HEALTH SYSTEMS DIVISION

Problem Gambling Services

WELCOME

Problem Gambling All Providers Meeting

Hosted by State Problem Gambling Service StaffJune 15, 2017

GotoMeeting Webinar

We will begin in a few moments…….

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Webinar Etiquette and Structure• We will be administratively muting this call and recording it. You will

not be unmuted or allowed to verbally ask questions.

• You can use the chat box to ask questions at anytime during the webinar, and we will read and answer at the end of each presentation.

• To minimize the GoToMeeting box from your screen, click on the orange arrow button. Click again to bring it back.

Agenda Items• Welcome (5 minutes)

• Oregon Lottery Updates- Stacy Shaw (20 minutes)

• State Updates (20 minutes)

• Respite Services in Josephine County- Jean Linck and Marilane Jorgenson (20 minutes)

• PGS Prevention Data Spotlight and Positive Cultural Framework Project Update: Phase 1- Roxann Jones (15 minutes)

• Questions and Answers (10 minutes)

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Post Webinar

• PowerPoint, accompany documents and CEU certificates will be emailed to you next week.

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Oregon State Lottery

Presented by:Stacy Shaw, Oregon Lottery

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Video Lottery Retailer Training Update

– Over 4000 Video Lottery retail staff trained – 6% completed post training survey

• 82 % would recommend to others• 90% said they know where to find information and

what to do if customer asks for help• 93% understand role in promotion of responsible

gambling• 54% say they have greater job satisfaction • 8 in 10 report having conversations with their

managers about promoting responsible gambling– Print version of the training available in 7 languages

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Traditional Lottery Retailer Training Update

– 10 minute mobile enabled training is currently being produced

– Focus on “ Six things every retailer needs to know”• Age verification• Line of sight and vending• Available Responsible Gambling information• Game specific information • Problem Gambling information• Availability of free, professional, confidential

help– Summer pilot program with:

• Convenience with gas chain Jacksons Foods –57 locations

• Multi-register grocery chain Safeway Albertsons – 94 locations

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Lottery Employee Training Update

– Advanced training with player and retailer facing employees• In person two hour sessions

– Led by industry expert Janine Robinson– Topics included

» Having difficult conversations» Dealing with discouragement » Self care

• Six sessions including staff from– Field sales– Player services– Field service– Promotions – Hotline

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Television Advertising Update

– “Signs” campaign in currently in market

• 400 TRPs between June 5-June 25

• 4 :15 second versions rotated– Spinning out of Control– Too much time– Significant other– Life Spinning

• Unique “kinetic type” execution both shows and says the message for maximum impact

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Trigger Campaign Update

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April 2017– 324,164 clicks to the web siteMay 2017- 278,672 clicks to the web site

Questions

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State PGS General Updates

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� Next PGS All Provider Webinar/MeetingSeptember 21 from 9-10:30am. To register: https://attendee.gotowebinar.com/register/5132121536815906306Agenda to be emailed mid August

2017 Training Calendar now available listing out the monthly prevention and treatment calls and all provider webinars and other upcoming trainings planned. Located at: http://www.oregonpgs.org/all-providers/workforce-development/

State PGS General Updates

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Upcoming Training Opportunities:

� 31th National Conference on Problem Gambling� July 21-22, 2017� Preconference: July 19-20,

2017� DoubleTree by Hilton, Portland,

OR� Still time to register at

http://www.ncpgambling.org/training-certification/national-conference/

Conference Subsidy

• Conference subsidies are available for the National Conference on Problem Gambling.

• Subsidy covers some of the cost of mileage and lodging. Does not cover cost of registration

• The subsidy is intended to offset some, but not all of the costs of attendance

• Must apply by July 1, 2017 to be eligible for consideration. • You must a pay for all cost upfront and will be provided a subsidy

check at the conference. • If you want more information or receive the form, please contact

greta.l.coe@state.or.us

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Online TrainingsProblem Gambling Treatment Training for Clinicians & Supervisors• 8 Online modules available from January 2017-January 2018• Register at:

https://graduate.lclark.edu/programs/continuing_education/counselors_and_therapists/problem-gambling-treatment-online/– Problem Gambling Treatment in Oregon: The Big Picture– Overview of Problem Gambling– Problem Gambling Assessment and Treatment Planning– Diversity, Social Equity and Problem Gambling– Problem Gambling and Money– Family Treatment for Problem Gambling– Problem Gambling Treatment: Supervision Part I– Problem Gambling Treatment: Supervision Part II

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Lewis and Clark Gambling Counselor Pre Certification - Part 1

• Dates: Saturdays, September 16 and December 2, 2017, Plus 8 online modules

• Time: 9 a.m.-5:30 p.m.Instructor: Rick Berman, MA, LPC, CADC III, CGAC II; Mark Douglass, LPC, NCGC-II/BACC, CADC I

• Cost: $195, includes 30 CEUs or PDUs • Register at: https://graduate.lclark.edu/live/events/233905-

gambling-counselor-pre-certification-i

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New Helpline Services

• Second back up specialist will be added for after hours, weekends and holidays.

• Motivational Text Messaging Program– For Gambler, Family and available in English and Spanish– 2 texts a week for 3 months– People will sign up through the helpline– Implementation date will be this summer

• OPGR Facebook page• Other additional services are also being considered and in process

of being researched- stay tuned.

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Infographics-Older Adults and PG

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Infographic-Co-Occurring and PG

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State Prevention Updates� 2017-19 Problem Gambling Prevention Plans are due on/or before June

30, 2017 submitted in OPDS. For assistance with plan development please contact Roxann or visit oregonpgs.org to view the recorded training at http://www.oregonpgs.org/prevention/reporting-tools/.

� Problem Gambling Prevention 2016-17 Annual reports are due on/or before August 15th. Annual report form can be at http://www.oregonpgs.org/prevention/reporting-tools/.

� PG Prevention Advisory Committee is in the process of reviewing the previous Substance Abuse Prevention Coordinator Manual and editing the manual to create the Problem Gambling Prevention Coordinator Manual.

� PG Prevention Advisory Committee will also serve as the Work Force Development Committee for Prevention.

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Family Therapy Learning Session and Forums

• Dates in 2017: July 27, and October 26 • Time: 10-11:30 am• Facilitated and Coordinated by Teresa McDowell, Ed.D., Professor

and Chair, Department of Counseling Psychology; Lewis & Clark Graduate School of Education and Counseling

• Calls will include pre-meeting readings and structured agendas and topics.

• Information on login and call in, along with reading assignment provided via email closer to each call.

• 1 hour of CEUs provided for those that attend.

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Advanced Families and Problem Gambling Treatment Discussions

• Dates in 2017: Sept 7, Nov 30• Time: 10-11:30 am• Information on login and call in provided via email closer to each

call. All levels of clinicians welcome.• Please mark your calendars if you are interested.• Information on login and call in provided via email closer to each

call. • 1 hour of CEUs provided for those that attend.

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August Treatment Call

• Wednesday, August 2• 3:00 – 4:00 pm• Log in and call instructions• Agenda to be sent mid July

• Future dates in 2017: October 4, and November 1.• See training calendar: http://www.oregonpgs.org/wp-

content/uploads/2016/03/2015-17-PGS-Calendar-rev-2-1-17.pdf

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Procedure Code Updates

• General FLEX code will still be in effective, however some specific FLEX code categories have been added

– FLEX01- Staff Professional Development (includes registration cost, travel, lodging and per diem, contracts for certification supervision or consulting)

– FLEX02- Transportation- client travel to services, bus/taxi passes, etc. All other clinician travel for client services should be coded to mileage G30.

– FLEX03- Community/Social Engagement- long standing alternative activities-limited partial gym membership, local art type community classes, etc.

– FLEX04- Overall Wellbeing- items to improve employment prospects, eye glasses, etc.

– FLEX05- Nutrition for Events- food and beverages for client activities– FLEX06- Temporary Housing – short term housing, oxford house, hotels,

cleaning fees, pet fees, deposits to assist client with permanent housing plan, other than rent.

• New Procedure and Rates document will be sent on June 15.

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Reimbursement Rate Increase• Worked with the Actuarial Services Unit of OHA to determine how our PG

rates compared to other rates (Medicaid, CCO, etc.)• It was determined that our rates were a bit low. • Actuarial unit determine that we should increase rates by 11 percent. • This does not mean that contracts gets more treatment funding, as most

treatment providers have not been encountering up to the max of their allocations.

• For those programs that have been accounting up to their allocated amount, state program will monitor encountering and will amend contracts for additional funds when needed.

• By increasing rates, subcontractors will get a better reimbursement if they are on a fee for service system and at a statewide level our expenditure rate will increase and it will appear that we are using a greater level of our funds to treat the client.

• New Procedure and Rates document will be sent on June 15.

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Criminal Justice System Collaboration

• State has been working with Department of Correction Intake Administrators

• Our want was for assessment/screening to be completed on those entering the DOC system at intake.

• DOC was open to that, however first wanted to understand the need.

• Recommended screening all intakes for a period of time to see what the data will tell us.

• State PGS developed screening tool based off of the CPGI.• We will start screening all intakes starting August 1, 2017 for six

months. (appr. 450 intakes a month, 60 are women)• Results will determine next steps. Stay tuned…..

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New Advisory Committees

FYI• Two new Advisory Committees will be developed this upcoming

fiscal year– Treatment Workforce Development- help develop workforce

development training plan for upcoming years.– Rural Services- help develop system to better support rural

services/communities

• Development of Rural Services Advisory Committee will begin in September. Email with specifics, obligations of being on committee and recruitment will begin late Summer.

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Clinical Supervision

• Contracting with Christopher Anderson in the fall of 2017• He will conduct a webinar supervision session once a month for 90

minutes.• Dates have not been determined yet, but will be by end of August.• This opportunity is being offered as many gambling clinicians do not

have supervisors with specific knowledge or experience working with gambling clients.

• Opportunity for gambling clinicians to hear and present about past cases and potential scenarios that you may see with guidance from an experience gambling counselor/supervisor.

• Stay tuned…..more to come.

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Questions

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Crisis Resolution Center

CRC is licensed and certified as aSecure Residential Facility by the

Health Systems Division of Oregon

Crisis Resolution Center

• We offer a safe, confidential environment for the purpose of addressing the needs of an individual experiencing a psychiatric emergency related to their gambling disorder or their family as it relates to the gambling disorder. This service is geared toward brief intervention in order to stabilize and motivate the individual to include assessment of the next level of care.

Crisis Stabilization Inpatient

• Our staff is skilled in providing treatment to individuals who present with complex co-occurring disorders.

• The program is designed to stabilize the individual and enhance motivation in a safe, therapeutic, homelike environment.

• Average length of stay is 5-7 days.

The interdisciplinary professional staff includes:

� Psychiatrist � Registered Nurses� Qualified Mental Health

Professionals and Associates

� Staff certified to work with gambling and substance use d/o

Eligibility for Non Hospital Hold

Individual must be:• 18 years old or older • Assessed and referred by a qualified professional• Screened by a physician• Meet the criteria and be placed on either a Physician’s or Director’s

Hold

The following are not considered appropriate for placement in CRC:

� Persons in need of seclusion and restraint due to non-compliance or assaultive behavior, or

� Persons who are in need of semi-skilled or skilled nursing care or who are non-ambulatory.

Eligibility for Voluntary Crisis Care

Individual must be:

� 18 years old or older � Ambulatory � Referred from a state funded gambling treatment program � Meet the DSM5 criteria for Gambling Disorder

Referral is made through the Options for Southern Oregon Gambling Recovery Program, but final acceptance is granted by the CRC Supervisor:

Erik Dominger RN, BSN, QMHP

Referrals are appropriate for… an individual experiencing:

� Moderate suicidal ideation

� Co-occurring disorders

� Poor or non-existent support system

� Prior treatment failures

�High relapse risk

�Uncontrolled gambling

�A need for medication and/or psychiatric evaluation and stabilization

We strive to work with the referring clinician to i dentify goals and objectives which may include the followin g:

• Assess and identify co-occurring disorders that have prevented successful recovery in a less intense level of care.

• Stabilize and engage the individual; build motivation• Begin developing awareness and skills to cope with

relapse phenomenon, which may include risk factors, triggers and warning signs; and creation of a financial safety plan.

• Interrupt an ‘out of control’ cycle of gambling; identify signs and symptoms of gambling withdrawal

…continued

• Begin improving ability to recognize unhealthy behaviors and their role in perpetuating problem gambling and/or relapse potential.

• Develop a discharge plan to safely discharge the individual back to their community outpatient program or;

• If appropriate, refer for residential treatment services for problem gambling and/or co-occurring disorders.

• Facilitate and initiate solid introduction to 12 Step supports with onsite GA as well as AA or NA meetings.

• Individual and didactic education groups to cope with mental health

For services or questions contact:

CRC Campus

541-472-9983• Lynn Fernon, QMHP,

LCSW, CRC Clinical Program Manager

• Erik Dominger, RN, BSNCRC Supervisor

• The Crisis Specialist on duty

Gambling Treatment & Outreach Annex

541-472-9996Jean Linck, CGACII/NCGCII, Coordinator of the Problem Gambling Treatment and Outreach Program Monday through Thursday

OPTIONS FOR SOUTHERN OREGON324 RAMSEY AVENUE

GRANTS PASS, OR 97527

We are pleased to be able to serve individuals referred from any Oregon County and look forward to hearing from you .

Questions

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PGS Prevention Data Spotlight and Positive Cultural Framework Project

Update: Phase 1

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Presented by Roxann Jones, PGS State Staff

Positive Cultural Framework Project

What is it?� Positive Cultural Framework is an approach based on improving

health and safety in communities and organizations. Utilizing “Positive Community Norms” as well as recognizing the many different layers in a community (e.g., individuals, schools, workplaces) impacts the culture.

� Partnership with the Center for Health & Safety Culture at Montana State University to develop a communication campaign to reduce and prevent problem gambling across the state of Oregon.

� The campaign will embrace a positive, hope-based framework which will seek to draw youth, adults and key stakeholders into engagement.

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Aligning with the Process

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Simplified Behavior Model

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Social Ecological Model

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Transforming Our Approach

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The Importance of

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Concern + Hope

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What is the difference between concern and fear?

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Concerns about Gambling in Oregon

• Problem gambling is a public health concern

• More than 81,000 Oregon adults are believed to meet the criteria for being current problem or disordered gamblers

• For each individual with a gambling problem many others are affected (spouses, children, etc.)

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Concerns about Gambling in Oregon

• Estimated social cost in excess of $500 million:

- Criminal Justice System- Human Service System- Oregon Economic Health- Legal System (bankruptcy, divorce, etc.)

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Concerns about Gambling in Oregon

• Oregon 11th graders who reported gambling had higher rates of;

- skipping school- being in a physical fight- sad for 2+ weeks- using alcohol, marijuana and other drugs

• 64% of Oregon 11th graders stated that their parents have NOT talked to them about the risk of gambling/betting

Oregon Student Wellness Survey, 2016

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Hope in Oregon

• 43% of Oregon adults have NOT gambled in the past year

• 68% of Oregon 11th graders did NOT gamble in the last 30 days

• Most Oregon adults believe that the harms associated with gambling outweigh the benefits

Oregon Adult Gambling Behavior Study, 2016 and Oregon Student Wellness Survey, 2016

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Hope in Oregon

• 85% of adults are aware that treatment is available for problem gambling

• Most Oregon adults believe that treatment is effective

• 73% of adults believe that gambling problems can be prevented through education and awareness

• Less than 3% of Oregon adults are considered at-risk or disordered gamblers.

Oregon Adult Gambling Behavior Study, 2016

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Logo and Brand Testing

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Phase 2

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Questions

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Contacts

• Greta Coe, Problem Gambling Services Manager– Greta.l.coe@state.or.us; 503-945-6187

• Roxann Jones, Problem Gambling Prevention SpecialistRoxann.r.jones@state.or.us; 503-947-5548

• Patricia Alderson, Problem Gambling Administrative Support– Patricia.alderson@state.or.us; 503-945-9710

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Final Notes:

• PowerPoint, accompany documents and CEU certificates will be emailed to you next week.

Thanks for your participation in this webinar, and for the work that you do

every day!

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