WA SECTF - Work Group - Licensing - Public Meeting
(June 30, 2021) - DOH Medical Marijuana Program

Sanjay Gupta - High THC Compliant Product

A presentation on the state medical marijuana program and confirmation of ongoing rulemaking for medical consultant certification preceded several questions by work group members.

Here are some observations from the Wednesday June 30th Washington State Legislative Task Force on Social Equity in Cannabis Licensing Work Group (WA SECTF - Work Group - Licensing) Public Meeting.

My top 3 takeaways:

  • Work group members were briefed by DOH Medical Marijuana Program Manager Allyson Clayborn on the department’s responsibilities to patients, caregivers, and medical practitioners (audio - 10m, Chat Log, Recognition Card County Map).
    • Clayborn reported that she’d replaced Shelley Rowden as program manager in January, and had a “program assistant named Reem” Aldaghestani as well as general DOH “support staff.” She relayed that the goals for the program were to “protect access for patients with qualifying conditions, ensuring product is safe, quality tested, accurately labeled.” She then described “three big things” which defined the program.
    • Patient Database. Patients choosing to register their authorizations in the database were afforded extra privileges in law, though Clayborn emphasized patient participation was voluntary “unless the patient is under the age of 18.” She told work group members patients could purchase from “about 286” cannabis retailers with medical endorsements without paying local sales taxes, possess greater quantities of cannabis products, had protection from arrest, could participate in a patient cooperative to collectively grow medical cannabis, or cultivate “up to 15 plants” themselves with their doctor’s approval. Patients and cooperatives could “purchase immature plants, clones, and seeds” from licensed producers.
    • Medical Marijuana Consultants. Clayborn explained that DOH certified consultants worked at endorsed retailers assisting patients by registering them into the database, issuing recognition cards, “and they can help with product selection.” Consultants completed “20 hours of training from a state-approved course” and were required to have completed cardiopulmonary resuscitation (CPR) training, and continuing education post-certification, she reported. As of April 2021, there were “583 certified consultants” and 574 were actively employed by an endorsed retailer.
    • Compliant Cannabis Products. “Higher quality products” specifically for medical patients had to pass stricter testing requirements, Clayborn stated. Perhaps unintentionally, these products were therefore "very hard to find in stores" and "expensive to make, the testing is very expensive." She expressed her intention to raise consultant awareness about the benefits of compliant products, “how to explain it to patients, and then where, where it can be found.”
    • WSLCB staff were responsible for the addition of medical marijuana endorsements to retail licenses.
      • Clayborn shared a map of endorsed retailers registering patients between October 2020 and March 2021, and described how it had been used to “identify some of the areas where medically endorsed stores exist but that they’re not using that endorsement.” She was planning outreach to endorsed stores not registering patients to refresh staff on “what it means to be medically endorsed and that they understand the patient community that they’re serving.”
      • Of 286 endorsed retailers, Clayborn told the group that only “about 157...are active stores” with at least one consultant on staff and having issued a recognition card, leaving around “129 medically-endorsed stores that are not actively using that medical endorsement.”
    • Clayborn commented that the rulemaking process at DOH was “incredibly long...a year, easy” and active rulemaking was focused on “trying to...correct some of the knowledge gaps that are existing right now...between the medical marijuana consultant and the patient.” She said that ongoing rule revisions aimed to ensure consultants were “well trained, that they know their products, they have a better understanding of the patient community that they’re serving.” Clayborn expected DOH staff to facilitate “annual training” to help consultants stay “up to date with the rules and regulations.”
  • Members of the work group and public raised several questions about medically compliant products and retail endorsements.
    • Work Group Co-Chair Michelle Merriweather inquired about the availability of compliant medical cannabis items. Clayborn admitted there were issues of availability and that retailer “awareness just isn’t there of what DOH compliant product is” and “who the patient community is.” She added that it was possible the cost of items was “off putting” (audio - 1m). 
    • Work Group Co-Chair Monica Martinez asked how patients were procuring medical cannabis, wondering if “it’s hard to get patients into the stores ‘cause the product’s so much more expensive...where are the patients getting their product?” Clayborn speculated patients were “just using any, any product” as compliant product was “hard to find and I think that there’s not enough knowledge about what it is and how it can help.” She assumed most patients used whatever cannabis items “they feel like is working best for them” (audio - 2m).
    • Micah Sherman, work group member and Raven Co-Owner, asked Clayborn her opinion of “the advantage of a DOH compliant product for a patient” (audio - 2m).
      • Clayborn stated that while she wasn’t a medical cannabis patient, she would “want my medicine to be...clean" in order to “be aware of what I’m putting into my body.” She continued, saying the presence of “pesticides or certain chemicals that can exasperate certain symptoms” would concern her, “and I feel like patients have indicated the same.” Clayborn hoped awareness about compliant products would increase so patients “have all the information that they can to make the best choices for themselves.”
      • Sherman wondered if producers “self-selecting samples for that testing is, is a sufficient way to make a claim that that product is safe for patients?” Clayborn said she was unaware of testing protocols and that her position at DOH wasn’t “part of that work.” Sherman responded that Raven didn’t participate in the DOH medical cannabis program as he found it “fundamentally flawed in its construction and has little to no value for patients” he’d interacted with beyond getting “that certification card so they can buy plants.” He wanted to see reforms in the program to address things that “disincentivize us as producers” as his impression was “that it doesn’t provide a lot of value for patients” .
      • Sherman’s company produces cannabis products including a range of CBD cultivars and blends.
    • Paul Brice, Happy Trees Owner, asked about the tax exemption process for endorsed retailers (audio - <1m). 
    • Paul Jackson offered gratitude to Clayborn for a prior presentation to another group (audio - 1m).
    • Gregory Foster, Cannabis Observer Founder, asked about “the designation for the different levels of product.” He presumed Clayborn knew about the long-running Quality Control (QC) Testing and Product Requirements rulemaking project at WSLCB which would “impact the, the definition of testing of products” including possibly achieving “parity with the DOH definition.” Foster was curious if Clayborn was “anticipating that or looking at that” and what could happen to DOH’s definition “if they’re the same” as WSLCB standards for all cannabis items. Clayborn replied that she’d been in communication with WSLCB staff and the DOH definition of compliant products was intended “to serve the patient community, and if that needs to adjust...we’re ready to do that.” Foster offered to assist with “engagement in the rulemaking process at DOH” (audio - 3m).
      • In a follow up email exchange with Clayborn, Foster described concerns he had heard about “patient trust in the registration database.” Sharing a 2016 DOH contract amendment with cloudPWR, the database provider, he asked about a deliverable titled, "Admin. - DEA File Access" noting “there are many, many things that could refer to...But in the absence of an authoritative statement, I can relay that speculation has filled the gap.”
      • After “some digging”, Clayborn replied, “When a healthcare provider who authorizes medical cannabis has a patient who registers in the database, they are able to see their authorizations in the system, if their patients chose to register in the database. Non-authorizing healthcare practitioners who are allowed to prescribe controlled substances may access healthcare information on their patients for the purpose of providing medical care for their patients. Practitioners who are allowed to prescribe or dispense controlled substances will have the option to search the database by the patient’s name and date of birth to review the patient’s healthcare information. In order to have those query privileges, the provider must enter their DEA number when they register in the system.”
      • She concluded, “Since healthcare providers are given the option to enter their DEA number, that report is imported from the DEA so we can verify the numbers, but no data ever goes back to the DEA. They do not have access to any information in return, they can’t request information, card numbers or names, the only purpose of their interactions with the database is to verify healthcare providers DEA numbers if they choose to enter it when they create an account.”
    • Pablo Gonzalez, WA SECTF appointee, asked “what makes it attractive for a retailer to carry the medical endorsement” and what would make prospective social equity retail licensees want “to get a medical endorsement.” Clayborn’s response was that the process for retail business owners to set up a medical endorsement “takes work and, and money to make sure that you’re set up in it.” She acknowledged it wasn’t easy, but could bring a retail establishment “the patient community” which was “a group of customers there...that you can serve that other stores wouldn’t be able to.” Clayborn added “there is space there where there could be better incentives” and her staff had looked at “changing...the database itself and one of the things that we’re looking at is like how can being part of the medical cannabis industry provide value to the store owners.” Gonzalez remarked that security of the patient database was important, as was the option for retailers to charge more than the minimum $1 to issue recognition cards. Clayborn shared her understanding that the majority of retail licensees already possessing medical endorsements charged “between, like, 10 and 20-ish” dollars to cover operating costs and added that officials at DOH were considering a “new data system” that could automate some responsibilities of retailers (audio - 3m).
    • Sherman said the patients he’d interacted with “want to be able to have a relationship with the person that’s growing their medicine” (audio - 4m).
      • Prior to I-502, he said the association between patients and those providing their cannabis was a "legal, above-board relationship" and a “much more effective way of ensuring that you have clean and safe product that works for you.” Sherman believed that “transparency, relationship, and care” between the patient and producer “is always going to be more valuable than some analysis from a lab after the fact."
      • Regarding equity in the cannabis industry, Sherman wanted to see “parity across the different points in the supply chain.” If producers were able to interact directly with patients, he predicted Raven could undertake "customized production" suited to individual patient medical needs such as specific “terpene recommendations” - a process “next to impossible” to conduct with a retailer as the intermediary. Sherman mentioned this request was something he’d heard “so consistently from every person that I’ve talked to in that world that I just feel like I would be remiss in not mentioning it in this context.”
      • The work group could make recommendations on “what would the ideal medical provider license in the 502 market look like?” He encouraged the work group and WA SECTF members to evaluate how “the economic structure[s] that we’ve produced facilitate or hinder the sort of social and care relationships that we used to have in the medical system.”
      • Sherman had long advocated for the right of smaller producers to conduct direct sales with adult consumers.

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