 And we're all set. Thank you, Dave. Good afternoon. This is a reconvening today. Of the Massachusetts gaming commission, a convening of a new meeting. Public meeting number 512. I'm Jordan Maynard and I am serving as interim chair of the gaming commission. This meeting is being held virtually using remote collaboration technology. So we'll do a roll call. Good afternoon, commissioner O'Brien. Good afternoon. I'm here. Good afternoon, commissioner Hill. Good afternoon. I'm here. And good afternoon, commissioner Skinner. Good afternoon. It is approximately 105. We have some technical difficulties. So I apologize for that. And it is April 3rd, 2024. We're going to start with item number two. And for that, we will kick it over. And then we'll go to director monahan of the investigations and enforcement bureau and licensing manager Dave McKay. Apologies for the technical issues for the last few moments. I can hear you now and hopefully you can hear me. There is a request for a beverage amendment at encore. And I'm going to turn it right over to Dave McKay who's taken the lead on this. Great. Thank you, Caitlin. Great. Good afternoon, interim chair Maynard and commissioners. Before you is a request from encore Boston harbor to amend its gaming beverage license to add a new least outlet venue. Seaf Seamark seafood and cocktails. This will replace the space formerly held by the Sinatra restaurant. As discussed starting on page three of the meeting packet, the application was reviewed by the division of licensing. The scope of the review also included verification pertaining to the licensed area manager for encore Boston harbor Chelsea Brewster. To ensure that she held a valid certification from a recognized alcoholic beverage server training program. And as properly licensed by the commission. And also that the design for the jointly responsible person Seamark. Ricardo Soto also holds a valid certification from a recognized alcoholic beverage server training program and is properly licensed by the commission and is in good standing. Furthermore, an onsite inspection was performed by Lewis Lozano, IEB casino regulatory manager. And as you saw before, Birkin division chief of the gaming agencies on the call. In case you have any questions regarding that, but that inspection confirms the accuracy of the reported licensed area information. Additionally, this inspection also confirms the licensed area surveillance and security wearing compliance and provided adequate coverage. I did want to pause at this moment to address one point of a clarification. Commissioner Skinner posed a question. In regard to the language on application page three. Under the jointly responsible person box, which states attach evidence that the licensee maintains authority over the jointly responsible person. And I also wanted to note that the division of licensing. Has obtained a copy of the lease agreements between on core and Seamark. And additionally, just revisiting the license area information. As previously noted, Chelsea Brewster acts as the licensed area manager responsible for the outlet on behalf of on for Boston Harbor. And will see Mark has appointed their own designee Ricardo Soto as the jointly responsible person. Lastly, I did want to know the division of licensing worked with the Juliana, Catanz, already and Jackie Chrome on behalf of on for in relation to this request. And we are recommending that the commission approve this request. And at this time, I'm happy to try and answer any questions that you may have. Thank you, Dave fellow commissioners. Do we have any other questions? And thank you. Commissioner Skinner for raising raising that question. I don't see any Burke. I'm just going to ask, are you all good? Oh, wait, Mr. Brian. No, no, good. I was just going to comment on how much I like the Chelsea Brewster name. It was literally thinking it was a company picking seaside locations. What a great name. Burke, are you are you good with everything? Yes, last week, Lewis and I were able to walk through the CCTV cameras meet what we want and the security of the alcohol and the bars are in function with what they represented and we expected it inspected it and was proven to be so. Great. Well, with that said, and seeing no other commissioner Hill. Mr. Chairman, I move that the commission approved the amendment to encore Boston. I was beverage license as included in the commissioners packet and discussed here today. Second. We have a motion from Commissioner Hill, a second from Commissioner O'Brien, Commissioner O'Brien. Hi. Commissioner Hill. Hi. Commissioner Skinner. Hi. And I'm a, yes, that's for zero. Congratulations and good luck to encore Boston Harbor and to see Mark's seafoods and cocktails. And thank you to the IEB and the licensing team. We appreciate your diligence and great work on this. So, thank you very much. Thank you, Dave. Next item, we're going to kick it over to director of research and responsible gaming. Mark Vanderlinden and Dr. Rachel Volberg for the presentation of the gambling and problem gambling in Massachusetts results of a follow up population survey. I do want to say a couple of things though. Dr. Volberg is well known and respected by all of us here at the gaming commission. But for the benefit of the public, Dr. Volberg is a research professor at the school of public health and health sciences at the University of Massachusetts at Amherst. She has been involved in research on gambling and problem gambling since 1985. She's been recognized by the national institutes of health to study the prevalence of problem gambling. And has been a principal investigator on the MGC's Sigma study. She has been published extensively. And we cannot say it enough. We are fortunate to have her expertise and experience here in the Commonwealth. I believe that the commissioners have received the study Dr. Volberg will be discussing here today. I want to take the time to say that we were lucky in the first place to have a baseline study. And we're even more lucky to have a follow up. It presents the commission with a great opportunity to build policies and regulations based on research and hard data. Our game sense program, our play management tools and our ongoing studies, including those related to how we will use AI, how we will promote safe and healthy marketing and player acquisitions. Many other initiatives will be shaped by this study. The MGC will continue to meet the patrons where they are, especially those who are most vulnerable. And we will continue to educate and promote our programs to help those who need it most. I get approached by many outside of the building who call it the Massachusetts model or the Massachusetts mirror. But what matters most to us is that we continue to research, study and help those who gain. And we can do so in a healthy and sustainable way. I do have one question for my fellow commissioners. Do we want to ask questions as we go? Or do we want to save them to the end? I think in general we save it to the end unless there's something organic that would really require a dive into a particular slide. It makes sense to keep doing it like we've been doing it. Sounds good. Just flag it for me if something comes up because I, if we have something on the screen. What that said, director Vanderlinden and Dr. Volver. Great. Thank you for that great introduction and chairman Maynard. Good afternoon commissioners. And welcome to our new executive director being certified. I am more than pleased to be here today with Dr. Rachel Volver. Before I turn it over to Dr. Volver, if I could just do a quick introduction. So included in the 2011 expanded gaming act is a requirement that Massachusetts gaming commission established an annual research agenda. This included a baseline study of problem gambling and the existing prevention and treatment programs that address its consequences. To fulfill this requirement. The MGC and in March of 2013 the MGC selected a research team from the University of Massachusetts Amber School of Public Health and Health Sciences. To implement a comprehensive research agenda that included this baseline a baseline study of problem gambling. Shortly thereafter and before any casinos opened in the state. The UMass team fielded a survey and released that baseline report. Now roughly 10 years later, the same team of researchers were tapped by the MGC to carry out follow up general population survey. The main purpose of this study is to determine whether and how gambling attitudes, gambling behavior. And problem gambling problems changed in Massachusetts following the introduction of three casinos. Results from the follow up general population survey are directly comparable to those that were found in 2013 and 2014. In the baseline survey. In addition to these overall assessments report addresses the question of whether the demographic and behavioral patterns of gambling and problem gambling prevalence. Changed in Massachusetts between 2013 and 2021. As as. Chair Maynard said we are really lucky Dr. Volberg was a principal investigator for that 2013 study and again for this follow up general population. Survey so and I've had the pleasure of working with her that entire time and I can speak to her credentials and her overall just excellent work in the space. So with that I'll turn it over to you Dr. Volberg. Thank you. I guess I'm blushing and feeling like I'm ready to retire now. At any rate, greetings commissioners and interim chairman Maynard. It really is a pleasure to be here today to present the results from this important survey. I know we've been waiting a long time for this so let's just get right into it. I emailed Mark earlier about 15 minutes ago to tell him I was having some minor technical difficulties so Mark, are you going to be able to show my slides. So, let's move to the next slide please. Yeah. So this slide just presents an overview of what I'm going to be talking about today. We're going to focus first briefly on the methods that we use for the survey, which were very similar to the methods we use for the baseline survey in 2013 and 2014. And then I'm going to walk through the major findings from each of the major sections of the survey, including attitudes, gambling behavior, problem gambling prevalence, and then comparing recreational at risk and problem dealers, discuss a little bit about what we found about awareness of problem gambling services in Massachusetts, discuss changes that we identified since 2013, and then touch on some future directions. Next slide. So this slide and the next one presents some information about how the survey was conducted. As I mentioned, it was aligned very closely with the baseline survey questionnaire. We wanted to be able to do as much comparison as possible. We did add some items based on what we had learned in the interim since the baseline survey. We added some items assessing sports betting in a good bit more detail. We were interested in finding out more about non gambling spending at the casinos. And of course, given the timing of the survey we were interested in what the impacts of the COVID-19 pandemic might be on behavior. To sort of frame this, this was not introduced to people as a survey of gambling very purposefully so that we did not over recruit gamblers and under recruit people who were either not involved with or not interested in gambling. We described the survey to them as a survey of health and recreation. And we started off the questionnaire with questions about physical and mental health and preferred types of recreation to make that a real thing. We asked about alcohol and drug use. And then we moved into assessing attitudes about toward gambling gambling behavior and problems and questions about services. We did a random sampling of households and individuals in households, and we had targets set for particular groups that we knew from the baseline were harder to recruit into surveys generally. That included Asians, African Americans, Hispanics and young adults. Particularly those aged 18 to 20, they just don't seem to like to talk to people who are doing surveys. Next slide. So, this is, this is where people may not realize how dogged we were in our efforts to recruit people into this survey. We started with an invitation letter to randomly selected households. There was a small $1 incentive in each of the envelopes that we sent out. That was followed a week later by a reminder postcard. I'm sorry two weeks later by a reminder postcard two weeks later by another letter with the self administered questionnaire included. And then our final push was to recruit people by telephone if they hadn't responded in the previous two modes. And you can see that the majority of people completed the survey online. About a quarter of our respondents completed the self administered questionnaire and a little under 2% completed by telephone. We were very pleased with the proportion of respondents who completed the survey in Spanish it was much higher than what we had had in the baseline. The response rate was 27 and a half percent, which in the olden days when I first started doing survey research would have been kind of disappointing but in the current day and age that was actually pretty respectable. Once we had all of the data in hand, we conducted a number of statistical methods to align the sample with the Massachusetts waiting Massachusetts adult population. And the waiting included the variables that you see gender, age, ethnicity and education. Next slide. So now on to some results. The first topic area that I want to talk about is concerns attitudes towards gambling amongst Massachusetts adults. And the slide that you're looking at presents responses to a question about the overall availability of gambling in Massachusetts. It shows that there the clear majority of Massachusetts adults in 2021 and 2022 believed that the availability of gambling in Massachusetts was too high. This was a significant change compared to the baseline survey before any casinos had become operational. So it's likely in our view that this change reflects both the introduction of casinos in Massachusetts and the impending introduction of legalized sports betting, because the survey was carried out sort of in the midst of the work to pass legislation on that issue in Massachusetts. There were some demographic differences related to beliefs in the availability about gambling in Massachusetts. Groups that believed or more likely to believe that gambling was too widely available, included women, adults aged 18 to 20 Asians and retired adults. And those who were more likely to believe that the current availability was fine, included adults aged 25 to 54 whites, Hispanics, and people who were employed. Finally, those most likely to believe that gambling was not available enough included people with less than a high school education and people with incomes under $30,000. So this slide presents responses to a question about the overall benefits and harms of casino gambling specifically in Massachusetts. And it shows that there has been quite a significant change in the proportion of adults in Massachusetts who viewed the benefits and harms of casino gambling as about equal. Nearly half of Massachusetts adults viewed the benefits and harms about as about equal compared to only 19% prior to the introduction of casinos in the state. And it's worth noting I think that responses to this question in the baseline survey were based on people's expectations, whereas the responses in the follow up survey were based on people's actual observations and experiences. So again, there were differences in beliefs about the benefits and harms of casino gambling based on demographics. Men were more likely than women to see casino expansion as beneficial Asians were more likely than whites Hispanics or blacks to see casino expansion as harmful. Education was associated with attitudes with those with some college or with college degrees, most likely to see casinos and beneficial. Employee people retired people and disabled individuals were more likely to see casino gambling as beneficial compared to people who were students. There were no differences in views about the impact of casinos in relation to age or household income. Next slide. So one of the things that we did in developing the report that you have before you is we, we developed a number of hypotheses based on what's known in the research literature and sort of the, the expertise. Within the team. And so periodically through this presentation you'll see some of the results of our testing of those hypotheses. And the first hypothesis had to do with attitudes we hypothesized that attitudes toward gambling would be less negative in the follow up survey, compared with the baseline reflecting Massachusetts adults experience with the actuality of casino gambling in the Commonwealth. However, this hypothesis was not supported, because a significantly greater proportion of adult Massachusetts adults believed that the current availability of gambling in the state was too high in 2021, compared to 2013. There, there was however a noticeable shift towards the center in views about the harms and benefits of gambling with fewer people viewing expanded gambling as beneficial, but also fewer people viewing expanded gambling as harmful. So moving on. We're now going to talk about gambling participation. Next slide. For consistency, we provided all of our respondents with a definition of what we meant by gambling and I provided that for you here. We actually assessed 13 different activities in the gambling section of the questionnaire. Each of those activities we assessed past year participation, frequency of participation in the past year and expenditures on that type of gambling in a particular month. I want to just specify, I won't read through the list of 13 different activities but it included sports betting, as well as online gambling and lottery and casino and the usual activities that we assessed for. The next slide is a presentation or a comparison rather of past year participation rates overall and for each of the different types of gambling in the baseline on the left hand side and in the follow up survey on the right side. And so what you can see is that after participation, for the majority of the gaming activities that we assessed. The only types of gambling where past year participation did not decline significantly were daily lottery gains as the keynote or monitor game and online gambling. The declines in past year purchases of instant lottery tickets and traditional lottery tickets as well as participation in casino gambling, horse racing and sports betting all ranged in about the 25% decline. Next. So these were our next two hypotheses which had to do with gambling behavior. And I will say that we had, we did not take the the pandemic into account when we generated these hypotheses, but we anticipated that participation in casino gambling would be higher in the follow up survey compared with with the baseline reflecting the impact of the introduction of casinos and the expansion of that type of gambling in Massachusetts. However, that hypothesis was not supported because past year participation in casino gambling declined significantly between the two surveys. And it's the same reason. We have that participation in lower. Potentially reflecting shifts in gambling participation and expenditures from lottery to casinos that's a cannibalization or substitution is a very major concern when you think about the full the full suite of gambling activities. Because participation in traditional large jackpot lottery gains and instant scratch tickets was lower compared with in 2021. I'm sorry in 2021 compared with 2013. This hypothesis was partly supported. But as you'll see in the next slide. We had a major unanticipated event. Every scientist nightmare is something unpredictable that comes in sideways on your experiment. And the pandemic came in sideways on everybody's life with major impacts. But we realized as we were finalizing the questionnaire for the follow up survey that we needed to include some questions about coven to assess this specific issue. So we did a number of things we considered the timing of the restrictions in Massachusetts and the past 12 month recall window, because that fielding in 2021. We did that for a number of very solid scientific reasons but we knew that people's responses could be affected by the recency of the pandemic. We looked more broadly at the correlation of changes in the general population surveys, both the baseline and follow up with changes in our concurrent online panel surveys to see if the behaviors were moving in similar directions. And then as I mentioned we had specific questions that we added about the impact of coven 19 on gambling behavior. And what we found was that, indeed, the pandemic and the associated restrictions almost certainly had an impact on prevalence rates of gambling participation in the follow up survey. We believe, however, that this affected the behavior of recreational gamblers to a much greater extent than those experiencing gambling problems, simply because it's more difficult for people who are heavily engaged in gambling to change their behavior in contrast to folks who are less engaged who are more likely to find it easier to stop gambling or to reduce their gambling as they sort of dealt with shut down conditions and restrictions that follow the closure of the casinos for quite some time. Next. So this next section addresses the issue that is always the elephant in the room whenever we're talking about gambling surveys. Everyone wants to know what's going to happen with problem gambling that is the major negative impact that people consider when they think about gambling. So this slide just presents the classification criteria that we use. It's validated instrument to assess gambling problems in. We are just a slight technical difficulty. We give you most of the time, but there's a break there. You can start over. I think the last part we caught was, this is the most important part that people like to look at and get a hold of. Okay. Sorry about that. As I told Mark, I'm having some, we're having major heavy rain out here. And so I think the climate is affecting my presentation. Sorry. So this, this slide here is just the criteria that we use for classifying people in the survey as non gamblers recreational gamblers at risk problem and pathological or disordered gamblers. In the interest of time, I had been chatting along about how this works in relation to clinical criteria, but I think I'll move right along and ask Mark to show the next slide. So this is what we found in the, in the follow up population survey. And based on a population adult population in Massachusetts in 2021 of 5.4 million. We estimate that somewhere between 54,000 and 114,000 Massachusetts adults were problem gamblers in 2021. An additional 400 to 530,000 Massachusetts adults were at risk. And communities, the proportion of the Massachusetts population affected by gambling related problems that that we have here is actually pretty conservative. And now the next slide. So this was our fourth and perhaps most important hypothesis. We hypothesized that problem gambling would be higher in 2021 compared to 2013 reflecting the increase in gambling availability. However, this hypothesis was not supported as the prevalence of problem gambling did not change significantly between the two surveys, as you can see. So instead, we saw an increase in the proportion of non gamblers in the Massachusetts population, and a decrease in the proportion of recreational gamblers, rather than any changes in the higher risk groups. So a separate consideration concerns how the prevalence rate in Massachusetts in 2021 compares to other states. And we have developed a methodology to allow for standardization of problem gambling prevalence rates to let us compare Massachusetts or another jurisdiction with many other jurisdictions. And I will say that the prevalence rate in Massachusetts of problem gambling in 2021 was mid range between 2.8% in New Jersey in that in a couple of years earlier, and a 0.7 rate in New York, which was actually low because that survey was conducted in 2020 in the middle of the pandemic. Next slide. So now I want to focus a little bit on sports betting. As you are all aware, I'm sure the sports wagering act requires the commission to conduct research to answer for specific questions. And we are focused here on the first question, which is whether sports betters are different than individuals participating in other forms of gambling. We analyzed our data to investigate whether people participating in sports betting in Massachusetts differ from individuals participating in other types of gambling. And what we found was that sports betters do differ from individuals participating in other sports types of gambling. There are significant differences in the demographic characteristics of sports betters compared to those who bet who gambled but not on sports in the past year, and much higher rates of participation among sports betters. And the next two slides demonstrate that. This is focused on demographics and shows that sports betters in Massachusetts were more likely than non sports betting gamblers to be male under the age of 35 white to have a bachelor's degree or higher, and to be employed. Overall, I would say that Massachusetts sports betters, at least in 2021 were very similar to sports betters in other jurisdictions, that is more likely to be male, young, well educated and either employed for attending school full time. The next slide. Yes, the next slide compares past year participation rates for all of Massachusetts adults and compared to sports betters and shows pretty clearly that sports betters are much heavier gamblers than Massachusetts adults in general. So, for example, when it comes to the traditional lottery, 62% of sports betters had purchased a lottery ticket in the past year, compared to 43% of Massachusetts adults and on down the line. So some of the biggest differences were gambling at a casino, private wagering, and then betting online. Finally, moving into our comparison of gambling roots. Oops, can you go back a little bit more. Do we have. Okay. And then there should be comparing gambling with thank you. I'm not going to spend too much time on this. This was comparing problem at risk and recreational gamblers along a number of different demographic characteristics so the, the top left is gender, then you have race ethnicity and education and then income. And so you can see that, for example, problem gamblers and at risk gamblers in Massachusetts in 2021 were more likely to be male, rather than female. They were less likely to be white. They were less likely to have attended college or to have graduated from college, and they were more likely to have lower incomes. And the next slide, again, is comparing gambling participation among those three groups recreational at risk and problem gamblers. And what we, what we see based. Just one second with what it catch up you were it was kind of garbled there for a second I think it's the weather. So, maybe try again. Thank you. Okay, sorry about that. So, this slide just shows that there are some significant differences in the types of gambling that different groups of gamblers have engaged in in the past year. And, you know, we can we compare, we use recreational gamblers as our main comparison group because that's the largest group so that's what most people do. But at risk gamblers were more likely to have played lottery games to have gambled on casino table games and slot machines to bet on sports wager privately bet on horse races and bingo and gambled online. Problem gamblers were more likely than recreational gamblers to have played lottery games and gambled on casino table games as well as slot machines. Yeah, so the demographics and the gambling participation of these groups is is important and interesting, mostly from the perspective of targeting resources in terms of prevention. So rather than spend any more time on that is we can move along. So, one of the things that I have always been interesting and probably taken the most flat from in terms of my academic career is estimating expenditures on problem gambling or expenditures on gambling by different groups of gamblers. So what this slide shows is that in total at risk and problem gamblers spend much more on gambling annually than recreational gamblers. It's interesting to compare the proportion of expenditures shown in this figure with the proportion of these each of these groups in the sample so although recreational gamblers constituted 51% of our sample. They accounted for only 12% of the reported expenditures, and the disparity is even more noticeable for at risk and problem gamblers. So as a reminder at risk gamblers constituted 8.5% of the sample, but they accounted for 68% of the reported expenditures on gambling in the past year. Problem gamblers constituted 1.4% of the sample, but accounted for 20% of the expenditures. And then the next slide. I feel is also an important point of information for the gaming commission and for the general public to consider. In the baseline report, we argued that the proportion of expenditures accounted for by different gambling groups should be monitored to see if and how this changed in the wake of expanded gambling. And what this slide shows is that in 2013 recreational gamblers accounted for 26% of self reported expenditures at risk gamblers accounted for 51% and problem gamblers accounted for 23% of self reported expenditures on gambling. In 2021, as you can see recreational gamblers accounted for a much smaller proportion of self reported expenditures and at risk gamblers accounted for a much larger proportion of self reported expenditures compared with 2013. So while both of these results conform to what's called the Pareto principle where 20% of outcomes, whether it's occupational health and safety or engineering quality control health businesses, 80% of outcomes are generally accounted for by 20% or less of the individuals involved. So this change in particularly in the, the, the at risk expenditures is a concern. And I think, you know, we'll want to figure out some good prevention messages to be able to address that particular issue going forward. I'm just a couple of slides now on differences across these groups in terms of health. Recreational gamblers were likely in 2021 than in 2013 to identify their physical health status as poor or fair, and to say that they had experienced serious problems with depression or anxiety, or other mental health problems in the past 30 days and in the past 30 years. The differences were not statistically significant. I'm sorry that the differences between at risk and problem gamblers were not statistically different. But, you know, again, it's possible that some of the responses. So these questions they had to do with experiencing the pandemic, then they had with the introduction of casino gambling in Massachusetts. The next slide shows comparisons for tobacco use binge drinking and illicit drug use. And you can see that recreational gamblers in 2021 were actually less likely than recreational gamblers in 2013 to have used tobacco and to have binged on alcohol in the past 30 days, but more likely to have used illicit drugs. And then in terms of problem gamblers, they were less likely in 2021 than in 2013 to have binged on alcohol in the past 30 days. And there were no significant differences in any of these behaviors among at risk gamblers in 2021, compared with 2013. And then, finally, we turn to awareness of services. So everyone in the survey, all of the respondents were asked if they had seen or heard any media campaigns to prevent gambling problems in Massachusetts in the past year. And it is definitely a concern that awareness of problem gambling prevention efforts is lower in 2021 than in 2013, since there are now, and more in 2021, substantially more gambling opportunities in Massachusetts. And we had actually anticipated that awareness would be higher. So we had questions about wanting and seeking help for gambling problems in the survey. The number of individuals endorsing either of those questions was actually too small to report. But we do have some recent survey data from Connecticut that provides some useful data points. In Connecticut, where we conducted a survey in 2023, 25% of Connecticut's respondents classified as problem gamblers had wanted help for gambling problem in the past year. 21% had sought help, but the majority preferred to try to curb their gambling on their own. And those who did seek help in Connecticut, most often access sources other than the state funded treatment services. So I think that information could be taken on board in Massachusetts, even though we are in a different state, we are right next door. Dr. Volberg, I'm sorry, this is commissioner Brian. Do you know what were those non state offer? Do you have any sense of what those services were? My recollection, because I haven't looked at the Connecticut data in a few months. My recollection is that the most often access resources were actually gamblers anonymous and friends and family. So people seeking help from their friends and family to give them their credit cards or help them manage their money somehow. You know, make sure that they didn't take their debit card with them when they went to gamble. There's a lot of things that people try to do on their own before they're willing to sort of say, well, I need some outside help. And that's not that that's actually not even specific to gambling. There's there's a lot of sort of, you know, personal issues that people experience where the first thing they want to do is see if they can take care of it, take care of it themselves or just, you know, informal help. Okay, thank you. Mr. Chairman, I have a quick question as well. I just want to be clear, Dr. Volberg. When I see everyone was asked if they had seen or heard any media campaigns over the last year, are we talking from 2024 to 2023, or are we still in 2021 because I'm, I'm finding it hard to understand how it could have dropped 50%. When all I see on TV are now ads trying to help people get help and give out numbers. When was this actually done? The survey was conducted from September of 2021 through March of, I'm sorry, April of 2022. When I see this as says within the past year, that this is the survey we're talking about not from, yes, from 4324 to 4323, is that accurate? Yes, that's correct. Yeah, I just wanted to be clear about that that that makes me understand this a little bit better. Because it was over the last year that we started seeing those commercials and PSAs and things of that sort. Thank you. And if I can just put a plug in for some additional research that we're going to be presenting to you later in the year. We do have a different kind of survey that we've been fielding more recently. And that actually has some additional information about awareness of services that we will be able to share that probably in the next six months. Thank you. Thank you. Thank you, Commissioner Hill and Commissioner Bryan. And actually on this particular side, they, they. They've now. I can ask my question because they did too. Doesn't this present understanding that some of the data may be lagging. Doesn't this present a real opportunity to the commission to push out these great services to get more. Put more light on it and perhaps make sure that, you know, people know, right, we want to meet them where they are. You know, people know these things exist. Yeah, and I think that, you know, there's, there's, there's always an opportunity when you see something like this where, you know, data have gone in a direction that you think is opposite to what you either expected or what you like. It's an opportunity to think about concentrating resources in a, in a targeted way. You know, and the fact that there is quite a lot of stigma around gambling problems, you know, people have great shame about not being able to manage their money. But there's also quite a lack of awareness about where to find help. You know, people think that they need to have insurance coverage to get that help. Those are all messages that can be pushed out there and I think should be pushed out there. And, you know, and to also to sort of, you know, echo the National Council's old helpline, you know, or tagline of, you know, where there's hope there's help. You know, that treatment can be effective if you seek it out and that it is available in Massachusetts. Thank you. So, on the next slide. I'm, I just want to direct your attention down to the bottom here, where we do have some more current information on numbers of calls to the helpline in Massachusetts in fiscal year 22. In fiscal year 22, and unique website visitors. And my takeaway from this is that clearly the helpline, the phone calls are not where the bulk of the help seeking is happening. The magnitude of the number of unique website visitors is pretty impressive. And it suggests that that may be where people are at least initially starting the process of looking for help to address a gambling problem is to go on the website and, you know, look for maybe for self health materials or online resources. So that was that 56,000 number was actually a good and pleasant surprise. So, next slide. So just to identify pretty specifically what the changes were that we felt were most important. Since the baseline survey in 2013, there has been an increase in the view that gambling is too widely available. And this was prior to the legalization and operationalization of sports betting. Gambling participation has declined for most types of gambling in Massachusetts since 2013. We think at least partly due to the lingering effects of the pandemic, but there has been a much longer trend of decline in gambling and problem gambling prevalence in North America. So some part of the decline in participation is probably part of that longer trend. There's been a reduction in lottery spending and increases in spending on casinos sports betting and online gambling. We did identify some significant differences between sports betters and non sports gamblers. And so that was that was work that was specifically addressing a question in the sports betting legislation. There was no change in the problem gambling, although problem gamblers are more likely in 2021 than in 2013 to gamble for excitement and entertainment. We noticed that at risk gamblers account for a larger proportion of gambling expenditures. Finally, in contrast to what we found in 2013, there were no significant differences in rates of depression, anxiety or other mental health problems across those different groups of gamblers. And then finally the reduction in awareness of problem gambling prevention. So the next slide is just a review of the strengths and limitations of the study. We made strenuous efforts as you heard to obtain high coverage and a representative sample. The response rate was lower than desired but still acceptable to us. It was restricted to adults living in households and we know that prevalence rates of problem gambling are much higher amongst people who do not have housing and amongst people who are incarcerated or living in group group living quarters. We only interviewed in English and Spanish so there were obviously some groups that were not included in the survey. And then probably the last major limitation is that we are limited in our causal attributions because the baseline survey and the follow-up survey were with different people. So we can't make causal attributions. In terms of future directions, we always have lots of work that we'd like to carry out. But these are the main areas where we think we can make contributions. We want to do some very easy to figure out our own sport setting is to come over to our family. Yes. Thank you. You're good now. A little muddle. So that first that question right under the multivariate analysis is one of the four questions that's included in 23N. We want to do some work looking at the predictors of at risk and problem gambling overall, as well as predictors of problem gambling in some groups in the population. And then we want to see if we can replicate a very interesting finding that we had from the baseline survey, which was the importance of friends and family in contributing to people's status as recreational at risk or problem gamblers. Then combining the population and the panel data, we would like to look at identifying the riskiest forms of gambling in Massachusetts, specific gambling harms, and using the panel data primarily, see if we can identify predictors of treatment seeking. And then as I sort of, you know, tempted you a little bit in response to Commissioner Hill's question, we do have some reports on deck that will be coming at you later this year, one looking at changes in our online channels that we've been doing annually since 2022. And then we have a very large, very large integrated report on all of the social and economic impacts that we have identified to date of casinos in Massachusetts. And so that will be coming up later this year as well. And I believe that's my last slide. And here is where you can get the reports and all of our other reports, and all of the commissions other reports online. So thank you. So commissioners, thank you, Dr. Bolberg and you made me think of, you know, we can't control the weather but we can adjust the sales so thank you for continuing on with us. Commissioners questions. And thank you, Dr. Bolberg very helpful and informative as usual. A couple of takeaways for me. When we've talked about this right to PSA campaigns. And I think back to make a light build a life that works way back when to the you know my predecessors where they were trying to get sort of diversity in the construction and building trades and how helpful and impactful that was. And it would seem like to Commissioner Hill's point maybe want to get more up to date information in terms of the awareness but it would seem to me an area right for opportunity for us, especially online right mark to sort of push some of this out. But another area that I'm really curious, Dr. Bolberg if you are upcoming researchers going to dive into is that shift that that 14% that went from, you know, recreational into at risk. And who that was, what are this, you know, how did that happen, but then also the 3% that went from problem into recreational like what worked, what got that 3% out of that risk range into, you know, the less risky area and can we continue to get them moving right get them off into recreational again so I see Mark kind of bleeding in as well you guys might have some thoughts on that already but. And then my only other comment is whether we can get sort of Chinese translators interpreters in, because I know we've had separate reports on the impact of that community. Particularly in the other brick and mortar and what we've seen there that would be of interest to me going forward also but I thank you very much for the information. So I guess in response to your, your first issue Commissioner of Ryan. The, the multivariate analysis that we're thinking about doing will contribute somewhat to understanding what the factors were that that cause movement from one category to the other, or one type one group of gambling to the other. But it's actually not the strongest or most reliable way to understand those kinds of transitions and I would, I would put a plug in here for a another cohort study I know they're very expensive but maybe we can find a cheaper way to do them. But a cohort study where you follow the same people over a number of years to watch their transitions in and out of gambling. You know we have the cohort study that we conducted in Massachusetts from 2013 to 2019 that speaks very much to those kinds of transitions and what what predicted those transitions. And so I would say the, the second thing that we would want to do after the multivariate analyses would be to revisit the magic study and see if there is data there specific to your question about transitions. And then, yeah, I already made the plug for figuring out how to do a cohort study again going forward that they're just they're invaluable in understanding, you know, individual trajectories. In terms of the, the second part of your question regarding interviewing in other languages. I've done a lot of surveys, like probably close to 100. And I have to tell you that you have to, you really have a balancing act when it comes to trying to represent the entire population of a jurisdiction like Massachusetts, versus drilling down into specific communities that are very often extremely difficult to access and extremely difficult to access in particular, you know, to conduct surveys. And, you know, refugees and immigrants, for example, can be very very challenging. In addition to the number of languages that they speak they're just very suspicious about, you know, why are you here to questioning me about my behavior. So I, over the years have done quite a bit of work on looking at how to get information from communities like that. And everything that I've learned from sort of community based research specialists is that the standard survey works for most of the population, but it's not always the best way to get information from some of these communities. And so I'm an advocate of community based participatory research, where basically, you know, the people from the community do the research, and the research is brought back to them, and shared with the community in ways that they can understand and actually impact. And so I think, you know, alternate research strategies is an important way to think about, you know, a full research agenda. It's not just a survey but it's a survey plus. And I think that's, I'm thinking back to the study that we did about the Asian community and the impact, and that that was discreet to supplement. So, just a thought that I had too, that I'd hate to see me you talk about who gets impacted and communities in color that get impacted most, whether I don't want to leave out a group that we know we've already heard from, right, the impact that they have. If I could just say two comments on that, that's part of that's the beauty of an annual and ongoing research agenda is that we can pivot from year to year to make sure that we respond to different needs. One, and two, our community driven research line is there just for that. And whenever we get a report that comes from that line of research, it always looks different than the research like what Dr. Volver and what Dr. Volver just presented. And that's because of all of we're trying to address all the challenges of, you know, doing research with a community with different communities. Right. Thank you very much. Thank you, Mr. Brian. I sign on also to your thoughts and thank you for raising them Commissioner Hill. Dr. Volberg, I just want to say thank you. This was great information, information that we can now take back and digest and help us moving forward with decisions that we have to make. It was a great report. I'm still digesting a lot of it. You know, I look at, you know, one particular issue where they where people think there's too much gambling, you know, 67%. Yet 60% had been involved in some form of gaming over the last year. So even though there was a concern that there was too much, it didn't stop them from gambling. So interesting information that we saw and need to digest and thank you for today and taking the time to come see us again. Very, very informative. And it's going to be very helpful to all of us moving forward. Really, that's really good to hear because, you know, I, Massachusetts has a special place in my heart. I wasn't born here, but my daughter grew up here and now is, you know, functioning adult in the Greenfield, Massachusetts. But, you know, we didn't have, we didn't have any gambling research that I was involved with here until 2013 and it's been an incredible privilege and a real learning process for me to actually be around when the results of a study are taken into consideration. You know, usually I jet in and then jet back out after I present my data, and I don't hear or even see, you know, what the process is that follows that. So, it's been a real privilege to be able to lead this project and a real privilege to have had the support of the Commission for this long lasting world-class gambling study that I'm very proud to lead. And if I could add one more thing, Mr. Chairman, and I'm looking forward to the information that you're going to be presenting later this year and you've already touched upon it, especially, you know, when we're looking at capturing the numbers that are leaving our state in the last couple of years, and I brought this up so I'm sorry I'm going to bore my fellow commissioners for a second because I've already talked about this. But, you know, very close to where I live is New Hampshire. And now that they've expanded their gaming and their gambling, you know, I'm saying a lot of Massachusetts residents, you know, leaving mass, because it's so close. There are other, you know, with casinos and where they are placed here. And obviously, sports wagering, even though it's done on our phone, there are folks who are leaving the state to go and do it elsewhere. So it's going to be very interesting moving forward the data that you present to us and the data that you're getting that's going to continue to help us do what we need to do here. And Commissioner Hill, actually, Rachel, you didn't talk about out of state patronage casinos out of state. And I thought that that was a really interesting point that it's in the baseline in 2013. 21% of respondents indicated they gambled out of state and in 2021 that was cut in half to 10%. With most of that reduction, going to Connecticut casinos. I have to say Connecticut was not particularly happy about it. Thank you, Mark. Thank you, Commissioner Hill and Dr. Volberg, your, your comments really struck me. I tell people all the time. I wasn't born in Massachusetts, but I got here as soon as I could. So, you know, we, it's, it's good to hear that you feel the same way. You know, I, I'm not going to belabor the point. I think it's an opportunity, right? When I see your study, I see opportunities and opportunities for improvement. And my fellow commissioners do too. And so, you know, how can we take this data and knowledge and turn it into action. And so that's really what I'm concerned about. And I'm glad to hear that you enjoy watching us turn it into action and that you have that opportunity to do so. And a lot of that has to do with director Vanderlinden and his team. So we appreciate them too. Anything else anybody has, I will say that Commissioner Skinner just recently had to drop off and she apologized for that, but she was in for most of the meeting. Do we have any commissioner updates? Any other business? Do we have a motion to adjourn? Move to adjourn. Second. Commissioner Hill, second. Commissioner O'Brien, Commissioner O'Brien. Aye. Commissioner Hill. Aye. And I am an eye. So three zero to adjourn. Have a great day, everyone. Thank you. Thank you.