about whatever we could do to prepare for is incumbent upon us. Is one of process and, and regulation changes or, or if necessary, or making additional commitments to consultants or studies or whatnot. Let's, let's put off that discussion until later. Certainly not before the fall is what appear, what I seem to be hearing, given that there seems to be quite a bit of focus at this time in, in the MGM opening. So if I could just summarize, I think where we are. I would direct staff to focus their attention in the near term in the next 30 to 45 days on a draft response to the letter itself, the micro issue of the letter on the reconsideration. And to the extent possible, based on the discussion today, to anticipate some of the items that then may follow into a potential broader discussion about Region C, which could be everything from what would it take to do a new market study? What if anything, if the Commission wanted to do, you know, find out what the market would bear through an expression of interest, is that something we could legally do under the statute of regulations? And if not, what changes would need to be made? And potentially maybe a series of public comment questions based on the macro issue about Region C. Is that my understanding? That is a good summary. Any other reactions? Yeah, I would only just, you know, forewarn ourselves that because we're taking up this issue right now and we always have an open MGC comments line that, you know, we may not have to wait for a public hearing before we start getting thoughtful letters, communications. I think even in the Chairman's point, we may have potential applicants who weigh in through what is just a normal comment process that we always use. So we're starting with this meeting, with this item being on the agenda, kind of restarting that conversation and probably spurring a lot of comments already from the public. We're always open to public comment. Absolutely. Any final thoughts, Commissioner O'Brien? No, I think... Is that a good talk or what? I was just going to summarize it properly. Okay. Any final thoughts? Commissioner Zaniga, just one thought. Does staff have enough, did they heard from us on enough to start preparing a response to that letter? Are there any issues in that letter that we haven't discussed that they would feel or just strictly research they will be doing with regard to items in the letter? Thank you, Commissioner Cameron. I think we're good to get started and obviously if we have any questions or preliminary issues, we will circle back with the commission. Okay. Thank you. Okay, that sounds like a plan. I think it's a good discussion. Let's move on to the... So if we could, Mr. Temporary Chairman, if we could just switch up, I apologize, items 4 and 3 and move up items 4. Director Griffin has committed to presenting an outside forum at which he'd need to leave by about 11 o'clock if possible. Okay. So you want to go to item 4? Yeah, please. At this point? Please. Okay. Thank you. Director Griffin. Good morning, commissioners. Good morning. Actually, director, just one second. Just in the event that any of the commissioners on the phone leave the phone call, please let me know so that we can reflect that in the minutes. But we'll assume that you're still on, even if you're not talking, of course. Go ahead, director. I'm joined by my colleague, I'm Budsman, John Siemba, and we're here to talk about the Boston Private Industry Council mitigation fund redesignation. And so I'm going to actually turn it over to John to set some context. Okay. Thank you, Jill. By way of background, earlier this year, the commission voted to award two workforce pilots in Region A. When we drafted the guidelines back last December, we only anticipated that we would have one workforce pilot in each region. However, given the importance of workforce development in each of the regions, the commission did move forward with two $300,000 grants. However, it was clear at the time of the award of the Region A pilots that we would need to meet with the Boston Pick regarding some of the specific grant spending categories and some of the commission's decisions regarding priorities under that grant. We have met, staff has already met with Boston Pick and they have made the request that Jill will outline for you. We also, during the meeting with the Boston Pick, we also requested that they meet with the Metro and North Regional Employment Board and that meeting has occurred as well. As you recall, when we previously awarded two workforce pilots in Region B, we asked them to coordinate as well, which they did, subsequent to our award. And I think we have some good news in that regard here. So let me turn it back to Jill. So as you remember, you voted to approve $300,000 to the private industry council grant. And the marketing and the data management staff advised that we would like to talk with the applicant following the vote and talk about the use of those funds. And so those are the funds in question. The private industry council has requested that rather than using them for marketing and data management, that they reprogram those funds to use for staff. And they indicated that they currently don't have staff capacity at this time to handle the grant management. Staff thought that this was a reasonable use of these funds for this year. Now, this is 26,765. Obviously, it's not enough for a full staff position. However, the private industry council has had conversations with other funders in the region and and has had some promising conversations about potential match of those funds. So is this request contingent on them getting matching funds or is this simply the request to release the funds? It's not contingent upon them matching funds. It's to utilize for consultant use or whatever they deem appropriate. I've had a chance to visit with director Griffin on this issue. I was encouraged by the fact that the Boston pick again, you know, you work with these entities. They have certain geographical boundaries they need to work in. Happy that Boston also put in an application. We awarded the application because obviously they covered the city of Boston, which is outside kind of the host communities regional employment or designated regional employment board. But I was happy to hear, you know, there's better alignment on projects because there's some cross-collaboration that can happen because we're all sharing certain partners. So I'm glad that they're like making some programmatic alignment through all this. I compliment them on kind of getting the administrative cost down to where it is. It now reflects less than 10% of the award, which I think is great. It certainly allows for more money to be put out for the programmatic use.  So I'm glad they're making this happen with this request. I'm glad that they're also pursuing some other money. And, you know, as I said before, I still think it's a great news story for us to think about. $300,000 award to Metro North, $300,000 award to the Boston Pick in leveraging other cash and in-kind contributions we're putting close to about a million dollars on the street for workforce development for not only our licensee, but for the community. So I think that's even a I think that's an incredible news story. So I wholeheartedly support your recommendation. I think it's great and great work to you and John for bringing the parties together. Thank you, Commissioner. Commissioner O'Brien, I wanted to just follow up on your question about the contingency. I had a conversation with the funder in question. They need to bring it before their board like we are doing today, but it sounds very promising. So I want to let you know that. And thank you, Commissioner Stebbins for bringing up those points about the meeting and the collaboration. We're very encouraged. And I did want to emphasize that the staffing we think appropriate for this year in future years, we're hoping and expecting that the two you know, if they decide to reapply in the future that they would come together as a single applicant as like what happened in Region B. But they had a promising meeting on the 24th of July. They talked about collaborating together to convene all the career counselors in the region to talk about and get updated regarding the on-core jobs and to talk about general hospitality needs of other employers in the region. They talked about training funds and best leveraging all the training funds. And they talked about collaborating for outreach and community engagement and opening up training programs for all in the region. And developing a regional sector focus for hospitality. So we're very encouraged and think that reprogramming those uses with these collaborative efforts would be a really good use. Thank you director. Any reactions from us on this topic? Thank you. Commissioner Cameron? No, I agree. Collaboration is what everyone has been hoping would happen and sharing those funds and as director Griffin just explained. Sounds like a positive step. Thank you. Yeah, it's great when there's different groups trying to strive for a common goal. We really encourage efficiencies through collaboration so I'm glad to see that in the future. So is there a motion from the request or any other discussion? If there's no other discussion I'd move the commission to approve the use of $26,765 of the previously approved $300,000 grant to the Boston private industry council towards a staff and consultant position. Thank you. Commissioner Stevens? Commissioner, is there a second? Second. Okay. Motion is made and second. I'll go now in roll call. Commissioner Stevens? Yes. Commissioner O'Brien? Yes. Chairman Crosby? Yes. Commissioner Cameron? Yes. And Commissioner Zuniga votes yes. The ayes have it unanimously. Thank you. Great work. Okay, the next item on the agenda would be director van der Linden. Is there a need or time to set up a motion? Roll set. Commissioner Zuniga? Yes. I want to watch this presentation with the video as well as the audio which I can't do when I'm hooked up live with these votes. We don't have any more votes to vote, right? No. We don't have any more scheduled votes. Right. So I do want to watch the presentation but I'm going to sign off and I'll be back in a moment. Okay. So we should note for the record then that chairman Crosby is leaving the meeting although he will be watching the stream because he's clearly interested in the topic. Thank you chairman. Director van der Linden? Great. Good morning commissioners. Good morning. Good morning. I am joined by doctors Heather Gray and Debbie LePlant from the Cambridge Health Division on Addiction. I've worked with both of these fine people for the past several years now in evaluation of various responsible gaming programs including the GameSense program which will be presented to you today as well as Play My Way and the Voluntary Self-exclusion Program. So thank you for coming. As you know in 2015, Plain Ridge Park Casino opened up and with it came the very first GameSense program information center in the United States. At the GameSense Information Center patrons can access a variety of information intended to increase informed player choice including how games work, the probability of winning and explanation of house advantage and tips and tools to promote positive play. The information is available in a variety of different formats but probably most powerfully is when it comes from the knowledgeable and friendly GameSense advisors who have been there since the beginning 16 hours a day, 7 days a week. Our responsible gaming framework that the commission adopted is recently version 2 just recently a few months ago in version 1 back in 2014 adopts an evidence-based and precautionary approach. Basically saying where evidence exists we will use that evidence and we will implement programs that are in line with that evidence-based approach. However, where there is an element of risk and a potential for harm we won't sit back and wait for evidence to emerge we will use a precautionary approach. Basically that the lack of scientific certainty should not and will not be a reason to postpone measures to prevent harm. The GameSense program is really an example of our implementation of this precautionary approach. When the commission first adopted GameSense and moved forward to the GameSense Information Center while there was promising evidence that moved us in the direction of adopting this program including that it went very well with the commission's overall agenda and mission the evidence was uncertain or it was in its beginning stages. So we took what I feel like a very aggressive step to evaluate this program. What you will hear today is the accumulation of basically four evaluation efforts. The implementation is very interesting and I think that it's very promising to me as we continue down this road with GameSense. We'll use this the information that's presented today as we begin to as we continue to think about how do we improve the GameSense program what steps do we need to do to help our GameSense advisors be more successful more effective in the work that they're doing. And so with that I think I will go ahead and turn this over to Dr. Gray Dr. LaPlante. Good morning. That's even better. Good morning. On behalf of Dr. LaPlante and the Division on Addiction I'd like to thank the commission for inviting us to do this research and to present on it this morning. I'd like to start with a little context for the GameSense program and Director Vanderlin covered some of this so I'll be brief. As you know in 2011 Massachusetts Pass Expanded Gaming Act and that act included several mandates designed to mitigate potential harm that might come from expanded gambling opportunities and one of those was the requirement for on-site complementary substance use compulsive gambling and mental health counseling. Just about three years after that the commission adopted the GameSense brand to fulfill this requirement and it required that all new gambling venues would provide space for a GameSense information center to be staffed by the Massachusetts Council on Compulsive Gambling. In the spring of 2015 you contracted with us at the Division on Addiction to evaluate GameSense and the other responsible gambling initiatives. As Director Vanderlin mentioned those include the Play My Way Voluntary Budgeting System and the Voluntary Self Exclusion Program. Shortly after that Plain Ridge Park Casino opened and with it opened the very first GameSense program in the United States. Massachusetts was a real leader here. Just this past year as you might know MGM implemented GameSense throughout its properties in the United States. So we took the first six months after Plain Ridge Park opened to develop a system for evaluating the program. We worked really closely with the GameSense advisors and their partners in this along with Director Vanderlin and Theresa Fiori. So we used a lot of feedback from the GameSense advisors on how this system should work. They were willing to try lots of different things. And really the focus in these first six months was developing a system for the GameSense advisors to classify the interactions they were having with patrons on the floor and others. From 2015 to May 2016 we had our first wave of data collection and that became Report 1. Shortly after that started the Sigma team went into the field and did their first survey of Plain Ridge Park patrons. And they followed that up with another survey in the summer of 2016 that actually became part of that became our third report. In August 2016 we made some refinements to our data collection system and launched our second wave of data collection which also lasted six months. That became the basis for our second report. In May 2017 we conducted a survey with Plain Ridge Park employees that became our fourth report and then just last month we delivered our comprehensive evaluation of GameSense. And that brings us to today. Dr. Can I just make one observation? This commission you made it seem in your remarks that we adopted GameSense exclusively to fulfill the requirement of the on-site space for substance and mental health. But that was not our intention. Our intention was to adopt GameSense for the higher goal in the same paragraph in the legislation which includes a number of strategies public health strategies and the overall mitigation of potential harm. Just wanted to clarify that. So now I'll get into a little bit more detail about our four reports. The report once summarized those first six months of data collection and it included two sources of information. The first were checklists or computerized records of services that GameSense advisors provided.  And then we also wanted to get the impressions of the people who were using the program. That included mostly patrons playing rich park staff and others. And so those became our visitor surveys. Report two took the same form as report one except whereas in report one we focused a lot on the user's satisfaction with the program. In report two we turned more to their thoughts and behavior surrounding responsible gambling. The report three as I mentioned was our analysis of Sigma's patron intercepts. We only focused on the GameSense questions. And report four was our analysis of our playing rich park casino employee survey. So we situated all of this work within the re-aim framework and that's a way to conceptualize the impact of a public health program. And you can see it includes five dimensions which together spell the re-aim. The first dimension is reach and that's the question of whether the right people are receiving the program. Effectiveness is it working as intended? Adoption, is it being adopted in the right settings? Implementation, is it being implemented in the way that it was originally intended? And finally maintenance, is it being sustained over time? As you'll notice in our presentation we focused mostly on the first of these dimensions, reach and focused slightly less on effectiveness just given the nature of the work that we did. So it's important if we are studying effectiveness to know the intended purpose of the program. And so here you see a section of the 2014 responsible gaming framework and that stated that the game sense was designed to serve as the patron's central point of contact for inquiries and enrollment into voluntary responsible gaming programs and services including self-exclusion programs play information and management systems and educational tools to assess play risks provide responsible gaming tips and increase players' knowledge of how games work while dispelling common gambling myths. And that last part is important because we know that there are a lot of gambling myths that can contribute to gambling related problems. So it's important to try to dispel those when possible. And this framework evolved as you know there's an updated version of the responsible gaming framework that came out in May of this year. Again game sense is in this framework designed to serve as a central point of contact and this framework adopts a relatively new term of positive play and that is defined in the framework as gambling within personally affordable limits being honest with oneself and others about one's gambling and not being significantly negatively impacted by belief in luck or other superstitions. So now I'm going to turn more towards our methodology. As I mentioned we spent about six months working closely with the game sense advisors on developing a system for them to categorize their interactions and this was a system that we developed and that we are confident in as of December of 2015. So they had four games when they came to classify their interactions one was simple and this often includes something as simple as giving directions to something inside the casino or providing a greeting maybe someone comes to the game sense center to take a break to get a bottle of water and doesn't go beyond that. Instructive is when a game sense advisor delivers information about responsible gambling or problem gambling to the visitor that's usually a patron but could be someone else and it's a one way interaction. The game sense advisor giving information but it's not a conversation. Demonstration is just what it sounds like. So for instance the game sense advisor might use a demonstration of pulling a marble out of a bag and then putting it back in and you'll get slot machine play is independent from one play to the next and not like a conveyor belt where if you just wait long enough then you'll get the win. And finally exchange was the most substantive kind of interaction and that was a real conversation between a game sense advisor and a visitor about responsible gambling or problem gambling. There's a lot of information about what those terms meant and we actually did a lot of training to make sure they understood all of these categories. Now all of the surveys that I'll be presenting today from reports one and two come from visitors who had exchange interactions. So at the direction of the commission we only surveyed visitors who had this kind of interaction with game sense advisors and we want to be cautious in stating that the results of our visitor surveys don't necessarily generalize to people who only had the other kinds of interactions. Okay so now I can start to get to some findings starting with report one. We found that in the first six months of data collection the game sense advisors recorded 5,659 interactions and that translates into about 31 interactions each day. We asked how many people they interacted with and the answer there was 9,342. This we know is somewhat of an underestimate because they didn't always record the number of people involved but we know there were at least that many and that translates into about 52 visitors a day. Now we got an estimate from Penn National about how many patrons were coming to the casino each day during that same window and we used that to come up with an estimate of reach. So that indicates that on average each day the game sense advisors were directly connecting with about 0.67% of casino patrons. What was the window doctor? The window the dates it was December 2015 to May 2016. So what happens when a customer comes more than once to the casino? That's part of the number. They would be counted twice but also if a visitor spoke to a game sense advisor more than once in a day that would also be counted twice. So we describe in the report that there's some uncertainty but it's present in both counts the numerator and the denominator. So now we start to look at how the game sense advisors were categorizing their interactions. We have a little glitch here. You see that they categorized their interactions 70% of them were simple and again that was something like giving directions or simple greeting 13% were instructive. The mystery category there is demonstration and that was just 1%. So when they started they didn't have a lot of demonstrations that they were using regularly that increased and about 16% were those exchange interactions where they had a real conversation. Now we have some visitor survey findings. So one of the questions we asked and we asked this of everyone who completed a survey was did you have any of the following concerns when you began your conversation with a game sense advisor? In other words, what prompted you to speak to the game sense advisor? And you can see that about 70% of them said that they were curious about game sense and this is not just surprising it was a new program. They didn't know who were these people with the green shirts and what were they all about and they wanted to find out. You can see that the other options were endorsed less often. So for instance 39% said that they spoke to a game sense advisor because they wanted to learn more about how gambling works. About 2.5% said that they wanted help or information about problem gambling and that's something that we saw often is that that more extreme level of help was not often reported. We asked did you learn about any of the following and we asked this among a smaller group of people. So 77% or so said that they learned strategies to keep gambling fun and the numbers went down from there 48.4% so they learned how gambling works. This was interesting because Play My Way hadn't been implemented yet during this wave but still 26.4% said they learned how the play management, it didn't have a name yet would work what it would be and so we think that the game sense advisors were anticipating this program and already speaking to patrons about it. Now we asked how satisfied are you with your interaction with a game sense advisor. You can see that 77.8% said they were extremely satisfied and that was the biggest category of course 16.7% said they were very satisfied. We asked as a result of your conversation with the game sense advisor will you do any of the following and they could select as many as they wanted. The most often selected answer was tell someone about the game sense info center and 56.9% of people endorsed that option. Now we have no way of knowing whether they actually did any of these things but this is at least what they said that they would do as a result of that conversation. We included both the options reduce my gambling behaviors and increase my gambling behaviors because we didn't go into this with any assumptions that it would only go in one direction. We know that public health programs often have unintended consequences and wanted to leave that option open. Now I'm going to turn to report to in this case the game sense advisors reported 7,878 interactions or about 44 a day and these interactions involved 16,993 visitors most of whom were patrons that was true in the first wave as well and that translates to about 94 visitors a day or about 1.33% of casino patrons so that's another estimate of reach in terms of how they categorize their interactions this is similar to report 1 and report 1 70% were simple and report 2 73% were simple 15% were instructive 2% were demonstration and 10% were exchange so we asked a question about how they might again this is only for exchange visitors people who had a conversation with a game sense advisor about how they might hypothetically use those game sense advisors in the future we asked if you felt you were starting to lose control over your gambling would you feel comfortable asking a game sense advisor for help and here we have a distinction that I'm introducing for the first time between first time respondents or people who completed a survey for the first time and repeat respondents who are completing a survey for the second time so you can see that among first time respondents 89% answered yes to this question 11% said they weren't sure and none said no and among repeat respondents 97% said yes they feel comfortable asking a game sense advisor for help 2% weren't sure and none said no now you might remember this question from the first round in the first round we asked will you do any of these things as a result of your conversation so we repeated that question for first time survey respondents and then we also asked it among repeat respondents to try to get a sense of do people do what they say they're going to do I'm sorry I've jumped ahead here this is a question of why they talk to a game sense advisor sorry about that so this question we see that for first time respondents similar to the first round about 77% said that they spoke to a game sense advisor simply because they were curious and you can see that that drops among repeat respondents so after people are repeatedly interacting with game sense advisors that curiosity isn't driving them anymore for the repeat respondents the most frequently endorsed option was I wanted to learn more about strategies to keep gambling fun and that was at 61.2% again you can see in the very bottom row that it was rare for people to say they spoke to a game sense advisor because they wanted information or help about a gambling problem Doctor remind me how is repeat defined here so if someone had an exchange with a game sense advisor and that person indicated that they had never completed a survey before they were asked to complete a survey and they were considered a first time responder and we knew that it was a first time respondent when we looked at the data because it was on a different color of paper and so if they had a conversation with a game sense advisor and they said yes I've already done a survey then the game sense advisor would administer a green survey and it had some overlapping questions and some new questions and so we could tell which was which so there's only one repeat yes they were only asked to do it twice at the most is that what you mean? yes the repeat only it only means a second interaction a second meaningful interaction or what was the exchange a second exchange this is an important distinction so it doesn't tell us how many times they've had an exchange it tells us how many times they've done a survey now ideally they do a survey after every exchange that was our intention with the game sense advisors in fact their response rates were really high it was 85% in round one 99% in round two wouldn't that turn off the respondent potentially? to ask them to ask them to do every time there's an interaction to ask them to do a survey an exchange would it turn them off from speaking to a game sense advisor? no from filling out the survey I already filled it out that's why we didn't ask them to do it more than twice and I think the game sense advisors were pretty good at emphasizing we know you did this before but this one has slightly different questions I would also the game sense advisors do roughly 90% plus of the voluntary self exclusions and individuals that entered into the voluntary self exclusion program through the game sense with a game sense advisor were not asked to complete a survey not for this because they were doing one for our evaluation of the voluntary self exclusion program so I just want to emphasize that in terms of the information or help about problem gambling that group that specifically came to the game sense information center for help were not counted in that category that's true and just while we're on this topic of repeat versus first time another distinction I want to make is that it doesn't tell us how many total interactions a person had with a game sense advisor so they could have had 30, 40 simple interactions and then or instructive or demonstration and then the first time they haven't exchanged that's when they first asked for a survey so their total game sense exposure if we consider all the different kinds of interactions is separate from whether their first time repeat and that'll become important in some future findings okay so now I'm getting back to the one that I already introduced and this is the question of as a result of your conversation with a game sense advisor will you do any of the following or it was worded for the repeat respondents did you do any of the following alright so here we see that 68.2% of first time respondents said I will seek out information about how to keep gambling fun and then about 54% of the repeat respondents said that they did do that after their conversation 54.3% of the repeat respondents it's the last column and then we asked one of the options was I will think about changing my own gambling behavior and 36.9% of first time respondents said that they would do that and 38.8% of the repeat respondents said that they did do that they did think about changing their gambling behavior and this corresponds to a pre contemplative stage of change if you're familiar with stages of change and how it relates to changing one's own behavior so they're thinking about making a change but aren't quite ready to do it yet just to clarify in that point the stages of change if they're pre contemplative they're not willing to consider they don't even think about making the change but the significance to me of this finding is that it's indicating to me that perhaps they're moving down through the stages of change and that they're perhaps moving into a contemplation or even preparation prior to the action stage so I would take that as a very positive finding that perhaps even if there's not a behavior change that we can measure that there is movement in the stages of change and then we also see along similar lines we see that 22.1% said that I will spend less time or money gambling and then 26.4% said that they did spend less time or money gambling so those might be even in a further stage of change yeah what I noticed from this chart and maybe this is kind of like what you're talking about is that there's one that goes down the first one the fun part goes down between the first and the repeat but the other three the responsible ones go up right? right and so it might have something to do with their reasons for going to talk to the game sense advisor more than one time in the first place so they might already have been more seriously thinking about changing their behavior and that's what prompted them to talk to the game sense advisor did we do a statistical compare? we did not so even though the percentages look like they might be going up and down it is possible that statistically speaking they're the same yes, margin of errors that's great to the next slide but hold that thought we couldn't do statistical tests on this because the surveys were completely anonymous that goes to the concern about the burden on the participants whether they would want to complete a survey if we were asked for their name so there was no way to track from one person's first time survey to their repeat survey or to know the degree of overlap okay let's look at this one okay so now we're starting to look at total game sense exposure and if you remember a few minutes ago I told you that there was account for each person about how many total interactions they had had with a game sense advisor of all four types of course we had to rely on the patrons and other visitors to give us that number their best estimate we had no way of tracking that so we started to look at the relationships between that total game sense exposure and some thoughts and behaviors so what we found among the first time respondents was that total game sense exposure was unrelated to all of the 15 responsible gambling knowledge and behavior outcomes and those would be things like whether they've used a certain responsible gambling strategy in the past year or whether they answer correctly questions about the most likely outcome of a slot machine play you know what I'll let you finish this slide but I have a question because it's to each of the findings sure so we've solved the same thing when we consider the questions that fell under their category of reactions to game sense this is more along the satisfaction questions like whether they would recommend game sense to a friend here we saw that total game sense exposure was unrelated to most of the resources and treatment knowledge outcomes except several outcomes that involved play my way so for instance people who had had more total interactions more likely to be aware of play my way more likely to be aware of their local gambling treatment resources more likely to understand how play my way works and more likely to identify correctly the purpose of play my way so for instance if you look at the question of whether they understand how play my way works the people who answered that question correctly reported about 3.5 total interactions with a game sense advisor people who answered it incorrectly reported about 1.5 and finally among the repeat survey respondents that total game sense exposure wasn't related to any of the survey responses how can you tell they're unrelated well in this case a lot of these questions were simple right or wrong answer and so we looked at the groups of people who got it right and the groups of people who got it wrong and then we looked at how many total interactions each group reported again relying on their best estimate of how many interactions they had had and then we did a statistical test to see if that count of interactions was different between the two groups and they got it right means like let's say a gambling myth or what is they're getting it right I can give you some examples if you'll bear with me just for a minute I believe so for one of the game sense questions it was maybe I'll just look at it rather than give you my best estimate let's see that's the Sydney report so a question like how does play my way work the correct answer is players set limits and get notifications when they are close to their limits that's the right answer a wrong answer will be something like players set limits and can't gamble anymore once they reach their limits what page I'm sorry I'm on page 101 another question about the purpose of play my way this question is simply what's the purpose of play my way and the correct answer is to help players monitor their gambling this is on page 103 and an incorrect answer would be to put a limit on how much people can gamble but most people regardless of their exposure answered the questions correctly right so could it could it also be just a factor of the questions that were asked and so that wasn't necessarily a very good indicator of of the impact of exposure to game sense yep we talk about the potential for a ceiling effect in the limitations in the report and in the presentation today for some of these questions there is a possibility that the the rate of answering correctly was so high that the game sense advisors really couldn't push it in one way or the other Dr. Leclerc pointing out on page 103 that of the first time survey respondents answered the question what is the purpose of play my way correctly compared to 95.3% of repeat visitor respondents so those rates of answering that question particularly were pretty high and that might be because the game sense advisors are doing a good job of explaining how the program works and then we respond to the third report Sigma surveyed 479 patrons and this is a different population we call that in reports one and two we are looking at a segment of a segment so just the people who had exchange interactions with game sense advisors here they really broadened it they opened it up to anyone who happened to be in the casino on the day that they were surveying of the casino and their response rate was 22.4% and if I may this survey conducted by Sigma the patron intercept survey the game sense questions were a small part of a much larger survey and that the original intention of that effort by Sigma was the piece about trying to understand where players are coming from whether they're coming from out of state or in state and what their spend is and so we found that the casino and then their surrounding area and at the end there was a series of questions about game sense knowledge and exposure so we started the game sense section of the survey with a pretty basic question of are you aware of the game sense program we found that 56.9% were aware of the program again this is people who were on the casino floor on their way out and we asked those people well Sigma asked those people have you spoken to a game sense advisor and they found that 18.1% said yes this is another estimate of reach and that corresponds to 9.6% of all respondents and just to be clear the intercept happened at all three inferences or exits to the casino just the entrance or exit right near the game sense information center but it was a random sampling right it was one out of every six people so you have a good broad sample much broader than our visitor surveys that was a purpose and in this one we already account for the repeat factor and because they're telling us yeah because this is coming from the patrons themselves this isn't coming from an estimate provided by the game sense advisors so you might start to notice a trend here 98% so that they were satisfied with the information provided by the game sense advisor and most of them thought that their particular advisor was helpful about 91% either agreed or agreed strongly that their game sense advisor was helpful none of them disagreed 59% said they learned something new about gambling and we asked did your interaction with the game sense advisor change the way you gamble we observed that 58% said no this gets cut off a little bit but it's 20% who said yes I've changed how I think about my gambling but I have not changed how I actually gamble and 22% said yes I have changed how I gamble and if you recall back to a few slides we saw about 24% or so if people in our surveys were saying that they had changed how they gamble as a result of their conversation so highlighting some consistent findings so for the most part we didn't find associations between game sense exposure and their self-reported gambling activity on the day of the survey so I'll show you two findings here if we look at how much they reported spending on the day of the survey the people who were aware of game sense spent about the same as those who weren't aware of game sense and then the people who had spoken to a game sense advisor spent about the same as those who did not speak to a game sense advisor they noticed a slight difference there in the amount spent but it wasn't statistically significant so we'll call those even now moving on to our last report and this as I mentioned was our survey of Plain Ridge Park employees we had 258 of them complete a survey they did so at one of four Town Hall style meetings we got about 72% of people who attended the Town Halls unfortunately not all of them attended the Town Hall even though it was described as mandatory so our sample represents 52% of all the employees at that time we found that 58.5% said that they had interacted with a game sense advisor and then we wanted to dig a little bit deeper into this question of what was the conversation like and so we asked did you talk to a game sense advisor about problem gambling or responsible gambling and we saw that 33.5% had done so so presumably the rest of them had just had a casual conversation with a game sense advisor we found that most people 71.4% had never referred a patron to a game sense advisor and most of the time of those people 88.1% said it was simply because the opportunity had never come up to refer someone to a game sense advisor we found that this exposure to game sense advisors was highest among security and surveillance employees which makes sense and lowest among food beverage and retail employees we asked a series of questions to try to understand their understanding of the game sense program especially because this program was so new we wanted to know whether they understood what works and what it's all about so one of the questions was what do game sense advisors do we found that they were aware that game sense advisors are responsible for greeting people teaching people to avoid gambling beyond their limits enrolling people in play my way enrolling people in voluntary self-exclusion and helping to connect people to problem gambling or other mental health treatment but at the same time they weren't aware that game sense advisors are responsible for giving people directions teaching about odds and probabilities teaching people how to play the casino games unenrolling people from play my way and unenrolling people from voluntary self-exclusion one of the questions was who can use the game sense program so most but not all respondents understood that casino patrons can use game sense 88.9% about two months before our survey the employees at Plain Ridge Park had gotten a newsletter that specifically said that they too can use the program as a personal resource but only 37.9% knew it at the time of our survey this might be some room for improvement as far as their training and understanding of the program so we found that 42.7% of the employees correctly identified how play my way works now of course the game sense advisors themselves are mostly responsible they are responsible for enrolling patrons and play my way but there could be opportunities for other employees to discuss the program and so it's useful to know do they understand it and only 9.1% accurately identified the characteristics of the voluntary self-exclusion program at Plain Ridge Park Mark remind me if our PPC employees restricted from gambling at PPC yes I wonder if that at least potentially partially explains the low number seemingly low number of employees who think they can use it as a resource casino employees are a high risk group and I agree with Heather that's probably something that we can take a look at when we think about how we're communicating with casino employees what the purpose of the game sense program and who is for absolutely moving on we asked about employees opinions about the game sense program because again this is something they could communicate to patrons whether they intend to or not their opinions about the program could be communicated to the patrons and so we asked one of the opinion questions was do you agree or not game sense encourages people to think about their own gambling behavior and most people agree at 86% and then we balance this with potential negative impacts like game sense interferes with player enjoyment we found that 60% disagreed with that statement 18% agreed that game sense does interfere with player enjoyment and 22% didn't know employee exposure to game sense so simply have you ever spoken to a game sense advisor just it just reminded me of a finding I think it was from the first survey that talked about whether or not an enhanced their visit to Plain Ridge Park casino that I don't think that you captured in the PowerPoint an interesting contrast to that specific question or perception of PPC employees right so if you ask people who had a conversation with a game sense advisor whether it enhanced their experience that day most of them said yes okay so we looked to see whether people who had interacted with a game sense advisor responded differently than those who hadn't found that for the most part that was unrelated so but I'll highlight where it was related respondents who had ever interacted with a game sense advisor were more likely to be able to identify what the game sense advisors did understand how play my way works and correctly answer one of our questions about the independence of slot machine play but they weren't more likely to know that they can use game sense as a personal resource understand how voluntary self exclusion works sorry you won't be able to read that I don't think I can either let's see understand their own role in intervening with patients with potential gambling related problems and have positive or negative opinions about the program so if you're an employee who works and say restaurants and you've had an interaction with a game sense advisor your opinions about the program are the same as someone who hadn't that one sorry that's the last one there the one that's tough to read we asked if they understood their role in the system the questions were let's see should play my way employees try to determine if a patron has a gambling problem only half of them knew they should not try to do that it's not on here so I'll just say it and then 64% knew that they weren't supposed to intervene with someone whom they thought had a gambling problem so those are some other potential room for improvement so I think I'm at my conclusions now thanks for bearing with me through all these findings first in terms of reach two estimates of reach in our first two reports where we relied on those the census of game sense advisors activities our estimates were about 1% and about 70% of those were simple superficial and the sigma report the estimate was closer to 10% so we conclude that at least during our windows of observation interactions that directly relate to promoting responsible gambling casino venue patrons were rare so questions for you would be does this extent of reach fulfill your program goals and is the cost per patron acceptable we found across all of our reports high satisfaction with the program and with the game sense advisors another consistent finding was most respondents who had spoken with a game sense advisor reported that they had learned something new about gambling or strategies to keep gambling fun and about 20% reported changing their behavior as a result of their conversation for the most part respondents responsible gambling knowledge and behavior was unrelated to their game sense exposure that comes from report to the exception can I go back a little bit sure to the previous slide or the first one this one more yeah the way you laid out it would assume that the cost the benefit is equal to all patrons but we know that in this industry this industry heavily relies on a small piece of the population to get most of the revenues have you thought about how whether that has a cost benefit whether that has a cost benefit affecting the right people not just everybody on average but for the sake of argument the atypical player this is a term you came up with for the play my way or those at risk or those experiencing problem gambling did you analyze that is that part of a cost benefit analysis I think that this particular evaluation wasn't designed really to do a full cost benefit analysis and I think that if you were to advance in that direction that those are things that certainly would want to consider is you know who are the best targets and whether or not your reach within particular target groups goes up and down and what you want your reach to be for particular target groups I think that that's what you're saying and I think that that's something that would be really valuable to integrate into a formal cost benefit analysis right and I think that reach also needs to not be narrowly defined as an interaction with a game sense advisor but the extent at which the game sense program works across the spectrum of different types of providing information in different types of ways certainly and as I said in my opening remarks that the interaction with the game sense advisor or the game sense advisors are the heart of this program but it's not right for every patron and that game sense is expressed in the casino and for that matter outside of the casino in different ways we agree with that I think that one of the conclusions in our report is that we could go beyond just looking at game sense advisor interactions and look at reach involved with things like websites and pamphlets and other ways of information distribution you do some commercials and things like that so I think a formal analysis that incorporates all of those potential avenues would be important and our particular evaluation at this point wasn't designed to go in that level of detail but hopefully this provides some early preliminary information that points you in the right direction. Thank you. Just to mention that an exception here concerned to play my way we found that both patrons and employees who had interacted with the game sense advisor tended to know more about play my way and we think that again it goes back to the game sense advisors being really enthusiastic about describing the program and how it works and especially because our second round of data collection happened just two months after play my way was implemented so it was really on their minds and they were doing good job of describing it. I know you're also evaluating play my way but remind me or tell me this is something that I just came up on my own but is it fair to attribute the rate of usage to play my way at least partially to the game sense advisor interaction just by the number of people that sign up at the kiosk as opposed to the machine for example. It's like the under data that would be interesting. Right. Do you think play my way? We did count and wave to the game sense advisors gave us an estimate of how many people were coming up to them with questions about play my way and how many were saying good or bad things about play my way and there were a lot of conversations so I would suppose that the game sense advisors were encouraging people to enroll also they had incentives to enroll. The patrons themselves had incentives. It's one thing for me to sign up if a machine tells me but what if the person I know and I always say hi to says here we're doing a promotion. Yes. Okay so some cross report limitations as I mentioned at the outset our visitor surveys don't represent all of the casino patrons only those who chose to discuss problem gambling or responsible gambling with game sense advisors because of the nature of our evaluation we can't distinguish any causal effects we can't say that game sense did something or did not do something it would take a more rigorous evaluation designed to establish those causal pathways. Halo effects refer to the visitor's perceptions of the game sense advisors. You might remember from our first presentation here we asked not just was the game sense advisor helpful but were they knowledgeable? Were they caring? Did they listen to you? They had really high evaluations of the game sense advisors on all of those dimensions. It's possible we know from other research in this area that usually what will happen is a person has a really general either positive or negative impression of someone. You think about your server at a restaurant you either like them or you don't and then that if it's positive a halo effect where you say yes every dimension they're great at we think that's probably happening to some extent here. It doesn't take away from the fact that the visitors really liked the game sense advisors that would be at the heart of the halo effects. We talked earlier about a ceiling effect or restriction of range where if people mostly already know the correct answer then the game sense advisors would have trouble pushing it up any further. I think that might have happened with some of the questions. Some recommendations now in the report for each of the four reports we made recommendations and the commission responded to many of them as we were going and they've already for instance made efforts to increase game sense advisors clinical supervision on the basis of some of our observations they took some steps to improve a messaging to increase game sense awareness. Some current program evaluations are to repeatedly evaluate the legislative fit as the ability of game sense info centers to address substance and mental health issues remains unclear. Can I just what do you mean by legislative fit in this context? I think this goes back to the point you raised at the beginning about whether game sense is only designed to fulfill this legislative mandate or has a broader role. So if game sense has the broader role that you mentioned earlier then that legislative fit might not be so much of a question. It's just when we see in the legislation mental health and substance use issues as part of the counseling service we know from our work with game sense that that's not typically covered and so we see sort of a disconnect there. Is that what you think the legislature intended? Well, we're just basing it on what the legislation says. In that one instance, not the broader interpretation. Right. Would you have a counseling center at a casino for example? I'm not a commissioner and I don't think I would answer that question. Well, have you seen it anywhere else in the country? I don't believe so. No. Or the world for that matter. Or at least tried to. We're advocating that that happens. But maybe it's a change, maybe striking that part from the legislation if it doesn't exist. Well, we do have the power to interpret our own statute. I was thinking about that this morning. Trying to go back to the number of meetings that we had to resolve a number of policy questions. Couldn't recall whether that one came up and decided it was a group. But that just doesn't make sense. We have done a number. It doesn't. You speak quite a bit about first do no harm. I think that if we were trying to read the letter, the specific letter of that one sentence about the on-site space to provide counseling services, it would actually potentially produce more harm. But the game-sense advisors as a result of some of our earlier observations got some more training. They particularly got mental health first aid training which covers I've gone through it myself. Some of you might have as well covers a whole range of issues including substance use and mental health issues. So they might be more prepared to deal with those kinds of crises than we know. The game-sense advisors in fact currently are in the midst of a four-week orientation for the new game-sense advisors coming on and it was true with Plain Ridge Park Casino but they have extensive training and as you said they go through the mental health first aid they go through the basics of motivational interviewing problem gambling 101 and in fact advanced coursework in that they visit a GA meeting in the area they're familiar with they're oriented to the services mental health substance abuse other services that exist within the community where they're working and so while they are not clinicians or I guess that's not entirely true but most of them are not clinicians I would not envision counseling services being provided on space but they are equipped with some of the very basic skills and knowledge that would equip them to address a range of different issues that they would be presented with when a patron is in distress which is what Commissioner Stebbins was alluding to some of the earlier conversations when we decided with this program and I'll wrap up here our final set of recommendations concerned evaluation of the program so we recommend establishing objectives for instance to do with reach that can be measured and that the commission invests in measuring progress toward those objectives at Plain Ridge Park Casino and at the two forthcoming info centers I think on the basis of the data we've collected so far it's premature to conclude that Game Sense promotes positive play among most patrons or increases players knowledge of how games work while dispelling common gambling myths and that future work could document those kinds of effects by investing in randomized control trials where you assess positive play before and after Game Sense exposure Thank you again. Thank you very much. Let me go to questions from fellow commissioners, Fanny? Yeah, I would not to put Mark in the spot but you know be curious at some point talking with you and Teresa as to what the results show strategies are kind of next steps that you're going to undertake as well as you think about the site at Springfield it's going to be different than PPC it's a different layout and I know we're awaiting a presentation from you and Elaine I think in the coming weeks kind of the new roll out the new image and advertising for the program. Yeah and it's I'm really excited about some of the findings in here that it highlights some areas that I think that we can really expand on so for example the demonstration and interactive types of interactions is quite low and I think that it would highlight our need to continue to develop new games to engage patrons with keep those games fresh, keep the Game Sense advisors excited about doing those so that we could see that type of interaction grow because I really do believe that those types of interactions are effective at promoting the overall goals of the program I think that there's great opportunity in working with casino operators and both the basic training of Game Sense so new employee training of Game Sense but as well ongoing training of Game Sense up to and including really letting them know that this is a resource for the employees at the casinos there's a host of other ways in which I think that this evaluation will be really really helpful for us in moving the program and advancing it Yeah I agree with that very much the employees the reach the demonstration you know it's easy to fall into whatever the raffle that works or the marvels but somebody might just quickly say I've already seen that one and bypass it if we're trying to keep doing that over and over I think it's got to the heart of how slot machines work but you're right, thinking creatively is something we should think about Commissioner Cameron, if you're still with us do you have any comments for our group of researchers I'm going to take that as a perhaps not maybe she put it on mute or maybe Can you hear me? Yes, I can hear you Commissioner Thank you I thought it was very interesting presentation informative and Mark and Commissioner Zaniga you just made my point that I was going to make which is the whole reason for an evaluation is to then incorporate and improve the process and sharing these results with both the game sense advisors and the operators I think is a critical piece and then really tweaking what is a very good program to make it stronger and Mark just made that point and so those are my thoughts on listening to the evaluation how important it is to then incorporate the findings to strengthen the program Yeah, no I think we're all committed to the ongoing evaluation of everything that the research and evaluation of everything we do and I think there's great road map of a number of things for us to follow up on this Thank you very much Dr. Gray and the plant This is great Thank you very much Okay Does that conclude the item on there Director VanderLinden Yes it does Great Well I was thinking we might need a break but it doesn't appear we should keep the next item on the agenda because we already got through number four would be the commissioner updates I have just to real quickly Director Griffin and I were informed by the folks at MGM that it looks like October 9 which is going to be our it's expected to be our kind of last AOC meeting out in Springfield our wrap up that MGM is planning a diversity celebration post after the AOC meeting and certainly that's something that we're all invited to so certainly hope we can all add that to our schedules and again because of what I think has been a good working relationship with the skills cabinet they informed us that it appears they're going to make capital investment into Bunker Hill Community College to upgrade some of their culinary space again to help address a lot of the local workforce shortages in terms of culinary so just those two items to share with us that AOC process has been in my estimation greatly received by that community the overall community of business leaders advocates and diversity advocates the whole process and I think if you talk to MGM they want they're hoping that other stakeholders in the region can kind of pick up the example they've set and kind of carry it forward into new construction projects as the region continues to grow right and Director Griffin has done a fantastic job chairing that committee I might add Commissioner Bryan any updates Commissioner Cameron any updates on your end? I have nothing now thank you well I'll just mention that I just came from the conference the annual conference of the National Council on Problem Gambling there were we continue to be recognized as quite progressive and ahead of the pack when it comes to all the research and evaluation that we're doing of programs there were a lot of discussion around sports betting for example and the keynote speaker many in the panels on the general sessions all point to if you're going to do expand into sports betting take a look at what Massachusetts did when they expanded into casino gaming put resources for research put resources in program evaluation and harm mitigation which again continues to be just a theme for which we are recognized not just nationally but internationally there were two delegations in that conference one from Japan and one from Saipan the people from Japan came just this this week came to Massachusetts we had arranged for this in advance to that conference to take a look at the game sense center and play my way because they are quite interested in implementing those or advocating for the implementation of those programs in the newly approved Japan expansion or casino expansion secondly we met people from Saipan who want to come in September or winter for climate reasons purely for climate reasons but they want to come and take a look at the same thing same game sense play my way again approaches in the United States that have never been done before and for which we continue to take a lot of credit so I just wanted to and one last thing MGM received the corporate social responsibility award in that conference largely due to their efforts on game sense at a corporate level so even our licensees are getting some recognition quite a bit of recognition I might add on these efforts you know it's interesting this is in the first time that we've had folks visiting us from Japan in this case to look at game sense but I remember I think it was consultants came to look at how we did the process of where to award a casino license that they were here I think over a year ago to kind of explore that process with local officials so hopefully we're a good example for them to follow right well and to be fair we did a lot of what they're doing and and came up with these programs you know not on our own with the help of people who had already gone through it okay so if that's it for updates there's no other business director we're all set is there a motion to adjourn so moved motion is made and second Commissioner Stebbins yes Commissioner O'Brien Commissioner Cameron and Commissioner Zuniga votes yes for 2-0 we are adjourned thank you very much we're going to sign off Commissioner Cameron thank you thank you bye bye