Casinos seemed to be dealing with this issue 3 different ways.
1) Some places flat out dont give you change and allow you to donate your coins to a charity. The cash out machine allows you to pick one of 4 local charities to choose from. (Cosmopolitan)
2) Some places dont allow the machines to give you coins but will allow the casino cashier to do so. Basically when you go to the machine with a TITO for $20.80 it will pay you $20 and give you another ticket for the 80 cents. You can accumulate those and give them to the cashier for the full amount. (Stratosphere, Sunset Station did this)
3) Some place just pay you the same way they always have (most places....El COrtez, AZ Charlies, Boulder Station)
Kinda makes me think that whole coin shortage thing is BS. If nothing else its good to avoid the ones that follow rule (1)