Pages tagged "HB 1101"


Unfortunately, Maryland Did NOT Become the 19th Medical Marijuana State

When the Maryland Senate voted earlier today to approve HB 1101 today, it failed to become the 19th medical cannabis (marijuana) state. In spite of the bill's comendable intentions, it remains highly flawed. Some have touted the HB 1101 approach as a "yellow light" on medical cannabis, yet sadly, it can only be seen as a "yellow light" on a "bridge to nowhere."

In spite of the bill's laudable intent, the approach is completely untested, and causing even greater concern, the program is almost certainly  unimplementable for legal, financial and practical reasons. In fact, the Maryland Department of Legislative Services found that participation program is "expected to be low (or nonexistent)" and will "not likely to be able to comply with the bill’s requirement to set its fees at a level sufficient to offset program costs...unless it sets its fees at a level that would likely be prohibitively high."



Legal Reasons for Concern

HB 1101 would allow patients to obtain medical cannabis from "Academic Medical Centers" (AMCs), which are essentially teaching-hospitals that have federal approval to conduct trails on human subjects. While this is creative way to reinvent how medical cannabis is distributed to patients, only one potentially eligible AMC (Sinai Hospital in Baltimore) has expressed interest in becoming an AMC. However, by becoming an AMC, the hospital would likely be placing its credentials to conduct research on human subjects in jeopardy. Considering that federal interference is one of the reasons Maryland has been reticent to adopt a proven safe access model, it does not add up why Maryland would be encouraging its facilities to endanger the credentials.

But let's assume for a moment that this legal concern is not in fact an issue...

Financially Unimplementable

The DLS analysis points out that HB 1101 must be able to offset the financial costs incurred by the commission that will be set to implement it. While the DLS report mentions that the state might not be able to find any willing and eligible AMCs, it concludes that even if Sinai or another institution stepped forward and applied to be an AMC, the program would still be unable to offset its anticipated costs. Moreover, the state will have to bear the costs of establishing the administrative rules for the program, even if no AMCs ever apply to the state. It's rare feat for an essentially symbolic piece of legislation to come with a price tag, but that's what HB 1101 does, meaning Maryland taxpayers could be forced to pay for a program that may not serve any of the state's patient population.

But let's assume for a moment that the price tag issues are not a factor...

Dubious Practical Value

Absent concerns about the financial and legal viability of HB 1101, the program still contains practical flaws that would make it arguably the least patient-friendly bill in the country. The bill fails to grant physicians to right to recommend cannabis to their patients unless an eligible AMC has been approved by the state to recommend and distribute medical cannabis for certain conditions. In other words, if an AMC did not have foresight to include a patient's particular condition in its application to become an AMC, the patient would be shut out from the program. This would be particularly harmful to patients with rare conditions and conditions for which medical cannabis is an emerging therapeutic option. This also means that the Commission would have to approve conditions, and given the strong resemblance of the work group created by SB 308 (2011) that had difficulty meeting its statutory requirements, it would also require the state's patients to take a serious gamble that the Commission could meet its function.

Geography is another practical concern that should resonate with patients across the state. The most likely AMCs (Sinai, Johns Hopkins Hospital, and the University of Maryland Hospital) are all in Baltimore. Patients who do not live along the I-95 corridor, such as combat veterans living with PTSD in Cumberland, or retirees with cancer living on the Eastern Shore, may have to drive 2-3 hours each way in order to access their AMC to obtain medicine. Even if a patient is fortunate to have a caregiver assist them, the potential 6-hour trip is a completely unnecessary burden to safe access.

So what are Maryland patients left to assume? As someone who lived in Maryland for over 30 years, and has most of my loved ones still residing in the state, there was no state in 2013 that I had more personal hope for than Maryland. I really wanted Maryland to be the next medical marijuana state, but HB 1101 simply falls short, and significantly so.

Maryland's new medical may make lawmakers feel better, but it remains extremely unlikely that it will do the same for the state's patient population.

 

 

NH set to become the next medical cannabis state, while MD considers yet another symbolic bill

Yesterday, the New Hampshire House of Representatives overwhelmingly passed House Bill 573, by a voted of 286-64. The bill is expected to pass the Senate, which approved similar legislation last year. In fact, the year's bill will provide patients with greater access options, as they will be able to purchase medical cannabis from a state-regulated dispensary in addition to being able to cultivate their own medicine in an enclosed, locked facility. While last year's bill was vetoed by the previous governor (the veto fell just 2 shorts shy of being overridden),  it is expected that it will again pass the senate followed this time with the signature of newly elected Governor Maggie Hassan.

ASA worked with NH state Representative Donald "Ted" Wright to help with language as the bill made its way through the Health, Human Services and Elderly Affairs Committee, and commends the work of the committee and each of the legislators that voted in favor of the bill that will create true safe access in New Hampshire. Although the bill failed to included protections against housing, employment or education discrimination, HB 573 is a very patient friendly bill, and will provide access to patients living with any of a number of debilitating conditions. Unfortunately, the same can not be said about legislation that is about to pass the Maryland General Assembly.

Late on Wednesday, it was announced that both the Maryland House Health and Government Affairs and Judiciary Committees approved HB 1101, a bill that would in theory create an access model where patients would obtain medicine from hospitals that are approved to conduct research on human subjects.  Earlier this month, Maryland was considering a true safe access, HB 302, which would have been created access through dispensaries and cultivation while providing patients with the strongest privacy protections in the nation. Instead, this system can only be described as a symbolic bill because even the state's own Department of Legislative Services (DLS) analysis said the likelihood that any facility is approximately "nonexistent." In fact, the state's analysis noted that;

"Both the University of Maryland Medical System (UMMS) and the Johns Hopkins University (JHU) previously advised (with regards to a similar bill introduced in the 2012 legislative session) that they did not intend to participate in the program as academic medical centers. JHU and UMMS have confirmed that their intentions have not changed. It is unclear how many, if any, other institutions are eligible (and willing) to participate as
academic medical centers under the bill."

In other words, the state has no idea (or confidence for that matter) that there is a single facility in the state that will provide medical cannabis to patients with a qualifying condition. Even less friendly for patients is the fact physicians will not be able to write recommendations for conditions for which they have not been pre-approved to recommend. In fact, there is not a single debilitating medical condition that a patient in Maryland would be guaranteed access for under this law, bad news for Marylanders with rare conditions.

Worse still, this completely unproven approach is anticipated to be a financial quagmire for the state.  The DLS analysis further states that,

"Because participation in the program is expected to be low (or nonexistent)...DLS advises that the commission is not likely to be able to comply with the bill’s requirement to set its fees at a level sufficient to offset program costs (notwithstanding that some costs, including those associated with the required database, are the responsibility of DHMH rather than the commission) unless it sets its fees at a level that would likely be prohibitively high."

In other words, if by some miracle, some eligible facility stepped forward to become a provider of medical cannabis, the state would be hemorrhaging money on the program. Regardless of whether a facility stepped forward, the state would still bear the expense of promulgating unimplementable regulations. Bottom line, Maryland is about to pass the expensive symbolic medical cannabis law in history.

So there you have it. Neither Maryland nor New Hampshire are set to pass perfect medical cannabis bills in 2013, but the difference between them is night versus day. Or should I say, sickness vs. wellness.