Our First Look At Amendment 2’s Proposed Rules
Today a Notice of Development of Rulemaking titled Rule No. 64-4.012 Medical Marijuana for Debilitating Conditions was published on the Florida Administrative Register. This is our first look at some of the initial regulation the state will use when implementing Amendment 2’s rules.
The state Board of Health has also announced 5 public rule development workshops for next month:
February 6, 2017, 2:00 p.m. – 4:00 p.m.
Duval County Health Department
900 University Blvd. North
Jacksonville, FL 32211
February 7, 2017, 10:00 a.m. – noon
Broward County Health Department
780 SW 24th Street
Fort Lauderdale, FL 33315
February 8, 2017, 9:00 a.m. – 11:00 a.m.
Florida Department of Health, Tampa Branch Laboratory
3602 Spectrum Blvd.
Tampa, FL 33612
February 8, 2017, 6:00 p.m. – 8:00 p.m.
Orange County Health Department
6102 Lake Ellenor Drive
Orlando, FL 32809
February 9, 2017, 4:00 p,m, – 6:00 p.m.
Betty Easley Conference Center
4075 Esplanade Way, Room 148
Tallahassee, Florida 32399-0850
The public is invited to attend (Dr. Gordon, Patricia, and myself will be attending the Tampa workshop), but if you can’t attend you’re invited to leave a comment at this link.
Feedback received at the workshops will likely influence changes to the proposed rule, thus, we do not expect the rule to be implemented in the exact form you see here. However, it provides useful insight as to the starting point of the workshop discussions and we are working to analyze what the effect would be if implemented as currently drafted.
64-4.012 Medical Marijuana for Debilitating Medical Conditions
(1) For the purposes of this chapter, in accordance with Article X, Section 29, Fla. Const., the following definitions shall apply:
(a) “Medical Marijuana Treatment Center (MMTC)” shall have the same definition as a dispensing organization in s. 381.986(1)(b), F.S.
(b) “Caregiver” shall mean a legal representative as defined by s. 381.986(1)(d), F.S., who is at least twenty-one (21) years old and has successfully passed a Level 1 background screening as defined in s. 435.03, F.S.
(c) “Medical use” shall have the same definition as medical use in s. 381.986(1)(g), F.S.
(d) “Qualifying patient” shall mean a qualified patient as defined by s. 381.986(1)(h), F.S., who has been diagnosed to have a qualifying debilitating medical condition, has a physician certification, and who has a valid patient Compassionate Use Registry identification card.
(e) “Qualifying debilitating medical condition” shall mean conditions eligible for physician ordering contained in s. 381.986(2), F.S., or cancer, epilepsy, glaucoma, positive status for human immunodeficiency virus (HIV), acquired immune deficiency syndrome (AIDS), post-traumatic stress disorder (PTSD), amyotrophic lateral sclerosis (ALS), Crohn’s disease, Parkinson’s disease, multiple sclerosis. Also, any debilitating medical conditions of the same kind or class as or comparable to those enumerated, as determined by the Florida Board of Medicine.
(f) The 45 day supply limitation set forth in s. 381.968(2)(e), F.S. shall be an adequate supply for a qualifying patient’s medical use.
(g) A physician authorized to order medical marijuana means a qualified ordering physician who has met the requirements of s. 381.986 (2-4), F.S.
(h) “Physician certification” means DH8011-OCU-12/2016, “Physician Certification,” which is incorporated by reference and available at http://www.flrules.org/Gateway/reference.asp?No=Ref-#### and must be submitted with each “Compassionate Use Registry Identification Card Qualified Patient Application.” A physician certification may only be provided after the physician has conducted a physical examination and a full assessment of the medical history of the patient. In order for a physician certification to be issued to a minor, a parent or legal guardian of the minor must consent in writing.
(2) All MMTCs, physicians, patients, and caregivers must be registered in the online Compassionate Use Registry as required by s. 381.986(5)(a), F.S., and Rule 64-4.009, F.A.C. All orders for medical marijuana must be entered into the registry for processing accordingly.
(3) The process for registering as an MMTC shall be the same approval and selection process outlined in s. 381.986, F.S., and Rule 64-4.002, F.A.C., and subject to the same limitations and operational requirements contained therein.
(4) All MMTCs shall follow the medical record keeping standards as set forth in Rule 64B8-9.003, F.A.C., as adopted and incorporated herein.
(5) All MMTCs shall abide by the security, product testing, labeling, inspection and safety standards set forth in s. 381.986, F.S and this chapter.
What does it mean?
To condense the above a bit, the proposed rules suggest:
- MMTC is the legal name for a dispensary.
- A caregiver is a legal representative of the patient (probably Power of Attorney is required), is at least 21 years old, and passes a Level I background check.
- Qualifying conditions include those listed directly within the text of Amendment 2. The state is, however, trying to restrict one of the most important aspects of the law (same kind or class or as comparable to those enumerated) to specific determinations made by the Board of Medicine. We feel this is not in the spirit of the law and will adamantly oppose this proposed rule.
- Doctors will still need Compassionate Use certification to order marijuana for patients.
- Doctors will need to perform complete physical examinations on patients and complete a “full medical history review”.
- For a patient under the age of 18, the guardian must consent in writing before the physician can order marijuana.
- All MMTCs, doctors, patients, and caregivers must be registered in the online Compassionate Use Registry and all orders for marijuana must be entered into that database (which is currently the way a doctor orders marijuana for patients).
Also interesting is the initial draft of the proposed rules for the new medical marijuana license in the state of Florida:
64-4.011 Compassionate Use Registry Identification Cards.
(1) All patients and legal representatives are required to have a valid Compassionate Use Registry identification card to obtain medical cannabis.
(2) To apply for a patient Compassionate Use Registry identification card, a person must:
(a) Be a Florida resident, as evidenced by a valid Florida driver’s license or identification card; a current utility bill in the person’s name including a Florida address; a current Florida voter registration card; or for minors, a certified copy of birth certificate or current record of registration from a Florida school (K-12), and proof of residency of designated legal representative,
(b) Be a qualified patient who has been added to the Compassionate Use Registry, by an authorized physician licensed under Chapter 458 or Chapter 459, to receive low-THC cannabis or medical cannabis from a dispensing organization,
(c) Submit DH8009-OCU-10/2016, “Qualified Patient Application,” and DH8011-OCU-10/2016, “Physician Certification,” which are incorporated by reference and available at http://www.flrules.org/Gateway/reference.asp?No=Ref-#### and http://www.flrules.org/Gateway/reference.asp?No=Ref-####.
(3) To apply for a legal representative Compassionate Use Registry identification card, a person must submit DH8010-OCU-10/2016, “Legal Representative Application,” which is incorporated by reference and available at http://www.flrules.org/Gateway/reference.asp?No=Ref-####.
(4) In order for a minor applicant to receive a patient Compassionate Use Registry identification card, the minor applicant must reside in Florida and have a legal representative designated in his or her application and in the online Compassionate Use Registry.
(5) Each applicant shall pay a $75.00 non-refundable application fee in the form of a check or money order payable to the Department of Health. The card shall expire one (1) year after the date of the physician’s initial order.
(6) An applicant shall have sixty (60) days from the date the department provides notice that the application is incomplete to make corrections, provide additional information or resubmit the application.
(7) If there is no initial order by the patient’s authorized physician at the time of the approval of the applicant’s Compassionate Use Registry identification card, the Department will provide a temporary verification which may be used, with a photo ID, to obtain medical cannabis for a period of 30 days or until the applicant receives the permanent identification card, whichever occurs first.
(8) To maintain an active Compassionate Use Registry identification card, a patient and/or legal representative must annually submit DH8009-OCU-10/2016 and/or DH8010-OCU-10/2016, along with the application fee and any required accompanying documents to the department forty-five (45) days prior to the card expiration date.
(9) When there has been a change in the patient’s name, address, or assigned legal representative, that patient must notify the department within ten (10) days by submitting a completed Change, Replacement or Surrender Request, DH8012-OCU-10/2016, which is incorporated by reference and available at http://www.flrules.org/Gateway/reference.asp?No=Ref-####. A patient who has not designated a legal representative at the time of application to the department may do so in writing at any time during the effective period of the patient’s registry identification card.
(10) A patient who no longer has a qualifying medical condition shall return his or her registry identification card to the department within ten (10) days of receiving such information by his or her physician along with a completed Change, Replacement or Surrender Request, DH8012-OCU-10/2016.
(11) Requests to replace a lost or stolen card will require the applicant to submit a Change, Replacement or Surrender Request, DH8012-OCU-10/2016, along with a copy of his or her Florida ID and a $15 replacement fee.
(12) The department may revoke a Compassionate Use Registry identification card for any of the following, but not limited to:
(a) The patient or legal representative makes material misrepresentations in his or her application;
(b) The patient uses his or her card to obtain cannabis for another individual;
(c) The legal representative uses his or her card to obtain cannabis for an individual who has not designated them as their legal representative or who is not a qualified patient
(d) The patient or legal representative purchases, obtains, possesses, or uses cannabis not sold by an approved dispensing organization; or
(e) The patient is no longer a qualified patient.
What does that all mean?
The above proposal outlines the rules for the medical marijuana license card program the state must implement per Amendment 2. Here’s some takeaways:
- In order to receive medical marijuana, all qualified patients must have a valid Board of Health issued ID Card.
- Patients must be residents of Florida and prove as such with documentation.
- To receive an ID Card, the patient must be qualified and entered into the Compassionate Use database by an authorized physician first.
- Patients must submit an application along with a valid doctor’s order.
- The application fee is proposed to be $75.
- ID Cards will expire 1 year after a doctor’s initial order is written.
- If a patient changes their name, address, or legal representative (caregiver), the Department of Health must be notified within 10 days.
- Replacement licenses are $15.
- The Department may revoke an ID Card for misrepresentations on the initial application, if the patient supplies another individual with cannabis, if the patient uses or possesses cannabis not obtained from a MMTC, or if the patient is no longer qualified.
Remember, these are all proposed rules. If you disagree with anything, let your voice be heard. 71.3% of Florida’s voters approved this Amendment and the legislature knows it.
Attend the meetings and leave an online public comment. Whatever you do don’t be quiet.