WA House RSG - Committee Meeting
(March 9, 2023)

Here are some observations from the Thursday March 9th Washington State House Regulated Substances and Gaming Committee (WA House RSG) Committee Meeting.

My top 4 takeaways:

• Washington State Institute for Public Policy (WSIPP) staffers briefed on the fundamentals of their group’s work, and how it came to involve cannabis policies.
  • One of the directives approved by voters in Initiative 502 (I-502) in 2012 was “earmarking revenue for purposes that include substance-abuse prevention, research, education, and healthcare.” RCW 69.50.550 mandated that WSIPP conduct cost-benefit analysis of cannabis laws. These reports were executed under contracts with the Washington State Health Care Authority (WA HCA) as an aspect of their Division of Behavioral Health and Recovery (DBHR) mandates related to I-502 and cannabis legalization. Additionally, some WSIPP reports on cannabis subjects have been mandated through separate legislation. 
  • Prior WSIPP publications on cannabis include:
    • Legalization of Recreational Marijuana in Washington: Monitoring Trends in Use Prior to the Implementation of I-502 (2013)
    • Preventing and Treating Youth Marijuana Use: An Updated Review of the Evidence (2014)
    • I-502 Evaluation Plan and Preliminary Report on Implementation - First Required Report (2015)
    • Updated Inventory of Programs for the Prevention and Treatment of Youth Cannabis Use (2016)
    • Employment and Wage Earnings in Licensed Marijuana Businesses (2017)
    • I-502 Evaluation and Benefit-Cost Analysis - Second Required Report (2017)
    • Measuring Youth Cannabis Use in Washington State (2019)
    • Suppressing Illicit Cannabis Markets After State Marijuana Legalization (2019)
  • The WSIPP panel began with Associate Director for Research Eva Westley introducing Amani Rashid, Senior Research Associate, “the lead of our long-term evaluation of Initiative 502.” The two would speak to the background context about WSIPP, the most recent findings on the impact of I-502 from their team, and wrap up with “a discussion of WSIPP’s current work toward our 2023 report” (audio - 1m, Video - TVW).
  • WSIPP was the State “nonpartisan research institute that conducts research at the direction of the legislature and our board of directors,” said Westley. Their research covered “policies and programs that are going on in Washington or that could apply to Washington,” and she noted they specialized in “quantitative research including outcome evaluations, economic analyses, and evidence reviews.” Westley explained that “in the case of our initiative 502 evaluations, we were actually written into the citizen’s initiative, and our assignment is now directed in RCW.” Beyond research directed in law, she mentioned the WSIPP board could also assign research “of importance to Washington State, and consistent with nonpartisan mission,” but “we received an assignment to evaluate Initiative 502, and we will spend the bulk of the presentation today speaking to this work” (audio - 3m, Video - TVW).
    • Westley indicated there was “a current vacancy” on the WSIPP board for a Washington State House Republican Caucus appointee following the 2022 retirement of former-Representative Larry Hoff, “and we look forward to welcoming his replacement.” At time of publication, the board of director’s page still listed that vacancy.
    • After calling attention to some of the institute’s past publications on cannabis topics, Westley added that WSIPP staff gave a presentation: Overview of WSIPP Research Related To Youth Cannabis Use to lawmakers in March 2021.
    • Westly also presented on WSIPP analyses to the Northwest Prevention Technology Transfer Center (PTTC - NW) in May 2021 as part of a webinar on the Benefits and Costs of Prevention.
  • According to Westley, Rashid joined WSIPP in 2020 “and started leading this project in 2022,” bringing economics experience to the role in reviewing their most recent benefit-cost analysis (BCA) of I-502 from 2017 and research to be released later in 2023 (audio - 1m, Video - TVW).
    • Before Rashid, Senior Research Associate Adam Darnell was the lead WSIPP researcher evaluating I-502 until he left the institute for the private sector in 2019.
  • Rashid explained how the initiative language specified a “benefit-cost evaluation of the implementation of I-502 by examining outcomes related to, but not limited to, public health and healthcare, public safety, substance use, criminal justice outcomes, economic impacts and administrative costs, and revenues.” She continued, noting that such “evaluation takes place over a 20 year period with the final benefit-cost assessment…due in 2032, and intermediate reports required along the way.” With so many criteria to consider, “there's a lot of foundation we need to lay in service of conducting a comprehensive BCA,” Rashid commented (audio - 4m, Video - TVW, presentation).
    • “Before we start talking about monetary benefits and costs, we need to first understand how Initiative 502 impacts these relevant outcomes,” stated Rashid, offering the example of considering the “dollar health costs or benefits of Initiative 502 [after understanding] how I-502 impacted health outcomes and healthcare use.”
    • She noted the legalization measure had “many components,” such as “adult possession;” establishing and regulating manufacturing and retail sale; “and mandated prevention and education; this is just a selection of components of the law.” Rashid said that it was possible “each of these components themselves may have their own relationship with the outcomes,” speculating that existence of a legal market “may increase heavy cannabis use, but on the other side, I-502 also mandates prevention programming and education” which could lower said use. 
    • Accounting for all these factors in their reports meant “there's a lot to do and a 20 year window that we have to consider,” as their staff produced four reports, the 2015 and 2017 reports, as well as one upcoming in 2023, and a final BCA to be released in 2032. “The ultimate aim of the study is to culminate into a benefit-cost analysis of the net impact of I-502 in Washington state,” she remarked. Their first report looked at the “background and implementation of I-502…and outlined a potential research plan for the overall study,” Rashid said. Then in 2017, she commented that researchers “published a report that began to work on those outcome evaluations and produce preliminary findings.” Moreover, the report “we're working on now…continues to lay the foundation for that future benefit-cost analysis,” Rashid added.

• Senior Research Associate Amani Rashid discussed the 2017 “I-502 Evaluation and Benefit-Cost Analysis - Second Required Report,” and answered some questions on enforcement and treatment.
  • Rashid described how the 2017 report focused on “how I-502 in particular impacted cannabis abuse treatment admissions” by comparing the “treatment episode data set” for Washington “relative to similar states that didn't legalize non-medical cannabis.” The results failed to find “any significant relationship between I-502 and changes in cannabis abuse treatment,” she told committee members, but she cautioned that because “the data ends in 2014…this study only considers the first two years” ending before the majority of retailers opened, “so, this is a very preliminary look.” Moreover, in looking at changes in data after I-502 was approved, she remarked the report “doesn't consider the nuances of…how different factors of I-502…may affect pieces differently” (audio - 4m, Video - TVW).
    • Along with the comparison between states, Rashid said the 2017 report had found that higher sales in a county “systematically” related to “higher reported adult cannabis use,” both generally and for “20 or more days within the last month,” which was what they deemed “heavy” cannabis consumption. 
    • She explained that looking at reported cannabis use by those under 21, “we do not find that county sales relate to differences in reported youth cannabis use or drug-related convictions.”
    • The data, covering 2011 to 2015, indicated “roughly 12% of adults…reported past month cannabis use,” added Rashid.
  • Committee Co-Chair Sharon Wylie asked about a possible relationship between “drug-related convictions [and] a trend nationally to make it a low priority in terms of enforcement during that time period.” Rashid answered that the report hadn’t studied drug-related conviction data in other jurisdictions, and only looked at whether cannabis sales in Washington counties might “specifically predict drug-related convictions” (audio - 1m, Video - TVW).
  • Ranking Minority Member Kelly Chambers was curious if treatment admission rates would be considered in their future analysis. Rashid replied that they would be updating topics, “and we'd like to see as aspects of the law unfold, how it changes.” She cautioned that National Survey on Drug Use and Health (NSDUH) data on treatment admissions “changed so we can't compare in Washington outcomes before and after 2015…we can't just look over time because of that discontinuity, [nor could researchers] replicate exactly the study due to that data limitation.” However, Rashid noted that “we will look at…Washington, and look at healthcare treatment…and cannabis use disorder diagnoses,” while attempting to “find ways to update that information [as] best we can.” Chambers followed up to ask about “readmission” rates, and Rashid promised that data was “on the list of things we’d like to look at in this particular iteration of the study, [but] we're not sure if we'll be able to” (audio - 2m, Video - TVW).
  • Returning to the 2017 report, Rashid reiterated that when WSIPP researchers considered “several youth groups and across all groups we [didn’t] see any kind of systematic pattern of higher [sales in] counties, higher reported use; lower [selling] counties, lower reported use.” Neither was there a pattern of cannabis sales correlation to a “difference in drug related convictions,” she stated. But Rashid wanted lawmakers to keep in mind “this is not saying that these outcomes didn't change with I-502 necessarily, what it is saying is when we look at Washington and we're looking at just retail; we're not seeing systematic differences with some of these outcomes across the state.” She assured the group that they would continue evaluating youth impact, and “results may change as the implementation of the law progresses and more outcome data” became available (audio - 2m, Video - TVW).

• Rashid outlined what impacts were being evaluated by WSIPP researchers in 2023, and addressed several questions; the first of two reports was subsequently published in June.
  • Moving to 2023, Rashid said their analysis “primarily aims to expand upon the scope of the previous work” which had “looked at a subset of relevant outcomes.” She relayed that “given the large scope of the topics that we will cover in the forthcoming study we've broken it up into two reports” (audio - 7m, Video - TVW).
    • The first, to be published in June, was “purely descriptive in nature. It will first summarize cannabis related policies, not just I-502, but also major policies that have passed since then,” inclusive of “legislation and regulatory rules.” It would also cover “cannabis sales, cannabis revenues, and expenditures from the dedicated cannabis account over the past decade.” Although not an “analysis of the net economic impact,” it would convey “the numbers as they are, we're looking at how the numbers have changed over time.”
      • Published June 1st, A 10-Year Review of Non-Medical Cannabis Policy, Revenues, and Expenditures showed where sales were happening, and where taxes collected from legal cannabis ended up. The report’s conclusion stated, in part:
      • All cannabis excise tax revenue goes into the DCA [dedicated cannabis account], and most of the DCA funds are transferred to the SBHPT (healthcare for children that require complex care) and the general fund, with a growing amount distributed to localities...As of 2022, about 7% of the DCA funds are spent on prevention, about 5% on other forms of healthcare, 3% are spent on industry oversight and support, and the remaining less than 1% is spent on research. Over the years, cannabis-related revenues and subsequent expenditures have grown significantly…in [Fiscal Year] 2016 totaling $181 million,” and “totaling $519 million” by FY2022.
        • Find out more from a WSLCB spreadsheet of distributions to local governments covering FY 2016-FY2022.
      • “It is important to note this report…does not reflect the net impact of I-502 on the economy, and it does not reflect all the costs associated with the implementation of I-502. In addition, the expenditures we summarize do not necessarily reflect new government spending. For example, the general fund previously provided funding for HCA’s contracts for community health centers but that funding is now provided by the DCA.”
        • Some studies of the economic impact of legal cannabis in Washington were sponsored by cannabis trade groups, produced through government contracts, or compiled by national advocacy organizations.
      • “This report does not detail the impact of the [coronavirus] COVID-19 pandemic on the cannabis industry, regulatory policy, or costs to governments and businesses,” and did not “forecast expenditures impacted by the new allocations, which will go into effect in FY2023.”
      • Read about modifications and allocations of cannabis revenue from Washington State Office of the Governor budget bill signings in 2020, 2021, 2022, along with the 2023 capital and operating budgets which were signed on May 16th.
    • A second report, an “outcome evaluation” scheduled for September, would “examine the relationship between I-502 and then a subset” of topics, including:
      • Cannabis retail and “how it relates to reported substance use”
      • “Related diagnoses in healthcare use”
      • “An aspect of traffic safety and criminal justice outcomes”
      • Other topic areas “with more to come in subsequent years”
    • When analyzing outcomes, Rashid made clear the September analysis “will be set predating” the coronavirus pandemic, “all of our studies will go through 2019 and and at the close of 2019.” Avoiding data from 2020 was important, she commented, since the “full impact of COVID itself on these outcomes is still unfolding and unclear.” Researchers were trying to wait to “better understand” how that event “can be integrated into the study. We ultimately don't want to misattribute changes due to COVID to I-502,” said Rashid.
    • Because “this is ongoing work at various stages of development,” Rashid was comfortable outlining the “study plan, and we'll speak to the data a little bit, but we will not speak to specific results” prior to the report’s publication in September; “we'll be happy to talk about it then.”
    • While NSDUH treatment data had changed, meaning “we can't update that study exactly,” Rashid noted that they had secured national data on “reported cannabis use and other substance use.” This would let WSIPP staff evaluate “before and after the enactment of I-502, and alternatively before and after the advent of sales” in July 2014, “relative to other states,” she explained. Rashid talked about how they would look at two age groups, minors aged 12 to 20, and “and then 21+, of legal age” and be able to evaluate separate outcomes, not just for cannabis, but also “alcohol use, cigarette use, and other drug use.” Rashid anticipated their analysis “capturing Washington in the broader context, but it misses…the nuance of how different components in the background can, can predict differences in outcomes.” Much of the September report would use State data to “focused on local access to licensed retailers. So, we're gonna look at how access predicts differences in outcomes.”
      • In 2022, WA HCA DBHR published Location Matters: Access, Availability, and Density of Substance Retailers after some researchers expressed concern that individuals’ proximity to cannabis retailers could be an indicator of use.
    • Rashid provided a map of “operational licensed retailers, by county, in 2019…in August of 2019 there were about 480 retailers.” She mentioned there’d been earlier study of how retail accessibility impacted use and public health outcomes, but that there were a variety of ways to define such access: “is there a operational retailer in your neighborhood, is there one at all? Another question would be how many are there in your neighborhood, or an alternative way to think of access could be on average…how close are these retailers to residential areas?”
    • Representative Kristine Reeves asked if the study planned to “overlay” data on areas with bans and moratoriums, something she’d voiced frustration about on other occasions. Rashid responded that the “data simply show where retailers are and the month they started operation, and the month they ended operation.” She knew the team was “exploring if we can access [the] data in a usable way…to be able to identify where we don't see retailers due to a local ban” (audio - 1m, Video - TVW).
    • Chambers checked to see whether the map included “tribal locations,” where sovereign tribal governments had entered into a cannabis compact with the state which permitted retail sale. Rashid answered that the map had “all the operational licensed retailers” provided by the Washington State Liquor and Cannabis Board (WSLCB), “I don't know if that includes tribal retailers or not. I have reached out to the LCB about that; we're looking into it” (audio - 1m, Video - TVW).
      • Find out more about tribal companting for cannabis from the September 2022 signing of the 21st compact between Washington State and the Hoh Tribe.
    • Wylie then inquired about “data on the number of medical dispensaries,” or cannabis retailers with a medical endorsement. “Yes, there is information on…which licensed retailers have a medical endorsement. This map doesn't distinguish that but it is possible to distinguish that,” replied Rashid (audio - 1m, Video - TVW).
      • WSLCB leaders had been looking into how many endorsement holders were staying compliant with requirements in November 2022, and discussed a rulemaking petition on the matter on March 28th which, although accepted, had been delayed as staff prioritized other rulemaking projects.
  • Rashid mentioned, “when thinking of how does access predict differences in outcomes, the first outcome that we'll be looking at is reported cannabis use,” and they would be updating their 2015 analysis of consumption patterns among those 21 and older, including “any previous cannabis use, past month cannabis use, and heavy past month’s cannabis use” (audio - 3m, Video - TVW).
    • Rashid previewed that their reporting “heavily highlights…the importance of looking at the impact of I-502 on substance use disorder; related mental health and behavioral health diagnoses; and health care utilization.”
    • They would have data covering the “population of Medicaid enrollees ages 12+” through WA HCA, which she described as covering “cannabis use disorder, alcohol use disorder, opioid use disorder, and general substance use disorder diagnoses,” along with “related mental health diagnoses…psychotic disorder, mania, bipolar, and depression diagnoses.” Rashid said they’d would also see “information about substance use in-patient/out-patient treatment and mental health in-patient and out-patient treatment, and then last will be looking at antipsychotic, anti-anxiety, and depression prescriptions.”
    • “We understand that this is not the comprehensive list of all the ways in which I-502, or retail access, can touch the healthcare system,” said Rashid, but this was the data they were evaluating, while staying open to “other questions that could be asked.” Looking at those under 21 and older individuals separately, her team could see how cannabis accessibility played out “differentially across these groups if data allow for it,” plus implications access had on “other sub groups” based on “sex, by race and ethnicity, and by residential region, so urban versus rural.” Rashid said this was dependent on what data sets they could access for their analysis.
    • Co-Chair Shelley Kloba approved of examining “racial equity…at least your desire to look at it, if you're able to get that data,” before bringing up the “all-payer claims database, are you able to access that…because that's a much broader set of Washingtonians” (audio - 1m, Video - TVW).
      • “The Medicaid information that we can access is very detailed at…the diagnosis and treatment level,” which was why it was selected, Rashid answered.
  • “The next outcome of interest is the traffic fatalities,” Rashid described, indicating it was part of their broader look at public safety impacts from I-502. “Given time and data availability we're starting with traffic fatalities through the Washington Traffic Safety Commission (WTSC)” which she noted were inclusive of “information from the [Washington State Patrol toxicology] lab so that we can see the presence of drugs via blood test” (audio - 2m, Video - TVW).
    • She said staff would study “overall how do traffic fatalities changed, and how [did] access within regions predict differences in the rates of fatality, but really focusing on rates of fatalities where the driver tested positive for cannabis.” Rashid expected they could further use available information “to look at specific THC [tetrahydrocannabinol] levels,” as “greater than five nanograms THC per milliliter of blood which is the per sethreshold for Washington and then we will also look at…the presence of alcohol, other drugs, and then poly-drug use.” She cautioned that “among the population of drivers in a fatal crash in the data only about 60% actually receive the blood test,” and “this is a start to the traffic safety with, with future considerations for other ways to better capture traffic fatalities. It's a tough one since we don't have a system for, for testing for real-time cannabis use while driving.”
      • In 2022, WTSC researchers had revised their interpretation of some poly-drug testing results from traffic fatalities after determining historical overreporting of the cases, though even with the changes a trend of increasing poly-drug incidences remained the same.
    • Reeves wondered whether they could determine “causation” with each fatal crash. Rashid said that wouldn’t be possible, but they could identify if THC was present and she confirmed her understanding that “does not mean, it does not imply that the driver was using cannabis and then drove in real time. Depending on the person, THC can stay in your blood for up to 30 days after use” (audio - 1m, Video - TVW).
    • Representative Greg Cheney was curious if field sobriety tests by law enforcement could be incorporated into their traffic data. As an attorney, he’d seen such tests used as a “significant indicator of impairment, particularly on cannabis, as to whether or not there is…active influences.” Rashid conveyed their ability to leverage that could “boil down to how, how complete the data on that recording [was]” (audio - 1m, Video - TVW).
  • Criminal justice outcomes were the last area mentioned by Rashid, who noted the 2017 BCA set up the background of how conviction data would be examined, adding, prior “studies have looked at how arrests have changed” across the U.S., and “in Washington over time.” WSIPP researchers had “unified the criminal history database” in order to understand “how access and how legalization has predicted differences in drug related charges,” convictions, “and we're considering sentencing,” she added, emphasizing they were “looking beyond just arrests” (audio - 3m, Video - TVW).
    • Rashid clarified that the driving under the influence (DUI) arrest and conviction data wouldn’t differentiate between cannabis and alcohol in reporting an individual’s charge. However, they were generally looking at cannabis-related charges “in particular, and then we will look at alcohol and other drug related charges and convictions.” Additionally, Rashid said they would evaluate misdemeanor possession arrests, and should the data allow for it, breaking criminal justice info up based on subgroups.
    • Kloba wanted to know if this would include racial demographics, and Rashid was clear “if data allow for…we definitely plan to break this out by racial group[s] among other subgroups” (audio - 1m, Video - TVW).
    • Vice Chair Chris Stearns asked if their subgroups “will include Native Americans/Alaska Natives.” Rashid mentioned those subgroups were included in their data, but she wasn’t certain “whether sample sizes of, of all the various subgroups are large enough to support studying each of those subgroups on their own to make responsible, consistent statements.” She stated she would look at sample size before their analysis was finalized (audio - 1m, Video - TVW).
      • Wylie followed up to see if WSIPP staff would address “recommendations for data that might be useful to track going forward.” Rashid expected they would outline the “limitations” related to “what data would be needed…to more comprehensively answer the question, or to answer a question at all.”
    • Cheney observed the Washington State Department of Licensing (WA DOL) driving “abstract includes the basis for the stop being either alcohol or marijuana.” If a substance noted in DUI data from criminal charges wasn’t clear, “that data may reside” with WA DOL (audio - 1m,  Video - TVW).
  • Rashid reiterated how there would be the June “look back on cannabis policy revenues and expenditures,” and then a September report that “focuse[d] on the impact of I-502 and access to licensed retailers” which together would comprise the 2023 BCA. She recognized there would be other aspects to look at in the future: as “the findings change; new questions may arise” (audio - 1m, Video - TVW).

• Committee leaders had a few questions about when and how WSIPP cannabis reports would be released before concluding the meeting (audio - 3m, Video - TVW).
  • Voicing gratitude for their information, Kloba checked on the timelines for the remaining BCAs, including whether the 2023 reports on revenue analysis would “use data that ends at 2019, like in the other half, or will it be all the way up to like 2022?”
    • Rashid described how the June portion of their report was “just a descriptive retrospective” leveraging WSLCB and Washington State Office of Financial Management (WA OFM) information on “sales revenues and expenditures that will go through…fiscal year 2022.” She continued, stating “for that analysis, we're not trying to make statements about how I-502 [was] impacting outcomes, but merely describing the state of the world. There's no reason not to include those years.” But the September report would “start to dig in on public health and safety impacts, to be cautious that's where we cut off in 2019.”
    • Kloba clarified, “the fact that there's a large gap between 2023, and then that final analysis” mandated for 2032, left her wondering if officials “were to desire a more timely [update in] five years, 2028 for instance…can you remind us what's the process by which we could do that?” Westley shared how “that is something that you could assign us via a budget proviso, or if a policy bill, those are both ways that that kind of work could come to us, and…we have gotten that before for other cannabis related work.”
  • Wylie checked how the reports would be released by WSIPP staff, to which Rashid encouraged legislators to watch the institute publications page for their “completed” reports, but “plans for the forthcoming study are…once the study is completed that report will then be published” (audio - 1m, Video - TVW).
    • As an organization member of the WA HCA Prevention Research Subcommittee (WA HCA PRSC), Rashid and other researchers presented “WSIPP’s Initiative 502 Evaluation: Report Three Overview” on behalf of WSIPP in December 2022. That presentation shared data on cannabis use through 2019, and outlined how the third implementation report would address outcomes related to:
      • Within-state analysis
        • Traffic fatalities
        • Criminal Justice (charges/convictions/sentencing)
        • Reported youth use [Healthy Youth Survey]
        • High school outcomes (academic and disciplinary)
        • Cannabis/substance use disorder and (related) mental health diagnoses
      • National comparison
        • ▪ Reported cannabis and other substance use
  • Wylie declared the panel “has been very, very useful,” and thanked Westley and Rashid as she brought the work session to a close (audio - <1m, Video - TVW).