tient kits or write letters to soldiers Who are serving abroad and it's it's just been a really great way for the department to get to know each other And do some volunteer activities as part of the the whole thing And finally, um, we are a finalist in the massachusetts economic impact awards, which I believe comes up in the next Week or two. Yeah So we'll we'll report back following that hopefully um We have donated 2.3 million to uh, local charitable organizations this year Um, we have even though we only had the majority of our employees start in june We were able to log to the 2,400 employee volunteer hours year to date I think One of the coolest things we've done this year is as you know Our money from the play dates was all going to be donated on the gaming side was all going to be donated to charity And so we held an event We didn't tell the six charities that we'd selected how much money we'd made and we unveiled it at that event There were also the mayor of moldon and medford were there as well And they were floored. They had no idea that they were going to get this kind of money So that was a a great way to uh To uh move past the play dates. Yeah 111 thousand dollars And and it was funny because we asked the organizations what they thought they were going to get And they said something like well, I thought it was going to be like 10 grand Right And so they were I mean the red red life was unreal Yes, oh, uh, one other thing, um Just to clarify The board of directors of wind resorts has selected with matt maddox's approval and an executive coach for him The person has been They have entered into a contract and matt has started meeting with the executive coach and really seems to like the person So I wanted to give you that feedback as well Thank you for that update Great. Well any other questions? Thank you commissioners that concludes my report Thank you. Thank you very much So commissioners, I think that yeah, I think no, I think the question is now um Do you have the um fortitude uh To do the junk at regs because it may be that we want uh some of the folks who are on court to stay during that And then take a break and go to lunch. Yep. Are you good? Yeah, I do. I do uh, probably have a couple of questions for Um Thank you, bob And thank you for your your report. Thank you very much So So we are jumping now. We're going backwards now to for b council council troese Thank you and director wells Bands All right. Good afternoon, madam chair and commissioners Uh, so director wells director band and I and um director van der linden van der linden should be here Um momentarily we're here to talk to you about the junk at regs, which you discussed a bit at your last meeting Uh, so in your packet you have two draft regulations. You have 205 cmr 134.06 Which is the actual junk at regulation Um, there's also an accompanying memo that just sort of outlines Uh, the purpose of each section, but uh, just some of the key components Excuse me The regulations require all junk at enterprises and representatives to be licensed. They require Our licensees to maintain a monthly junk activity report That would be made available to the iv upon request And they prohibit junk at enterprises and representatives from marketing to individuals on the licensees no marketing lists for the The voluntary self exclusion list So there's also a second regulation in your packet, which is the licensing regulation. That's 134.01 So that regulation just adds the solo Junk at representative that you discussed at your last meeting to the list of persons who would be required To be licensed as a key gaming employee standard. That was the one Type of license that wasn't already accounted for in the regulations So, um, I just want to point out before we get to any questions that We do have one change that we plan to make to the regulations that you have in your packet Just based on some discussions this morning So section 5b talks about the process for how the Junk at enterprises and reps would receive the names of people To which they're not allowed to market. Oh, where's that again? It's on page two right at the bottom Of the of the two page right so So the way it's written right now the process Would be that the junk at enterprises and reps would have to provide their potential marketing lists to the licensees The licensees would go through the list and sort of eliminate anyone who Fits into these categories that we've defined as not being appropriate for marketing and return the lists to Uh, the enterprises or reps, but we intend to change that and have the process be that the licensees will simply provide their Complete no marketing lists to the junk at enterprises and reps and it would include Anyone on the vsc list, but you wouldn't be able to identify from which list people had come So it would just make the process a bit more efficient And I think there were some privacy concerns about doing it that way when we talked about the last time Have those all been resolved Um, yeah, I think that the privacy concerns uh revolved in large part around the voluntary self-exclusion list Um the statute Clearly spells out that that privacy and confidentiality is of utmost importance for For individuals who sign up for the voluntary self-exclusion list I think the the solution that it was drafted by carry and the team Really does an excellent job of protecting The privacy of those on the bsc list because it combines Individuals that would be on that list With all other persons that would not be marketed to so and so that's not a masking It's not a bar that prohibits disclosure. It's just disclosure can be made as long as privacy is maintained Cur, wait Well, especially in effectuating the purpose of signing up for both lists Right. I just heard because of the privacy concerns last time I just want to make sure that what you were proposing is the new approach We had talked about that the last time And there were concerns raised about the privacy protections that are inherent in the voluntary exclusion list So I'm just looking for affirmation that doing it this way is not violating any sort of non disclosure prohibitions on that list So the point is that you raised a good point the disclosure of the name Even though the privacy will be protected is okay under the statute Is that correct? Yeah. Well, I would like the legal to answer that definitively. I believe that you know just in terms of Protecting the identity because it's it's a More than one list that's coming together that you wouldn't be able to determine whether or not this individual is on a no marketing list Whether they're on some other list or whether they're on the voluntary exclusions Right. I'm just looking to make sure that we're not technically violating anything that says you cannot disclose this name I agree if we can work the solution. I think it's a better way to do it I actually like this modification. I had a the concern on on the other way in which If the the whole purpose of signing up for these lists is not to be marketed to or invited to And if if that acts as a barrier because realistically that the operator cannot Know for sure who is on the list and has to go back and forth as to can I talk to this person or not? May may really end up being a real a real barrier. I I I believe and maybe This is this is something that we should certainly put Make a disclosure. Let's say on anybody who's Signing prospectively That the the names are going to be shared only to the extent to effectuate the the problem, which is essentially what this is Happening. I think there was a concern that There's already some people in the list that maybe did not get a notification like that And that could have been you know, we had talked about maybe needing regs I'm just thinking back to the last time we talked about it I guess what I'm saying is I like this approach better than when you've just talked about everything it I just want to make sure and get confirmation that we're not running a fowl of any statutory prohibition on the school Yeah, I'll have to confirm that but uh, I think we could See if there are more questions we could still move forward and confirm that while we're in the process, right? I like this approach as well, and I think notwithstanding the notion that the need for confidentiality I think there's There's a by necessity to execute the program to make sure that people are not marketed to you need to share those names And it's I understand that this is The beginning of the rulemaking process so we would get input on this This particular issue Which it will be really helpful if there are concerns and it gives us an opportunity to just Cross T dot the I On the precise legal question that you raise I presume carry you that's addressed here But it's important to just check that and then Look at the look at input. It's just the beginning of the process correct director wells Did you want to add? You've got competing interests of privacy and then the interests of not marketing to people who have a gambling problem So, you know, this Solution seems to be the best way to address both those concerns With giving the most privacy to the individuals Yep, just a quick question since we're on Section number five just so i'm clear on five a Number four we talk about individuals have been placed on the exclusion list. Those are people we want on the exclusion list for certain reasons But when you get down to be I just want to make sure that those are the people who are reflected in Item number one the gaming licensee is identified as being Not appropriate to receive market Yeah, so I didn't include it in the reg because that information is publicly available But I certainly can put it in if you prefer that it be in the reg as well Yeah, it's a public list. Yeah, you can check it in our website but we could we could so Setting this section aside the way that it would be written now would be that the licensee provides a list including You know, everyone who's outlined here in one through three All in one list to the junket enterprises and reps and we could include even though the information is otherwise available We could also include people on the exclusion list if we prefer it all to be We think it's to be specific. I mean the information is public, but I still would want it to be that specific and it doesn't really become a Requirement of our licensee it becomes a requirement of the junket operator to look to that list Belts and suspenders I I was wondering if the exclusion list incorporates Junkets so it only applies to The requirements of the reg on the exclusion list He's places and owners only on the casino operators not Only on the casino operators. Well, then that would that would then point to commissioner stephens point of Bringing the exclusion list into this right. Well, so The note the the marketing restrictions for the junket enterprises and reps Already they do include that they can't market to anyone on the exclusion list This would just be talking about The list the actual list that they'd be receiving from the licensee. So the restriction is already there It's just how do we want the physical so then okay, but so the commissioner stephens point we might as well include all of them in one place The vse list Obviously the the mgc manages the voluntary self-exclusion list that list is sent out to gaming licensees twice per week Gaming licensees It's explicit that they can't share that list beyond their other other casino properties that They own so they could share it with it a You know encore can share it with their property in las vegas or Plainridge park casino can share it with other pin properties But beyond it's very explicit that that that it ends right there And so it would not allow them to share actively share that list with junkets But I think that the the solution that that is presented It's not sharing the list, but it's the junkets are sharing this and removing the name That's that's all good and they're just like the last point was talking about the exclusion list Not the voluntary self-exclusion just for just for the record, which is a public list It's only has 10 people or so however many And I see no harming just including those 10 people as well as you point out How do folks that Encore exclusively doesn't want on the property. How does any of that information get shared? People who You know have a trespassing order. I mean those aren't people you want Back on the property. How does that information potentially get shared the target operator or license? It could all be a bigger list that that then that then you know Further alleviates the need for the You know the the private issues With the junkets. Yeah It sounds good So we are looking you're looking for a vote today to begin the regulatory process Are there further questions for Kerry or Karen or Bruce or Mark? If you want to add Bruce you're kind of quiet I actually just have A couple of questions just from the industry. Perhaps I can just direct to Bob and Jackie These um Yes, please You know, I'm Bob or Jackie I think Mark's gonna switch I just I just like to understand a little bit more of the of the industry These um with these representatives typically will want to market to people outside of Boston or Massachusetts, it's typically for the outside player What is your sense? It does it even matter? Sure, typically in the industry for a place like ours It would be folks that are outside of the bounds of the local region It would be a little unusual to have a rep went right in your backyard So it could be and they're all over in major cities around The United States. It could be somewhere from Chicago or Miami or wherever and those are folks that typically Traditionally don't want or not interested in working inside a casino operation, but just no customers And so this is very common in the industry As a matter of fact, there are you know reps that rep win in on core in Las Vegas And I'm sure actually many of them have already Said we'd love to do business in Massachusetts But and so we said we would you know try to advance the both the licensing and the promulgate the regs Portion so they could get in business, but it's yes very common in the industry and usually it's outward coming into us And is it typical for a junket representative to Work with more than one operator. Yes Usually not in the same market Right, so they usually they would have a preferred place in a particular jurisdiction is the norm But sometimes multiple it depends Vegas is a little bit different a place like ours, you know, it would be pretty much exclusive to us I would believe Great, thank you Great. Thanks. Excuse me any further questions Comments, do we have a motion for counselor troese Madam chair, I move that the commission approved the small business impact statement for the amendment to 205 cm r 134.01 and the new regulation section 134.06 Licensing and registration of employees vendors junket enterprises and representatives and labor organizations as included in the packet second Others in favor Opposed for sarah catherine. Thank you Madam chair, I further move that the commission approved the version of the amendment to 205 cm r 134.01 and the new regulation 134.06 Licensing and registration of employees vendors junket enterprises and representatives and labor organizations as included in the packet And authorized staff to take all steps necessary to begin the regulation promulgation process Sorry to interrupt. We may want to just modify the motion to uh with the as amended As amended and as as amended at this hearing second All those in favor Opposed five zero Four zero Thank you spirit I I suspect he would he would have been a five zero Thank you. I think that it makes sense now to I'm looking at my my timekeeper janice. Does it make sense now for us to do a break? Could could we just in terms of the afternoon session? I'm going to suggest That when we come back both for Viewers purposes and the commission's readiness purposes that we go to item number nine Which is the responsible research gaming magic report. We have a guest who's traveled That would give her the ability to present leave and then staff what they would fill up the rest of the agenda Sounds good. I I want to extend though an invitation for rachel to stay for the rest of the meeting if you would like Thank you Thank you. I think that makes great sense. I saw that you were here. So thank you very much. Um, We will convene It's 117 to quarter of two. Is that okay? 145 150 150 Sure. Thank you everyone Thank you. Austin. Uh, we are reconvening meeting number 276 of the mass chooses gaming commission Today september 12th And we have skipped ahead on our agenda Uh to item number nine research and responsible gaming director vandalin, please Great. Good afternoon commissioners Before we dive into the agenda item Looking at the massachusetts gaming impact cohort wave three. I just wanted to mention responsible gaming education week Responsible gaming education week is september 16th to 20th The theme this year is watch your time and have a game plan educational activities are being led by our gamesense advisors at At each of the gamesense info centers at all three casinos The mgc's partnered with the mass council and compulsive gambling And each of our licensees to promote the week via their social media platforms in-house signage And have purchased items to be used in gamesense info center educational activities and prizes One of them is a very nifty little watch to commemorate watch your time And the licensees have purchased these and gamesense advisors are distributing them at each of the casinos We at the end of the week typically what we do is we come back and we share some stories about events that happened during the week And um hope we can do that at a future meeting So the the presentation today. I'm joined by dr. Rachel Volver. She's the principal investigator of of this project And she's a professor at umass amherst school of public health and health sciences I'm not going to give too much of an intro because she her powerpoint is excellent But I will say this is this is a unique project And the information that it provides Is incredibly impactful Prevalence studies take a look at a given point of time and can tell you can tell you the condition as it exists I'm not and are very valuable in their own right this particular study a cohort study tracks individuals over the course of time Why is this important because we can we can kind of see how problem gambling how at risk gambling How gambling in general progresses In an individual over the course of time. We can see how problem gambling Progresses we can see how it starts. We can see how people recover from from at risk or problem gambling We can see um, what are the risks and protective factors? Um that are associated in individuals Um to help begin to craft Very specific very targeted prevention and intervention initiatives If we know what's what are contributing factors to problem gambling we can we can address that that that puts its head and shoulders above So the gaming commission now has been Investing in the study for for several years Um and it's it's especially now and with each each wave of this study We get more and more valuable information more and more specific information That can be used by the gaming commission by the department of public health by By other state agencies and by other stakeholders generally To help them better understand this issue So, um, I hope that tees it up and i'm going to just now turn it over to dr Willeberg Thank you very much mark. Good afternoon commissioners madam chair um It's been quite a while since I have presented to The commission I was trying to think when the last time was I think it was the summary Integrative report that we presented in december last year So it's a pleasure to be back in boston and to be appearing before you So as as mark indicated, I'm going to be presenting today on the results of The cohort study, uh, this is going to be looking at Results from the first three waves of data from the cohort We actually have Additional data that we'll be Hoping to present in early 2020 Which will incorporate the next wave wave four of the study And we just came out of the field with wave five of the study A little bit earlier this summer. So, you know, it's The data is piling up and we are Finally being able to sort of push out What some of the really intriguing results are So Since it's been a while and since We have at least Two members of the commission who haven't seen Any of this material before I thought I would go back to basics I want to start by giving you some definitions and and talking through a few key terms It's a It's a very scientific very scientificy Sort of report so I think it's probably helpful to understand what some of the basic Things are that we're trying to understand. I want to give you some background on how the study came to be Give you a Sense of our current status and then move into the findings and implications and future directions So if I'm if I'm talking too fast Please slow me down I've given the front part of this talk a couple of times Both to the commission and then to the public health trust fund So, you know, just slow me down if I'm talking a little too fast So mark indicated in his introduction That there's a difference between What's called a prevalence Study and what is now what we are looking at today, which is a cohort study Um the The surveys that we're doing under the social and economic impacts of Gamleon massachusetts study Are what are called repeat cross sectional studies? So they take snapshots at given points in time But they are not the same people In in the sample. So it's not the same people in each snapshot The the value of a cohort study is when you're following the same people over A period of time, they're all exposed to The same issue of importance that that you want to understand What is affecting their behavior? So in this case We are collecting Information from the same people As they all experience the introduction of casino gambling in massachusetts And the reason that's important is because it gives you much greater power to Make causal attributions. So you can actually Because you can see how their behavior changes over time. You can look at something That precedes a change in their behavior and be much more confident that that change in their behavior Is attributable to something that is behind them in time So Mark asked me when we were getting ready. He said are you going to have your bathtubs? And I was like, oh, yes, absolutely I have to have my bathtubs um prevalence of problem gambling is something that Generally everyone's concerned about when you are talking about expansion of gambling and from From the point of view of public health and from epidemiology specifically That that prevalence rate it tells you like what the level of the water is in your bathtub What it doesn't tell you is anything about What is affecting the that level of water? So if you think about You know sort of who's in the water at any one time You want to when you're developing services for those people It's important to know if it's the same people that are in that bathtub at all times Or if there's some kind of exchange such that you know, there's people who have had gambling problems But not for very long or you know, if it's all the same people in the bathtub those are people who have chronic unremitting gambling problems and Usually are considered by treatment professionals to be much more complicated cases and much more expensive to treat so the the The water level is your prevalence rate But then your incidence rate is the number of new cases or the new people that are flowing into your bathtub And then there's ways. There's a couple of different ways that Water can leave the bathtub. So there's different plugs that you can pull one is uh, if um, if people Leave the population because they've died or if they've moved out of the jurisdiction. They're no longer part of your prevalence rate another is if And this is the second bathtub because I couldn't find a bathtub that did both of these in one picture but another way for people to leave the the The group that are That are creating your prevalence rate is if they recover from a gambling problem So that's sort of like evaporation out of your bathtub and then there's also the issue of particularly people who've had a gambling problem in the past are more vulnerable to developing a problem again, and so We're very interested in the rate of recurrence You know people who had a gambling problem at time one Didn't have a gambling problem at time two, but then have a gambling problem at time three Again, these are very important pieces of information to know in terms of crafting effective and efficient interventions Another term that I like to make sure people understand or at least try to help them understand Is the term etiology And etiology is a specific area of public health research It's concerned with the causation of a particular condition and in this case How problem gambling develops and fluctuates over time What etiology lets us do is identify the risk factors and the protective factors and these in in some cases these factors can Can be modified so you can modify people's behavior You can change things in their environment such that You you prevent the their progression from Being engaged in gambling to experience in gambling harm to then having a gambling problem So moving on into a little bit of background there were Quite a number of small-scale cohort studies of gambling and problem gambling that were conducted in the 1990s for the most part And they all had some serious limitations Because of their size they tended to have very small numbers of problem gamblers enrolled in them Which limited the robustness of the findings because they were there were just a few people that were sort of in the study for a while And they were all quite circumscribed in terms of time in other words they went from anywhere from two to five years And what that means is that You might have Good information for those people, but there's not very many of them And you have good information For those people, but it's for a very short period of time So you don't know what sort of the longer stretch of their experience might be The limitations of those early studies led to the launch of a number of much larger-scale cohort studies in four countries And this slide shows you some details about those four studies I'm not going to spend very much time on this I just wanted to give you an indication that two of the studies The two in in canada in alberta and in ontario were all headed up By rob williams who's our Co-principal investigator on the on the cohort here and the swedish australian and New zealand study were all studies that i was involved in So when rob and i Were putting our proposal together to do the cohort study here in massachusetts We pretty much had a A bird's-eye view of all the mistakes and all the challenges that these other studies had run into And we were able to build I think a much better mousetrap as a result of That experience with those with those large-scale studies earlier on so Moving on to massachusetts specifically It may surprise all of you to know that there actually have been no major cohort studies of gambling in the united states Massachusetts is the very first one Another unique feature of the cohort study in massachusetts is that The change in gambling availability While this study is underway is going to be much greater than for any of the other cohort studies that were conducted internationally because of the introduction of casinos during the time that we are interviewing people That's a that's a very significant change in the gambling landscape And it's occurring right in the middle of when we are involved with these people The as I indicated just a minute ago Because we sort of knew all the challenges That these other studies had been Had encountered we were able to address those limitations But we were also able to be much more efficient Because we were building on what had been found in these previous studies So we didn't have to ask every single question. We really were able to target in And then because the cohort was actually Built from People who had participated in our baseline general population survey for sigma We actually are very synergistic across the two studies And we've been able to use data from sigma to triangulate on what we see happening with the cohort study And we've been able to take data from magic to understand what we're seeing In the in the impact study So the massachusetts gambling impact cohort study or magic Which some people hate that name, but We actually we We liked it ourselves and then it turned out that all of our participants in the study really like it as well They they feel They've really taken Great pleasure in being a member of the cohort Every time we go out for data collection I I get many many phone calls and and phone messages From people in the cohort like where's my questionnaire and aren't you supposed to be out in the field again? So they're they're very um They're very invested in the study But the study actually has Three specific goals. So the first one is to examine incidents Uh, and again, that's the the water flowing into the bathtub Um, the population that or the proportion of the population that newly develops a condition over a specified period of time And the reason this is important to understand is because new cases and relapsing cases require a different mix of services to be effective The second goal of the cohort study is to examine Stability and transitions associated with problem gambling and I'm going to be able to talk a little bit about that Today and then the the third and largest goal is to develop a full ideological model Of problem gambling in massachusetts to identify the risk and protective factors and to enable the development of Strategies to You know to promote those protective factors and to Minimize the risks So this very busy little slide Um tells you something about our current status Uh, as I indicated wave one, uh, was actually our baseline general population survey The full sample of 9,578 We selected About half of those people for to be invited to Join the cohort. Um, we selected 100 percent of five High-risk strata and then a third of our remaining respondents were from From our low-risk one low-risk stratum Wave two is actually where we established the cohort We went out in the field in uh, 2015 And completed data collection later that year And the established cohort Was 3139 people Dr. Wilbur, uh, you mentioned that this is the first major Coverage study first goal. How do you define Major Is it in terms of size is in yeah in terms of size So is it a percentage of Because I saw for instance, australia had 15 000 and now we have three that can you just just yeah, so, um Because that's a great statistic. So we just want to be clear sure so A major cohort study would be a a sample that included several thousand people or more In the case of australia They interviewed 15 000 people for their baseline survey Similar to the almost 10 000 that we had in our baseline survey And and then they followed up with about 7 000 of those people who actually stayed in the cohort for a number of years So we had about a A third right of ours So yeah, so we had about two-thirds of the people in our We had about two-thirds of the size of the australian baseline survey in our baseline survey We had about a half of the size of the australian cohort in our cohort I would just note that There was In your remarks, there were five major studies which you were all involved in Which is this is also a major one not just because of the size But also the other elements that you described, which is the major introduction of casinos Is one that is really unique It is yeah that we are going to straddle that we straddle between because we started with the baseline Before which is the first wave Before the introduction of casinos and we're now going to see the effects of those introductions And another another piece that's unique. It's that it's the first cohort altogether small or major In the united states when it comes to gambling and that's also very important Okay, well There has not been any other cohort studies on gambling in the united states Yeah, and and one of the things that that I Wasn't planning to go on into a lot of detail, but one of the reasons that we're able to To Have a cohort of this size Um and still be able to get all of the value out of the exercise that we that we hope for is that We we Purposely oversampled For people who would be at risk for developing a problem one of the challenges of those earlier cohort studies was that They all tried in different ways to over recruit problem people who would develop a gambling problem But uh in australia for example the the difficulty or the one of the challenges that they ran into was they had to have a very large baseline general population survey The strategy that they took to over recruit for people who might develop a gambling problem Was they over recruited in geographic areas where there were a lot of gaming machines And it turned out that that was not a great strategy for getting people into the cohort who would transition So they ended up having far fewer transitions Looked so to be able to look at people changing is one of the things that gives a study of like this power And so we over recruit for people that we thought would change And in fact we have been Successful in doing that Mark did you have something No, okay, so um wave three Was fielded a year after wave two We were able to get about two-thirds of the folks who joined us in wave two to Complete the the questionnaire in wave three We then had hiatus So wave four actually went out in 2018 But we Have been Able to maintain the size of the cohort pretty well at about 2400 We just were talking with the data collection folks about wave five they're getting ready to deliver wave five to us and they told us that that They're pretty sure that we're going to be just over 2400 For the sample size for wave five and we have in our Deliverables for fiscal year 20 going out with wave six Next next spring So I would have to say that The Massachusetts cohort study at this point With what with all of the work that we have planned through fiscal year 2020 Is already the longest lasting cohort study that has been carried out internationally Um, I also would like to just mention that I never in a million years expected that we would start a cohort study in massachusetts Prior to the opening of all of the casinos And it was the commission's vision. I think To have this cohort start Very very early in the process of introducing casino gambling to massachusetts That I think in the end Is going to serve all of us in the commonwealth Because it really is going to be A a unique in the world opportunity to understand the impacts of an introduction of this scale Of gambling Into a population Actually just wanted to add to that it's It wasn't really the wisdom of the commission although you're all very wise It was it was outlined in statutes section 71 specifically Specifically called for Right there there absolutely was it was decided that That it was a requirement in section 71 That called for the research agenda But the commission made a very wise decision to say if we really want to understand what is the What is the impact of the casino casinos on the progression of gambling and problem gambling so we can really understand etiology Let's launch it now And so that's that's uh, we launched it very early compared to to perhaps when we would have necessarily needed to So kudos to everybody Okay, um, I'm not going to spend uh very much time on this slide Because everybody hates Waiting except a very small number of people in the biostatistics department of my of my school I think I was going to tell you to cut this slide to cut this slide Yeah, we only we only use waiting to adjust the data In in calculating the incidence rate so that we can be more confident About generalizing to the adult population of massachusetts We don't use waiting for anything else In this study, but we do use waiting for all of our other population studies. So Unfortunately, we do have to acknowledge how we wait and So that other researchers can um delve into the data eventually and um and understand what we did and see If they agree with it So this slide Lays out on the left hand side. This tells you the um strata that we sampled from From the baseline general population survey So we took 100 of the people in the baseline survey who were problem gamblers 100 of the at-risk gamblers 100 of the people who spent um a hundred dollars a month 100 dollars a month or more on gambling and those who gambled weekly and then we had a small group of people military veterans who had served since Since 9-11 who had very high rates of problem gambling in the baseline general population survey And we felt that it was important to include them as a specific stratum And then all of the other participants in the baseline survey um the next column over gives you the sample size and then the The achieved cohort those are the people that we actually were able to complete interviews with in wave two And um, you can see that there's somewhat different response rates by group, but overall We recruited uh 65 of the people that we selected from our from our baseline survey Great. So is this strata all mutually exclusive or can somebody be Somebody who gambles weekly and spends let's say 1200 Yeah, so basically, um We took all the problem gamblers first And then we took all the at-risk gamblers because they were mutually exclusive groups And then anybody who gambled A hundred dollars a month or more, but wasn't an at-risk gambler or a problem gambler You start to add them up. It's a cumulative add up. Yeah. Yeah. So then by the time you get down to military service 9-11 or 2001 after those are the those are the Veterans that were in the sample, but who had not been caught in any of the in any one of the top Is that what you were? That's exactly that. Yeah, what I was asking Um, we use a multimodal strategy In uh data collection for wave one and wave two Well with wave two when we recruited the the cohort itself We used the same approach that we had used with the baseline general population survey Initially inviting people to participate online a self-administered online questionnaire And then if they ignored us we sent them a self-administered hard copy questionnaire a couple of times And then if they still ignored us if we had a telephone number for them, which we did for about 80 percent of the people We actually called them and tried to complete an interview by phone We've changed a little bit for wave three and And more recent waves We initially invite them to complete online Then if they don't complete online within a period of time We invite them to where we send them a self-administered questionnaire And then if they still haven't responded We we don't try to complete an interview by phone anymore But we do some telephone prompting to try and get people to complete one or the other of the two ways And part of the reason for that is It's less expensive because you don't have to train telephone interviewers and do telephone interviews But also it it means that All of the data for wave three and forward is self-administered So there's no there's there's much less likely likelihood of social desirability biasing the the data So I presume it's effective the prompt Yes, yeah, we we usually get We get a lot of people who um who want to complete the self-administered questionnaire And so when we send out the you know the initial letter, you know, it's the next wave of magic, you know Here's your online Your your your your code to you know to get in and complete online And that's when I get all of these phone calls from the participants saying I don't want to complete online. I I'm waiting for my questionnaire Like when is the questionnaire coming out? And so I have to have And we have quite a few conversations with folks who're like I don't have a computer and I'm I can't I can't do this online Like yes, we know we'll be sending out the you know the questionnaire comes about Four weeks after the initial letter So another very important piece of Stuff that we have to do is we have to make sure that the same people are participating in the in the study And we do a lot of work with each wave To match participants across waves And so what what this slide shows you is that across the the various waves We've got We actually had a small number of people About 44 in who who joined the cohort in wave two when we started it But had actually not been the same person At that address who had completed our interview For the baseline survey But they completed our interview for the cohort study. So we're like okay now you're in the cohort Now we're going to keep you They just For whatever reason, I mean, you know, maybe somebody had moved out of the household and and somebody said oh I'll finish this and didn't pay attention to the instructions that this had to be the person who had completed last time So we take a lot of Of Time to Basically match people across Gender age Race ethnicity And level of education Those are the four variables that we use to match participants across waves So you can see what that does is it affects the size of the group that we have available for analysis But we're in wave three. We're at about 2450 people who Have participated with us in all three of the waves And then this is this is a a nice little map that I like to sort of use to demonstrate that This is where the addresses that we that we know the cohort Participants live at There's a star on the map for each of the addresses that we mail advanced letters to And um, I like the fact that it looks pretty representative of the distribution of the population of massachusetts Including just a couple of people out there on the islands So now actually getting into some data for you. Um I have my glasses because I want to make sure I read this properly So this first uh slide here on the results Um Shows changes in gambling participation across the three waves of the study to date And I just want to clarify for you that this is what's called a pair-wise comparison So this means You're looking at the same the same people Answering the same questions at three different points in time Okay, it's and and again, it's um It's it's much more powerful in in understanding change If it's the same people answering the same question and you're comparing their behavior in wave one To their to that same person's behavior in wave two to that same person's behavior in wave three So this is unweighted data. We're not attempting to represent the general population We're looking at the 2428 people who completed all three waves And completed all of enough of the questions in all three waves for us to include them in this in this graphic um the The analysis of the results um shows that from wave two to wait I'm sorry from wave one to wave two There was a significant increase in the uh proportion of people in the cohort Who participated in daily lottery games? And a significant increase in people who uh bet on sports And those who uh wagered privately amongst themselves However, the magnitude of these changes was uh quite small In looking at wave two to wave three there were significant increases in uh daily lottery participation and in online gambling participation However, both of these changes um Were the result not of actual changes in behavior but Changes they were they were due to what we thought were very minor changes in how we asked the questions And in fact people are quite sensitive to exactly how you answer the questions So it gave us real insight into how careful we have to be In every wave of the survey or every wave of the study to Not change the questions if we want to be able to compare to previous waves So It's not that we're not going to change any questions It's just we have to be very careful when we change questions and not try to attribute any change to Um you know to their behavior when we know that we changed the wording of that question In the in the case of daily lottery We felt it was important to be as up to date as possible So we we actually added just the the names of two new Monitor games that had come online since the beginning of the study And that led to that increase in daily lottery play. It was it was that small Of a change So we just it it made us very vigilant about Looking at changes that we see across waves and making sure that we can confidently attribute Any changes that we see To you know their actual behavior or reporting of their behavior Rather than you know something that we've done to try to Be you know more reflective of what the current situation looks like The oh the casino. Oh, yes That's right. That was the most important finding So You'll see on the the sort of third set of bars that There was a significant decrease and it's a statistically significant decrease in the Proportion of Participants in the study who had gambled at an out-of-state casino in the past year So it went from about 33 32 percent in wave one it was 33 percent in wave one 32 percent in wave two and then it went down to 22 percent in wave three Wave three the data were collected After the opening of the slot parlor and so this finding Triangulates very well with information that we have from the plain plain ridge park casino cohort patron survey, excuse me Where we were able to ascertain that A very significant number of the people who were patronizing Plain Ridge Park casino in that first year Actually would have spent their money gambling at an out-of-state casino if plain ridge park had not opened So this was very nice corroborating evidence of The success in recapturing Massachusetts gambling dollars that were leaving massachusetts and going elsewhere Thank you more. This is the stuff that I like So So this this is unweighted data, but it is Basically Looking at the numbers of people in the cohort who had status At wave one and then their status at wave two and then the the table below is their status at wave two Followed by their status at wave three This is just a basically An accounting table to tell you where every every one of the three thousand one hundred and thirty nine people fell From wave one to wave two and then wave two to wave three More significant is the incidence and remission table here tables and We've presented these data both in terms of unweighted data Which is the actual cohort and then the weighted data to give you an idea of how many people In the state of massachusetts are represented by the The number of people in each of the rows so My slides are very small Oh, that's very helpful. Thank you So you can see that the The incidence rate is Is calculated by the number of people who go from no not being a problem gambler in wave one to being a problem gambler in wave two divided by the The all the people that are um that were not problem gamblers in wave one But and and and so you add the 24 93 and the 60 together. That's your denominator Um similarly with the weighted um you add The no no and the no yes together and that's your denominator for The people who are incident or going from not being a problem gambler in wave one to being a problem gambler in wave two Below that um is what's called The way you calculate the remission rate Is these are the people who were problem gamblers in wave one And looking at their status in wave two. So you've got And and this is interesting and and important to know you've got about Half of the people who were problem gamblers in wave one Transitioning to not being a problem gambler in wave two But maybe at risk Yeah, um and probably are at a little bit of heightened risk because they were problem gamblers at wave one So we know they had been problem gamblers in the past, but then they weren't at that level When we interviewed them in uh in in 2015 Um and then down below that is the same table, but for the um the cohort from wave two to wave three So you've got an incidence rate. That's um quite a bit lower And we know that there were some There were some uh recruitment differences between the the recruitment For the baseline survey we we basically told people it was a health and recreation survey because we didn't want to over recruit People who were enthusiastic gamblers if you tell people it's a gambling survey Get a lot of gamblers So by the time we recruited them into the cohort we were being much more honest or straightforward and They they knew from the baseline that it was a gambling survey Um and then they agreed to let us contact them again and when we did We told them it was a gambling study And so we think we actually over recruited gamblers and and that probably contributed To the somewhat higher incidence rate that we have from wave one to wave two From wave two to wave three the incidence Is about it's quite a bit lower But it's now reflective of um what's actually going on with this cohort And it's also very similar in terms of uh the other cohort studies that um that we've been involved with and are aware of This is about um it's certainly within the ballpark of what we've seen in other jurisdictions But again, uh the remission rate is is still Quite high that is about Almost half of the people Who were problem gamblers in wave two? Then transitioned to not being a problem gambler in wave three So moving on into the issue of stability and change Um, this is very similar to what we've seen in other jurisdictions Recreational gamblers tend to stay recreational gamblers. They're they're not very likely to Um to change they're the least likely group to change Um non gamblers about half of them remained in that category across all three waves But a little over half of them actually moved into Um a higher category so Most of them moved into being recreational gamblers But a few actually moved into being at risk for problem gamblers um Problem and pathological gamblers about a third of them remained in that category across the three waves So there's quite a bit of movement and then at-risk gamblers were the most likely to change status Across the three waves of the study to this point Then there was another uh very interesting group of people who moved in and out of risk categories across waves So for some people they experienced a decrease in risk category Um, you know certainly uh the proportion of problem gamblers the the two-thirds of problem gamblers who moved out of problem gambling Many of them moved to an at-risk category But quite a few of them also moved even further down to uh recreational gambling There were also individuals who experienced an increase in risk category. So they moved up the continuum And then there was this very interesting group of people who like went back and forth So they either went up and then came down or they You know went down and then came back up And each of these groups, you know is is interesting for a variety of reasons But in in in the current instance It's what's most interesting is the amount of movement because Typically or conventionally problem gambling has been viewed as a chronic and unremitting disorder And to see this amount of movement is really pretty surprising And and and has implications for you know the kinds of Messaging that you might want to do to people but also Has implications for the kinds of services that you might want to roll out Yes, yeah, I I think that that's that's really where the rubber It's the road is that is trying to take this data and Interpret it in a way that We can we can use it. We can begin to think about resource allocation We can think about messaging if we think about game sense Understanding that at-risk and problem gamblers are actually moving around To me gives me a lot of hope that There there are things that we can do within that environment that will hopefully Assist people to to move down that continuum to be to be recreational gamblers And if recreational gamblers in the most stable group there We it reinforces the idea that we need to provide a different type of information that hopefully maintains this group as recreational gamblers was there Maybe you'll get to this later or in the details of the report but Is there something to discern between The differences between those that decrease in risk category versus those that increase In the risk category. I know you talk about protective factors or risk factors Our next report. That's the next report. That's the next report coming in So we're currently analyzing all of these data plus wave four Yep And what we're going to do with that next report is we're going to look specifically at the risk and protective factors That is what are the variables that That you see in wave one that or see in wave one that predict Status in wave two. What are the variables that you see in wave two that predict status in wave three? And basically, you know, what are the variables that predict an increase in In severity versus what are the variables that predict a decrease in severity? So we'll have four we'll have one two three We one two two to three three we'll have three transitions for each of the members of the cohort Which will give us a lot more statistical power And then with each New wave of the of the study Will be able to add to that That power of the analysis And and then the other piece that's going to come in With wave five, but then even more with wave six is we will be post casino introduction And then we'll be able to go back and take a look at are there differences in what predicts transitions From before the casinos opened to after the casinos opened and that again will be a very unique and one of its kind Areas to explore So i'm not going to spend any time Sorry timing is for these waves. So when we Call somebody a recreational gambler or non gambler. What's the The time frame in terms of amount of time for the stability so for the for for one year So every so each one is really a year. Yes, okay All right, so let me try and get through this discussion fairly expeditiously So we did see small increases in gambling participation But the changes that we saw in wave two to from wave two to three I think I I I went through this we're actually Due to changes in how the questions were phrased It is notable That out of state gambling decreased significantly. I'm sorry out of state casino gambling. I need to be specific about that Decrease significantly and we do think it Triangulates well with other data that we have from sigma To Suggest that the slot parlor Does seem to have been successful in recapturing Massachusetts residents who had been gambling it out of state casinos The problem gambling uh incidence rate from wave one to wave two Was quite high as I indicated but is due to Is subject to some methodological limitations And the incidence rate at from wave two to three declined And remission was quite substantial. So So the the equal size of those groups Is very interesting in terms of the implications for services Okay, so the second set of bullets here I wanted to just draw your attention to one of the differences between The the The amount of transitioning that we've that we've seen in the massachusetts cohort Is much higher than Transitions that were observed in some of the other studies For for example in victoria Only four percent of the Participants in that cohort study actually Transitioned down over the course of their entire study And almost six percent transitioned up Whereas in In the massachusetts study just even in the first three waves. So the victoria study was five waves In massachusetts, we already have 13 percent of Our Participants who've transitioned down. We have 15 percent who've transitioned up And 13 percent who've moved at both wave two and wave three So that's just a Significantly higher Rate of movement and we think what it reflects is our Success in recruiting people who are at high risk for movement We think the sampling strategy that we use is actually six been successful What what about the possibility that the one in victoria at least or some of the others Were mature gaming markets that it's precisely the introduction of casinos that may be created Creating these volatility. Well, but this is all of this transitions Are before anything except the slot parlor In in massachusetts, that's right, but you're right the the results in victoria Are very much reflective of a of a very mature Gaming market with very widely distributed gaming machines in particular in many many different venues We saw a very different mix of Incident and remitting cases in sweden for example Most of the new cases in sweden in in the swedish cohort study were new cases They they hadn't had a previous history of gambling problems. So it wasn't There were far fewer people who remitted In sweden. So there's different things that are going on in different jurisdictions and different gaming markets So Again, it's not just a question of You know sort of identifying transitions, but there's a number of possible reasons for the differences Again, the maturity of the gaming market There's also a good possibility that some of the Differences may be due to how problem gambling was measured in the different studies We use the the PPGM in massachusetts In most of the other studies. They use the canadian problem gambling index It may also be due to the somewhat longer Inter-assessment period from wave one to wave two Some of you may recall that we had to wait until the referendum to to The next wave we had to wait until the referendum Was decided in 2014 before We could go ahead with data collection on the cohort So there was that was the first wave or the second wave well So that was wave two when we when we established the cohort We had to wait until after we knew there were going to be casinos in massachusetts to proceed with the study We did And then I think I'm leaning more and more towards this last one, which is The cohort in massachusetts Just has a much higher proportion of individuals who were selected to be at high risk for transitioning And that's exactly what we're seeing I'm I'm struck by that ishikasa. I'm not an academic Or scientist and I I would have thought that you would skew to make sure you're neutral in those things But you're saying that you actually recruited for that And I and I thought I understood at the beginning, but maybe I didn't so Now are you suggesting that that Does that impact you negatively on your conclusions or does it just support your theory? No, it it actually provides us with much more Information ultimately about what is what what is causing those transitions to happen And that in in the end gives you much greater power. Yeah, you had mentioned at the beginning. So that's why So that's why we knew we wanted to over Recruit people who would transition and we anticipated that they would transition towards problem gambling Um, but we we now are also seeing that there's a lot more movement back and forth Um, then we had actually and you get you get Information that will benefit you in a different way even though you can't do direct comparisons to other studies that have been done around the world Yeah, I mean we always want to look at what else, you know at at what other research Studies of a similar kind you found because you want to sort of benchmark exactly But the massachusetts study is is really unique in a lot of ways and and I really have to pay tribute to all of the people that that conducted those earlier cohort studies because You know, I I participated in in several of them and and rob williams contributed Obviously to to the other two But we were really able to strengthen The design of of what we proposed in massachusetts Based on what had been learned in those other jurisdictions richer data richer and more powerful. Yeah my recollection of the over sampling of At risk and problem gambling on on wave two Was really driven and this is what I recall but you know, you're being more nuanced is driven by the fact that the incidents Um is really small compared to the rest of the population So we if we if we simply sample according to the population And we lose people which we anticipated that that the cohort does because eventually time works against you in the cohort We risk losing the key people that we want to study To the point of not being able to ascertain much from them So I I think yours is a lot more nuanced in terms of talking about the volatility of this risk group But at least from my perspective, it was also practical in terms of The longevity of the cohort itself That we needed to keep it richer initially because we are prone to lose people gamblers at risk and non gamblers along the way Thank you. Okay. Um, let's see. What have I got here? Oh, so this is something that that Many people find surprising I think But there's good research across all of the addictive disorders alcohol illicit drugs And gambling now Which suggests that these disorders actually are much less stable Than had historically been thought There are many many alcoholics and and and drug users In the general population who You know remit for a while or who stopped using for a while And similarly there are people who you know become concerned about their gambling and decide to stop gambling for a while Or decide to cut back on their gambling for a while So The The chronic They either need my glasses or bigger slides Right, so um The the interesting thing about um The one of the interesting things about this instability is that there are people in the population who are chronic Not in the sense that they have Long-standing unremitting problems of although there are some that are like that But in the sense that they are at a higher risk At any given point in time for a relapse Okay, so once you've had a gambling problem You know you are more vulnerable for having a gambling problem in the future Similarly to if you you know overcome an alcohol problem Um, you know in circumstances in your life change You're you're more vulnerable to going back to that Pattern of behavior than someone who had never been there in the first place And then it's also important to understand that um That that there that people who are experiencing addiction tend not to have unremitting manifestations That is they go back and forth sometimes quite often And to the extent that you can Keep them from you know moving towards the more severe end of the spectrum and keep them sort of on the safe side of the spectrum You know that is a long-term contribution to their personal health, but also to their community's health There isn't you can can you um, are you for example thinking about the progression down from not From casual gamblers to risk at risk gamblers Or from right so to to increasing severity So yeah, I mean the the whole notion of effective prevention is to keep people from Moving along the continuum from sliding down to that severe end So, you know the more you can keep people on this side The better off ultimately you are I'm not going to spend too much time on the rest of this slide. It more speaks to sort of the the psychiatric or the the clinical Issues related to disordered gambling in the dsm 5 I do want to talk briefly about the limitations Any good scholar has to acknowledge that every study has its limitations We don't think that we were successful in accounting for all of the sampling biases When we developed the waiting scheme But that becomes less and less of an issue because now there's only one thing that we're using the waiting for which is the incidence rate Um individuals who were recruited into the cohort were aware by the time they were recruited into the cohort Um that it was a gambling study and so their decision to participate may have been shaped by the fact that they Like to gamble or were interested in gambling Uh the there is research to show that Um people who are asked to reflect on a regular basis about their behavior may actually um Improve their behavior just because they're reflecting on it And also some social desirability to show improvement to the researchers Although we've tried to address that by Making sure that um all of our respondents or all of our participants now Are self-administering the questionnaire. So there's no interviewer bias That's inter interfering there And then um observed changes over time are sensitive to the reliability of the measurement instrument meaning you know any any sort of Device that you use to measure Something you know comes with some sort of confidence interval around it And some instruments are more precise than others We use the most precise instrument we can but it is still an instrument and it still has measurement error So my last few slides here Are in terms of implications for prevention and treatment I indicated with my bathtub slides. I think that a stable prevalence rate over time can be due to at least to to two of One of two possibilities Either you've got ongoing unremitting problem gamblers in the same individuals Or you've got a rate of new cases that's roughly equal to the rate of Cases that are remitting and that seems to be the situation that we have in massachusetts The second one or both Well, we don't know yet about the whether the prevalence rate is stable or not But we do know that we've got a rate of new cases that's roughly equal to the rate of remitting cases Both in wave one to two and wave two to three Those two scenarios have very different implications If if problem gambling is chronic and new cases are uncommon Then you really want to devote resources to treatment to get those people to To get them some help and to get them to And particularly to get them to help in terms of remitting However, if incidents and recovery or remission are both high um, you want a greater emphasis on Prevention as well as treatment and recovery support because you've got You know these new cases who may not have who may have just developed a new vulnerability Or you've got these remitting cases that clearly have some vulnerability But if you can put some measures in place you can prevent them from relapsing in the future Can I ask a question here to the following? There has been other studies and researchers Notably the division of addiction who talks about These arc of adaptability or adaptation Um In general what could we Say would be a Reasonable time frame To either be Past or account for that adaptation if any Relative to these scenarios that you point out here Yeah, so the the adaptation hypothesis basically says that once you've exposed the population to a new creator of disease That the vulnerable sectors of the population will you know experience the disorder and then will either Recover And then and be immune or immunized or they'll Leave the population because they die or they move out Um, and then you'll be left with an immunized population Uh, which you know, which means the prevalence rate Come down I think You know that it that's a um It's an interesting sort of thing to try and interlace with what we're finding from the cohort study Because you're talking about a population level um Set of changes the the adaptation theory really speaks about the population Whereas the cohort study is really looking at individual trajectories And so those individual trajectories have to like be built up You know to be a population you you really have to build up a lot of those trajectories Which is what we're trying to do. I think once um, we have an idea in You know in 2020 The plan is to do a very large follow-up general baseline general population survey And what we'll what we'll know Once we have those data is whether the prevalence rate has changed And then what we'll be able to do is we'll be able to put the pre-post Um snapshots together with what we've learned about what's going on at the individual level To understand what's contributing to any what what contributed to the change in prevalence in the follow-up population survey And that will give us an idea of whether we've had adaptation Or whether we can expect adaptation in massachusetts after the introduction of the casinos What what is there anything you care to speculate any one of these? I mean I have a my own armchair analysis, but As to whether we might be seeing a lot of variability and then of course the recommendation is to do both not just um treatment but prevention and treatment If we are having if we are seeing um high rates of um ins and outs Yeah, we're not I or is it too early to tell for now with three waves of data It's a little it's a little too early to tell if we're seeing um You know long term remission and that would be adaptation Or if these people are going to continue to move in and out That's again, that's going to be an important piece of information for us to have In terms of the services that we might want to Yeah, I wasn't talking about adaptation anymore. I was just thinking about the high rates of in and out Leading us to then take away that we we would need a greater emphasis on both prevention as well as treatment Yeah, I think the the the piece of analysis that we're just starting now with way four is to try to understand The similarities and differences between people who move a lot versus people who don't Because that's going to tell us if there's like a uh sort of a A stratum of people who just are problem gamblers all the way along That's your chronic unremitting cases and and We know that there's probably some of them in the cohort, but we don't know how big the fraction is um And and then there's going to be like, you know a bunch of movers And then there's going to be the people who don't change and each of those strata is going to be interesting and And and informative in terms of the kinds of services that people in that stratum might best um Benefit from But you need to know the size of the strata Okay, it's end up time. Yeah, I'm mark if you can help us these are Very critical slides, but I almost feel as though We're staying tuned a little bit going forward. So I'd like for you to be able to Complete your thinking But also be aware of we've got a few more items for today's I think we've only got a couple more slides here actually To me it's it's it's really interesting we have to to recognize that recreational gamblers are an incredibly stable group um, and um It's supported by the data in this study and um, I think that that does uh support um Support the prevention efforts both inside the casino and outside of the casino The uh instability of specifically at risk and problem gamblers Is also really interesting and as rachel's pointing out the next wave will put a little bit more We'll put a lot more detail to it what it does To me For me And what I'm hoping it will do for the broader community of treatment providers Is to say uh is to to help kind of Orient them to the nature of of problem gambling In the population in specifically massachusetts That that that people do move around a lot and that's that's the more common thing than uncommon thing and um, and the the other thing that I I found really interesting in this is that um individuals who Are problem gamblers or at-risk gamblers tend not to stop gambling all together They tend to to continue to gamble Hopefully at a at a lower at a lower risk or recreational that to me has a lot of treatment implications and understanding that While your treatment goals are a personal choice That it's it's common for people to want to try if you're a problem gambler that abstinence is not always The true path towards recovery that you can you can be in recovery you can be in remission Without saying that that you need to abstain altogether. Again, it's it's a personal choice where whether or not you abstain This was an interesting finding in our voluntary self exclusion evaluation as well where Individuals at enrollment in voluntary self exclusion Were asked about what what their goal was in terms of gambling individuals that approached it Saying that they wish to gamble more moderately But continue to gamble Generally had better outcomes than individuals who who expressed a desire to abstain altogether Yeah, and that that was the the last slide that I sort of wanted to draw your attention to is um this issue of Um not People people are not likely to stop gambling even though they're experiencing harm or having problems controlling their gambling They really want to be able to continue with something that they at one point really enjoyed Um, but it's gotten it's gotten very difficult and challenging for them And so the the whole notion that um in order to uh get treatment or to Um get help for a gambling problem Many many treatment professionals will as they do with with alcohol disorders will basically say You know Abstinence should be your goal. Abstinence is the best goal And if you're not going to be absent, then I'm you know, then I can't provide treatment um And this whole notion that people can continue to gambles But at a lower level and sort of putting the other parts of their lives back together Really is Uh consistent with um with the data that we have here that people are very unlikely to transition to being non gamblers from from any other part of the continuum and so we have to figure out how to Basically get to people where they're at in terms of what they want to do with their gambling and This is very consistent with this idea that Controlled gambling or moderate gambling is not incompatible with recovery from a problem And so we can I I would love to conclude that I would also just say this study is contributing to a much larger Study and group of studies of cohorts where we're we're in Our research teams in the process of developing low-risk gambling guidelines Which really is it's at the heart of what we're trying to do through through game sense as well of providing guidance Nudging people in the direction that if they're going to gamble to do so in in a way That is No harm to the individual to the family Or it's a harm reduction. I mean we will settle for harm reduction if that's what works incrementally, right? So if you want any more information feel free to visit our website or Send me a question Send me an email You know where to find me on the road Thank you Excellent. Do we have any questions for dr. Volberg at this time? Mr. Stevens, thank you. No, thank you very much indeed. Thank you so much Rachel. All right. Thank you mark There's been a request for a short short break And we should take it so that we can finish up our Our business 10 minutes. So that puts us at 325 and we will reconvene in order if that unless there's somebody with a competing schedule That would put uh item seven item seven That will be next up Excellent Thank you. Thank you again. We are calling reconvening meeting number 276 and Again, we are going slightly out of order We are now turning to item seven on the agenda and licensee policies on switching jack And commissioner Stevens. I know that you're been looking at this with Bruce and berks Um, thank you, madam chairman. I'll hand it over to the experts, but this is An interesting issue that has popped up I certainly appreciate the the value team that has Confronted this and worked with our gaming agents And to work with our licensees to to raise their awareness of it, but Overall again, this is a report. There's no vote expected But I think this is just a reminder of how we're trying to help protect some vulnerable patrons as well as Meet some of our statutory obligations to collect outstanding obligations as we may come across them as the statue was pretty clear about but I'll hand it over to the experts Madam chair commissioners This topic is is really kind of unique to massachusetts because nobody else really collects money from the department of revenue At least that i'm aware of so we didn't have this new jersey when we were there It's a unique topic for here I brought in field manager berkane and the supervisor ballerina Because they were kind of pioneers in this for us in this state to to find some of these inconsistencies The jackmots. I'll let them explain.  We accounted for the department of revenue $223,000 But that that's including everybody who is checked right now necessarily people might be Not necessarily switching jackpots, but that's a dollar amount For the three casinos or for only one And is that unpaid taxes or child support or do we know the breakdown? Do we know what the brand is under an intercept, right? Do we know what the breakdown is? We could probably get that for you, but I don't have this I was just curious if you had it. Yeah, they delivered to us as intercept All right. Good afternoon as bruce said we're joined today by val trend of filova supervising gaming agent at the on-court property and the ppc property that we call boston harbour metro zone Little background about this is uh, I think val took it upon herself. So little kudos to val last february march to start reviewing The accounting paperwork eye track reports and she would uh Reference when where what time a jackpot was hit a taxable one And then she would go to the cctv review room And just watch the process And on rare occasion she was noticing that patrons who won the jackpot would get up and allow another person to sit down in their place So today we have a power point Program for you to show Some of the highlights of this we have a memorandum we want to talk about So I think in the package is the memo A lot of the memo information is shown in the power point. So i'm just going to Rese through some of the highlights of the memo for us The investigation enforcement bureau gaming agent division has been focusing its attention On the surveillance of uh switching the practice involving the slot machine players switching seats After a jackpot of 1200 or more with a friend accomplice or other player This act is illegal and hinders the enforcement Of chapter 23 k and our regulation 205 cm or 133 Because it would allow a player Who may be on the self exclusion list Or a player who may owe monies to department of revenue To improperly collect winnings Recently as I said mga mgc gaming agents have reviewed surveillance footage at plain ridge mgm and on core And we uh can go over that In the power point The impact on vsc's individuals place themselves on the Massachusetts gaming commission voluntary self exclusion Exclusion list to do so in an effort to mitigate the negative impact gaming may have on that individual Pursuant to 23 k During any period of voluntary exclusion the person shall not collect any winnings recover any losses Resulting from gaming activity at a gaming establishment Additionally our regulation the voluntary self exclusion reg of 133 A gaming licensee shall not pay any win winnings derive from gaming to an individual who's prohibited from gaming In a gaming establishment by placing their name on that list A vsc agreement could be circumvented if a vsc patron simply switch seats with another person To accept the winnings the impact on the massachusetts department of revenue To expand the gaming act of 2011 specifically spelled out An mgl 23 k the need for jackpot winners in excess of $1,200 to be reviewed and ascertain whether the winner owes any pass child support money or Ascertain whether the winner may owe pet Pass due tax liability to the commonwealth So now we'll get into some of the slides All right slot machine jackpot process What we ask the casinos to do with all the internal controls is Based on what the internal controls say for that section is to give us what they How they want to do it we call it out in the field the submission For instance, what level do you want to have a shift manager involved with the slot machine jackpot perhaps A $50,000 one What surveillance is responsibility? When the security officer helped witness the payment for example But last but not least is the 138 56 absolutely states that you must pay the winning patron the money Additionally a slot machines are programmed as we know to lock out at $1,200 so a person Trying to circumvent the system But by switching if Anything was hit for $1,400 A voucher or Tito would not be printed out the machine locks out which means there's going to be interaction with casino staff Meaning that you're going to probably have to be checked through the Department of revenue system and surveillance would probably be in looking at that jackpot also And lastly as I discussed a little bit the 23 k section 51 Is the department of revenue requirement that a person who may oh Past child support or may oh past tax liabilities is checked in the system before they pay out the jackpot Gaming agent review led by val and all the other gaming agents We've been reviewing jackpot switches from march of 2019 Through august of 2019 During this time, we've looked at over 2,200 individual videos of jackpot payments at all three casinos The gaming agents have found 14 Incidences of successfully switching seats And after we began to alert the casinos and talk about this process The casino surveillance departments have halted another 29 Attempted switches With respect to the 14 were we able to do anything? pardon With respect to the 14 incidents Were we able to to correct them? I mean yes, uh once we notified a compliance office about this They worked towards finding those patrons If the other patron we can track these surveillance, perhaps they have a player's card. They were playing somewhere else we uh would put something in that the Players file the next time they come in they would be talked about Asked to uh, you know make make good with the arrangement But a person who receives it unjustly It would be interviewed next time they came in if uh a note is in their file Can um maybe we I was going to get to this one might as well get to this now. Um, is it ever Cost to marry you can do people who are friends or married come together and they Know that they're going to be switching seats because that's what they like to do. They'll pull their money and they Take turns is there ever a situation if you will where a switch could be Uh justified let's say Well, we we look at that. Um Sometimes you're wondering where the the money is coming from if there's a husband or wife situation Perhaps the husband's pushing the button and then the wife pushes the button. I mean good sense could mean that They're a family, so um They're trying their luck together if you will A little bit Yeah, I I think we use common sense when it comes to something like that and we review their play for a little bit And you know use our head if it's something that it looks like one of the individuals is definitely avoiding Uh the jackpot all together We would look into that A comical example could be if i'm sitting here playing the machine and you're going by Whoever spun the reels won won the jackpot What if someone just came down the aisle and reached over his shoulder and pushed that button? It's my money. He didn't win it. He pushed the button So we have to work with what makes logical sense Uh statistics we have some statistics from each of the casinos As you can see at plain ridge park. We had 1200 Up to almost 1200 reviews by iub As you can see in the center column Seven of the eight Uh jackpot switches were noticed at the beginning after we alerted the surveillance department Most of them have been prevented by the surveillance department And so they've done a very nice job out there The next slide mgm A lesser sample size of uh 800 plus We have five situations where we notice the switch And there's two situations where mgm surveillance department has prevented And on for obviously just being open almost 200 reviews And right now we have one situation where we've noticed that last week you found them I think maybe right after the end of uh, August we've had a second Okay, so um with that that we've observed Pardon that the iub is observed Yes, ibsi two rather than one. Yeah, right at the beginning of september we'll make it two now And with that So in in these in these three charts, um, you start with the the higher number Is the reviews conducted by the iub? Um Is that the universe of jackpots over 1200 dollars for that period? Yeah, these are taxables. They don't take long to review No, my question is is that is there any other jackpots that were that happened? But were not reviewed by the iub for whatever reason Well oftentimes, I think when we talk about jackpots, I think I often think of it as a taxable jackpot of 12 That's exactly what i'm talking about. So anything above 1200 Dollars, this is this is the this is the universe of what can happen at any given time Especially that With ppc they were saying telling us the length of time it took kind of kept track of how long it took us And it didn't take us that long. They're totally on forward channel Mm-hmm and speaking about the Submission process Some casinos have a like an iphone on the slotted tenants wrist and they'll see where the jackpot is So once they get over there on their way, they could notify Surveillance hey section d machine number 50 I have a $2,000 jackpot. They could start their process there. I have any this slotted tenant Perhaps hasn't even gotten there yet So by the time you go there introduce yourself verify it get information go over to the jackpot kiosk and run the information through The dor system and start to get the cash It should be more than enough time for that for surveillance to call down and say hey It's not the lady in the red dress. It's the gentleman in the blue sweater Mm-hmm. Did you I'm sorry. I know that the lottery has this sometimes with people doing ticket switching for the same reason to get around dor child support They'll sometimes grab vulnerable people and say I'll give you 10 percent those people don't realize they're going to take a dor hit Now they have dor issues that sort of thing There's an obligation in lottery my understanding when you pick it when you go in for certain winnings to avert that is your ticket You're claiming it only for yourself that sort of thing Do we have anything in our regs or in the casino rules that are the same thing on unbigger jackpots and hits Well, uh, the only rule we have in our submissions are the winning person has to be paid That jackpot. Do they sign anything? I know in lotter. You should actually sign the ticket to say it's your work It's in our regs that apply to the casinos. I think you're talking about a perhaps um Alerting the public that you have to be the person But also the consequences so you're not what you're not supposed to Right, so I guess the question is have we looked at all in terms of this in terms of the lottery And how they deal with making sure people don't do the switching Because they've been looking at this for years in terms of maybe Statutory changes too to make it a criminal act to knowingly switch or anything like that I uh, I don't know. I assume you have to sign your The wdg And submissions are a fluid document if uh after this review if we get together with the casinos and if it was a prevalent problem Seeing the statistics were under well under one percent. I think But uh, we don't want it, you know, you don't want any of this to happen If uh, we started to review this with compliance, we could ask them to update their submission to be more In compliant with our concern I think the difference with the lottery is you don't know I buy the ticket I take the ticket out of view of anybody to scratch and bring it back whereas You know a locked up machine. We're actually Catching somebody I think right in the lottery a lot There's a tacit agreement between the person claiming and the person who's going to have it right And so there's a fault of urban going up to the lottery saying yes This is my money my ticket when in reality they have a side agreement They're only keeping a thousand and they're giving nine to someone else for the specific purpose of defrauding And we had the tiebreaker of having a surveillance system Right Can you bring us through these slides? Yes, uh val's gonna walk us through some examples of actual switches Thank you. Uh, good afternoon commissioners. Um, yeah, it's all right Okay, just nice and close. Oh, okay. Sorry So in this slide over here, we can see that, um A man and a and a female are playing on the Are sitting next to each other It's clear that the female is the one playing on that slot machine and Over here after After the The females With the jackpot it's clear that uh, they switched spots. So now the male is sitting on that machine and Right here you can see that the The slot attendant is is there to retrieve all the information from the patron And so they they take their id and You shoot the w2 form On yeah over here the slot in is giving the w2 form to the male patron who signs The the form and the slot and then gives them the cash money So is the the the male was observing the female before the jackpot here, right? They it's fair to say that they're at least perhaps together in that situation Yes Or did what she switched and he provided his information. Yeah, could did we find out? Were we able to correct this because we are supposed to balance and Since this is happening Like weeks after it happened They didn't We didn't have any information on the woman So we don't know if if she had a player's card Who she is at all we just had the information of the male patron patron So i'm not sure if uncle or is able to Do anything about so for instance if she had had an obligation to pay child support We don't We weren't able to recover that for dor So that would be an example. They may be together Commissioner, but they would could have separate interests That's why it's really important that we have the casino check these Before they pay the jackpot and you would catch it every time It's a 10 minute process to do that It probably takes 15 to pay the jackpot by the time you jack everything and you mean check The surveillance very the same person that that was sitting at the machine when the jackpot But it's also possible and i'm just speaking theoretically here that they were related that they were married Our boyfriend girlfriend or you know Meaning that it would be of no consequence Perhaps well, you know, does he know? From a previous marriage. Yeah, she might have a child back taxes in his name or you know, there can be a lot of scenarios with that So yeah, because even though you're married you could have separate interests for instance With respect to a former marriage to have child support obligations that run through one of you So this is if you if you notice this first slide up in the left hand corner, you'll see 10 19 as the time And if you'll go to the fourth slide when they're paying patron You'll see that it says 10 39 I think that's more than ample time that a casino could be Checking Yeah, so eight minutes enough time to check it All right 20 20 20 minutes 10 10 19 to 10 39. Is that right 10 29 is when the plot attendant comes over 29 right And then 10 39 is when he comes back with this W2 Oh there it says 10 30. Yeah, got it. Yeah, plenty of time sure and I was thinking eight minutes was plenty So 20 Okay Thank you. Now number two Okay, this example is from a ppc where this It's clearly that this female is playing on the slot machine When the jackpot hits She gets up go to the nearest eight gear you machine and Right here. We see that when the slot attendant comes in another female Who was sitting next to first one is presenting the The information needed for the slot attendant to Complete the transaction And right here we can see that the sort of tendon is uh paying the female in a in a with a dark hair the The jackpot and I think In the situation we um I think We knew I think both females had players cards And um, I'm not sure if uh, if ppc was able to retrieve the money but So if I understand correctly to commissioners and egos Point that while they could be married the rule though Is it by statute by regulation that we must that pay the winning patron? It's the regulation The regulation, right? So the regulation requires even if it's a married couple or a couple shared interests sisters Brothers whatever they must pay the winning that that's what the regulation says And I think the regulation is very much on on point. It makes total sense I'm I'm really you know, and I should this is not just a hypothetical I am actually related to somebody who likes to play with his brother in las vegas And they actually play together And they change sweet seeds, you know try your luck now and they pull their money They say, you know your turn now and they all cheer for each other and then they change And they also do this in that situation not here because they've never done that in Massachusetts um Otherwise, I would really have to tell them You know the problem is these other jurisdictions don't have to check against a dor thing, right? But in that situation, what should somebody like that say then they should both present their information Both present their information. Is that what would well, you know, I I would The first thing I would ask is why didn't you want it in your name? And you know, I I would run it in the dor Uh system just to make sure That that individual didn't know back stuff and I don't care if it gets paid in his name, but You know, I would make sure that he didn't know taxes or you know, child support Yeah, no, there's another there's another principle here anybody doing that knowing that everybody's on their surveillance in a casino So and really how many jackpots has this happened on never But no, but this is not they do pull their money that is part of the fund Yes, and they they take turns Okay, and because it's not I don't think in Las Vegas that would ever happen to you because They are not double checking you against the system or Right anything like that. So I think you're clear You know, I'm concerned about what Do we do I say I think I think we would check the dor system to make sure that that individual doesn't know anything You know in back taxes or child support The one who won who actually won okay, not the other one Yeah, I think that would be pretty simple Okay, I mean they're both technically violating the regs. So what's the consequence to violating the reg? Yeah, well, is there any I mean did they get excluded for some period of time or Yeah, that I think would be left up a casino I it depends how much you know, how big of a deal you want to make out of that Well, the whatever the reg is on the casino. We regulate the casino. We are asking that they check Go back to the tape to pay the winning. No, I'm aware I'm just saying that once you've determined someone's violated the reg You're telling you're saying it's a reg the winner has to collect And the purpose of it is to make sure dor gets child support in the area taxes So once that's been determined, they violate the reg Do we have any other reg that talks about the consequences or mandates that they do? You know that's something we can even look at the regs and see if we want to strengthen that a little bit and make sure we require them to You know check the jackpots and and do this correctly I could see some advantages to doing that. Right, especially if you have a recidivist who keeps doing it. Yep absolutely We have an example three female plane at the machine triggers the jackpot patron Locates other players on the casino floor to claim the jackpot It's a little more egregious. Yeah, right somebody's sitting there. Slotted tenant retrieves the information from the male patron who's attempting to claim the jackpot The male patron then gives the cash collected from the jackpot to the original female who activated the jackpot He just Now, uh, remember some of these are in our review. These are days and weeks later. We're finding this from our initial review No, but did you see this game any money off for his cut? Yeah, yeah, I don't I'm just wondering if it's in the footage Oh, yeah once again the uh, yeah, yeah, palming once again the video is much more clear than still shots, right? Right But this is from your summary. This person was on the vnc On this last example Yeah, it looks like it from your summary Okay, right, right, which of course That so this is an important exercise, right, right? Not only for the dlr conference, but for responsible gaming So we're trying to Prevent this we have alerted the casinos. They are working well with us. You got to remember the MGM on core casino has table games revving all day long big properties so it is a task And uh, the a very good good faith effort is being produced right now And um, so we we will continue to work with them with with those findings I just I strongly think the more important message is We're trying, you know, we're working with our licensees not to allow people to kind of one skirt the regulation skirt You know when a bsc signs up. Hey, don't let me on the property And following those regs as well as You know, you know making every effort to catch somebody who owes her friends a do or some money correct I think it's a positive thing that the Commonwealth does versus other jurisdictions that need to see the dollar amount that's retrieved And and as we've seen the amount of time For the slot attendant to walk over when the They get the alert to check the w2 information and come back and the payment is more than enough time for surveillance to Yes Double check I suppose that they could they could also They could also Be trained the slot attendants to say When they arrive Something to the effect we're going to roll back the tape just to make sure that you were the one That they at which point at which point they At which point they may need no need to roll the tape back is part of my point They could I I don't know if that would happen all the time. It would be nice if it did but I just don't know my The reason of my questions is that I can I can imagine the argument from the operators saying this takes away resources For us We need a higher threshold because we are otherwise observing the high state games for example Because we have all these other surveillance Is that is that a fair argument from this side? You know, I've been in this industry a long time and and my specialty has always been surveillance I would find that a real hard argument to swallow Fair enough Well, I think it's great work on vows part to identify Well, I you know, it just doesn't take that long to do that and you know, they have People in the room that are reviewing things all the time and It just But I like that she was vigilant and she saw something that was unusual and And and we appreciate that It would be worthwhile I think just checking on the lottery because there was some chatter a while back about even proposing misdemeanor Consequences for people that did this. Okay. Um, I don't know if they ever did anything about it I think it's a bigger issue for the lottery because to your point. It's far easier to switch a ticket And then imagine it's harder to track. It is harder to track But for consistencies purposes and then just a conversation about whether there should be consequences particularly if people continue to violate I'd be interested to know what their Great, that's worth. Thank you very much. Thank you. Thank you. Okay. We are now moving on to item Number eight Investigations and Enforcement Bureau director wells, please. Thank you Good afternoon, madam chair members of the commission. Good afternoon. Good afternoon. You know, you've had a long day I will try to uh expedite matters here Uh, so I have two matters on for your consideration. Um The first matter is entitled modification of massachusetts supplemental form So as you know, uh throughout the history of the gaming commission, we've used the multi jurisdictional personal history disclosure form to get information on not only qualifiers but also for key executive employees And when the commission, uh started even before I was a member of the team here, they Created the massachusetts supplemental form to add some questions to that multi jurisdictional form that massachusetts regulators would be interested in So what we've done is taken a look at the form particularly in light of the events of last year and the issue with wind resorts And We are proposing that we add some questions to the form with relative to settlement agreements and sexual harassment And also we have sort of a catchall question These these are questions. We have investigators generally currently asked in the course of Interviews, but these kinds of questions can be a little awkward in interviews and it makes sense to have a Regulated format where the questions are asked the same way and they're put forth in a in that kind of format So we're suggesting that we put them in the form you can see The first two questions 17 and 18 I have to do with settlements. We Took this language tweaked it a little bit, but generally this language is what? The nevada gaming control board has modified their supplement to add those and you know after the The wind matter came to light. So that's where we got those And then there's the other questions that have been presented before you So in briefing the commissioners individually, you know, in particular, we did speak with commissioners zuniga He had asked that we could Potentially specifically discuss whether we need question 19 which asks have you ever participated in any type of sexual harassment sexual Misconduct or unlawful discrimination? And whether we need that question in light of the fact that we have also included question 20 Which says have any allegations of sexual harassment sexual misconduct or unlawful discrimination made concerning your behavior? Including by employees and or subordinates So We could do it either way The thinking behind putting question 19 is there is it's a broader capture of information from the actual applicant him or herself That more information is generally Better and more more leads if there's any information which might be relevant to suitability But i'll leave it, you know to the commission's discussion and deliberation and whether or not you would like that included on the form And if there's any other questions on the form that you think Should not be included or would like modified i'll leave that to your comments and discretion Here let me let me just Expound to that. I'm thinking specifically of Question 19 that appears to me quite broad Especially as it relates to You know situations that were that are Sometimes blurry And that people come in And leave with a different understanding I think it's better to use these examples since it's public, but let's just assume that Somebody like assistant sari or mr. Al Franken was responding to these To this form Prior to those allegations that were public or after those allegations were public I suspect That they would have a hard time answering these question now My more fundamental question is what are we trying to get? To in these question in question 19 the objective of the question I would suggest is to try to be able to capture instances of sexual Harassment misconduct or unlawful discrimination, which have not been reported and therefore the the company's unaware of Yeah, but it's the it's the person feeling this out, right? So they'd have to self disclose. So if somebody Went on a date that turned out to be not a great date And they don't know how that person the other person is going to Look at that situation now looking back Is the reason to to put this here To get them on the record so that should something later Surface to be able to come back and take away their license for example It would seem to be so that the language is somewhat of a term of art Those phrases sexual harassment sexual misconduct unlawful discrimination It seems like the distinction between 19 and 20 is 20 specifically related to allegations and by context in the workplace 19 would seem to capture allegations of the same Ill but not necessarily in the workplace And I'm wondering I get why you want it and I'm just I like the idea of it And I'm what I'm struggling with is how to capture the information in a way that addresses His concern about ambiguity So there are other ways to ask the question broader than 20 Or maybe a caveat within 20 That addresses commissioners any of these concerns about sort of You know vagaries of life, right? I mean you could I mean, I think that what 19 is trying to capture is a situation you may have An individual male or female that's even in the workplace right engaged in activity Which would fall under and I would suggest you're correct that that term of art Like it's a legal term sexual harassment and misconduct and unlawful discrimination So that sort of that legal term rather than right that day, right the um, but didn't rise to the level of Well, nobody reported. I think that's that's the issue. It's this is an issue of self disclosure Where there may be a situation where someone Absolutely knows they did something wrong and this is their opportunity to disclose it I in in addressing and rick is Pardon me commissioner Zuniga's concern That um, you know, what if someone doesn't doesn't know what our expectation is in these forms is to be truthful and we have that That language, you know is in the is in the application forms throughout and I think that You know in a case-by-case analysis if you generally didn't believe that what you did was sexual harassment Then when you put down no then that's a truthful answer So that would be how you'd address it, but I'll leave it I think sequentially too if you it seems sequentially 20 should be 19 and 19 should be 20 um Okay, I mean, I don't know in my head if I'm if I'm reading through it. I would think That might frame it a little bit better and then the question is really does that and 21 Give you what you need. Yeah, I mean, I think Commissioner Zuniga's question when we had the discussion was if you have question 20 in there Which covers allegations which have been made against an individual in the workplace? Do you need question 19 as well? and I'll leave that sort of it's that that's a It would suggest as a commission's discretion How deep do you want us to dive into these kinds of allegations because if you want it Workplace reported, you know internal controls analysis that kind of thing That's what you're looking at then having question 20 should be sufficient But if you really want the Investigator is doing a deeper dive into, you know other acts of misconduct and generally broader analysis into Integrity honesty and good character then this may be something that you'd want to add So we have included that for your consideration and we just need some direction how you would like us to proceed It's number 20 just limited to employment. Well Because I I yeah, I guess you could put in there Well, we've got including by employees and subordinates, so it definitely includes that Yes, but it's no I guess to your point that may not be limited to that Could it be at college When I was when I was at college, yes, absolutely. Yes yes well The one that seems broad to me is 19 only because there is Perhaps a small but significant Significantly important number of potential scenarios in which the person might legitimately not know Whether, you know, there's there's there's not a I don't know option If the idea is to put in No, so that then when we later find out whether somebody was Accused we could come back That's that's one thing or but Which I I don't feel good about how about phrasing it. Are you aware of? Any other conduct In which you've participated in that would rise to love, you know, like is there a way to say it that sort of captures that aware? And so if they say like I didn't know she said that about, you know, five years later She comes and says You know what he did to me was inappropriate. I think it was sexual harassment. Well at the time he fills out the form or she If it's phrased that are you aware of it goes to the knowledge the state of mind It would that be falsehood if there's proof that they did they were aware this person made the allegation contemporaneously Yeah, I mean I perhaps also What do we do with somebody who says yes And uh describes a situation that is Just like the scenario of pain which is the one that um, you know The blurry one a blurry one in which well I I don't know. I mean there was that there was that bad date over there or whatever What are we supposed? What are we gonna do with that? What's what's was interesting? the the attorney from ruben and runman was very helpful to us and giving us some sort of Sort of expertise on these types of investigations and What she indicated to us is that Generally we're doing some kind of investigation into sexual harassment and this and sexual misconduct is that When you do an investigation like that it You are looking for patterns because generally if someone's engaging in this type of behavior It's not a one-off If it's real, you know that sort of intentional Those those acts so she was telling us which we found very helpful is that If if you're doing a legitimate investigation to that you're going to look into Other whether they're not there are other instances or is it just the classic he said she said Which you may not be able to do anything with if that's the only evidence you have But delving a little deeper and seeing if there's a pattern and as we all know now from a certain other investigation that Can come to light that once you start digging a little bit more and asking some more questions and Checking into other areas you might find more So that would be the relevance of getting that information is because it may lead you to a pattern of behavior Which may lead to a finding or a recommendation of unsuitability I mean if you I feel like a board smithing it But if you say are you aware of any incidents in which you participated in any type of sexual harassment sexual misconduct Or unlawful discrimination that did not result in a formal allegation If it still goes to the knowledge of somebody comes five years after the fact and says back in you know 2015 so and so did x the person's not falsely filling out the form Not so sure that gets to the pattern of conduct though that you're hoping to that Well, it's the it's the red flag. I mean what you're looking for An answer one way or the other on this form is not going to necessarily be determinative But it is going to say to an investigator. Oh, okay Let me let me look into this and let me see if there's an area of a further area of inquiry Let let's you know go to the hr department in your prior job and see you know Were there any allegations in the prior job not just look at where you are here It depends, you know the nature of suitability investigations is that you can never know everything about an individual ever And if you think you can you're kidding yourself But if you can create a system which will identify flags or areas where you need to make further inquiry So you can do a reasonable risk analysis and figure out where the areas Of risk are for that particular individual that helps you direct the investigation in timely manner So that would be okay. This might be an area We need to look into a little more further check with you know Higher co-workers maybe do another some other Introducing people they've worked with I agree with everything you're saying and I think we get to that with the three other questions Yeah, so that you know ultimately I'll need it's ultimately when there was either an investigation an allegation a charge I just think that the broadness Even with your clarifications commissioner about you know in the workplace or to your knowledge I I think the broad nature of it comes from Did you participate in any And by definition some of these The way how some of these allegations later turn out now have there been allegations? That's that's a clear cut But or a charge no question about that Could you establish? Track record by doing further inquiry after that That's that's a clear charge In terms of you know, what you could do to to to get to the nature of maybe one allegation or 10 allegations, etc but To me 19 is just Almost too broad for somebody to say well, I I really don't know It is conceivable that a lot of people might think of a scenario in which Okay, there is not an allegation I don't think I Participated in what's the definition here But there was never any charge or complaint or allegation I cannot know for sure that there will never be and that's the conundrum To me, this is just unnecessarily broad we can get to the other What we were what we're after With the other three I'm just trying to think of a hypothetical that might sort of Identify what then if you don't have this what you potentially are missing. So say you have a situation where you know John Smith who is a qualifier or a key executive Head engaged say in college or or later, you know in workplace With a bunch of other individuals Sent, you know harassing messages to another employee And no no knew he did it and later became, you know, more aware of what he should or shouldn't be doing And so knows that that he did the wrong thing, but there were never any charges If we don't ask this question Then we may never get that information and that may be something that that individual would have self-disclosed So that I'm just trying to think of a hypothetical that would so are we looking for confessions here Well, the nature of You know Regulatory suitability investigations isn't self-disclosure. We do expect self-disclosure. So the question is are you asking The right questions that are going to elicit the information And I guess the question for the commission is is that the kind of information you would like us to follow up on? Or is that something, you know, you'd be okay if we just never knew that Sorry In the interest of full disclosure and your obligation to be forthcoming in your application Is there any other information which Might reflect adversely in an evaluation of your honesty integrity or good character Otherwise impact a determination or suitability for gaming license or slash qualification Including any other misconduct not already disclosed above It goes a little bit more pointed than what you have in 21, but then would eliminate 19 In terms of Did you say any conduct or any miss including any other misconduct not already disclosed above? I I mean just to pick up on that and get Karen a moment to think about that I first of all jumping the question 21 I'm kind of like the fact that we're now including this I mean, I think a lot of us if we've been in public service getting the question thrown at thrown at us. So I'm Glad we've included that operationally because we're really talking about Key gaming executives and casino qualifiers. So this is a small Cod rate of people How often because again, this is a mass supplemental form may have differences from other forums where they've already completed Forms in other states. How much outreach typically does An executive call a viewer your team and say hey, I'm going through this Help me understand what you mean by question 21 or 15, you know, how much help me understand this question in this mass supplemental form So if it's the attorney they may say hey, I'm helping Ed fill out the form you have this new question. Give me an idea of what it means You could get to kind of a whole broad array of you know Well, we'd like you to consider these things sexual harassment Sexual misconduct those are the kind of things that we're looking for under this question so it doesn't pigeonhole you even to Some defined questions where there may be some vagueness, but it does I think at the end of the day give the applicant a chance to say All right, I'm going to you know point of self disclosure. I will tell you about XYZ incident now that I know you're looking for those types of incidents where I think 19 is a little bit vague and then I would have a question for you of should we be segmenting out from 19 unlawful discrimination because that seems to be more of a question or less of a value judgment around my answer and more I discriminated Was lawful or unlawful I don't know I'm trying to understand why you tied unlawful discrimination into sexual harassment and sexual misconduct Well, because it's misconduct and and it's usually you know, it's just something you know It's it's another area by the way where I think there's also some blurry line somebody could be joking about somebody's heritage, let's say and someone else might think it's inappropriate and and discriminatory discriminatory so Just take me In general to the process And I'd like your suggestion commissioner about you know, maybe really the catchall is really 21 That may be a solve that everyone's comfortable with is is it possible that somebody In the interest of full disclosure puts in what a situation that and and so now you're going to Interview that person We generally do an interview of all the qualifiers and the key executives So that would be standard and standard protocol would also be to go through the application with that person and and ask them about Can he gets to the operational question how they help? Assuming that it's like he said she said or you know Are you going to interview the other person for example?  It depends on what the allegation was Potentially a good investigation would investigate both the accuser and the accused, correct? But this is not an allegation. This is just a full disclosure. Remember If there's an allegation sure That that's covered and now and that that would be up to the party whether they would want to participate So if this is someone, you know from 20 years ago that doesn't want to speak to us It would be up to the that's up to that person and we would not Pressure that person into that and then it is what it is or draw any conclusions from them liking Correct and generally, you know Disclose, you know, that's what we find in these investigations It even will get to the criminal if you disclose things that's you're demonstrating Forthrightness and truthfulness. So if you're explaining, hey, there was this situation here and here's what happened That's an indicia of reliability in that you're coming forward and talking about it. You're not trying to hide anything So that actually works in the favor of the applicant Well, I like your suggestion about 21 In terms of adding are we are we talking about you know, if we eliminated 19 Because it's it's in my opinion. It's uncomfortably they they Are we um, are we talking about workplace? Only Or are we talking about any kind of well? No, it's connected to anything that would Be relevant to your suitability. So it's already captioned to be relevant to suitability. So it's giving a further example about Being a little more explicit in the catch on number 20. It's not confined to employment Correct, right You know, ultimately it sounds like where we are is um We could do the do the questions as is or or it seems like we could eliminate 19 Or the third option is what uh, commissioner o'brien said eliminate Eliminate 19 and add at the end of the question of the word qualification Including any other misconduct not disclosed above Which seems to be sort of in between the the two other options So we'll just look to see whichever the commission goes with we can then move forward with the forms as you desire Yeah, to be clear. I was fine with the the form as it was But I understand there's some concern about being vague disclosures for this level is high heightened The self-awareness that is required would also be needed to be heightened We can capture it in the way that you We thought so I'm fine with that recommended change Generally, we Uh, my understanding is in the past the commission has approved these forms So it probably makes sense just to do a quick vote on that make sure that we're clear that that's what the commission wants And then we'll go forward and I'll move on to the next one Is there further questions or discussion for director wells? So it looks like on a consensus emerged on on eliminating 19 and I'm I'm in the same I didn't have quite the level of concerns on 19. I was more in line with the chair But I see where you're coming from. I feel like Eliminating 19 and adding the phrase to what's currently 21. What would become 20? Sufficiently gets To the purpose of 19 and it might capture some other things Right, that's even being So I I do think you are seeking a vote On on this forum. So do we have a motion certainly madam chair I move that the commission approve the modifications To the massachusetts supplemental form as described by the commission staff today and as included in the commission packet As further amended however to strike proposed question 19 And add to the end of question 21 the phrase Including any other misconduct not disclosed above second And any further questions? All right Do all those in favor? All right Opposed for zero. Thank you director wells. Thank you very much. That's very helpful. And then the next area for the commission's consideration is in the Forms that we submit particularly to the service of level employees and the gaming employees There was some concerned by the commission about the Just sort of clarifying the sort of the instructions in the form So people that are filling out the form know what they are required to submit. So there's no ambiguity there So we've added for your packet some modifications Just to make it easier for people to understand that we really need truthful and full disclosure And that's what we're working with and that's what we expect So for example, you know charge in the definition of charge we want to Including We want to include the language including juvenile charges because what happens with juvenile charges There's the applicants required to disclose them. However, no juvenile charges are mandatory disqualifiers so Even though you have to disclose that you don't it's not going to be a mandatory Disqualifier even if it is a larceny charge that if you had been an adult would have disqualified you It does not disqualify you as a juvenile um And then we have, uh, you know that language under conviction to make that clear to the applicant Um dispositions also include delinquent and not delinquent which are dispositions for juvenile offenders The fact that you have to submit uh in the form The charges or offenses, uh, even if you weren't convicted or found delinquent or Even if you weren't placed in handcuffs, you don't have to actually be arrested to be charged with crime Um, we wanted to emphasize in the form also That applicants are not required to disclose records of criminal appearances criminal dispositions and or Any acts of delinquency that have been sealed so that information is Not required on the form and also to make uh applicants aware That the gaming commission will make inquiries to establish whether you have had any involvement with law enforcement agencies And that failure to disclose such involvement will be taken into into account in assessing your character honesty and integrity Just to make sure people are aware That that that is an issue and also There was a suggestion just to make the um the space for the uh applicant to fill out Any offenses put more more space in the form just in case there were several charges Or maybe several charges relating to the same incident that they would list all of those charges So those are the the types of changes made to the form There there was a suggestion In when we were doing the briefings that we might want to add something not to this part of the form but also to the front of the form that uh commissioner o'brien and uh commissioner Stebbins we talked about Which is that we may want to put some language that applicants may want to check with the employing casino hr department for advice On how to prepare out prepare to fill out the application form So we can add that as well that the commissioners think that's a good idea Just because the casinos themselves can help with this, you know as the regulatory authority It's not our role to to work with the employee to fill out the form They're submitting to us but the casinos can do that and the casinos may have some advice getting all your paperwork together Maybe you you know go to your icory and run your quarry before you fill out the form Just to make sure you have everything correctly and you have things so We've talked to the casinos about doing that with their um with their hr departments to work with their employees on that Because nobody's looking for anybody uh to uh make a mistake on the form We'd like everybody to fill it out honestly and completely It's easier for us because we can run through these much more efficiently and it's better for the applicant So communicating to these folks that are filling out the forms that honesty and completeness is Extremely important in this process Uh can't be emphasized enough so uh putting that in the um in the sort of the that front page on lms I think would be a good idea of the commission's in support of that I No, I I I like that idea and that suggestion. Um, you know something else I think we should do If we approve, you know the changes to the form Uh with respect to a lot of our workforce stakeholders that are out there you know Beating the bushes trying to get people interested in in pursuing Uh A casino career and you know, we had one of these meetings out in springfield Let's get them in the room and kind of again walk through this process help them understand Um, I think some of this language is You know might be you know might be viewed as Intimidating I know that's not what we're trying to get through but I think having a conversation Uh With those cbo's to kind of help walk them through the process again the same thing You know some of the instructions that a uh one of our licensees might use might be Great information for that cbo to carry to an individual like go do this Again, if you know, we find ourselves not able to to make those suggestions ourselves again it's more people out there aware of our process aware of what we're looking for and Helping the individual because again some of the cases they get to us are just people Yeah You've raised this before people just not completing the form and Some of the omissions are clearly like how could you have missed that? Right, um, but again trying to get people to be truthful and honest on the form You know, I think making extra room is is fine. Even though if you're filling out that much room Um You may not be a good candidate But again, I think t