Problem gamblers get more options but little help
Posted: Sunday, October 14, 2012
Hundreds of $5, $10 and $20 bills are changing hands at convenience stores around the state for Maryland Lottery scratch-offs, Pick-Threes and Mega Millions tickets.
At a bar near you, someone’s playing Keno or Racetrax, watching numbers flash on a screen and hoping his dollar turns to two.
But between the late 1980s and 2011, not a dollar was set aside specifically for the treatment of problem gamblers in Maryland, said Joanna Franklin, who in June was tabbed to run the University of Maryland School of Medicine’s Center of Excellence for Problem Gambling.
The center didn’t get started until the university received a three-year grant worth $5 million — less than the state’s take in one week from its three operating casinos — from the Department of Health and Mental Hygiene.
The center will train counselors to deal with problem gambling, operate a helpline that has continued in years past with and without state funding, and work to improve public awareness. It will also recommend how money should be spent on treatment.
But the gambling isn’t waiting. One casino per year has opened in the state since the first slot machine venue arrived in 2010.
Health officials in areas with casinos, like Worcester County, say it’s too early to tell what effect new slots venues are having on their communities, though a slight uptick has been noticed in the number of people concerned with problem gambling.
A state-commissioned study on the prevalence of gambling, published in 2011, found that 150,000 adults — 3.4 percent of those who had ever gambled in Maryland — experienced moderate to severe difficulties stemming from their gambling.
The study found “a relatively high rate of problem gambling prevalence” in the state before the introduction of slots.
Question No. 7, being voted on in the upcoming general election, would introduce table games and a sixth casino to the state. The new legislation doesn’t include any additional guaranteed money for the problem gambling center.
While neither the center nor Franklin have taken a side on the ballot item, some of her colleagues wonder why the state wants to move so fast.
“They’re talking about expanding before they’ve even built an adequate problem-gambling infrastructure,” said Keith Whyte, the executive director of the National Council on Problem Gambling since October 1998. “They’re playing catch-up now.”
An arms race for revenue
In the 1990s even previously stubborn states loosened up with regard to gambling, said Mark W. Nichols, a professor of economics at the University of Nevada, Reno who has dedicated his career to research on gambling expansion.
Most turn to the flashing lights to drive up tax revenues, Nichols said. Since the recession hit, he has seen expansion become so rapid that it seems as though there’s a race among states to see who can open casinos fastest.
Pennsylvania and Florida got their first legal racinos — combined racetracks and casinos — in 2006. Indiana opened two racinos in 2006, Kansas opened its first state-owned casino in 2009, Maryland and Ohio opened their first casinos in 2010, and Massachusetts’ first casino is set to open in 2014.
A bill has been filed for next year’s General Assembly in Virginia to bring casinos to that state.
With voters hostile to tax hikes, casinos provide a sort of voluntary tax — you only pay if you play.
This has proved to be the easy way out for states, Nichols said.
The move to gambling is coming so fast that “maybe (states aren’t) thinking through what sort of infrastructure we need to have in place,” he said.
Whenever states look to legalize casinos, “I see a lot of these same arguments,” Nichols said. “We need casinos for jobs and revenue, that’s the upside. Downside is problem gambling, crime, those sort of issues. None of those questions seem to have been fully satisfyingly answered.”
In Maryland, Hollywood Casino Perryville opened in September 2010. The Casino at Ocean Downs in Berlin opened in January 2011. And Maryland Live! opened in Hanover in June.
Funds go to education
As part of Maryland’s original casino legislation, casinos are required to pay $425 per slot machine annually into the state’s Problem Gambling Fund. That fund grows as the state’s casinos grow, but so far little has been spent to combat problem gambling.
State officials transferred more than $1 million from that fund to the Education Trust Fund to limit cuts to aid for schools. So it took until April 13 to put out a request for proposals to start the problem gambling center.
Casinos are planned in Baltimore city and Allegany County, jurisdictions with state’s highest and third-highest poverty rates, respectively, according to 2010 U.S. Census data.
A University of Maryland, Baltimore County study said people with lower incomes are more susceptible to problem gambling.
If Question No. 7 is approved, a casino will be built in a couple of years in Prince George’s County, which has a large African-American population.
“‘African-American’ or other races (primarily Hispanic) are associated with an increase in the odds of being at risk for problem/pathological gambling,” UMBC’s study said.
The expansion, when completed, will put a casino within about 45 minutes of every Marylander. The Research Institute on Addictions has said living within 10 miles of a casino can increase the chance of becoming a problem gambler by 90 percent.
Nichols said he wasn’t sure if Maryland’s expansion rate was faster than average.
But he said states generally put infrastructure in place to combat problems associated with the introduction of gambling into a community, and he was surprised Maryland had just started putting money into that cause, since the decision to allow casinos was made some time ago.
“It’s sort of building the bus while you’re driving,” Franklin said.
A slow start
In 2010, a survey by the Association of Problem Gambling Service Administrators found the average per-capita allocation for problem gambling services in 37 states was 34 cents. The allocation ranged from 1 cent in Maryland to $1.36 in Iowa.
The study said that, on average, 50 percent of state problem gambling service budgets were used for treatment.
Money for treatment is on its way in Maryland. Around $1.6 million a year goes to the problem gambling center. The rest of the money is supposed to go toward treatment, Franklin said.
This fiscal year, Franklin said, plans are for the Maryland Alcohol and Drug Abuse Administration, or ADAA, to dedicate $300,000 to $400,000 to treatment. Only $96,000 was dedicated to problem gambling last year, around $76,000 to the state’s hotline — and nothing to treatment, she said.
“We will have come from the very last place to almost middle of the pack,” she said. “That’s just huge.”
Franklin hopes the center can raise awareness that problem gambling can be treated and is an issue.
A Maryland resident seeking help today can go to a state-funded substance abuse treatment provider that will screen him or her for problem gambling. Care is never denied if an individual needs treatment, said Eugenia Connolly, director of the ADAA’s community services division.
But many insurance providers don’t cover treatment for problem gambling. States usually combat that by putting money aside specifically for problem gamblers who can’t pay.
In Connecticut, where there are two casinos, a little more than $1 million goes directly to treatment, said Lori Rugle, director of the state’s Problem Gambling Services program. That money is available not just for problem gamblers but for family members.
Doris Moxley, director of the addictions program for Worcester County, said she and her staff have been trained to treat problem gamblers. Moxley said that since the casino in Berlin opened, she has seen a few more people come in seeking help for gambling.
She expects more such people when there is more awareness of the problem and the casino has been around longer. The only funding available to treat such people, she said, is grant money that was available before the casino.
“What a lot of people don’t understand is, despite the fact that we have grant funds, they’re the funds of last resort,” Moxley said.
Lagging behind
In 2008, Oregon’s Problem Gambling Services program treated 2,012 people for problem gambling at a cost of $3.8 million. The program claimed this saved $8.1 million in social costs — including those for bankruptcy, crime, suicide and illnesses — that would have been incurred without treatment.
Pennsylvania had money dedicated for treatment immediately after the state introduced casinos. Its Compulsive and Problem Gambling Treatment Fund was set up to receive $1.5 million annually.
That has since grown to $2 million.
Franklin, who worked in Pennsylvania for years before she moved to Maryland, said that program had its hiccups. In the first couple of years, some of the money wasn’t spent.
But in the past year, $6.4 million was given to 37 county agencies in Pennsylvania, using both the Department of Health’s unspent allocations and new funds. The money supports gambling-addiction treatment, counseling, media publicity and awareness projects in schools, retirement communities and prisons.
Jim Pappas, executive director of the Council on Compulsive Gambling in Pennsylvania, said awareness has been key.
Before casinos arrived in 2006, Pennsylvania’s gambling hotline received about 800 calls from people in the state, about 20 percent of them from people seeking help for gambling problems.
That number has grown to around 1,800 and continues to grow as more casinos open in the state, he said.
A total of 1,308 people called Maryland’s hotline — 1-800-522-4700 — in fiscal 2012, Franklin said.
Of those, 262 calls were from people seeking help for gambling problems, 366 were inquiries about the casinos and 208 were people calling with questions about the lottery.
Hope remains
Franklin remains hopeful. And so does Whyte. But they don’t ground their hopes in the state’s history.“The intent is there,” Whyte said. “I just think their implementation has been shoddy.”
Franklin tried to fight for additional funding, like that in Pennsylvania, when Maryland passed legislation allowing a referendum on table games.
Pennsylvania’s problem gambling fund received about $3,000 per table, Franklin calculated. So she went to the General Assembly’s special session on gambling this year and lobbied for $1,000 per table. It didn’t work.
The law accompanying Question No. 7 doesn’t guarantee extra funding for gambling-related problems. But it does have a clause allowing “an annual fee for each table game, capped at $500 per table, to benefit the problem gambling fund.”
“I’m quite sure when it says ‘may,’ it means ‘won’t,’” Franklin said.
Still, Franklin said Maryland is “ahead of the curve” because it is merging mental health and addiction services. Alcohol and drug problems sometimes go hand in hand with problem gambling, so it will help for integrated services to be available at the same locations, she said.
Franklin said she hopes Maryland will take its first big step by using the $300,000 to $400,000 allotted for treatment to build inpatient programs that match or surpass those in states with more funding.
“You can’t take off and be at 10,000 feet,” Franklin said.
But could additional funding get Maryland to 10,000 feet quicker?
“Absolutely,” she said.
http://www.capitalgazette.com/news/government/problem-gamblers-get-more-options-but-little-help/article_4f1c5598-2970-5445-a8d7-add2ec3e6bd9.html
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