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California Department of Public Health Office of Problem Gambling Transition Legislative Report

2016

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Acknowledgement This report will be posted on the CDPH website and can be found at www.cdph.ca.gov under the publications and forms tab, OPG Transition Legislative Report 2016. Copies of the report, or inquires about the report should be directed to: Terri Sue Canale Chief, Office of Problem Gambling [email protected] 916-324-3020

Executive Summary Effective with the passage of the 2013-2014 Budget Act and associated legislation, the Department of Alcohol and Drug Programs (DADP) was eliminated July 1, 2013, and the Office of Problem Gambling (OPG) transitioned to the California Department of Public Health (CDPH) Center for Chronic Disease Prevention and Health Promotion. CDPH executed the successful transition of OPG from DADP. OPG continues to fulfill its mission under CDPH, administering prevention and treatment programs for gamblers and their families suffering negative consequences due to gambling addiction. In an effort to evaluate impacts of the transition from DADP to CDPH, including how and why services provided and overseen by OPG were improved, or otherwise changed as a result of this transition, OPG disseminates this annual report. The OPG Transition Legislative Report 2016 is the third report since the transition and takes into account all information and data for the 2014-15 fiscal year.

http://www.cdph.ca.gov/mailto:[email protected]

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Table of Contents Background 4 CDPH Stakeholders Become New OPG Partners 4 Prevention Program 5 Treatment Program Provider Training 5 Access to Services/Provider Demographics 6 Client Level Data 7 Access to Treatment Services 8 CalGETS Client Demographics (Gamblers) 9 CalGETS Client Demographics (Affected Individuals) 10 Regional Demographics 11 Current Health Diagnosis/Co-occurring (Gamblers) 13 Current Health Diagnosis/Co-occurring (Affected Individuals) 22 Treatment Outcomes (Gamblers) 29 Clinical Innovations 30 Closing Summary 31 Appendix: List of Acronyms 32

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Background In 2003, the Office of Problem and Pathological Gambling (OPG) was established under Section 4369 of the Welfare and Institutions Code, in the Department of Alcohol and Drug Programs (DADP). OPG's mandate is to develop and provide quality statewide prevention and treatment programs for Californians suffering from gambling disorder and for family members experiencing a negative impact to their lives due to problem gambling behavior. In 2006, OPG conducted a gambling prevalence study in California with 7,121 respondents, at the time it was the largest gambling prevalence study in the United States. The State was at the higher end of the range of prevalence rates identified in the United States; overall lifetime prevalence for problem and pathological gambling combined was 3.7% (estimated at just over one million individuals today). An additional 6-7% (2.2 to 2.7 million individuals) were estimated, in the report, to be classified as lifetime at-risk gamblers - those who scored low on the problem gambling screen, but may transition to problem or pathological gamblers at some point in their lives. Gambling problems exist on a continuum and vary in severity and duration. Pathological gambling lies at the most severe end of the continuum of gambling problems. Effective with the passage of the 2013-2014 Budget Act and associated legislation, DADP was eliminated as of July 1, 2013. The Governors Budget approved the transfer of OPG to the California Department of Public Health (CDPH). OPG is currently operating within CDPHs Center for Chronic Disease Prevention and Health Promotion. In order to execute this transfer, the California Health and Human Services Agency developed and implemented a transition plan, approved by the Legislature. OPG is required to prepare five annual legislative reports through June 2018 to ensure that the impacts of the transition are identified and evaluated both initially and over time. OPG determined that the previously established OPG Advisory Groups quarterly meetings would serve as the ongoing venue for stakeholders to provide input into public policy issues related to gambling disorder. The Advisory Group is comprised of representatives from the Legislature, state gambling regulatory agencies, other state departments, the California Lottery, educators, non-profit organizations, the recovery community and the gambling industry. A listing of current members can be found on the OPG website and meetings are also open to the public. CDPH Stakeholders Become New OPG Partners In 2015, OPG continued to expand its relationships with other CDPH programs, including the Chronic Disease Surveillance and Research Branch. OPG entered into a memorandum of understanding with the Chronic Disease Surveillance and Research Branch to participate in the 2015 Behavioral Risk Factor Survey (BRFS). A total of five gambling related questions were added to the 2015 BRFS. While the percentage of individuals who had gambled in the past 12 months, seemed low (20%), the percentage of those experiencing issues related to their gambling were within the same ranges as the 2006 Prevalence Study. The low percentage of individuals who had gambled over the past 12 months could be due to their definition of gambling, some do not connect activities like Lottery or bingo with gambling. The percentage of those who were experiencing issues related to their gambling ranged from .66% (individuals with financial

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troubles) to 3.28% (individuals who tried to keep gambling activities secret from family or friends). Prevention Program The OPGs Prevention Program contains the following mandated elements: toll-free helpline, training and education, outreach and public awareness campaign and empirically-driven research.

Toll-free helplines: While 1-800-GAMBLER intake calls related to problem gambling decreased by 266 calls from the previous year, the total number of calls the helpline received increased by nearly 12,000. Through a text support program, which was implemented in December 2014, individuals are able to access helpline resources via text. There were 97 text conversations with helpline counselors during the first seven months of the text program, making up some of the difference in the decreased calls for help. The Asian language helpline continued to see a drop in calls, showing a decrease of 13 percent from the previous year. OPG continues to evaluate the reason for the decrease. In an effort to increase online community outreach, the Asian language helpline administrator created a Facebook page, doubling referrals from online marketing from 10% in 2013 to 21% in 2015.

Training and Education: There were no significant changes to training and education. OPG and its contractors continue to meet the mandate to provide training and education to non-profit organizations, health care professionals, educators, gambling industry employees and law enforcement agencies.

Outreach and public awareness: OPGs multi-media outreach and public awareness campaign was allocated the same funding as the previous year. OPG created a new media campaign, Dont Ignore the Signs, depicting the signs of problem gambling behavior. In order to fully transition to CDPH, all media needed to be updated with the CDPH logo. During this fiscal year, OPG was able to complete all media updates to incorporate the CDPH logo

Research: As explained in the above section, OPG collaborated with a new partner, the CDPH Chronic Disease Surveillance and Research Branch, to participate in the Behavioral Risk Factor Survey.

Treatment Program 2014-15 marks the 7th year of CalGETS implementation. By June 2015, CalGETS had served just over 8,200 clients, with 221 outpatient providers, two agencies providing telephone interventions, two intensive outpatient facilities and two residential treatment facilities. Provider Training: The CalGETS Training program involves Phase I, Phase II and clinical guidance consultation.

During 2014-15, OPG hosted one Phase I Training event to authorize new CalGETS providers. A total of 46 providers completed Phase I Training, of which 42 became authorized.

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In addition to recruiting new providers, OPG sought to enhance the knowledge of and provide guidance to the established workforce. OPG provided three Phase II Training events in which 57 providers participated. Phase II Training consists of six-hour, single-day training events open to all CalGETS authorized providers and is intended to deliver advanced, leading edge information on the treatment of gambling problems.

Clinical guidance continued to be offered via telephone conference. These calls were led by CalGETS-authorized clinical guidance professionals who have extensive experience in the diagnosis and management of gambling problems. A total of 27 hours of clinical guidance and support were conducted in 2014-15. The number of clinical guidance and support hours will increase in the upcoming year due to the addition of new authorized providers.

The Annual Training Summit also provides an opportunity for providers to gain the continuing education units needed for their certifications annual requirement; 177 participants attended the Summit in March 2015.

Compliance Monitoring: OPG and designated contract staff conducted in-person reviews of treatment provider documentation to ensure compliance with CalGETS policies and procedures. During 2014-15, 21 compliance monitoring reviews were conducted ensuring that all providers had a review within two years of invoicing for services.

Access to Services/Provider Demographics: CalGETS contractors provide services in 23 languages/dialects. During FY 2014-15, the number of CalGETS providers increased by 26 as compared to FY 2013-14 because OPG hosted a Phase I Training event. Historically, there is a small amount of attrition (e.g., not all providers stay on with the program; some are unable to secure sufficient clients to continue to provide services, etc.), but the Phase I training event brought the number of providers up to near the levels for FY 2012-13. Provider demographics, licensure and language remained similar to FY 2013-14, with no significant changes. The following information was collected in the form of a survey; some providers declined to answer or were exempted from the survey.

Provider Demographic Information 2012-13 2013-14 2014-15 Total CalGETS Providers 229 195 221 Age (Mean) 54.5 57 56.3

Gender Male 57 47 52 Female 172 148 152 Race Caucasian 146 139 144 African American 10 12 11 Hispanic 14 11 13 Asian 23 23 26

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Native Hawaiian 1 1 1 Multicultural 8 4 6

Provider Licensure Information 2012-13 2013-14 2014-15 Number of Years Licensed (Mean) 12 13 12.5 Type of License PsyD 10 9 10 PhD 15 17 15 MFT 135 139 135 MSW 4 2 4 LCSW 28 27 28

Provider Language Information

2012-13 2013-14 2014-15 Providing Treatment in Language Other than English?

No 163 153 162 Yes 40 42 41 Spanish 18 20 21 Asian 13 18 18 Other 6 8 5

Client Level Data: CalGETS is offered in four modalities for gamblers and two modalities for affected individuals (those persons negatively impacted by the problem gambler's behavior) as described below.

Problem Gambling Telephone Interventions (PGTI) Gamblers and affected individuals may receive up to three treatment blocks of eight sessions in English, Spanish and various Asian languages. Telephone interventions allow access to services for clients who may be disabled, lack transportation, or live in rural areas of the state where outpatient services are not available.

Outpatient Gamblers and affected individuals may receive up to three treatment blocks of eight face-to-face sessions in English and other languages described above. Providers use their own clinical experience and treatment philosophies in combination with the advanced knowledge received through CalGETS training to provide evidence-based services.

Intensive Outpatient (IOP) Gamblers may receive up to three treatment blocks 30-days in length of this more intensive level of care. Clinical services are provided three hours per day, three times per week and include multi-modal treatments including individual, group and family counseling.

Residential Treatment Program (RTP) For the severest form of pathological gambling, gamblers may receive up to three treatment blocks, each 30-days in length. This is a 24-hour residential facility that is designed to address the many

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complicating factors that pathological gamblers can face in the course of this disease.

Enrollment in Services: Total gambler enrollment was similar to that seen in FY 2013-14, but there were changes for each treatment type. Fewer individuals sought telephone interventions or outpatient treatment while there was an increase in clients seeking intensive outpatient (IOP) and residential treatment. Affected individual enrollment slightly decreased from FY 2013-14, primarily due to decreases in PGTI use.

Total Gamblers Served 2012-13 2013-14 2014-15 PGTI (English/Spanish) 176 154 130 PGTI (Asian) 16 25 10 Outpatient 1072 995 966 IOP 30 8 59 RTP 44 42 74 Total Cases* 1338 1224 1239

Total Affected Individuals Served

2012-13 2013-14 2014-15 PGTI (English/Spanish) 18 19 3 PGTI (Asian) 0 11 8 Outpatient Treatment Network 412 424 415 Total Affected Individual Cases* 430 454 426

*Please Note: Some individuals may have accessed multiple services. Access to Treatment Services: In order to ensure access into treatment in a timely fashion, authorized providers track the time between initial helpline referral (contact) and intake into treatment. Here we report median times from first contact to intake into treatment. For outpatients the median time from first contact to intake was three days. Approximately 78% of outpatient clients completed intake into treatment within the first week after contact. For English/Spanish telephone clients, the median 13-day period from initial contact to the intake session stayed about the same with a median of 14 days in FY 2014-15, and 5.3% of clients receiving an intake session within seven days of initial contact. For Asian telephone clients, the median was 1 day in FY 2014-15, with 75% of clients completing intake within seven days of initial contact. The median for IOP clients in FY 2014-15 was four days, with 62.9% of IOP clients completing intake within seven days of first contact. For RTP clients, the median days from first contact to intake into treatment was 13 days, with 41.1% of clients completing intake within the first week after initial contact. There was a slight change in the number of CalGETS clients per month, but little change in treatment providers experience with gamblers.

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2012-13 2013-14 2014-15 Number of CalGETS clients seen per month (average)

4 4 2.9

Number of years providing treatment to gamblers 3.6 4 4.3

CalGETS Client Demographics (Gamblers): The mean age across all treatment components showed less variation than was seen in FY 2013-14. RTP clients were the youngest clients on average, but were only five years younger on average than the oldest group in IOP. Most modalities, except for Asian language PGTI and RTP, showed an approximate 60%-40% split for males vs. females. Racial and ethnic diversity among clients in CalGETS increased, particularly among those in IOP and RTP. In July 2014, OPG opened a second IOP in San Diego in an effort to provide services to a more diverse clientele, which has resulted in more diversity in terms of race/ethnicity in the IOP programs. The Other category is inclusive of clients who self-identified as American Indian, Alaskan Native and smaller populations not otherwise listed in the chart below. More Hispanics received services in the outpatient program, as well, relative to FY 2013-14. Of note were low employment levels among RTP clients; both of the two operating RTP programs provide career counseling services to CalGETS clients to aide in finding a job after completing the program.

Age (Mean) 2012-13 2013-14 2014-15

PGTI (English /Spanish) 48.9 45.9 47.2 PGTI (Asian) 47.0 51.5 45.8 Outpatient 47.0 46.6 47.0 IOP 40.0 50.8 49.7 RTP 48.0 41.6 45.0

Gender

2012-13 2013-14 2014-15 Male Female Male Female Male Female

PGTI (English /Spanish) 49% 51% 57% 44% 66% 34% PGTI (Asian) 63% 37% 60% 40% 50% 50% Outpatient 59% 41% 61% 39% 62% 38% IOP 70% 30% 63% 38% 67% 33% RTP 66% 34% 81% 19% 85% 15%

Race/Ethnicity 2012-13

Caucasian African American

Hispanic Asian Other

PGTI (English/Spanish)

62% 16% 30% 15% 4%

PGTI (Asian) 0% 0% 0% 100% 0% Outpatient 54% 8% 29% 18% 7% IOP 70% 4% 4% 13% 9% RTP 65% 10% 2% 20% 2%

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Race/Ethnicity 2013-14 Caucasian African

American Hispanic Asian Other

PGTI (English/Spanish)*

64% 8% 23% 22% 6%

PGTI (Asian) 0% 0% 0% 100% 0% Outpatient 52% 10% 14% 17% 9% IOP 100% RTP 57% 17% 17% 5% 5%

* Hispanic ethnicity was asked separately from race therefore these numbers don't sum to 100.




55% 12% 24% 25% 7%

PGTI (Asian) 0% 0% 0% 100% 0% Outpatient 50% 9% 18% 18% 6% IOP 59% 10% 5% 21% 7% RTP 41% 28% 19% 10% 2%

CalGETS Client Demographics (Affected Individuals): Affected individual client demographics showed some changes from FY 2013-14 with increases in the numbers of Hispanics and Asians in the outpatient program. The gender split remained fairly consistent, except for an increase in males in PGTI. This increase may have been an artifact of small numbers of affected individuals in the PGTI (English/Spanish) program. Age remained stable for the outpatient programs, but PGTI clients were younger than in previous years.

Age (Mean) 2012-13 2013-14 2014-15 PGTI (English /Spanish) 51.0 44.8 37.4 PGTI (Asian) 53.0 54.1 45.8 Outpatient 45.0 46.5 47.0

Gender 2012-13 2013-14 2014-15 Male Female Male Female Male Female PGTI (English /Spanish) 28% 72% 11% 90% 33% 67% PGTI (Asian) 12% 88% 11% 89% 13% 88% Outpatient 26% 74% 28% 72% 23% 77%




70% 4% 20% 17% 9%

PGTI (Asian) 0% 0% 0% 100% 0% Outpatient 57% 8% 14% 15% 6%

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PGTI (English/Spanish)*

56% 24% 38% 6%

PGTI (Asian Languages)

0% 0% 0% 100% 0%

Outpatient 58% 4% 17% 17% 4% * Hispanic ethnicity was asked separately from race therefore these numbers don't sum to 100.




67% 0% 0% 33% 0%


0% 0% 0% 100% 0%

Outpatient 50% 6% 24% 13% 7%

Regional Demographics: Regional data showed no major changes from FY 2013-14 to FY 2014-15; however, there were minor increases in Bay Area clients and minor decreases in Central Valley clients. Differences were observed when looking at regional data for specific CalGETS modalities. For PGTI (English/Spanish), there was a drop in the number of affected individuals served across all regions except North Mountain and an increase in gamblers served from Los Angeles and the Central Valley. For the outpatient program, there was an increase in gamblers from the Bay Area and a decrease in affected individuals from the Central Valley. For IOP and RTP, the majority of clients came from the Bay Area and Southern California, including Los Angeles.

Regional - All Clients in First Block of Treatment 2012-13 2013-14 2014-15

Region N (%) N (%) N (%) North/Mountain 67 (4.0) 46 (2.8) 33 (2.0) Bay Area 213 (12.8) 241 (14.6) 290 (17.7) Central Valley 231 (13.9) 207 (12.5) 163 (10.0) Southern California minus Los Angeles 674 (40.6) 705 (42.7) 710 (43.3) Los Angeles 347 (20.9) 349 (21.1) 361 (22.0) Central/Southern Farm 128 (7.7) 103 (6.2) 81 (4.9)

Regional - PGTI (English/Spanish) Gamblers in First Block of Treatment 2012-13 2013-14 2014-15


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Regional PGTI (English/Spanish) Affected Individuals in First Block of Treatment 2012-13 2013-14 2014-15


Regional PGTI (Asian Language) Gamblers in First Block of Treatment

2012-13 2013-14 2014-15 Region N (%) N (%) N (%) North/Mountain 0 (0.0) 0 (0.0) 0 (0.0) Bay Area 5 (38.5) 8 (33.3) 6 (60.0) Central Valley 1 (7.7) 1 (4.2) 0 (0.0) Southern California minus Los Angeles 1 (7.7) 5 (20.8) 0 (0.0) Los Angeles 5 (38.5) 10 (41.7) 4 (40.0) Central/Southern Farm 1 (7.7) 0 (0.0) 0 (0.0)

Note: One person was missing region information 2013-14. Regional PGTI (Asian Language) Affected Individuals in First Block of Treatment


Note: One person was missing region information 2013-14. Regional - Outpatient Gamblers in First Block of Treatment


Note: Eighteen individuals were missing region information 2013-14.

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Regional - Outpatient Affected Individuals in First Block of Treatment 2012-13 2013-14 2014-15 Region N (%) N (%) N (%) North/Mountain 9 (2.3) 6 (1.4) 5 (1.2) Bay Area 41 (10.4) 33 (7.9) 33 (8.0) Central Valley 56 (14.2) 60 (14.3) 40 (9.7) Southern California minus Los Angeles 168 (42.6) 217 (51.7) 220 (53.4) Los Angeles 104 (26.4) 93 (22.1) 105 (25.5) Central/Southern Farm 16 (4.1) 11 (2.6) 9 (2.2)

Regional - IOP Gamblers in First Block of Treatment


Regional RTP Gamblers in First Block of Treatment


Legend: California Regions

North/Mountain: Alpine Amador, Butte, Calaveras, Del Norte, Glenn, Humboldt, Inyo, Lake, Lassen, Mariposa, Mendocino, Modoc, Mono, Nevada, Plumas, Shasta, Sierra, Siskiyou, Tehama, Trinity, Tuolumne

Bay Area: Alameda, Contra Costa, Marin, Napa, San Francisco, San Mateo, Santa Clara, Santa Cruz, Solano, Sonoma Central Valley: Colusa, El Dorado, Placer, Sacramento, Sutter Yolo, Yuba Southern California minus Los Angeles: Orange, Riverside, San Bernardino, San Diego, Santa Barbara, Ventura Los Angeles: Los Angeles Central/Southern Farm: Fresno, Imperial, Kern, Kings, Madera, Merced, Monterey, San Benito, San Joaquin, San Lois

Obispo, Stanislaus, Tulare

Current Health Diagnosis/Co-occurring Problems (Gamblers): Health-related data indicated the presence of a variety of disorders, with the most common being hypertension and diabetes. The presence of these disorders emphasizes the need for CalGETS providers to refer to medical professionals in order to address health-related issues that are commonly seen among gamblers. Smoking was particularly common among those being treated in the RTP. Nearly two-thirds of RTP clients reported smoking and they had the highest reported number of cigarettes smoked per day compared to phone and outpatient modalities. The rates of current drinking fluctuated between FY 2013-2014 and 2014-2015, with decreases in IOP and increases

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in RTP. Substance use increased among CalGETS clients in RTP with the most frequently reported substances used being marijuana, cocaine, methamphetamine, and stimulants. Across FY 2013-2014 and FY 2014-2015, there was an increase in reported use of stimulants and marijuana in the RTP clients. Both RTP programs are operated by agencies with experience treating substance addiction and the co-location of substance abuse services in the RTP setting is vital to meeting the needs of CalGETS clients in residential treatment. With regards to mental health needs, our data show high levels of mood and anxiety disorders across all modalities, with some changes across FYs. Mood disorders were somewhat less frequent among clients in RTP relative to FY 2014-2015. The high incidence of mental health need, in addition to the gambling-related problems experienced by CalGETS clients, validates the use of licensed mental health professionals as the primary source of our workforce. At least 70% of all clients reported having health insurance, therefore they may be covered for co-occurring conditions like those identified above.

Co-Occurring Health Diagnoses Liver Disease N (%) PGTI 0 (0.0) (English/Spanish) PGTI (Asian) 0 (0.0) Outpatient 19 (1.9) IOP 0 (0.0) RTP 1 (0.3) Cancer N (%) PGTI 4 (2.3) (English/Spanish) PGTI (Asian) 0 (0.0) Outpatient 14 (1.4) IOP 0 (0.0) RTP 0 (0.0)

2012-13 Obesity

N (%)

11 (6.3)

0 (0.0) 54 (5.4) 0 (0.0) 3 (9.0) Heart

Disease N (%) 7 (4.0)

0 (0.0) 52 (5.2) 0 (0.0) 1 (0.3)

HIV/AIDS

N (%) 0 (0.0)

0 (0.0) 4 (0.4) 0 (0.0) 0 (0.0)

Diabetes

N (%) 16 (9.1)

0 (0.0) 94 (9.3) 3 (11.5) 0 (0.0)

Ulcer Disease N (%) 2 (1.1)

1 (6.3) 24 (2.4) 0 (0.0) 0 (0.0)

Respiratory

N (%) 4 (2.3)

0 (0.0) 23 (2.3) 1 (3.8) 0 (0.0)

Hypertension

N (%) 15 (8.6)

1 (6.3) 152 (15.1)

3 (11.5) 3 (9.0) Stroke

N (%) 2 (1.1)

0 (0.0) 2 (0.2) 1 (3.8) 0 (0.0)

Co-Occurring Health Diagnoses 2013-14 Liver

Disease N (%)

Obesity

N (%)

HIV/AIDS

N (%)

Ulcer Disease N (%)

Hypertension

N (%) PGTI (English/Spanish)

3 (1.9) 10 (6.5) 0 (0.0) 1 (0.6) 17 (11.0)

PGTI (Asian) 0 (0.0) 1 (3.8) 0 (0.0) 0 (0.0) 3 (11.5) Outpatient 16 (1.6) 60 (6.0) 4 (0.4) 4 (0.4) 113 (11.4) IOP 0 (0.0) 2 (25.0) 0 (0.0) 1 (12.5) 1 (12.5) RTP 4 (9.5) 0 (0.0) 0 (0.0) 2 (4.8) 4 (9.5)

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Co-Occurring Health Diagnoses 2013-14

Cancer

N (%)

Heart Disease N (%)

Diabetes

N (%)

Respiratory

N (%)

Stroke


7 (4.5) 5 (3.2) 13 (8.4) 3 (1.9) 2 (1.3)


Co-Occurring Health Diagnoses 2014-15

Liver Disease N (%)

Obesity

N (%)

HIV/AIDS

N (%)

Ulcer Disease N (%)

Hypertension


1 (0.8) 6 (4.6) 1 (0.8) 0 (0.0) 7 (5.4)


Cancer

N (%)

Heart Disease N (%)

Diabetes

N (%)

Respiratory

N (%)

Stroke


2 (1.5) 6 (4.6) 13 (10.0) 4 (3.1) 2 (1.5)


Current Smoker 2012-13 Yes

N (%)

No

N (%)

Mean Cigarettes per Day

Mean Number of minutes waited after

waking before smoking


53 (30.3) 122 (69.7) 10.3 21.1

PGTI (Asian) 3 (20.0) 12 (80.0) 8.5 78.8 Outpatient 336 (33.9) 656 (66.1) 3.5 10.2 IOP 13 (50.0) 13 (50.0) 7.25 26.2 RTP 22 (66.7) 11 (33.3) 11.7 62.0

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N (%)

No

N (%)



waking before smoking PGTI (English/Spanish)

47 (30.9) 105 (69.1) 5.5 8.6

PGTI (Asian)* 2 (7.7) 24 (92.3) - - Outpatient 296(29.7) 699 (70.3) 2.9 9.5 IOP 3 (37.5) 5 (62.5) 2.5 0.1 RTP 34 (81.0) 8 (19..0) 7.3 16.7

* One person reported smoking a pack per day, the other reported smoking 1-2 packs per day. One person reported waiting 10 minutes after waking and the other reported 60 minutes after waking before smoking.


N (%)

No

N (%)



waking before smoking PGTI (English/Spanish)

42 (32.3) 86 (66.2) 23.0 10.8

PGTI (Asian) 2 (20.0) 8 (80%) 13.5 60.0 Outpatient 276 (29.2) 669 (70.8) 3.4 13.1 IOP 21 (38.2) 34 (61.8) 2.2 3.8 RTP 46 (62.2%) 28 (37.8) 8.0 10.8

Current Drinker 2012-13 Yes

N (%)

No

N (%)

Mean Drinks per

Week

Mean Number of Times 5 or More Drinks in one

day, past 12 Months PGTI (English/Spanish)

56 (31.8) 120 (68.2) 2.0 1.84

PGTI (Asian) 3 (21.4) 11 (78.6) 5.3 0.33 Outpatient 465 (46.9) 527 (53.1) .75 2.64 IOP 11 (40.7) 16 (59.3) 4.0 1.85 RTP 21 (70.0) 9 (30.0) 4.1 2.2


N (%)

No

N (%)

Mean Drinks per

Week

Mean Number of times 5 or more drinks in one


43 (28.3) 109 (71.7) 1.2 0.8

PGTI (Asian)* 1 (3.8) 25 (96.2) - - Outpatient 474 (47.6) 521 (52.4) 2.3 0.8 IOP 5 (62.5) 3 (37.5) 6.9 2.8 RTP 16 (38.1) 26 (61.9) 5.2 1.4

* The 1 individual who reported drinking drank 21 cans of beer per week and drank more than 5 drinks in a day 10 times in the past year.

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N (%)

No

N (%)

Mean Drinks per

Week

Mean Number of Times 5 or More Drinks in one


50 (38.5) 80 (61.5) 2.3 2.0

PGTI (Asian) 2 (20%) 8 (80%) 2.0 0.0 Outpatient 465 (49.2) 480 (50.8) 2.4 2.2 IOP 15 (27.3) 40 (72.7) 5.1 1.3 RTP 37 (50.0) 37 (50.0) 6.3 1.8

Past Year Substance Use 2012-13

Marijuana N (%)

Cocaine N (%)

Hallucinogens N (%)

Inhalants N (%)

Narcotics/Opiates N (%)


13 (7.4) 3 (1.7) 1 (0.6) 0 (0.0) 4 (2.3)


PCP N (%)

Methamphetamine N (%)

Stimulants N (%)

Tranquilizers N (%)


1 (0.6) 2 (1.1) 0 (0.0) 2 (1.1)

PGTI (Asian) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) Outpatient 0 (0.0) 42 (3.0) 18 (1.3) 29 (2.1) IOP 0 (0.0) 2 (7.4) 3 (11.1) 0 (0.0) RTP 0 (0.0) 3 (9.0) 1 (0.3) 1 (0.3)

Past Year Substance Use 2013-14 Marijuana

N (%) Cocaine

N (%) Hallucinogens

N (%) Inhalants

N (%) Narcotics/Opiates


14 (9.1) 2 (1.3) 0 (0.0) 0 (0.0) 1 (0.6)


PCP N (%)

Methamphetamine N (%)

Stimulants N (%)

Tranquilizers N (%)


0 (0.0) 2 (1.3) 4 (2.6) 2 (1.3)


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N (%) Cocaine N (%)

Hallucinogens N (%)

Inhalants N (%)

Narcotics/Opiates N (%)


8 (6.2) 2 (1.5) 1 (0.8) 1 (0.8) 3 (2.3)

PGTI (Asian) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) Outpatient 145 (15.3) 27 (2.9) 2 (0.2) 1 (0.1) 17 (1.8) IOP 9 (16.4) 0 (0.0) 0 (0.0) 2 (3.3) 1 (1.8) RTP 33 (44.6) 25 (33.8) 7 (9.5) 2 (2.7) 20 (27.0) PCP

N (%) Methamphetamine

N (%) Stimulants

N (%) Tranquilizers


0 (0.0) 2 (1.5) 4 (3.1) 2 (1.5)


Co-Occurring Psychiatric Disorders Treated for in the Past Year 2012-13

Mood Disorders

N (%)

Psychotic Disorders

N (%)

Anxiety Disorders

N (%)

Substance Use

Disorders N (%)

Personality Disorder

N (%)

ADD/ ADHD

N (%)


54 (30.9) 4 (2.3) 25 (14.4) 6 (3.4) 1 (0.6) 6 (3.4)

PGTI (Asian) 3 (18.8) 0 (0.0) 1 (6.3) 0 (0.0) 0 (0.0) 0 (0.0) Outpatient 334

(23.8) 23 (1.6) 199 (14.2) 45 (3.2) 18 (1.3) 43 (3.1)

IOP 12 (44.4) 3 (11.1) 8 (29.6) 3 (11.1) 3 (11.1) 7 (25.9) RTP 9 (27.3) 1 (0.3) 4 (12.1) 1 (0.3) 2 (0.6) 7 (21.2)

Co-Occurring Psychiatric Disorders Treated for in the Past Year 2013-14 Mood

Disorders

N (%)

Psychotic Disorders

N (%)

Anxiety Disorders

N (%)

Substance Use

Disorders N (%)

Personality Disorders

N (%)

ADD/ ADHD

N (%)


49 (31.8) 11 (7.1) 25 (16.2) 8 (5.2) 3 (1.9) 2 (1.3)

PGTI (Asian) 4 (15.4) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) Outpatient 255 (25.6) 20 (2.0) 127 (12.8) 36 (3.6) 11 (1.1) 32 (3.2) IOP 6 (75.0) 1 (12.5) 3 (37.5) 0 (0.0) 0 (0.0) 1 (12.5) RTP 16 (38.1) 0 (0.0) 6 (14.3) 6 (14.3) 1 (2.4) 4 (9.5)

19


Disorders

N (%)

Psychotic Disorders

N (%)

Anxiety Disorders

N (%)

Substance Use

Disorders N (%)


N (%)

ADD/ ADHD

N (%)


35 (26.9) 2 (1.5) 19 (14.6) 5 (3.3) 1 (0.8) 6 (4.6)

PGTI (Asian) 2 (20%) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) Outpatient 246 (26.0) 23 (2.4) 148 (15.7) 28 (3.0) 5 (0.5) 33 (3.5) IOP 23 (41.8) 2 (3.6) 17 (30.9) 2 (3.6) 0 (0.0) 6 (10.9) RTP 28 (37.8) 6 (8.1) 22 (29.7) 17 (23.0) 5 (6.8) 8 (10.8)

Current Health Ratings 2012-13

Excellent N (%)

Very Good N (%)

Good N (%)

Fair N (%)

Poor N (%)


18 (10.3) 45 (25.9) 55 (31.6) 46 (26.4) 10 (5.7)

PGTI (Asian) 2 (13.3) 4 (26.7) 6 (40.0) 3 (20.0) 0 (0.0) Outpatient 70 (7.0) 195 (19.4) 393 (39.0) 269 (26.7) 80 (7.9) IOP 3 (11.1) 3 (11.1) 12 (44.4) 5 (18.5) 4 (14.8) RTP 1 (0.3) 7 (21.2) 9 (27.3) 13 (39.4) 3 (0.9) Current Health Ratings 2013-14 Excellent

N (%) Very Good

N (%) Good N (%)

Fair N (%)

Poor N (%)


16 (10.6) 31 (20.5) 51 (33.8) 41 (27.2) 12 (7.9)

PGTI (Asian) 3 (12.0) 2 (8.0) 13 (52.0) 2 (8.0) 3 (12.0) Outpatient* 84 (8.4) 195 (19.6) 335 (33.7) 240 (24.1) 77 (7.7) IOP 1 (12.5) 0 (0.0) 2 (25.0) 2 (25.0) 3 (37.5) RTP 5 (11.9) 7 (16.7) 17 (40.5) 12 (28.6) 1 (2.4)

* 64 (6.4%) individuals did not report current health ratings. Current Health Ratings 2014-15

Excellent N (%)

Very Good N (%)

Good N (%)

Fair N (%)

Poor N (%)


9 (6.9) 31 (23.8) 43 (33.1) 34 (26.2) 10 (7.7)

PGTI (Asian) 1 (10.0) 1 (10.0) 5 (50.0) 2 (20.0) 1 (10.0) Outpatient 75 (7.9) 189 (20.0) 361 (38.2) 241 (25.5) 79 (8.4) IOP 4 (7.3) 8 (14.5%) 24 (43.6%) 14 (25.5) 5 (9.0) RTP 4 (5.4%) 13 (17.6) 24 (32.4) 23 (31.1) 10 (13.5)

20

Currently has Health Insurance 2012-13 2013-14 2014-15 Yes

N (%) No

N (%) Yes

N (%) No

N (%) Yes

N (%) No


116 (67.1)

57 (32.9) 102 (67.1)

50 (32.9)

95 (73.1) 34 (26.2)

PGTI (Asian)* 11 (73.3) 4 (26.7) 15 (57.7)

8 (30.8) 7 (70.0) 3 (30.0)

Outpatient 761 (76.3)

237 (23.7)

717 (72.1)

278 (27.9)

762 (80.9)

180 (19.1)

IOP 13 (48.1) 14 (51.9) 6 (75.0) 2 (25.0) 45 (75.0) 15 (25.0) RTP 23 (71.9) 9 (28.1) 32

(76.2) 10

(23.8) 23 (31.5) 4 (5.5)

* Three individuals were missing health insurance information. Forty-five people were missing health insurance information.

Currently has a Physician 2012-13 2013-14 2014-15 Yes

N (%) No

N (%) Yes

N (%) No

N (%) Yes

N (%) No


118 (69.4)

52 (30.6) 101 (70.6) 42 (29.4) 87 (66.9) 42 (32.3)

PGTI (Asian)* 12 (80.0) 3 (20.0) 16 (61.5) 8 (30.8) 6 (66.7) 3 (33.3) Outpatient 711

(72.0) 276

(28.0) 654 (65.7) 341 (34.3) 706

(75.0) 235

(25.0) IOP 11 (44.4) 14 (56.0) 7 (87.5) 1 (12.5) 46 (76.7) 14 (23.3) RTP 22 (71.0) 9 (29.0) 28 (66.7) 14 (33.3) 22 (30.1) 6 (8.2)

* Two individuals were missing physician information. Forty-five people were missing physician information.

Family Members with Substance Abuse Problems 2012-13 None

N (%)

Children

N (%)

Spouse

N (%)

Parents

N (%)

Aunts/ Uncles N (%)

Grand- parent N (%)

Siblings

N (%)

PGTI (English Spanish)

105 (60.3) 6 (3.4) 5 (2.9) 40 (23.0) 12 (6.9) 5 (2.9) 31 (17.8)

PGTI (Asian)

15 (100) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0)

Outpatient 535 (53.1) 82 (8.1) 62 (6.2) 224 (22.2) 125 (12.4) 86 (8.5) 215 (21.4)

IOP 15 (57.7) 0 (0.0) 1 (3.7) 2 (7.4) 2 (7.4) 1 (3.7) 8 (29.6)

RTP 18 (54.5) 4 (12.1) 2 (0.6) 13 (39.4) 7 (21.2) 6 (18.2) 13 (39.4)

21


N (%)

Children

N (%)

Spouse

N (%)

Parents

N (%)

Aunts/ Uncles N (%)

Grand- parent N (%)

Siblings

N (%) PGTI (English Spanish)

93 (60.4) 6 (3.9) 6 (3.9) 29 (18.8) 12 (7.8) 6 (3.9) 23 (14.9)

PGTI (Asian)

21 (80.8) 2 (7.7) 1 (3.8) 1 (3.8) 2 (7.7) 1 (3.8) 1 (3.8)

Outpatient 443 (44.5) 78 (7.8) 62 (6.2) 231 (23.2) 120 (12.1) 80 (8.0) 216 (21.7)

IOP 6 (75.0) 0 (0.0) 1 (12.5) 2 (25.0) 0 (0.0) 1 (12.5) 1 (12.5)

RTP 21 (50.0) 3 (7.1) 1 (9.6) 19 (45.2) 3 (7.1) 5 (11.9) 8 (19.0) Family Members with Substance Abuse Problems 2014-15

None

N (%)

Children

N (%)

Spouse

N (%)

Parents

N (%)

Aunts/ Uncles N (%)

Grand- parent N (%)

Siblings


68 (52.3) 8 (6.2) 2 (1.5) 21 (16.2) 12 (9.2) 6 (4.6) 20 (15.4)

PGTI (Asian)

9 (90.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 1 (10%)

Outpatient 483 (50.5) 68 (7.1) 66 (6.9) 231 (24.2) 133 (13.9) 76 (7.9) 208 (21.8)

IOP 29 (49.2) 3 (5.1) 5 (8.5) 16 (27.1) 4 (6.8) 8 (13.6) 15 (25.4)

RTP 36 (48.6) 5 (6.8) 2 (2.7) 18 (24.3) 13 (17.6) 8 (10.8) 21 (28.4)

Family Members with Gambling Problems 2012-13

None

N (%)

Children

N (%)

Spouse

N (%)

Parents

N (%)

Aunts/ Uncles N (%)

Grand-parent N (%)

Siblings


119 (68.0) 1 (0.6) 4 (2.3) 31 (17.7) 6 (3.4) 5 (2.9) 19 (10.9)

PGTI (Asian)

10(66.7) 0 (0.0) 1 (6.7) 0 (0.0) 2 (13.3) 0 (0.0) 2 (13.3)

Outpatient 584 (58.0) 22 (2.2) 39 (3.9) 206 (20.5) 101 (10.0) 69 (6.9) 161 (16.0)

IOP 16(59.3) 1 (3.7) 2 (7.4) 4 (14.8) 4 (14.8) 1 (7.4) 3 (11.1) RTP 16(48.5) 1 (0.3) 1 (0.3) 9 (27.3) 4 (12.1) 5 (15.2) 5 (15.2)

22

Family Members with Gambling Problems 2013-14 None

N (%)

Children

N (%)

Spouse

N (%)

Parents

N (%)

Aunts/ Uncles N (%)

Grand-parent N (%)

Siblings


94 (61.0) 2 (1.3) 5 (3.2) 25 (16.2) 7 (4.5) 3 (1.9) 17 (11.0)

PGTI (Asian)

19 (73.1) 0 (0.0) 1 (3.8) 3 (11.5) 1 (3.8) 0 (0.0) 3 (11.5)

Outpatient 526 (52.9) 25 (2.5) 26 (2.6) 219 (22.0) 93 (9.3) 61 (6.1) 127 (12.8) IOP 4 (50.0) 0 (0.0) 0 (0.0) 3 (37.5) 0 (0.0) 1 (12.5) 0 (0.0) RTP 29 (69.0) 0 (0.0) 1 (2.4) 8 (19.0) 2 (4.8) 1 (2.4) 5 (11.9)


N (%)

Children

N (%)

Spouse

N (%)

Parents

N (%)

Aunts/ Uncles N (%)

Grand-parent N (%)

Siblings


75 (57.7) 1 (0.8) 4 (3.1) 21 (16.2) 8 (6.2) 4 (3.1) 13 (10.0)

PGTI (Asian)

8 (80.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 2 (20.0)

Outpatient 553 (57.8) 21 (2.2) 33 (3.5) 188 (19.7) 114 (11.9) 60 (6.3) 124 (13.0) IOP 36 (61.0) 0 (0.0) 1 (1.7) 10 (16.9) 4 (6.8) 7 (11.9) 7 (11.9) RTP 37 (50.0) 1 (1.4) 1 (1.4) 16 (21.6) 10 (13.5) 10 (13.5) 14 (18.9)

Current Health Diagnosis/Co-occurring Problems (Affected Individuals): Co-occurring health diagnoses were less common among affected individuals than gamblers; however, in the outpatient program, some affected individuals reported health-related issues. These were primarily related to hypertension and HIV/AIDS. Smoking was reported among a small percentage of outpatient affected individuals, but the rate was slightly lower than that seen in FY 2013-14. Drinking was reported by just under 50% of outpatient affected individuals. Of note was the low percentage of affected individual clients in the PGTI programs who reported smoking or drinking relative to outpatient affected individuals. These PGTI rates were lower than those seen in FY 2013-14, but it is of note that the total number of affected individuals in treatment was also lower. With these small samples, the change in rate may not be reflective of a major difference. There was a slight increase in both mood and anxiety disorders among affected individuals who received treatment in the outpatient program from FY 2013-14 to FY 2014-15.

23


Disease N (%)

Obesity

N (%)

HIV/AIDS

N (%)

Ulcer Disease N (%)

Hypertension


0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0)

PGTI (Asian) 0 (0.0) 0 (0.0) 0 (0.0) 1 (5.9) 2 (11.8) Outpatient 3 (0.8) 16 (4.0) 2 (0.5) 5 (1.3) 37 (9.3) Cancer

N (%)

Heart Disease N (%)

Diabetes

N (%)

Respiratory

N (%)

Stroke


0 (0.0) 1 (5.6) 2 (11.1) 0 (0.0) 0 (0.0)

PGTI (Asian) 0 (0.0) 1 (5.9) 2 (11.8) 0 (0.0) 0 (0.0) Outpatient 14 (3.5) 13 (3.3) 23 (5.8) 3 (0.8) 0 (0.0)


Disease N (%)

Obesity

N (%)

HIV/AIDS

N (%)

Ulcer Disease N (%)

Hypertension


0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 1 (5.3)

PGTI (Asian) 0 (0.0) 0 (0.0) 0 (0.0) 1 (9.0) 1 (9.0) Outpatient 2 (0.5) 21 (5.0) 5 (1.2) 1 (0.2) 26 (6.1) Cancer

N (%)

Heart Disease N (%)

Diabetes

N (%)

Respiratory

N (%)

Stroke


0 (0.0) 1 (5.3) 1 (5.3) 0 (0.0) 0 (0.0)



Disease N (%)

Obesity

N (%)

HIV/AIDS

N (%)

Ulcer Disease N (%)

Hypertension


0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0)

PGTI (Asian) 1 (12.5) 0 (0.0) 0 (0.0) 0 (0.0) 1 (12.5) Outpatient (N=408)

5 (1.2) 18 (4.4) 2 (0.5) 4 (1.0) 46 (11.3)

Cancer

N (%)

Heart Disease N (%)

Diabetes

N (%)

Respiratory

N (%)

Stroke


0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0)


24


N (%)

No

N (%)


Mean Number of minutes waited after waking before smoking

PGTI (English/Spanish) 3 (16.7) 15 (83.3) 2.2 15.6 PGTI (Asian) 0 (0.0) 16 (100) N/A N/A Outpatient 65 (16.5) 330 (83.5) 1.7 7.2


N (%)

No

N (%)



PGTI (English/Spanish) 3 (15.8) 16 (84.2) 2.5 14.1 PGTI (Asian)* 1 (9.0) 10 (91.0) - - Outpatient 55 (13.0) 369 (87.0) 0.2 6.9

* The one person who smoked had 18 cigarettes a day and waited 10 minutes from waking before smoking. Current Smoker 2014-15 Yes

N (%)

No

N (%)



PGTI (English/Spanish) 0 (0.0) 3 (100.0) 0.0 0.0 PGTI (Asian) 0 (0.0) 8 (100.0) - - Outpatient 46 (11.3) 362 (88.7) 1.0 5.7


N (%)

No

N (%)

Mean Drinks per Week

Mean Number of times 5 or more drinks in one day in the past 30 days

PGTI (English/Spanish) 5 (27.8) 13 (72.2) 0.7 0.2 PGTI (Asian) 0 (0.0) 15 (100) N/A N/A Outpatient 190 (48.7) 200 (51.3) 1.6 0.4


N (%)

No

N (%)


Mean Number of times 5 or more drinks in one day in the past 30 days

PGTI (English/Spanish) 5 (26.3) 14 (73.7) 0.35 0.0 PGTI (Asian)* 1 (9.0) 10 (91.0) - - Outpatient 198 (46.7) 226 (53.3) 1.6 0.4

* The one person who drank reported 1 drink per week and 0 times drinking 5 or more drinks in one day.

25


N (%)

No

N (%)


Mean Number of times 5 or more drinks in one day in the past 12 Months

PGTI (English/Spanish) 1 (33.3) 2 (66.7) 0.33 0.0 PGTI (Asian) 0 (0.0) 8 (100.0) - - Outpatient 176 (43.1) 232 (56.9) 1.5 0.64

Current Health Ratings 2012-13 Excellent

N (%) Very Good

N (%) Good N (%)

Fair N (%)

Poor N (%)


3 (16.7) 7 (38.9) 5 (27.8) 1 (5.6) 2 (11.1)


1 (5.9) 4 (23.5) 9 (52.9) 2 (11.8) 1 (5.9)

Outpatient 51 (12.8) 91 (22.8) 156 (39.1) 79 (19.8) 22 (5.5)


N (%) Very Good

N (%) Good N (%)

Fair N (%)

Poor N (%)


3 (15.8) 11 (57.9) 3 (15.8) 2 (10.5) 0 (0.0)

PGTI (Asian) 1 (9.1) 2 (18.2) 4 (36.4) 3 (27.3) 0 (0.0) Outpatient* 59 (13.9) 99 (23.3) 150 (35.4) 73 (17.2) 23 (5.4)

* 20 (4.7%) did not provide current health ratings.


N (%) Very Good

N (%) Good N (%)

Fair N (%)

Poor N (%)


1 (33.3) 0 (0.0) 2 (66.7) 0 (0.0) 0 (0.0)


0 (0.0) 2 (25.0) 4 (50.0) 2 (25.0) 0 (0.0)

Outpatient 42 (10.3) 103 (25.2) 166 (40.7) 75 (18.4) 22 (5.4)

Currently has Health Insurance 2012-13 2013-14 2014-15 Yes

N (%) No

N (%) Yes

N (%) No

N (%) Yes

N (%) No

N (%) PGTI (English/ Spanish)

12 (70.6) 5 (29.4) 15 (78.9) 4 (21.1) 2 (66.7) 1 (33.3)

PGTI (Asian) 14 (87.5) 2 (12.5) 7 (63.6) 4 (36.3) 8 (100.0) 0 (0.0) Outpatient 306 (77.7) 88 (22.3) 316 (74.5) 108 (25.5) 325 (80.6) 78 (19.4)

26

Currently has a Physician 2012-13 2013-14 2014-15 Yes

N (%) No

N (%) Yes

N (%) No

N (%) Yes

N (%) No

N (%) PGTI (English/ Spanish)

14 (77.8) 4 (22.2) 14 (82.4) 3 (17.6) 2 (66.7) 1 (33.3)



N (%)

Children

N (%)

Spouse

N (%)

Parents

N (%)

Aunts/ Uncles N (%)

Grand- parent N (%)

Siblings


11 (61.1) 1 (5.6) 0 (0.0) 4 (22.2) 1 (5.6) 1 (5.6) 3 (16.7)

PGTI (Asian)

15 (93.8) 0 (0.0) 0 (0.0) 1 (6.3) 0 (0.0) 0 (0.0) 0 (0.0)

Outpatient 190 (47.6) 39 (9.8) 36 (9.0) 102 (25.6) 61 (15.3) 40 (10.0) 77 (19.3)

Family Members with Substance Abuse Problems 2013-14 None Childre Spouse Parents Aunts/ Grand- Siblings

n Uncles parent N (%) N (%) N (%) N (%) N (%) N (%)

N (%) PGTI 15 (78.9) 0 (0.0) 0 (0.0) 3 (15.8) 0 (0.0) 0 (0.0) 1 (5.3) (English/ Spanish) PGTI 10 (91.0) 0 (0.0) 0 (0.0) 1 (9.0) 0 (0.0) 0 (0.0) 0 (0.0) (Asian) Outpatient 195

(46.0) 46

(10.8) 48 (11.3) 80 (18.9) 52 (12.3) 43 (10.1) 83

(19.6) Family Members with Substance Abuse Problems 2014-15 None

N (%)

Children

N (%)

Spouse

N (%)

Parents

N (%)

Aunts/ Uncles N (%)

Grand- parent N (%)

Siblings


1 (33.3) 0 (0.0) 0 (0.0) 1 (33.3) 0 (0.0) 0 (0.0) 2 (66.7)

PGTI (Asian)

8 (100.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0)

Outpatient 202 (48.7) 34 (8.2) 46 (11.1) 97 (23.4) 62 (14.9) 38 (9.2) 85 (20.5)

27


N (%)

Children

N (%)

Spouse

N (%)

Parents

N (%)

Aunts/ Uncles N (%)

Grand-parent N (%)

Siblings


7 (38.9) 2 (11.1) 4 (22.2) 4 (22.2) 1 (5.6) 0 (0.0) 2 (11.1)

PGTI (Asian)

6 (37.5) 1 (6.3) 5 (31.3) 2 (12.5) 0 (0.0) 1 (6.3) 2 (12.5)

Outpatient 102 (25.6) 41(10.3) 104 (26.1) 110 (27.6) 40 (10.0) 27 (6.8) 54 (13.5) Family Members with Gambling Problems 2013-14 None

N (%)

Children

N (%)

Spouse

N (%)

Parents

N (%)

Aunts/ Uncles N (%)

Grand-parent N (%)

Siblings

N (%) PGTI (English/ Spanish

7 (36.8) 1 (5.3) 5 (26.3) 4 (21.1) 2 (10.5) 0 (0.0) 1 (5.3)

PGTI (Asian)

7 (63.6) 1 (9.1) 1 (9.1) 2 (18.2) 1 (9.1) 1 (9.1) 0 (0.0)

Outpatient 101 (23.8)

45 (10.6) 126 (29.7) 101 (23.8) 43 (10.1)

29 (6.8)

49 (11.6)


N (%)

Children

N (%)

Spouse

N (%)

Parents

N (%)

Aunts/ Uncles N (%)

Grand-parent N (%)

Siblings


1 (33.3) 0 (0.0) 0 (0.0) 1 (33.3) 0 (0.0) 0 (0.0) 0 (0.0)

PGTI (Asian)

1 (12.5) 1 (12.5) 5 (62.5) 3 (37.5) 0 (0.0) 0 (0.0) 0 (0.0)

Outpatient 96 (23.1) 43 (10.4) 148 (35.7) 101 (24.3) 39 (9.4) 18 (4.3) 48 (11.6) Past Year Substance Use 2012-13 Marijuana

N (%) Cocaine

N (%) Hallucinogens

N (%) Inhalants

N (%) Narcotics/Opiate

s N (%)


0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0)

PGTI (Asian)

0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0)

Outpatient 40 (10.0) 7 (1.8) 3 (0.8) 0 (0.0) 8 (2.0)

28

Past Year Substance Use 2012-13 PCP


N (%) Stimulants

N (%) Tranquilizers

N (%) PGTI (English/Spanish) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) PGTI (Asian Languages) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) Outpatient 0 (0.0) 7 (1.8) 4 (1.0) 7 (1.8)


N (%) Cocaine

N (%) Hallucinogens

N (%) Inhalants



1 (5.3) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0)


PCP


N (%) Stimulants

N (%) Tranquilizers


0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0)

PGTI (Asian) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) Outpatient 0 (0.0) 5 (1.2) 5 (1.2) 6 (1.4)


N (%) Cocaine

N (%) Hallucinogens

N (%) Inhalants



0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0)

PGTI (Asian)

0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0)

Outpatient 48 (11.8) 5 (1.2) 1 (0.2) 0 (0.0) 5 (1.2) PCP


N (%) Stimulants

N (%) Tranquilizers

N (%) PGTI (English/Spanish) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) PGTI (Asian Languages) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) Outpatient 0 (0.0) 5 (1.2) 1 (0.2) 4 (1.0)


Disorders

N (%)

Psychotic Disorders

N (%)

Anxiety Disorders

N (%)

Substance Use

Disorders N (%)


N (%)

ADD/ ADHD

N (%)


2 (11.1) 0 (0.0) 1 (5.6) 0 (0.0) 0 (0.0) 0 (0.0)

PGTI (Asian) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) Outpatient 71 (17.8) 4 (.21.0) 41 (10.3) 5 (1.3) 3 (0.8) 7 (1.8)

29


Disorders

N (%)

Psychotic Disorders

N (%)

Anxiety Disorders

N (%)

Substance Use

Disorders N (%)

Personality Disorders

N (%)

ADD/ ADHD

N (%)


1 (5.3) 0 (0.0) 1 (5.3) 0 (0.0) 0 (0.0) 0 (0.0)



Disorders

N (%)

Psychotic Disorders

N (%)

Anxiety Disorders

N (%)

Substance Use

Disorders N (%)


N (%)

ADD/ ADHD

N (%)


0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0)


Treatment Outcomes (Gamblers): While OPG built processes for 30, 60 and 365-day follow-up surveys, contacting this population is difficult as they seem to be transient. In FY 2014-15 there were a total of 1420 attempted follow-up calls with 259 of those being completed. OPG is researching ways to increase data collection for follow-up surveys. The following is a snapshot of outcomes information for FY 2014-15.

Overall Life Satisfaction (Scale: 0 Worst 100 Best) 2012-13 2013-14 2014-15 Intake End of

Treatment Intake End of


Treatment* PGTI (English/Spanish) 51 59 46.4 68.3 46.4 68.9 PGTI (Asian) 49 68 35.4 55.6 44.7 46.0 Outpatient 50 59 50.2 61.0 48.3 60.6 IOP 35 80 **32.8 **48.4 40.1 47.6 RTP 37 49 45.2 53.0 42.3 57.4

* PGTI (English/Spanish) end of treatment numbers are collected at the last treatment session, not a separate discharge session. ** These numbers are based on 8 cases; 3 cases were missing end of treatment life satisfaction scores.

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Modified NODS Score (Assessment of Negative Gambling Impact 1-10) 2012-13 2013-14 2014-15 Intake End of



Treatment* PGTI (English/Spanish) 7.6 - 7.8 - 7.2 - PGTI (Asian) 7.5 7.4 7.4 7.1 6.3 6.0 Outpatient 8.3 7.3 8.2 7.1 8.14 2.3 Intensive Outpatient 8.8 **8.0 ***9.9 ***10.0 8.9 9.0 Residential Treatment 8.2 8.0 8.9 7.0 8.9 8.2

There were no end of treatment NODS score data for PGTI (English/Spanish) available because they do not collect end of treatment NODS scores. * PGTI (English/Spanish) end of treatment numbers are collected at the last treatment session, not a separate discharge session.NODS Score is not collected during treatment sessions, so this number is not available here. **This number is from one client; most individuals in IOP transferred to Residential, so scores are reflected in the Residential. *** These numbers are based on 8 cases; 3 cases were missing end of treatment NODS scores; all five present were scores of 10.

Gambling Urge Intensity (scale: 0 No Urges 100 Most Intense)

2012-13 2013-14 2014-15 Intake End of



Treatment* PGTI (English/Spanish) 42 27 48.0 23.8 51.2 12.8 PGTI (Asian) 49 38 65.7 42.4 56.0 34.0 Outpatient 56 44 54.7 33.9 56.2 33.2 IOP 76 50 64.5 30.2 45.0 51.4 RTP 60 59 53.8 38.9 56.1 47.9

* PGTI (English/Spanish) end of treatment numbers are collected at the last treatment session, not a separate discharge session.

Clinical Innovations: Hispanic/Latino Gambling Focus Group Project Hispanic/Latino individuals are an increasingly large part of the U.S. and Californian population. While Hispanics/Latinos participate in gambling in similar ways to as that seen among Non-Hispanic/Latino Caucasians, some academic research suggests that gambling problems may be more common among Hispanics/Latinos relative to the general public. Given the high rate of gambling participation and the potentially increased risk for gambling problems among Hispanics/Latinos, OPG is seeking to gather information on attitudes towards gambling, individuals with gambling problems, and professional treatment for gambling problems in a sample of Hispanic/Latino individuals from Imperial County. Imperial County is an ideal place to collect data on gambling problems among Hispanics/Latinos because it has one of the highest rates of gambling problems of any state county in the state and 70% of the population is Hispanic/Latino. Beginning in FY 2012-13, the University of California, Los Angeles, Gambling Studies Program (UGSP) began developing a protocol to collect data on the topics of gambling, gambling problems, and professional treatment for gambling problems. Data collection began with focus groups with of stakeholders/treatment providers at the Clinicas De Salud Del Puebla in Calexico, CA. Thirteen (13) stakeholders/treatment providers participated

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in the study. Upon completion of these focus groups, UGSP attempted focus groups with clients at the clinic, but one-on-one interviews with clients were found to be more useful, and 41 interviews were completed. In addition to the focus groups and interviews, each participant completed a brief survey on demographics, gambling behavior, and attitudes towards gambling and gambling problems. A large percentage of the patients reported gambling within the past month on things such as lottery/scratchers, slot machines and internet gambling. Over 70% of providers/stakeholders indicated they would seek help for a gambling problem from a mental health professional or family physician, for only patients only 58% of patients said they would do so. About 35% of those interviewed said they would go to a trusted relative or family member first for help with a gambling problem. Despite the percentage of those who would go to family for help, about 78% believed that professional treatment for gambling problems is important. Closing Summary Since the transition to CDPH, OPG has continued to fulfill its mission of serving Californians with gambling problems and those impacted by others with gambling problems. The total number of clients served in CalGETS since its inception exceeds 8,200 individuals and CalGETS is the largest state-funded gambling treatment network in the country. As outlined in this report, gambling problems are complex and multifaceted; often including substance-related comorbidity and psychiatric comorbidity. OPG continues to develop new partnerships with other state agencies in order to better serve those seeking CalGETS services. For example, OPG is currently working with the California Tobacco Control Program to assist providers in disseminating information, such as the 1-800-NO-BUTTS California smokers helpline and materials encouraging smoking cessation. Also, OPG continues to develop partnerships with mental health agencies and substance use disorder agencies. Furthermore, OPG will furnish information to providers related to Covered California and ask providers to encourage clients to obtain health insurance. OPG continues to use a data-driven approach to develop and fine-tune program components to better address the needs of those with gambling problems and those affected by others with gambling problems. Based on years of collected data, OPG asserts that the implementation of CalGETS has succeeded and has improved lives. It should be noted that in December 2014, OPG received a Bright Idea award from the Harvard Kennedy School, Innovations in American Government Award Program. This award was given to OPG for using innovative technology to administer the problem gambling helpline.

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APPENDIX: List of Acronyms

Acronym Term/Organization CCLHO California Conference of Local Health Officers CDPH California Department of Public Health CalGETS California Gambling Education and Treatment Services CTCP California Tobacco Control Program DADP Department of Alcohol and Drug Programs GA Gamblers Anonymous LCSW Licensed Clinical Social Worker IOP Intensive Outpatient Treatment MFT Marriage and Family Therapist MSW Master of Social Work OPG Office of Problem Gambling PGTI Problem Gambling Telephone Intervention PhD Doctorate Degree PsyD Doctorate Degree RTP Residential Treatment Program UCLA University of California, Los Angeles UGSP University of California, Los Angeles Gambling Studies Program

Structure Bookmarks California Department of Public Health Office of Problem Gambling Transition Legislative Report 2016 Acknowledgement This report will be posted on the CDPH website and can be found at under the publications and forms tab, OPG Transition Legislative Report 2016. Copies of the report, or inquires about the report should be directed to: Terri Sue Canale Chief, Office of Problem Gambling 916-324-3020 Executive Summary Effective with the passage of the 2013-2014 Budget Act and associated legislation, the Department of Alcohol and Drug Programs (DADP) was eliminated July 1, 2013, and the Office of Problem Gambling (OPG) transitioned to the California Department of Public Health (CDPH) Center for Chronic Disease Prevention and Health Promotion. CDPH executed the successful transition of OPG from DADP. OPG continues to fulfill its mission under CDPH, administering prevention and treatment programs for gamblers and their families suffering negative consequences due to gambling addiction. In an effort to evaluate impacts of the transition from DADP to CDPH, including how and why services provided and overseen by OPG were improved, or otherwise changed as a result of this transition, OPG disseminates this annual report. The OPG Transition Legislative Report 2016 is the third report since the transition and Table of Contents Background 4 CDPH Stakeholders Become New OPG Partners 4 Prevention Program 5 Treatment Program Provider Training 5 Access to Services/Provider Demographics 6 Client Level Data 7 Access to Treatment Services 8 CalGETS Client Demographics (Gamblers) 9 CalGETS Client Demographics (Affected Individuals) 10 Regional Demographics 11 Current Health Diagnosis/Co-occurring (Gamblers) 13 Current Health Diagnosis/Co-occurring (Affected Individuals) 22 Treatment Outcomes (Gamblers) 29 Clinical Innovations 30 Closing Summary 31 Appendix: List of Acronyms 32 Background In 2003, the Office of Problem and Pathological Gambling (OPG) was established under Section 4369 of the Welfare and Institutions Code, in the Department of Alcohol and Drug Programs (DADP). OPG's mandate is to develop and provide quality statewide prevention and treatment programs for Californians suffering from gambling disorder and for family members experiencing a negative impact to their lives due to problem gambling behavior. In 2006, OPG conducted a gambling prevalence study in California with 7,12 Effective with the passage of the 2013-2014 Budget Act and associated legislation, DADP was eliminated as of July 1, 2013. The Governors Budget approved the transfer of OPG to the California Department of Public Health (CDPH). OPG is currently operating within CDPHs Center for Chronic Disease Prevention and Health Promotion. In order to execute this transfer, the California Health and Human Services Agency developed and implemented a transition plan, approved by the Legislature. OPG is required to prepare five annual legislative reports through June 2018 to ensure that the impacts of the transition are identified and evaluated both initially and over time. OPG determined that the previously established OPG Advisory Groups quarterly meetings would serve as the ongoing venue for stakeholders to provide input into public policy issues related to gambling disorder. The Advisory Group is comprised of representatives from the Legislature, state gambling regulatory agencies, other stat CDPH Stakeholders Become New OPG Partners In 2015, OPG continued to expand its relationships with other CDPH programs, including the Chronic Disease Surveillance and Research Branch. OPG entered into a memorandum of understanding with the Chronic Disease Surveillance and Research Branch to participate in the 2015 Behavioral Risk Factor Survey (BRFS). A total of five gambling related questions were added to the 2015 BRFS. While the percentage of individuals who had gambled in the past 12 months, seemed low (20%), the percentage of those experienc Prevention Program The OPGs Prevention Program contains the following mandated elements: toll-free helpline, training and education, outreach and public awareness campaign and empirically-driven research. Treatment Program 2014-15 marks the 7th year of CalGETS implementation. By June 2015, CalGETS had served just over 8,200 clients, with 221 outpatient providers, two agencies providing telephone interventions, two intensive outpatient facilities and two residential treatment facilities. Provider Training: The CalGETS Training program involves Phase I, Phase II and clinical guidance consultation. Compliance Monitoring: OPG and designated contract staff conducted in-person reviews of treatment provider documentation to ensure compliance with CalGETS policies and procedures. During 2014-15, 21 compliance monitoring reviews were conducted ensuring that all providers had a review within two years of invoicing for services. Access to Services/Provider Demographics: CalGETS contractors provide services in 23 languages/dialects. During FY 2014-15, the number of CalGETS providers increased by 26 as compared to FY 2013-14 because OPG hosted a Phase I Training event. Historically, there is a small amount of attrition (e.g., not all providers stay on with the program; some are unable to secure sufficient clients to continue to provide services, etc.), but the Phase I training event brought the number of providers up to near the levels for FY 2012-13. Provider demographic Provider Demographic Information 2012-13 2013-14 2014-15 Total CalGETS Providers 229 195 221 Age (Mean) 54.5 57 56.3 Gender Male 57 47 52 Female 172 148 152 Race Caucasian 146 139 144 African American 10 12 11 Hispanic 14 11 13 Asian 23 23 26 Native Hawaiian 1 1 1 Multicultural 8 4 6 Provider Licensure Information 2012-13 2013-14 2014-15 Number of Years Licensed (Mean) 12 13 12.5 Type of License PsyD 10 9 10 PhD 15 17 15 MFT 135 139 135 MSW 4 2 4 LCSW 28 27 28 Provider Language Information 2012-13 2013-14 2014-15 Providing Treatment in Language Other than English? No 163 153 162 Yes 40 42 41 Spanish 18 20 21 Asian 13 18 18 Other 6 8 5 Client Level Data: CalGETS is offered in four modalities for gamblers and two modalities for affected individuals (those persons negatively impacted by the problem gambler's behavior) as described below. Enrollment in Services: Total gambler enrollment was similar to that seen in FY 2013-14, but there were changes for each treatment type. Fewer individuals sought telephone interventions or outpatient treatment while there was an increase in clients seeking intensive outpatient (IOP) and residential treatment. Affected individual enrollment slightly decreased from FY 2013-14, primarily due to decreases in PGTI use. Total Gamblers Served 2012-13 2013-14 2014-15 PGTI (English/Spanish) 176 154 130 PGTI (Asian) 16 25 10 Outpatient 1072 995 966 IOP 30 8 59 RTP 44 42 74 Total Cases* 1338 1224 1239 Total Affected Individuals Served 2012-13 2013-14 2014-15 PGTI (English/Spanish) 18 19 3 PGTI (Asian) 0 11 8 Outpatient Treatment Network 412 424 415 Total Affected Individual Cases* 430 454 426 *Please Note: Some individuals may have accessed multiple services. Access to Treatment Services: In order to ensure access into treatment in a timely fashion, authorized providers track the time between initial helpline referral (contact) and intake into treatment. Here we report median times from first contact to intake into treatment. For outpatients the median time from first contact to intake was three days. Approximately 78% of outpatient clients completed intake into treatment within the first week after contact. For English/Spanish telephone clients, the median 13-day period from initial con 2012-13 2013-14 2014-15 Number of CalGETS clients seen per month (average) 4 4 2.9 Number of years providing treatment to gamblers 3.6 4 4.3 CalGETS Client Demographics (Gamblers): The mean age across all treatment components showed less variation than was seen in FY 2013-14. RTP clients were the youngest clients on average, but were only five years younger on average than the oldest group in IOP. Most modalities, except for Asian language PGTI and RTP, showed an approximate 60%-40% split for males vs. females. Racial and ethnic diversity among clients in CalGETS increased, particularly among those in IOP and RTP. In July 2014, OPG opened a second IOP in San Diego in an effort to Age (Mean) 2012-13 2013-14 2014-15 PGTI (English /Spanish) 48.9 45.9 47.2 PGTI (Asian) 47.0 51.5 45.8 Outpatient 47.0 46.6 47.0 IOP 40.0 50.8 49.7 RTP 48.0 41.6 45.0 Gender 2012-13 2013-14 2014-15 Male Female Male Female Male Female PGTI (English /Spanish) 49% 51% 57% 44% 66% 34% PGTI (Asian) 63% 37% 60% 40% 50% 50% Outpatient 59% 41% 61% 39% 62% 38% IOP 70% 30% 63% 38% 67% 33% RTP 66% 34% 81% 19% 85% 15% Race/Ethnicity 2012-13 Caucasian African American Hispanic Asian Other PGTI (English/Spanish) 62% 16% 30% 15% 4% PGTI (Asian) 0% 0% 0% 100% 0% Outpatient 54% 8% 29% 18% 7% IOP 70% 4% 4% 13% 9% RTP 65% 10% 2% 20% 2% Race/Ethnicity 2013-14 Caucasian African American Hispanic Asian Other PGTI (English/Spanish)* 64% 8% 23% 22% 6% PGTI (Asian) 0% 0% 0% 100% 0% Outpatient 52% 10% 14% 17% 9% IOP 100% RTP 57% 17% 17% 5% 5% * Hispanic ethnicity was asked separately from race therefore these numbers don't sum to 100. Race/Ethnicity 2014-15 Caucasian African American Hispanic Asian Other PGTI (English/Spanish) 55% 12% 24% 25% 7% PGTI (Asian) 0% 0% 0% 100% 0% Outpatient 50% 9% 18% 18% 6% IOP 59% 10% 5% 21% 7% RTP 41% 28% 19% 10% 2% CalGETS Client Demographics (Affected Individuals): Affected individual client demographics showed some changes from FY 2013-14 with increases in the numbers of Hispanics and Asians in the outpatient program. The gender split remained fairly consistent, except for an increase in males in PGTI. This increase may have been an artifact of small numbers of affected individuals in the PGTI (English/Spanish) program. Age remained stable for the outpatient programs, but PGTI clients were younger than in previous years. Age (Mean) 2012-13 2013-14 2014-15 PGTI (English /Spanish) 51.0 44.8 37.4 PGTI (Asian) 53.0 54.1 45.8 Outpatient 45.0 46.5 47.0 Gender 2012-13 2013-14 2014-15 Male Female Male Female Male Female PGTI (English /Spanish) 28% 72% 11% 90% 33% 67% PGTI (Asian) 12% 88% 11% 89% 13% 88% Outpatient 26% 74% 28% 72% 23% 77% Race/Ethnicity 2012-13 Caucasian African American Hispanic Asian Other PGTI (English/Spanish) 70% 4% 20% 17% 9% PGTI (Asian) 0% 0% 0% 100% 0% Outpatient 57% 8% 14% 15% 6% Race/Ethnicity 2013-14 Caucasian African American Hispanic Asian Other PGTI (English/Spanish)* 56% 24% 38% 6% PGTI (Asian Languages) 0% 0% 0% 100% 0% Outpatient 58% 4% 17% 17% 4% * Hispanic ethnicity was asked separately from race therefore these numbers don't sum to 100. Race/Ethnicity 2014-15 Caucasian African American Hispanic Asian Other PGTI (English/Spanish) 67% 0% 0% 33% 0% PGTI (Asian Languages) 0% 0% 0% 100% 0% Outpatient 50% 6% 24% 13% 7% Regional Demographics: Regional data showed no major changes from FY 2013-14 to FY 2014-15; however, there were minor increases in Bay Area clients and minor decreases in Central Valley clients. Differences were observed when looking at regional data for specific CalGETS modalities. For PGTI (English/Spanish), there was a drop in the number of affected individuals served across all regions except North Mountain and an increase in gamblers served from Los Angeles and the Central Valley. For the outpatient program, there was an Regional - All Clients in First Block of Treatment 2012-13 2013-14 2014-15 Region N (%) N (%) N (%) North/Mountain 67 (4.0) 46 (2.8) 33 (2.0) Bay Area 213 (12.8) 241 (14.6) 290 (17.7) Central Valley 231 (13.9) 207 (12.5) 163 (10.0) Southern California minus Los Angeles 674 (40.6) 705 (42.7) 710 (43.3) Los Angeles 347 (20.9) 349 (21.1) 361 (22.0) Central/Southern Farm 128 (7.7) 103 (6.2) 81 (4.9) Regional - PGTI (English/Spanish) Gamblers in First Block of Treatment 2012-13 2013-14 2014-15 Region N (%) N (%) N (%) North/Mountain 19 (11.2) 15 (9.8) 6 (4.8) Bay Area 21 (12.4) 26 (17.0) 23 (18.5) Central Valley 18 (10.7) 21 (15.7) 11 (8.9) Southern California minus Los Angeles 49 (29.0) 38 (24.8) 35 (28.2) Los Angeles 28 (16.6) 27 (17.6) 30 (24.2) Central/Southern Farm 34 (20.1) 26 (17.0) 19 (15.3) Regional PGTI (English/Spanish) Affected Individuals in First Block of Treatment 2012-13 2013-14 2014-15 Region N (%) N (%) N (%) North/Mountain 3 (17.6) 1 (5.6) 1 (33.3) Bay Area 3 (17.6) 3 (16.7) 0 (0.0) Central Valley 2 (11.8) 1 (5.6) 0 (0.0) Southern California minus Los Angeles 4 (23.5) 10 (55.6) 1 (33.3) Los Angeles 0 (0.0) 1 (5.6) 0 (0.0) Central/Southern Farm 5 (29.4) 2 (11.1) 1 (33.3) Regional PGTI (Asian Language) Gamblers in First Block of Treatment 2012-13 2013-14 2014-15 Region N (%) N (%) N (%) North/Mountain 0 (0.0) 0 (0.0) 0 (0.0) Bay Area 5 (38.5) 8 (33.3) 6 (60.0) Central Valley 1 (7.7) 1 (4.2) 0 (0.0) Southern California minus Los Angeles 1 (7.7) 5 (20.8) 0 (0.0) Los Angeles 5 (38.5) 10 (41.7) 4 (40.0) Central/Southern Farm 1 (7.7) 0 (0.0) 0 (0.0) Note: One person was missing region information 2013-14. Regional PGTI (Asian Language) Affected Individuals in First Block of Treatment 2012-13 2013-14 2014-15 Region N (%) N (%) N (%) North/Mountain 0 (0.0) 0 (0.0) 0 (0.0) Bay Area 6 (42.9) 7 (70.0) 3 (42.9) Central Valley 0 (0.0) 1 (10.0) 0 (0.0) Southern California minus Los Angeles 2 (14.3) 2 (20.0) 3 (42.9) Los Angeles 6 (42.9) 0 (0.0) 1 (14.3) Central/Southern Farm 0 (0.0) 0 (0.0) 0 (0.0) Note: One person was missing region information 2013-14. Regional - Outpatient Gamblers in First Block of Treatment 2012-13 2013-14 2014-15 Region N (%) N (%) N (%) North/Mountain 34 (3.4) 24 (2.5) 21 (2.2) Bay Area 119 (12.0) 143 (14.6) 184 (19.3) Central Valley 153 (15.4) 122 (12.5) 109 (11.4) Southern California minus Los Angeles 432 (43.5) 424 (43.4) 398 (41.7) Los Angeles 184 (18.5) 204 (20.9) 192 (20.1) Central/Southern Farm 71 (7.2) 61 (6.2) 51 (5.3) Note: Eighteen individuals were missing region information 2013-14. Regional - Outpatient Affected Individuals in First Block of Treatment 2012-13 2013-14 2014-15 Region N (%) N (%) N (%) North/Mountain 9 (2.3) 6 (1.4) 5 (1.2) Bay Area 41 (10.4) 33 (7.9) 33 (8.0) Central Valley 56 (14.2) 60 (14.3) 40 (9.7) Southern California minus Los Angeles 168 (42.6) 217 (51.7) 220 (53.4) Los Angeles 104 (26.4) 93 (22.1) 105 (25.5) Central/Southern Farm 16 (4.1) 11 (2.6) 9 (2.2) Regional - IOP Gamblers in First Block of Treatment 2012-13 2013-14 2014-15 Region N (%) N (%) N (%) North/Mountain 0 (0.0) 0 (0.0) 0 (0.0) Bay Area 3 (10.0) 0 (0.0) 0 (0.0) Central Valley 0 (0.0) 0 (0.0) 0 (0.0) Southern California minus Los Angeles 10 (33.3) 1 (12.5) 47 (85.5) Los Angeles 16 (53.3) 6 (75.0) 8 (14.5) Central/Southern Farm 1 (3.3) 1 (12.5) 0 (0.0) Regional RTP Gamblers in First Block of Treatment 2012-13 2013-14 2014-15 Region N (%) N (%) N (%) North/Mountain 2 (6.6) 0 (0.0) 0 (0.0) Bay Area 15 (50.0) 21 (52.5) 41 (56.9) Central Valley 1 (3.3) 1 (2.5) 3 (4.2) Southern California minus Los Angeles 8 (26.7) 8 (20.0) 6 (8.3) Los Angeles 4 (13.3) 8 (20.0) 21 (29.2) Central/Southern Farm 0 (0.0) 2 (5.0) 1 (1.4) Legend: California Regions Current Health Diagnosis/Co-occurring Problems (Gamblers): Health-related data indicated the presence of a variety of disorders, with the most common being hypertension and diabetes. The presence of these disorders emphasizes the need for CalGETS providers to refer to medical professionals in order to address health-related issues that are commonly seen among gamblers. Smoking was particularly common among those being treated in the RTP. Nearly two-thirds of RTP clients reported smoking and they had the highest reported number of cigarettes smoked per day compar Co-Occurring Health Diagnoses 2012-13 Liver Disease N (%) Obesity N (%) HIV/AIDS N (%) Ulcer Disease N (%) Hypertension N (%) PGTI (English/Spanish) 0 (0.0) 11 (6.3) 0 (0.0) 2 (1.1) 15 (8.6) PGTI (Asian) 0 (0.0) 0 (0.0) 0 (0.0) 1 (6.3) 1 (6.3) Outpatient 19 (1.9) 54 (5.4) 4 (0.4) 24 (2.4) 152 (15.1) IOP 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 3 (11.5) RTP 1 (0.3) 3 (9.0) 0 (0.0) 0 (0.0) 3 (9.0) Cancer N (%) Heart Disease N (%) Diabetes N (%) Respiratory N (%) Stroke N (%) PGTI (English/Spanish) 4 (2.3) 7 (4.0) 16 (9.1) 4 (2.3) 2 (1.1) PGTI (Asian) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) Outpatient 14 (1.4) 52 (5.2) 94 (9.3) 23 (2.3) 2 (0.2) IOP 0 (0.0) 0 (0.0) 3 (11.5) 1 (3.8) 1 (3.8) RTP 0 (0.0) 1 (0.3) 0 (0.0) 0 (0.0) 0 (0.0) Co-Occurring Health Diagnoses 2013-14 Liver Disease N (%) Obesity N (%) HIV/AIDS N (%) Ulcer Disease N (%) Hypertension N (%) PGTI (English/Spanish) 3 (1.9) 10 (6.5) 0 (0.0) 1 (0.6) 17 (11.0) PGTI (Asian) 0 (0.0) 1 (3.8) 0 (0.0) 0 (0.0) 3 (11.5) Outpatient 16 (1.6) 60 (6.0) 4 (0.4) 4 (0.4) 113 (11.4) IOP 0 (0.0) 2 (25.0) 0 (0.0) 1 (12.5) 1 (12.5) RTP 4 (9.5) 0 (0.0) 0 (0.0) 2 (4.8) 4 (9.5) Co-Occurring Health Diagnoses 2013-14 Cancer N (%) Heart Disease N (%) Diabetes N (%) Respiratory N (%) Stroke N (%) PGTI (English/Spanish) 7 (4.5) 5 (3.2) 13 (8.4) 3 (1.9) 2 (1.3) PGTI (Asian) 0 (0.0) 1 (3.8) 1 (3.8) 0 (0.0) 0 (0.0) Outpatient 15 (1.5) 29 (2.9) 94 (9.4) 28 (2.8) 5 (0.5) IOP 0 (0.0) 1 (12.5) 2 (25.0) 1 (12.5) 0 (0.0) RTP 0 (0.0) 0 (0.0) 3 (7.1) 1 (2.4) 0 (0.0) Co-Occurring Health Diagnoses 2014-15 Liver Disease N (%) Obesity N (%) HIV/AIDS N (%) Ulcer Disease N (%) Hypertension N (%) PGTI (English/Spanish) 1 (0.8) 6 (4.6) 1 (0.8) 0 (0.0) 7 (5.4) PGTI (Asian) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 2 (20.0) Outpatient 18 (2.0) 68 (7.2) 6 (0.6) 9 (1.0) 130 (13.8) IOP 0 (0.0) 6 (10.9) 1 (1.8) 2 (3.6) 8 (14.5) RTP 4 (5.4) 3 (4.1) 0 (0.0) 0 (0.0) 13 (17.6) Cancer N (%) Heart Disease N (%) Diabetes N (%) Respiratory N (%) Stroke N (%) PGTI (English/Spanish) 2 (1.5) 6 (4.6) 13 (10.0) 4 (3.1) 2 (1.5) PGTI (Asian) 0 (0.0) 0 (0.0) 1 (10.0) 0 (0.0) 0 (0.0) Outpatient 20 (2.1) 39 (4.1) 99 (10.5) 33 (3.5) 6 (0.6) IOP 1 (1.8) 5 (9.0) 10 (18.2) 5 (9.0) 1 (1.8) RTP 0 (0.0) 4 (5.4) 9 (12.2) 4 (5.4) 0 (0.0) Current Smoker 2012-13 Yes N (%) No N (%) Mean Cigarettes per Day Mean Number of minutes waited after waking before smoking PGTI (English/Spanish) 53 (30.3) 122 (69.7) 10.3 21.1 PGTI (Asian) 3 (20.0) 12 (80.0) 8.5 78.8 Outpatient 336 (33.9) 656 (66.1) 3.5 10.2 IOP 13 (50.0) 13 (50.0) 7.25 26.2 RTP 22 (66.7) 11 (33.3) 11.7 62.0 Current Smoker 2013-14 Yes N (%) No N (%) Mean Cigarettes per Day Mean Number of minutes waited after waking before smoking PGTI (English/Spanish) 47 (30.9) 105 (69.1) 5.5 8.6 PGTI (Asian)* 2 (7.7) 24 (92.3) - - Outpatient 296(29.7) 699 (70.3) 2.9 9.5 IOP 3 (37.5) 5 (62.5) 2.5 0.1 RTP 34 (81.0) 8 (19..0) 7.3 16.7 * One person reported smoking a pack per day, the other reported smoking 1-2 packs per day. One person reported waiting 10 minutes after waking and the other reported 60 minutes after waking before smoking. Current Smoker 2014-15 Yes N (%) No N (%) Mean Cigarettes per Day Mean Number of minutes waited after waking before smoking PGTI (English/Spanish) 42 (32.3) 86 (66.2) 23.0 10.8 PGTI (Asian) 2 (20.0) 8 (80%) 13.5 60.0 Outpatient 276 (29.2) 669 (70.8) 3.4 13.1 IOP 21 (38.2) 34 (61.8) 2.2 3.8 RTP 46 (62.2%) 28 (37.8) 8.0 10.8 Current Drinker 2012-13 Yes N (%) No N (%) Mean Drinks per Week Mean Number of Times 5 or More Drinks in one day, past 12 Months PGTI (English/Spanish) 56 (31.8) 120 (68.2) 2.0 1.84 PGTI (Asian) 3 (21.4) 11 (78.6) 5.3 0.33 Outpatient 465 (46.9) 527 (53.1) .75 2.64 IOP 11 (40.7) 16 (59.3) 4.0 1.85 RTP 21 (70.0) 9 (30.0) 4.1 2.2 Current Drinker 2013-14 Yes N (%) No N (%) Mean Drinks per Week Mean Number of times 5 or more drinks in one day, past 12 Months PGTI (English/Spanish) 43 (28.3) 109 (71.7) 1.2 0.8 PGTI (Asian)* 1 (3.8) 25 (96.2) - - Outpatient 474 (47.6) 521 (52.4) 2.3 0.8 IOP 5 (62.5) 3 (37.5) 6.9 2.8 RTP 16 (38.1) 26 (61.9) 5.2 1.4 * The 1 individual who reported drinking drank 21 cans of beer per week and drank more than 5 drinks in a day 10 times in the past year. Current Drinker 2014-15 Yes N (%) No N (%) Mean Drinks per Week Mean Number of Times 5 or More Drinks in one day, past 12 Months PGTI (English/Spanish) 50 (38.5) 80 (61.5) 2.3 2.0 PGTI (Asian) 2 (20%) 8 (80%) 2.0 0.0 Outpatient 465 (49.2) 480 (50.8) 2.4 2.2 IOP 15 (27.3) 40 (72.7) 5.1 1.3 RTP 37 (50.0) 37 (50.0) 6.3 1.8 Past Year Substance Use 2012-13 Marijuana N (%) Cocaine N (%) Hallucinogens N (%) Inhalants N (%) Narcotics/Opiates N (%) PGTI (English/Spanish) 13 (7.4) 3 (1.7) 1 (0.6) 0 (0.0) 4 (2.3) PGTI (Asian) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) Outpatient 206 (14.7) 39 (2.8) 12 (0.9) 5 (0.4) 50 (3.6) IOP 9 (33.3) 3 (11.1) 2 (7.4) 1 (3.7) 4 (14.8) RTP 10 (30.3) 8 (24.2) 1 (0.3) 0 (0.0) 6 (18.2) PCP N (%) Methamphetamine N (%) Stimulants N (%) Tranquilizers N (%) PGTI (English/Spanish) 1 (0.6) 2 (1.1) 0 (0.0) 2 (1.1) PGTI (Asian) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) Outpatient 0 (0.0) 42 (3.0) 18 (1.3) 29 (2.1) IOP 0 (0.0) 2 (7.4) 3 (11.1) 0 (0.0) RTP 0 (0.0) 3 (9.0) 1 (0.3) 1 (0.3) Past Year Substance Use 2013-14 Marijuana N (%) Cocaine N (%) Hallucinogens N (%) Inhalants N (%) Narcotics/Opiates N (%) PGTI (English/Spanish) 14 (9.1) 2 (1.3) 0 (0.0) 0 (0.0) 1 (0.6) PGTI (Asian) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) Outpatient 169 (17.0) 30 (3.0) 12 (1.2) 2 (0.2) 45 (4.5) IOP 3 (37.5) 2 (25.0) 0 (0.0) 0 (0.0) 0 (0.0) RTP 12 (28.6) 7 (16.7) 2 (4.8) 1 (2.4) 9 (21.4) PCP N (%) Methamphetamine N (%) Stimulants N (%) Tranquilizers N (%) PGTI (English/Spanish) 0 (0.0) 2 (1.3) 4 (2.6) 2 (1.3) PGTI (Asian) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) Outpatient 0 (0.0) 33 (3.3) 13 (1.3) 22 (2.2) IOP 0 (0.0) 2 (25.0) 0 (0.0) 0 (0.0) RTP 0 (0.0) 12 (28.6) 4 (9.5) 1 (2.4) Past Year Substance Use 2014-15 Marijuana N (%) Cocaine N (%) Hallucinogens N (%) Inhalants N (%) Narcotics/Opiates N (%) PGTI (English/Spanish) 8 (6.2) 2 (1.5) 1 (0.8) 1 (0.8) 3 (2.3) PGTI (Asian) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) Outpatient 145 (15.3) 27 (2.9) 2 (0.2) 1 (0.1) 17 (1.8) IOP 9 (16.4) 0 (0.0) 0 (0.0) 2 (3.3) 1 (1.8) RTP 33 (44.6) 25 (33.8) 7 (9.5) 2 (2.7) 20 (27.0) PCP N (%) Methamphetamine N (%) Stimulants N (%) Tranquilizers N (%) PGTI (English/Spanish) 0 (0.0) 2 (1.5) 4 (3.1) 2 (1.5) PGTI (Asian) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) Outpatient 0 (0.0) 30 (3.2) 10 (1.1) 16 (1.7) IOP 0 (0.0) 2 (3.6) 1 (1.8) 1 (1.8) RTP 5 (6.8) 19 (25.7) 11 (14.9) 9 (12.2) Co-Occurring Psychiatric Disorders Treated for in the Past Year 2012-13 Mood Disorders N (%) Psychotic Disorders N (%) Anxiety Disorders N (%) Substance Use Disorders N (%) Personality Disorder N (%) ADD/ ADHD N (%) PGTI (English/Spanish) 54 (30.9) 4 (2.3) 25 (14.4) 6 (3.4) 1 (0.6) 6 (3.4) PGTI (Asian) 3 (18.8) 0 (0.0) 1 (6.3) 0 (0.0) 0 (0.0) 0 (0.0) Outpatient 334 (23.8) 23 (1.6) 199 (14.2) 45 (3.2) 18 (1.3) 43 (3.1) IOP 12 (44.4) 3 (11.1) 8 (29.6) 3 (11.1) 3 (11.1) 7 (25.9) RTP 9 (27.3) 1 (0.3) 4 (12.1) 1 (0.3) 2 (0.6) 7 (21.2) Co-Occurring Psychiatric Disorders Treated for in the Past Year 2013-14 Mood Disorders N (%) Psychotic Disorders N (%) Anxiety Disorders N (%) Substance Use Disorders N (%) Personality Disorders N (%) ADD/ ADHD N (%) PGTI (English/Spanish) 49 (31.8) 11 (7.1) 25 (16.2) 8 (5.2) 3 (1.9) 2 (1.3) PGTI (Asian) 4 (15.4) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) Outpatient 255 (25.6) 20 (2.0) 127 (12.8) 36 (3.6) 11 (1.1) 32 (3.2) IOP 6 (75.0) 1 (12.5) 3 (37.5) 0 (0.0) 0 (0.0) 1 (12.5) RTP 16 (38.1) 0 (0.0) 6 (14.3) 6 (14.3) 1 (2.4) 4 (9.5) Co-Occurring Psychiatric Disorders Treated for in the Past Year 2014-15 Mood Disorders N (%) Psychotic Disorders N (%) Anxiety Disorders N (%) Substance Use Disorders N (%) Personality Disorder N (%) ADD/ ADHD N (%) PGTI (English/Spanish) 35 (26.9) 2 (1.5) 19 (14.6) 5 (3.3) 1 (0.8) 6 (4.6) PGTI (Asian) 2 (20%) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0

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California Department of Public Health Office of Problem ... Document Library/OPG... · 1 . California Department of Public Health . Office of Problem Gambling . Transition Legislative