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Taking a Gamble

Pa. slots are raking in the cash, but will those that lose too much get the help that they need?

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Are state officials rolling the dice on gambling addicts?

When the state's slots-casino legislation was enacted in 2004, the state Department of Health was tasked with developing education, prevention and treatment programs to deal with problem gamblers. The agency was even allocated $1.5 million a year to offer programs like a 24-hour hotline and counseling for gambling addiction.

But though slots casinos began opening last year, few gamblers have sought out the department's expertise. Instead, they've been calling on the Council on Compulsive Gambling of Pennsylvania, a non-profit organization that has been helping problem gamblers statewide for a decade.

The result: CCG is providing the lion's share of assistance to gamblers and casinos alike ... but without additional funding from the state. And while officials at the non-profit say they are feeling the strain, they also say the state can't handle to job on its own and has done little preparation to do so.

"We have talked with the state for two years and have sent proposals to handle all of this for them, but we still haven't signed a contract," says Jim Pappas, executive director of the CCG. "Yet, we still seem to be doing a lot of the work."

Richard McGarvey, a health department spokesman, says the agency has been working with and talking to the CCG since 2004, mostly to get information about the field of gambling addiction treatment and using the group to train its trainers. McGarvey says he is surprised at the CCG's recent criticism.

"We've been working very closely with Jim Pappas and his group and are aware of the good work that they do," McGarvey says. "They are an established organization and we have had discussions about them possibly providing services, but we just haven't reached any agreements yet."

Pappas says the CCG has been the go-to agency in the state for years when it comes to compulsive gambling education and treatment. The agency already provides literature, training materials, and a hotline, 1-800-GAMBLER, staffed by counselors specifically trained to handle gambling addiction.

For years, the group operated a part-time hotline, but with the advent of slots gaming, the group upgraded the phone service to a 24-hour hotline staffed by counselors specifically trained to handle gambling addiction. Calls are fed into a national help center that is paid for by the CCG. The counselors talk to the person and provide information about problem gambling and try to ascertain how serious the problem is. The call center then also provides the individual with clinical service providers or support group meetings in the area.

"Our finances are pretty strained right now," says Pappas. "We are spending $60,000 a year that was earmarked for other programs to get our 24-hour hotline up and running."

The CCG already receives $100,000 each year from the Pennsylvania Lottery Commission to run its problem gambling programs. The agency receives another $20,000 a year in private donations.

The state's number, by contrast, is more of an information helpline -- 1-877-565-2112. Calls to that number are answered by health department staff, who are not trained in detecting or treating gambling addiction. If a caller is in crisis, the state line directs it to a counselor trained in drug and alcohol addiction.

McGarvey acknowledges that treating gambling addiction has unique complications not found in drug- or alcohol-abusers. But he says there are general treatment methods that work for addiction, regardless of what the client is addicted to.

"There is gambling-specific treatment that is important," McGarvey says. "But when you're treating any addiction there is some overlapping treatment."

Even so, gamblers seem to favor the CCG. In February, the 1-800-GAMBLER hotline received 90 calls. The state's line, meanwhile, received just 13. In fact, the state has received just 71 calls since its hotline went up in December.

CCG officials say that given those patterns, it's not clear why the state is creating a separate hotline at all.

McGarvey says he is a bit surprised at the CCG's criticism because the two agencies have been communicating and working together on the training programs. However, he says the group's concerns just show that they are passionate about the subject.

Passionate and worried.

"Basically," says Joanna Franklin, the CCG's education and training coordinator, state officials "haven't done crap. ... They're spending time and money trying to invent the wheel, but the wheel has already been invented and in-use here in the state.

"The number of calls have already increased and we know the big bump in calls and requests for treatment is coming and I'm really worried that we're not going to be ready."

The hotline is just one social-service program targeting the gambling addictions casinos will likely create. Some casinos have already begun working with CCG, hoping to train casino workers to help spot the symptoms of problem gambling. The organization is also training other trainers across the state, in order to create a pool of counselors to address what experts say will likely be an explosion of gambling addiction. According to the National Council on Compulsive Gambling, about three percent of Americans have some sort of problem gambling disorder. If just one percent of the state's 12.4 million residents need help, that's 6,200 problem gamblers needing assistance.

CCG offers training, though it isn't cheap: The agency usually charges $2,000 a day for training. Before Franklin officially joined the CCG, the state's rate for training was $400 per day. Although now that she's with the CCG, the state will pay $2,000 per day rate at upcoming training sessions in April and June.

State officials have begun training addiction counseling professionals, but CCG worries that it is using an inadequate training requirement.

The main cornerstone of national gambling treatment certification is 30 hours of classroom training and another 100 hours of supervised practice. However, Franklin says the state has loosened requirements by offering a "Certificate of Competency" for trainers that have completed the classwork, but not the supervised counseling. With the certificate, counselors can counsel problem gamblers, and train others to do the same.

"That's a real problem," says Franklin. "You're going to have trainers and counselors who have never treated a problem gambler. I think that's going to open the state up to a lot of liability and open counselors up to possible malpractice."

McGarvey says the supervised treatment is the only major difference between the state certificate and national certification. However, he says because there aren't a lot of certified trainers in the state, it's difficult for local counselors to fulfill the requirement for supervised counseling.

"The counselors that will get this certification already have a base in addiction counseling," McGarvey says. "What we're offering is better than getting no treatment at all."

And while gambling is a new endeavor for the agency and the program isn't as far ahead as McGarvey would like, he points out that the department has been treating drug and alcohol addiction for years. While gambling addiction has its own set of treatment guidelines, a lot of the same principles apply regardless of the addiction.

"We've been doing addiction training for years, and a lot of the counselors we have worked with are coming forward looking for gambling-specific training," McGarvey says. "We're definitely not re-inventing any wheel; we've been using this training model for years and now we're applying it to gambling.

"I understand that they might have concerns, but we are working on programs and hadn't received any funding until last year. We're not exactly where we'd want to be, but we're not at square one either."

What no one questions is that as more casinos open across the state -- the Meadows in Washington County will open in just a few weeks -- more gamblers will need treatment.

"We are working on the program: There's not a lot of depth, but we are farther ahead than we were last year," McGarvey says. "And hopefully we can get everyone trained that needs trained before there really becomes a need for these services.

"We of course hope there won't be a great need for these services. But, unfortunately, I don't think that's going to be the case."

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