1. MASSACHUSETTS GAMING COMMISSION RESEARCH DRIVEN PROBLEM GAMBLING MITIGATION JANUARY 10, 2014

2. AN ACT ESTABLISHING EXPANDED GAMING On November 22, 2011, Governor Deval Patrick signed Chapter 194 “An Act Establishing Expanded Gaming in the Commonwealth” 1 | MASSGAMING COMMISSION

3. THE MASSACHUSETTS GAMING COMMISSION The Gaming Act created an independent body responsible for overseeing and implementing the licensing process. 2 | MASSGAMING COMMISSION

4. PRINCIPLES OF THE GAMING ACT Transparent and competitive bidding of licenses Maximum long-term value to the Commonwealth Expansion of economic development benefits across regions of the state Protecting host and surrounding communities by addressing all social impacts and costs Ensuring rigorous public safety, regulatory and enforcement mechanisms will be the best in the country 3 | MASSGAMING COMMISSION

5. LEGISLATION DETAILS: FLOW OF FUNDS 4 | MASSGAMING COMMISSION Revenues derived from gaming are allocated by law to: Local Aid Stabilization Fund Manufacturing Fund Community College Fund Mass Cultural Council Gaming Economic Development Mass Tourism Fund Local Capital Projects Fund Debt Reduction Health Care Payment Reform Fund Community Mitigation Fund Public Health Trust Fund Race Horse Development Fund Gaming Local Aid Fund Transportation Infrastructure and Development Fund

6. COMMUNITY MITIGATION FUND Community Mitigation Fund: created by the Legislature to address impacts after a gaming facility is operational. 6.5% of the revenue from Category 1 Licensees is distributed to the Community Mitigation Fund. In addition, 10% of the gaming licensing fees, with the exception of initial licensing fees, is also placed in the Community Mitigation Fund. Funds to be expended “to assist the host community and surrounding communities in off-setting costs related to construction and operation of a gaming establishment including,” water/sewer, education, transportation, infrastructure, housing, environmental issues and public safety. A Community Mitigation SubCommittee and Local Community Mitigation Committees, including members from host and surrounding communities, will advise the Commission. 5 | MASSGAMING COMMISSION

7. PUBLIC HEALTH TRUST FUND Public Health Trust Fund: Intended to assist social services and public health programs dedicated to addressing problems associated with compulsive gambling including, but not limited to, gambling prevention and addiction services, substance abuse services, educational campaigns to mitigate the potential addictive nature of gambling and any studies and evaluations necessary, including the annual research agenda to ensure the proper and most effective strategies. 5.0% of the revenue from Category 1 Licensees is distributed to the Public Health Trust Fund. Annual fee of not less than $5,000,000 to provide programs to deal with compulsive gambling and other addictions 6 | MASSGAMING COMMISSION

8. RESEARCH AGENDA MASSACHUSETTS GAMING COMMISSION

9. BACKGROUND 2011 Expanded Gaming Act is unique in enshrining the role of research to enhance responsible gambling & minimize problem gambling in MA Section 71 of Gaming Act requires MGC to establish an “annual research agenda” to assist in understanding the social and economic effects of casino gambling in MA & in making annual scientifically-based recommendations to the Legislature 3 essential elements to the research agenda: Understand the social & economic effects of expanded gambling Baseline study of problem gambling and existing prevention & treatment programs Facilitate independent studies to obtain scientific information relevant to enhancing responsible gambling and minimizing harmful effects

10. FEATURES OF THE PROJECT First-of-its-kind gambling monitoring system that will Provide stakeholders in MA with a neutral database for strategic analysis & decision-making Generate early warning signs of changes in social & economic impacts of new & existing forms of gambling in MA Promote responsible gambling & mitigate problem gambling through refinement of services A comprehensive approach that establishes the impacts of casino gambling: At a Massachusetts-wide level At a regional level At a local level A ‘state of the art’ analytic framework for socioeconomic impact studies and a multiple methods research strategy Employs primary & secondary data collection/analysis Quantitative & qualitative research methods

11. THEORETICAL FRAMEWORK 1.Measure ‘impacts’ rather than ‘costs and benefits’. 2.Comprehensively assess all potential economic and social impacts. 3.Avoid applying arbitrary monetary values to non-monetary impacts. 4.Apply basic economic principles to evaluate the positive or negative nature of economic impacts. 5.Recognize that assessing overall nature of the observed impacts is sometimes a qualitative assessment that often involves some subjectivity. 6.Identify how much money is involved, where it is coming from, and where it is going. 7.Establish both the micro and macro geographic impacts. 8.Speculate on what the situation would have been without the introduction of the new form of gambling. 9.Assess impacts for years before and for years after the introduction of new gambling venues/opportunities. 10.Report the limitations and parameters of these results.

12. SOCIAL RESEARCH: METRICS AND DATA PROBLEM GAMBLING and RELATED INDICES Prevalence of PG Treatment provision Treatment/prevention costs Personal bankruptcy rates Suicide rates Divorce rates Child welfare involvement rate Treatment & Prevention Providers Population Surveys Secondary Data (e.g., ABI, ISP) Key Informants Focus Groups CRIME Crime rates Costs of gambling-related crime Secondary Data (NIBRS) Population Surveys Key Informants LEISURE ACTIVITY Percentage of populace who gamble Demographic characteristics of gamblers Population Surveys Patron Surveys License Plate Surveys Focus Groups EMPLOYMENT Employment and unemployment rates # people directly employed by casinos Gambling Venue Operators Employee Surveys Secondary Data (e.g. U.S. Census) HOUSING Owner-occupied vs. rental unit ratio Multi-unit housing and mobile homes Secondary Data (e.g., U.S. Census) Key Informants

13. SOCIAL RESEARCH: METRICS AND DATA EDUCATION School enrollments Demand for specific services (e.g., ESL) Secondary Data (e.g., MA DOE ) Key Informants SOCIOECONOMIC INEQUALITY Poverty Health insurance Participation and expenditure on gambling as a function of income level Secondary Data Population Surveys Patron Surveys ATTITUDES Toward impacts of future venues Toward impacts of established venues Toward gambling generally Toward further expansion Population Surveys Focus Groups PUBLIC HEALTH Health care utilization Cost of gambling-related comorbidities Health care facilities Social welfare programs Health habits Perception of health, MH status Secondary data ( e.g., MA BRFSS, Acute Hospital Case Mix Database, All Payer Claims Database, MA ETA, MA DOL, BLS QCEW ) Focus Groups Key Informants

14. SOCIAL RESEARCH: METRICS AND DATA QUALITY OF LIFE/SOCIAL CAPITAL/VALUES Happiness and life satisfaction Perceived social capital Personal values Population Surveys Focus Groups Key Informants ENVIRONMENTAL Environmental attributes (e.g., noise, traffic congestion, etc.) Population Surveys Key Informants

15. BASELINE STUDY: WHAT WILL WE LEARN? 1.What are the baseline levels of social & economic variables and their inter-relationships before casinos become operative in Massachusetts? 2.What is the current prevalence of gambling in Massachusetts? a.Demographic, game type, and geospatial pattern of gambling in MA? 3.What is the current prevalence of problem gambling in MA (+ actual # PGs)? a.Demographic, game type, and geospatial pattern of PG in MA? b.Social, health, and economic consequences of PG? c.# PGs that desire treatment and # seek treatment? d.Where do PGs go to receive treatment in MA? e.What barriers exist to treatment seeking? f.What PG prevention and treatment services currently exist in MA? g.How aware is the general public of existing PG prevention initiatives? h.How well do PG prevention and treatment services match up to best practices?

16. OPERATIONAL STUDY Purpose Determine impacts of new gambling venues on socioeconomic indices Determine effectiveness of PG prevention & treatment to mitigate impacts Data Sources Secondary Data Baseline & Follow-up Population Surveys -General Population (n = 10,000) -Targeted Population (n = 4,000) -Online Panel (n = 5,000) Gambling Venue & Government Data + Employee Survey Patron Surveys & License Plate Surveys Key Informant Interviews Focus Groups Geographic Levels: State; Region; Community Temporal Parameters: Annual Summaries (primarily) for years 2014, 2015, 2016, 2017, 2018

17. OPERATIONAL STUDY: WHAT WILL WE LEARN? 1.What are the nature, characteristics and magnitude of the social and economic impacts of legalized casino and slot parlor gambling in Massachusetts? 2.What is the geospatial and demographic pattern of these impacts? 3.What is the relationship between casino and slot parlor availability and gambling impacts? 4.Do these social and economic impacts change over time? 5.Which individuals, groups, organizations and sectors in Massachusetts benefit most and least from legalized casino and slot parlor gambling? 6.What does the data suggest about potential future impacts of further gambling expansion? 7.What has been the effectiveness of strategies to mitigate the negative impacts of expanding gambling in Massachusetts (particularly problem gambling)?

18. ADVANCING THE RESEARCH AGENDA Longitudinal Cohort Study Follows a group of people over time with a shared experience – exposure to new forms of gambling Provide detailed etiological information about how gambling and problem gambling develops, progresses, and remits. The information collected through a cohort study has significant value as it will highlight risk and protective factors important in developing effective prevention, treatment, and recovery support services. 17 | MASSGAMING COMMISSION

19. CONCLUSION Our goal is to conduct a world-class, comprehensive, rigorous & high-quality study of the impacts of gambling in MA. Our Research Team provides capabilities and experience relevant to all of the requirements set forth in MGC RFR (and to Expanded Gaming Act’s research agenda). We are committed to employing a public health approach. We are committed to meeting the highest standards of intellectual excellence. We are committed to working collegially with the full range of stakeholders in MA.

20. Thank you! For additional information, please contact: Mark Vander Linden Director of Research and Problem Gambling Mark.vanderlinden@state.ma.us (617)979-8445