Michigan revises medical marijuana law to their liking rather than the people's

[Markass]

Fuck this, what they're doing is changing the law to what they like, rather than leaving it with what the people voted for. They were asked to establish guidlines for a state ID program, not rewrite the parts of the law they wish. This is 'American democracy' in action.



Provisions of Michigan Department of Community Health

Draft Medical Marijuana Rules Needing Revision

1) Redefining Private Property as "Public"

Proposal 1 appropriately does not allow medical marijuana use "in any public place." The draft

rules, however, attempt to redefine "any public place" to include any place "visible to the public."

This would include being inside one's home by a window or on one's porch. These locations are

not "public places" and should not be considered so. This draft rule is both unreasonable and

contrary to the language of the law.

Recommended revision: Strike "'Public place' means a place open or visible to the public." [Rule

1 (17).]

2) The Opening Language of Draft Rule 3(1) Should Be Modified

The opening language of Rule 3(1) should be modified so it does not indicate that people with

debilitating conditions are required to apply for a registry ID cards, since some seriously ill

people will not use medical marijuana. In addition, the draft rule should not say that the patient

must meet the requirements of the administrative rules. The department does not have the

authority to impose additional requirements on patients.

Recommended revision, from: "A qualifying patient shall apply for a registry identification card

and, in addition to meeting the requirements of the act and the administrative rules promulgated

under the act, shall comply with all of the following: â?¦"

To: "A qualifying patient may apply for a registry identification card by submitting the following:

â?¦" [Rule 3(1).]

3) Strike Requirement That Physicians Practice Independently of One Another

The draft rules would require that a minor's two physicians who sign their certification practice

independently of one another. The law includes no such restriction, which would drive up costs

and time for minor patients' parents. Proposal 1 is already stricter than many of the state medical

marijuana laws by requiring minors to receive certifications from two physicians. All of the

medical marijuana states that track the number of minor patients had had zero or one according to

a 2006 survey of the state programs with registries. There is no need for this onerous restriction

on seriously or terminally ill minors, and it is counter to the language of Proposal 1.

In addition, Proposal 1 does not require that two physicians provide a certification for adults for

who granted someone else a durable power of attorney, so the draft rule should not add that

restriction.

Recommended revision, from: "â?¦ If the patient is a minor or has a representative as defined in R

333.101(19) of these rules, written certifications from 2 physicians, who practice independently

of each other, are required."

To: "â?¦ If the patient is a minor, written certifications from 2 physicians are required." [Rule 3

(1)(c).]

4) Patients Should Not Have to Submit the Names of Patients Their Caregivers Serve

The draft rules would require patients who are applying for ID cards to specify what other

patients their caregiver serves. This would require the caregiver to disclose that information to the

patient. Proposal 1 does not require this information to be submitted, and this requirement would

require a caregiver violate the privacy of his or her other patients. The department can check its

own database to see how many patients the caregiver serves. There is no need for this invasive

rule.

Recommended revision: Strike "The names of any other individuals for whom the patient's

primary caregiver also serves as a primary caregiver." [Rule 3 (1)(v).]

5) Requiring the Caregiver to Submit Criminal History Information

Draft Rule 3 (1)(a)(vii) includes a vague requirement that caregivers submit criminal history

information via the patient applicant, in addition to authorizing a background check. Only felony

drug convictions disqualify caregivers, so the vague phrase should either be stricken or be

modified to be clear that they only have to submit information if they have a felony drug

conviction.

Recommended revision: Strike "Information related to the criminal history of the qualifying

patient's primary caregiver." [Draft Rule 3 (1)(a)(vii).]

6) Specify That Copies of Identification Can Be Submitted

Draft Rule 3 (1)(b) is written as though patients and caregivers have to send the department their

original drivers licenses or other photo identification. Patients and caregivers will need their

identification. This should specify that photocopies may be submitted. In addition, minors may

not yet have any photo identification, so it should be clear that they would not need to provide

identification.

Recommended revision, from: "Submit photographic identification of both the qualifying patient

and the patient's primary caregiver, if applicable. The following shall be considered acceptable

forms of identification: â?¦"

To: "Submit photographic identification of both the qualifying patient and the patient's primary

caregiver, if applicable, except that if the qualifying patient is a minor who does not have

photographic identification, no photographic identification is required. Photocopies of the

following shall be considered acceptable forms of identification: â?¦" [Rule 3 (1)(b).]

7) Inventory Reports

The draft rules would require patients and caregivers to create and submit inventory reports about

their marijuana cultivation each year. The draft rule says that the patient would not be issued a

renewed card if they did not submit reports. The department does not have the authority to require

these records, nor should it. The law clearly enumerates the only reasons that a patient may be

denied a card, and failing to submit an inventory report is not one of them, because the law 63%

of voters approved does not require inventory reports. These reports would be self-incriminating

statements, documenting a violation of federal law. Proposal 1 already protects against diversion,

penalizing diversion with increased penalties and the revocation of one's medical marijuana card.

All references to inventory reports need to be stricken.

Recommended revisions: Strike all of the following:

"The applicant or primary caregiver authorized to grow plants for the renewal applicant shall

submit an inventory log regarding the plants grown during the previous year." [Rule 7 (4).]

"A registered primary caregiver shall make and maintain a complete and accurate inventory of all

usable marihuana produced and plants in the primary caregiver's possession that is authorized for

a registered qualifying patient's medical use. The registered primary caregiver shall make and

maintain a separate inventory for each qualifying patient that the primary caregiver assists with

the medical use of marihuana." [Rule 15 (3).]

"An inventory of the plants shall be maintained for the full registration year and the inventory

form shall be submitted with the renewal documentation." [Rule 29 (3.)]

"The plant inventory shall be returned with the patient registration and shall indicate the manner

in which the plants were destroyed or transferred to another qualifying patient." [Rule 29 (4).]

Also, needed changes to Rule 15 (7) are discussed below. The problematic inventory requirement

is also included in it.

8) Face-to-Face Meetings Are Unreasonable

The draft rules say that, if proof of identity is uncertain, the department may require a face-to-face

meeting. It can take more than nine hours to drive from the furthest point in Michigan to Lansing.

It would be unreasonable to require a very ill patient to travel several hours. Some people with

debilitating illnesses cannot tolerate any long trips. In addition, the draft rule does not create a

clear standard for when the department might require this burdensome trip. It is already clear

from Rule 3 (1)(b) that the ID card will only be issued with a valid form of identification.

Recommended revision: Strike "If proof of identity is uncertain, the department may require a

face-to-face meeting with an applicant and may require the production of additional identification

materials." [Rule 9 (a).]

9) The Department Needn't Contact Federal Programs

The draft rules helpfully provided for a discounted rate of $25 for beneficiaries of Medicaid or

Social Security Income. But because marijuana is not yet legal under federal law, patients have

legitimate privacy concerns about the department contacting a federal agency to verify their

eligibility. Some may reasonably fear their benefits could be cut off as a result. The MDCH

should instead rely on information submitted by the patient to confirm eligibility, as Rhode

Island's administrators do. If the department had a reasonable basis to doubt the documents, it

could ask the patient whether the patient preferred to pay a higher fee or for the department to

verify that he or she is a beneficiary.

Recommended revision: Strike "Contacting the department of human services or the social

security administration to verify a qualifying patient's eligibility for the Medicaid health plan or

Social Security Income benefits." [Rule 9 (f).]

10) Certification Language Should Track the Statute

The draft rule that discusses what the applicant patient must submit does not track the statutory

language and suggests the department may require something other than what the law requires,

which is a physician's written certification.

Recommended revision, from: "The applicant did not provide the information required under R

333.103 and R 333.105 to establish the qualifying patient's debilitating medical condition and to

document the qualifying patient's consultation with 1 or more physicians regarding the

therapeutic or palliative benefits from the medical use of marihuana."

To: "The applicant did not provide a document signed by a physician, stating the patient's

debilitating medical condition and stating that, in the physician's professional opinion, the patient

is likely to receive therapeutic or palliative benefit from the medical use of marihuana to treat or

alleviate the patient's debilitating medical condition or symptoms associated with the debilitating

medical condition." [Rule 13 (5)(a).]

11) The Language About Denying Applications Should Be Modified

The draft rules provide that an applicant can be denied a card if an applicant has willfully violated

the act or rules. However, the draft rules impose unreasonable requirements that the law does not,

such as the inventory requirement. The draft rule would allow the department too much discretion

to deny an application. Instead, an application should be denied only if the patient's card has been

revoked for a proven violation of the law.

Recommended revision, from: "An applicant has willfully violated the provisions of the act or

these rules."

To: "An applicant has had his or her previous registry identification card revoked for willfully

violating the provisions of the act." [Rule 13 (5)(c).]

12) The Reference to Inspections Must Be Stricken

One of the draft rules seems to envision the MDCH conducting inspections. This is in direct and

flagrant contradiction to the law voters passed. The law specifies, "Possession of, or application

for, a registry identification card shall not constitute probable cause or reasonable suspicion, nor

shall it be used to support the search of the person or property of the person possessing or

applying for the registry identification card, or otherwise subject the person or property of the

person to inspection by any local, county or state governmental agency." The draft rules'

inspection language needs to be stricken. This law makes the limited cultivation of marijuana

lawful under state law, and it is not a basis for treating the very ill like criminal suspects.

Recommended revision, from: "Authorized employees of the department as necessary to perform

official duties of the department, including the production of any reports of non-identifying

aggregate data or statistics, investigations or inspections of enclosed, locked facilities."

To: "Authorized employees of the department as necessary to perform official duties of the

department, including the production of any reports of non-identifying aggregate data or

statistics." [Rule 21 (a).]

13) Changing the Rule About Leftover Marijuana

The MDCH's draft rules suggest that a caregiver give any marijuana left over after one patient is

no longer qualified or dies to other patients he or she assists, which is reasonable. However, other

aspects of this draft rule are not. It would require the caregiver to provide an inventory to the

department, which is problematic for reasons discussed above, and, if the caregiver did not assist

any other patients, he or she would be required to hand over the marijuana to law enforcement.

Proposal 1 does not have any such provision. Sadly, state and local law enforcement in some

cases have collaborated with federal authorities to raid patients or caregivers. It is unreasonable to

require a cardholder to turn over marijuana, which is possessed in violation of federal law, to

police. These provisions should be stricken or modified to simply say that the caregiver or patient

may provide the marijuana to another registered patient, may destroy it, or may hand it over to

law enforcement for destruction. It should also give a set and reasonable timeframe that allows

for time to give the marijuana to the caregiver's other patients who may live some distance away

or to get back in town if the caregiver is traveling.

Recommended revision: Strike Rule 15 (6) and (7).

Replace with: "(6) If a registered qualifying patient dies or is no longer deemed a qualified

patient, a registered primary caregiver may transfer all marihuana produced for the former patient

to other patients who are currently registered to that primary caregiver, as long as the total

amount of marihuana per patient is within the requirements established in R 333.127 of these

rules.

(7) Except as provided in subrule (6) of this rule, if a registered qualifying patient dies or is no

longer deemed a qualified patient, a registered primary caregiver must, within 14 days of

learning that the patient has died or is no longer deemed a qualified patient either destroy all

marihuana produced for that patient or turn it over to law enforcement for destruction."

[Rule 15 (6) and (7)]"

14) Remove Requirement to Notify the Department of a Changed Telephone Number

Neither Proposal 1 nor the part of the draft rule listing what application materials a patient must

submit include the patient's telephone number. Since there is no requirement that they submit a

telephone number, it is not reasonable to require cardholders to notify the department of a

changed number.

Recommended revision: Strike "The registered qualifying patient's telephone number." [Rule 19

(1)(c).]

15) Make Enclosed, Locked Facility Language Conform With the Law

Some of the draft rules say patients must keep their marijuana â?? not just plants â?? in an enclosed,

locked facility. This contradicts the plain language and intent of the law. Proposal 1 requires

patients to keep their marijuana plants in enclosed, locked facilities that only a patient and

caregiver can access. However, the law allows people other than designated caregivers to assist

patients with administering marijuana. This is necessary because many terminal patients and

severely disabled individuals need round-the-clock care, which necessitates more than one aide or

the assistance of more than one loved one. Many patients will be physically incapable of

administering marijuana on their own. Naturally, the aides would not be able to administer the

marijuana if it was in an enclosed, locked facility that the aides were not allowed to access. This

language should revert to the language in the law.

Recommended revision, from: "â?¦ The patient shall ensure that the marihuana in his or her

possession is kept in an enclosed, locked facility."

To: "â?¦ The patient shall ensure that the marihuana plants in his or her possession are kept in an

enclosed, locked facility." [Rule 27(1).]

Rule 23 (2)(g) should be stricken for other reasons. It would also wrongly require marijuana to be

in an enclosed, locked facility.

16) The Certification Language Should Track the Law

Proposal 1 says the department "shall issue" an identification card to patients who submit their

application with their contact information, a written certification, and a fee, and that an

application can only be denied if the information is falsified or incomplete. To qualify, a

physician must be a DO or MD who is licensed to prescribe drugs. Yet, the draft rules do not

track the law, and instead of requiring a physician only to be licensed, require he or she be "in

good standing with the department." Also, the draft rule says that the department may examine an

original patient record if the doctor does not meet the definition of a physician. But the definition

of a physician is a licensed MD or DO. So the patient record would presumably be irrelevant to

determining the licensure status. Under the draft rules, the department would also deny patients'

applications if the patient does not allow his or her medical records to be examined if the

physician "does not meet the definition" of physician. The draft rule would allow the department

to take things into consideration when granting or denying the application that the law does not,

such as complaints by health care providers about the doctor. If the physician is unfit to practice

medicine, the proper venue where that would be addressed is physician licensing, not reviewing

the validity of a written certification.

Recommended revisions: Strike all of the following:

Rule 23 (3) and (4)

Rule 1 (24): "in good standing with the department"

Rule 3 (1) (c): "in good standing with the department"

Rule 7 (2): "is in good standing with the department"

Rule 9 (d): "and is in good standing with the department"

17) The Language on Law Enforcement and Confidentiality Must Track the Statue

The draft rules' language on verifying cardholders' status to law enforcement indicates that the

department might be planning to violate the confidentiality requirements of the act by stating that

a person is a registered patient in response to an inquiry about that person, rather than only

verifying an ID card after law enforcement has called in the random number on the ID card to

verify it. The distinction is important. Allowing a police officer to ask if a person is registered

based on the vague standard of a "bona fide reason" would allow fishing expeditions, which the

act does not allow. In addition, the draft rule says the department can confirm to law enforcement

that a caregiver only serves five people. There is no need for the department to verify that a

caregiver serves no more than five patients because the department would not issue a card for the

caregiver to assist a sixth patient.

Recommended revision, from: "Authorized employees of state or local law enforcement agencies

when they provide a specific name or address and a bona fide reason for the inquiry. Information

will be supplied only as necessary to verify any of the following:

"(i) That a person is or was a lawful possessor of a registry identification card.

"(ii) That a registered primary caregiver is not assisting more than 5 qualifying patients."

To: "(b) Authorized employees of state or local law enforcement agencies only to verify the

validity of a registry identification card that the law enforcement agency has been presented with,

as demonstrated by the reading of the card's registry identification number." [Rule 21 (b).]

18) A Person Can Only Authorize the Release of Information About Himself or Herself

The draft rules prudently specify that information about cardholders can only be released

pursuant to a signed release. However, as it is written, a person could authorize the release of

information about someone who does not want that information released. For example, a patient

could authorize the release of information about his or her caregiver. This needs to be modified.

Recommended revision, from: "Other persons upon receipt of a properly executed release of

information signed by a registered qualifying patient, a qualifying patient's parent or legal

guardian, a qualifying patient's registered primary caregiver, or a registered qualifying patient's

representative. The release of information shall specify what information the department is

authorized to release and to whom."

To: "Other persons upon receipt of a properly executed release of information signed by a

registered qualifying patient, a qualifying patient's parent or legal guardian, a qualifying patient's

registered primary caregiver, or a registered qualifying patient's representative. The release of

information shall specify what information the department is authorized to release and to whom.

No release of information may allow the disclosure of information about any person except the

person signing the release, except that a legal guardian may authorize the release of information

about a minor patient." [Rule 21 (2 (c).]

19) Remove Monitoring and Inspection Role

Proposal 1 does not create an investigatory role for the MDCH. Nor does it permit inspections.

Yet the draft rules envision monitoring by the MDCH that is not provided for in the act. This

draft rule would also have the MDCH notify law enforcement of things like a failure of a patient

to return registry ID cards within 14 days. The law doesn't say that cardholders need to return ID

cards, though, and there's no reason to require this since the department can just have the database

note that the number is no longer associated with a valid card. The draft rule would also have the

department notify law enforcement of a failure to keep marijuana in an enclosed, locked facility.

The department would have no reason to know if marijuana is kept in an enclosed facility, and

only plants are even required to be kept in enclosed, locked facilities. The department is not

responsible for law enforcement functions, and the only aspect that should remain is notifying the

department of falsified applications, which the law specifies the department may do, and which is

information that the MDCH would have reason to encounter.

Suggested revision: Strike current text for Rule 23 (1-5).

Insert: "(1) Pursuant to the act, the department may contact a qualifying patient, primary

caregiver, or a qualifying patient's certifying physician to verify an application.

"(2) Subject to subrule (1) of this rule, the department shall, when it has reason to believe a false

information has been submitted during the registration or registration renewal process, conduct an

investigation, and, if the information was falsified, refer the matter to law enforcement." [Rule 23

(1-5).]

20) The Language About Drug Convictions Must Track the Statute

The draft rules conflict with Proposal 1 by disqualifying patients and caregivers for convictions

that do not disqualify them under the act. The draft rule would disqualify patients and caregivers

for any drug conviction, which would even include a federal marijuana conviction for acts

allowed under state law! Proposal 1 does not disqualify patients for any unrelated drug

conviction, and caregivers are only disqualified for drug felonies. A violation of the medical

marijuana law, such as selling marijuana to a non-patient, could also result in a revocation, but

the department does not have the authority to rewrite the law to exclude bona fide seriously ill

patients based on unrelated convictions.

Recommended revision, from: "Conviction of a misdemeanor or felony offense involving the

manufacture, illegal delivery, or possession of a controlled substance."

To: "If the cardholder is a caregiver, conviction of a felony offense involving the manufacture,

illegal delivery, or possession of a controlled substance." [Rule 25 (1)(c).]

Recommended revision: Strike Rule 25 (1)(d).

Rule 23 (2)(e) also includes this problematic language. Additional problems with that rule are

discussed further down in this memo.

21) The Revocation Portion Needs to Be Revised

Rule 25 provides that a card may be revoked for violations of Proposal 1. But most of the grounds

for revocation don't say who will determine if the act was violated or based on what evidence.

The grounds for revocation should only be grounds if a court of law has determined the act was

violated in those ways.

Recommended revision, from: "Undertaking any task under the influence of marihuana, when

doing so would constitute negligence or professional malpractice."

To: "Loss of a civil lawsuit for undertaking any task under the influence of marihuana, when

doing so would constitute negligence or professional malpractice." [Rule 25 (1)(e).]

Recommended revision, from: "Smoking marihuana on public transportation or in a public

place."

To: "A criminal conviction for smoking marihuana on public transportation or in a public place."

[Rule 25 (1)(g).]

22) Caregivers and Patients Must Not Be Required to Disclose Their Grow Location

Proposal 1, like most medical marijuana laws, did not require patients to register a grow site, nor

did it provide cards for grow sites. It is not reasonable for rules to require a patient or caregiver to

disclose the location where they would cultivate. It is not entirely clear from the draft rules that

the location would have to be disclosed, but it suggests it would. In addition, some patients may

cultivate marijuana in different rooms of their house to stagger the harvest, which may be

necessary to ensure a steady supply of their medicine. Some may also try cultivating different

strains at different locations on their property. Having a grow card indicates cardholders could

only grow on one location, and it could create problems. References to a grow site and card must

be stricken. Instead, patients wishing to have documentation by their plants can photocopy their

ID card and keep it with their marijuana plants.

Recommended revision: Strike all references to grow locations, in Rule 29, Rule 11 (3), and Rule

13 (4).


On December 5, the Michigan Department of Community Health (MDCH) issued draft rules for Michigan's new medical marijuana law, Proposal 1. The draft rules go much further than the department's role under Proposal 1 and in several areas conflict with it. The MDCH has a comment period, and based on the comments will consider revising the rules. We need your help to make sure they do.

Please take the time to write and submit a comment urging the MDCH to bring the rules in line with the law. Be sure to be respectful and polite in your letters, which are due by 5:00 p.m. on January 9.

Proposal 1 tasked the MDCH with issuing state registry ID cards to qualifying patients, which will protect them from arrest. It gave the MDCH authority to issue rules about processing applications, adding additional qualifying conditions, and setting fees. But these draft rules go much further and seek to rewrite new and unreasonable requirements into the voter-enacted law. Here are some of the provisions of the draft rules that conflict with Proposal 1 and need to be revised:

The draft rules would require patients and caregivers to submit inventory reports on their marijuana cultivation each year. The law does not require any such records, and the department does not have the authority to require them. Inventory reports would be self-incriminating since they would document violations of federal law.

The draft rules indicate that all marijuana must be kept in an enclosed locked facility, when the law only requires that marijuana plants be stored in an enclosed, locked facility. There is no similar restriction for potentially deadly medications like prescription morphine, oxycontin, or methamphetamine.

The draft rules provide for monitoring, inspections, and reporting by the department that is not provided for in the act.

The draft rules seek to define a "public place" where marijuana cannot be used to include anywhere "visible to the public." This could include a front porch or the inside of a patient's house, if the patient is near the window.

Click here for a longer list of draft rules that need revision.
The MDCH will also be holding a public hearing on January 5 at 9:00 a.m. in Lansing. Please let me know at [email protected] if you are interested and able to attend. It is particularly important that qualifying patients, doctors, and attorneys speak out at the hearing. If you are able to attend, please remember to be respectful and polite and to dress appropriately for a government hearing.

Thank you for supporting the Marijuana Policy Project. Please pass this message on to other supporters of Proposal 1 so we can ensure that the law is implemented faithfully.

Sincerely,

Karen O'Keefe
Director of State Campaigns
Marijuana Policy Project

[xcrispi]

Sweet man ,
I asked that the Administration - MODS - Sundance would add Michigan as 1 of the med states here so I could post this myself in the appropriate place along w/ the info needed so ppl. could write BITCH letters and try to counter this nonsense .

The thread got nuked w /o explanation ?????????
WHAT THE FUCK !!!!! ??????

Crispi :mad:

Good lookin out Marc . :thumbsup:

[painretreat]

As in California--we are battling a lot of the same things! Fortunately, we have groups that are growing and getting it done!

Just keep posting it, as you have! And Bumping the thread to keep it alive and get people involved. This is where is is hard not to be able to PM and get a Lansing club going. Ours, advertise's locally, as much as we contribute to do it!

Guess we need 'BAKE' sells and car wash's!

I don't know if this will help. The head of our group and person trying to get our face to face meeting's, etc. is Lanny (a not for profit group and legit) at (760) 799-2055. I am sure he would talk to you and help you get your group to grow and be as active as ours. He is on the radio and T.V. Since, the main group is in my childhood and early adult year stomping grounds, I know many people around there. When I feel more secure about it, I will go on T.V. with my story, etc. Numbers help and you need committees, etc. Lanny might be of help. Good luck! Nice to see you so compassionate about it! P/R :thumbsup:

You need people in the medical community involved with passion and time!
Admire your diligence Markass and Crispi!!! P/R!

[TurboALLWD]

Sweet man ,
I asked that the Administration - MODS - Sundance would add Michigan as 1 of the med states here so I could post this myself in the appropriate place along w/ the info needed so ppl. could write BITCH letters and try to counter this nonsense .

The thread got nuked w /o explanation ?????????
WHAT THE FUCK !!!!! ??????

Crispi :mad:

Good lookin out Marc . :thumbsup:

I'll be the second to say, WHAT THE FUCK!!!! ??

How ironic, you know, with this being a marijuana website and all.

Wait, now i remember, their holding off on putting up Michigan because they want to wait until it goes into effect. Maybe they have a good reason, but honestly, whats better than having this thread and others on this subject easily viewable so Michigan doesn't take two steps back after legalizing? Stupid. Stupid. STUPID.

[easy_e]

yeah i kinda figured congress would kill it. Hadn't heard anything since it got voted in so figured the idea got trashed by state lawmakers.

[Markass]

yeah i kinda figured congress would kill it. Hadn't heard anything since it got voted in so figured the idea got trashed by state lawmakers.

It's the michigan department of community health that's in charge of this I do believe...And there have been revisions made to their revisions and those were sent to them:

DEPARTMENT OF COMMUNITY HEALTH



DIRECTORâ??S OFFICE



MICHIGAN MEDICAL MARIHUANA



GENERAL RULES



Filed with the Secretary of State on



These rules become effective on April 4, 2009.



(By authority conferred on the director of the department of community health by section 5 of initiated law 1 of 2008, MCL 333.26421 and executive reorganization order numbers 1996-1, 1996-2 and 2003-1, MCL 330.3101, MCL 445.2001 and MCL 445.2011)



Draft February 12, 2009



R 333.101, R 333.103, R 333.105, R 333.107, R 333.109, R 333.111, R 333.113, R 333.115, R 333.117, R 333.119, R 333.121, R 333.123, R 333.125, R 333.127, R 333.131, and R 333.133 are added to the Administrative Code.



R 333.101 Definitions.

Rule 1. As used in these rules:

(1) "Actâ?� means the Michigan medical marihuana act, Initiated Law 1 of 2008, MCL 333.26421.

(2) "Applicant" means a qualifying patient applying for a medical marihuana registry identification card on a form provided by the department of community health.

(3) "Code" means 1978 PA 368, MCL 333.1101.

(4) â??Convictionâ?� or â??convictedâ?� means a criminal conviction of an offense by a guilty verdict from a judge or jury, plea of guilty, or plea of no contest.

(5) "Debilitating medical condition" means 1 or more of the following:

(a) Cancer, glaucoma, positive status for human immunodeficiency virus, acquired immune deficiency syndrome, hepatitis C, amyotrophic lateral sclerosis, Crohnâ??s disease, agitation of Alzheimer's disease, nail patella, or the treatment of these conditions.

(b) A chronic or debilitating disease or medical condition or its treatment that produces, for a specific patient, 1 or more of the following: cachexia or wasting syndrome; severe and chronic pain; severe nausea; seizures, including but not limited to those characteristic of epilepsy; or severe and persistent muscle spasms, including but not limited to those characteristic of multiple sclerosis.

(c) Any other medical condition or treatment for a medical condition approved by the department pursuant to a petition submitted under R 333.133.

(6) "Department" means the department of community health.

(7) â??Enclosed, locked facilityâ?� means a closet, room, or other enclosed area equipped with locks or other security devices that permit access only by a registered primary caregiver or registered qualifying patient.

(8) â??Marihuanaâ?� means that term as defined in section 7106 of the code.

(9) "Medicaid health plan" means the medical assistance program managed by the department.

(10) â??Medical useâ?� means the acquisition, possession, cultivation, manufacture, use, internal possession, delivery, transfer, or transportation of marihuana or paraphernalia relating to the administration of marihuana to treat or alleviate a registered qualifying patientâ??s debilitating medical condition or symptoms associated with the debilitating medical condition.

(11) â??Paraphernaliaâ?� means any item defined as â??drug paraphernaliaâ?� pursuant to section 7451 of the code.

(12) "Parent or legal guardian" means the custodial parent or legal guardian with responsibility for health care decisions for a qualifying patient who is under 18 years of age.

(13) â??Petitionâ?� means a written request for the department to add new medical conditions or treatments to the list of debilitating medical conditions under R 333.101(5).

(14) â??Physicianâ?� means an individual licensed as a physician under part 170 or 175 of the code. For purposes of the act, neither a physician assistant nor a nurse practitioner is authorized to sign the statement attesting to the patientâ??s debilitating medical condition.

(15) "Primary caregiver" means a person who is at least 21 years old and who has agreed to assist with a patientâ??s medical use of marihuana and who has never been convicted of a felony involving illegal drugs.

(16) â??Public placeâ?� means a place open to the public.

(17) â??Qualifying patientâ?� means a person who has been diagnosed by a physician as having a debilitating medical condition.

(18) â??Registry identification cardâ?� means a document issued by the department that identifies a person as a registered qualifying patient or registered primary caregiver.

(19) â??Supplemental Security Incomeâ?� means the monthly benefit assistance program administered by the federal government for persons who are age 65 or older, or blind, or disabled and who have limited income and financial resources.

(20) â??Usable marihuanaâ?� means the dried leaves and flowers of the marihuana plant, and any mixture or preparation thereof, but does not include the seeds, stalks, and roots of the plant.

(21) â??Visiting qualifying patientâ?� means a patient who is not a resident of this state or who has been a resident of this state for less than 30 days.

(22) â??Written certificationâ?� means a document signed by a physician stating the patientâ??s debilitating medical condition and stating that, in the physicianâ??s professional opinion, the patient is likely to receive therapeutic or palliative benefit from the medical use of marihuana to treat or alleviate the patientâ??s debilitating medical condition or symptoms associated with the debilitating medical condition.

(23) Terms defined in the act have the same meanings when used in these rules.

R 333.103 New registration application; qualifying patient and primary caregiver.

Rule 3. A qualifying patient applying for a registry identification card shall comply with all of the following:

(a) Submit a completed application on a form provided by the department, together with the requisite fee. The completed application shall include all of the following:

(i) Name, address, and date of birth of the qualifying patient. The address for the qualifying patient shall be a physical address located in this state. A qualifying patient who is homeless shall not be required to provide a physical address.

(ii) Name, address, and telephone number of the qualifying patientâ??s physician.

(iii) The name, address, and date of birth of the patientâ??s primary caregiver, if applicable. A qualifying patient may designate 1 primary caregiver to assist with his or her medical use of marihuana.

(iv) A designation of whether the qualifying patient or the patientâ??s primary caregiver, if applicable, will be allowed to possess marihuana plants for the qualifying patientâ??s medical use.

(v) An attestation by the primary caregiver named on the application that he or she agrees to serve as the patientâ??s primary caregiver.

(vi) A primary caregiver shall authorize the department to use the information provided on the application to secure his or her criminal conviction history to determine if he or she has a felony conviction involving illegal drugs.

(b) Submit photographic identification of both the qualifying patient and the patientâ??s primary caregiver, if applicable. If the qualifying patient is under the age of 18 and does not have photographic identification, no photographic identification is required. Photocopies of the following shall be considered acceptable forms of identification:

(i) Current driver's license or identification card, with photo, issued by a state.

(ii) Identification card with photo issued by a federal, state, or government agency.

(iii) Current military identification card.

(iv) Current passport.

(v) Current student identification card with photo.

(vi) Native American tribal identification with photo

(vii) Permanent resident card or alien registration receipt card.

(c) Submit a written certification, as defined in R 333.101(22), signed by a licensed physician. If the qualifying patient is under the age of 18, written certifications from 2 physicians are required.

(d) If the qualifying patient is under the age of 18, submit a declaration of person responsible form.



R 333.105 Declaration of person responsible form.

Rule 5. A declaration of person responsible form is required for any qualifying patient who is under the age of 18. The form shall include all of the following:

(a) A statement that the qualifying patientâ??s physician has explained to the patient and the patientâ??s parent or legal guardian the potential risks and benefits of the medical use of marihuana.

(b) Consent of the qualifying patientâ??s parent or legal guardian to allow the qualifying patientâ??s medical use of marihuana.

(c) Consent of the qualifying patientâ??s parent or legal guardian to serve as the patientâ??s primary caregiver and to control the acquisition, dosage, and frequency of use of the marihuana by the patient.



R 333.107 Incomplete application.

Rule 7. If an applicant fails to provide the information required under R 333.103 or R 333.105, as applicable, the application shall be denied. The department shall notify the applicant of the information that is missing in the event the applicant wishes to reapply. An applicant may reapply at any time.



R 333.109 Verification of information.

Rule 9. The department shall verify the information contained in an application and the accompanying documentation, which may include, but is not limited to, the following:

(a) Contacting each applicant by telephone or by mail. If proof of identity cannot be determined with reasonable reliability, the department may require the production of additional identification materials.

(b) Contacting the parent or legal guardian of a qualifying patient who is under the age of 18.

(c) Verifying that a physician is licensed to practice in the state.

(d) Contacting the certifying physician directly to confirm the validity of the written certification.



R 333.111 Fees; reduced fees; renewal.

Rule 11. (1) The fee for a new or renewal application is $100.00, unless a qualifying patient can demonstrate his or her current enrollment in the Medicaid health plan or receipt of current Supplemental Security Income benefits, in which case the application fee is $25.00. To qualify for a reduced fee, an applicant shall satisfy either of the following requirements:

(a) Submit a copy of the qualifying patientâ??s current Medicaid health plan enrollment statement.

(b) Submit a copy of the qualifying patientâ??s current monthly Supplemental Security Income benefit card, showing dates of coverage.

(2) The department shall deny the application of a qualifying patient who submits a reduced fee for which he or she is not eligible and shall notify the qualifying patient of the application denial. A qualifying patient may resubmit the correct fee with his or her qualifying documentation at any time.

(3) The fee for a revised or duplicate copy of the registration identification card for the qualifying patient or the primary caregiver is $10.00. If a duplicate card is requested, the qualifying patient or primary caregiver shall submit to the department the fee with a statement attesting to the loss or destruction of the card.



R 333.113 Registration approval; denial.

Rule 13. (1) Pursuant to section 6(c) of the act, the department shall approve or deny an application within 15 days of receiving a completed application and the requisite fee.

(2) If an application is approved, within 5 days of approving the application, the department shall issue a registry identification card to the registered qualifying patient and the registered primary caregiver, if applicable. The registry identification card shall include all of the following:

(a) The name, address, and date of birth of the registered qualifying patient.

(b) If the registered qualifying patient has designated a primary caregiver, the name, address, and date of birth of the registered primary caregiver.

(c) The issue date and expiration date of the registry identification card.

(d) A random and unique identification number.

(e) A clear designation showing whether the registered primary caregiver or the registered qualifying patient will be authorized to possess marihuana plants for the registered qualifying patientâ??s medical use. The designation shall be determined based solely on the registered qualifying patientâ??s preference.

(3) When a registered qualifying patient has designated a primary caregiver, the department shall issue a registry identification card to the registered primary caregiver. The registered primary caregiverâ??s registry identification card shall contain the information specified in subrule (2) of this rule, as appropriate.

(4) The department shall deny an application for any of the following:

(a) The applicant did not provide the physicianâ??s written certification.

(b) The department determines that any information provided by the applicant was falsified.

(c) An applicant fails to provide a physical address located in this state. This provision shall not apply if the applicant is homeless.

(d) The applicant failed to meet the requirements of R 333.107.

(5) If the department denies an application, the department shall mail the applicant a denial letter within 15 days of receipt of the completed application. The denial letter shall be sent by certified mail to the address listed on the application form and shall state the reasons for denial and when the applicant may reapply.

(6) Denial of a registry identification card shall be considered a final department action, subject to judicial review.



Rule 333.115 Primary caregiver; number of qualified patients; compensation.

Rule 15. (1) The department shall issue a registry identification card to the primary caregiver, if any, who is named in a qualifying patientâ??s approved application. A registered primary caregiver may assist not more than 5 qualifying patients with their medical use of marihuana.

(2) A registered primary caregiver may receive compensation for costs associated with assisting a registered qualifying patient in the medical use of marihuana. Any such compensation shall not constitute the sale of a controlled substance.



R 333.117 Annual renewal; expiration of registry identification card; fee.

Rule 17. (1) Pursuant to section 6(e) of the act, a registry identification card shall be renewed on an annual basis to maintain active status as a registered qualifying patient or a registered primary caregiver.

(2) A registry identification card shall expire on the first day of the month 1 year following issuance of the card.

(3) An applicant for renewal of a registry identification card shall submit an application and information as provided in R 333.103(a), (c) and (d).

(4) If an applicant fails to comply with subrules (1) and (3) of this rule by the expiration date on the registry identification card, the registry identification card shall be considered null and void and of no further effect. The applicant may submit a new application to the department.

(5) The department shall verify the renewal application information in the same manner as specified in R 333.109.



R 333.119 Changes in status; notifications; requirements.

Rule 19. (1) In order to update registry information for a qualifying patient or primary caregiver, the registered qualifying patient, registered primary caregiver, or registered qualifying patientâ??s parent or legal guardian, as applicable, is responsible for notifying the department of a change in any of the following:

(a) The registered qualifying patient's name.

(b) The registered qualifying patientâ??s address.

(c) The registered qualifying patientâ??s primary caregiver.

(d) The registered qualifying patientâ??s legal guardian.

(2) The department may notify a registered primary caregiver by certified mail at the address of record within 14 days of any changes in status including, but not limited to, both of the following:

(a) The registered qualifying patientâ??s termination of the individualâ??s status as primary caregiver or designation of another individual as the registered primary caregiver.

(b) The end of eligibility for the registered qualifying patient to hold a registry identification card.

(3) If the department is notified by a registered qualifying patient that the registered primary caregiver for the patient has changed, the department may notify the initial primary caregiver by certified mail at the address of record that the caregiverâ??s registry identification card is null and void and of no effect.

(4) If a registered qualifying patientâ??s certifying physician notifies the department in writing that the patient has ceased to suffer from a debilitating medical condition, the department shall notify the patient within 14 days of receipt of the written notification that the patientâ??s registry identification card is null and void and of no effect.



Rule 333.121 Confidentiality.

Rule 21. (1) Except as provided in subrules (2) and (3) of this rule, Michigan medical marihuana program information shall be confidential and not subject to disclosure in any form or manner. Program information includes, but is not limited to, all of the following:

(a) Applications and supporting information submitted by qualifying patients.

(b) Information related to a qualifying patientâ??s primary caregiver.

(c) Names and other identifying information of registry identification cardholders.

(d) Names and other identifying information of pending applicants and their primary caregivers.

(2) Names and other identifying information made confidential under subrule (1) of this rule may only be accessed or released to authorized employees of the department as necessary to perform official duties of the department pursuant to the act, including the production of any reports of non-identifying aggregate data or statistics.

(3) The department shall verify upon a request by law enforcement personnel whether a registry identification card is valid, without disclosing more information than is reasonably necessary to verify the authenticity of the registry identification card.

(4) The department may release information to other persons only upon receipt of a properly executed release of information signed by all individuals with legal authority to waive confidentiality regarding that information, whether a registered qualifying patient, a qualifying patient's parent or legal guardian, or a qualifying patientâ??s registered primary caregiver. The release of information shall specify what information the department is authorized to release and to whom.

(5) Violation of these confidentiality rules may subject an individual to the penalties provided for under section 6(h)(4) of the act.



Rule 333.123 Complaints.

Rule 23. The department shall refer criminal complaints against a registered qualifying patient or registered primary caregiver to the appropriate state or local authorities.



R 333.125 Revocation; nullification.

Rule 25. (1) A registered qualifying patient or registered primary caregiver who has been convicted of selling marihuana to someone who is not allowed to use marihuana for medical purposes under the act, shall have his or her registry identification card revoked and may be found guilty of a felony punishable by imprisonment for not more than 2 years or a fine of not more than $2,000.00, or both, in addition to any other penalties for the distribution of marihuana.

(2) A registry identification card that is later determined to be based on fraudulent information is null and void and of no effect.

(3) Any person who has been convicted of a felony involving illegal drugs shall not serve as a qualifying patientâ??s primary caregiver under the act.

(4) The department shall send written notice by certified mail to a registered qualifying patient or the patientâ??s registered primary caregiver of any of the following:

(a) An intent to revoke or nullify a registry identification card.

(b) That a primary caregiver no longer qualifies for approval under the act based on a felony drug conviction.

(5) The notice referenced in subrule (4) of this rule shall include the right to request a contested case hearing. If the request for hearing is not filed with the department within 21 days from the date the notice was mailed by the department, the right to request a contested case hearing shall be waived.



Rule 333.127 Management of medical marihuana.

Rule 27. (1) A qualifying patient who has been issued and possesses a registry identification card shall not be subject to arrest, prosecution, or penalty in any manner, or denied any right or privilege, including but not limited to civil penalty or disciplinary action by a business or occupational or professional licensing board or bureau, for the medical use of marihuana in accordance with the act, if the qualifying patient possesses an amount of marihuana that does not exceed the following:

(a) Two and one-half (2.5) ounces of usable marihuana.

(b) If the qualifying patient has not specified that a primary caregiver will be allowed under state law to cultivate marihuana for the qualifying patient, 12 marihuana plants kept in an enclosed, locked facility.

(c) Any incidental amount of seeds, stalks, and roots.

(2) A primary caregiver who has been issued and possesses a registry identification card shall not be subject to arrest, prosecution, or penalty in any manner, or denied any right or privilege, including but not limited to civil penalty or disciplinary action by a business or occupational or professional licensing board or bureau, for assisting a qualifying patient to whom he or she is connected through the departmentâ??s registration process with the medical use of marihuana in accordance with the act, if the primary caregiver possesses an amount of marihuana that does not exceed the following:

(a) Two and one-half (2.5) ounces of usable marihuana for each registered qualifying patient to whom he or she is connected through the departmentâ??s registration process.

(b) For each registered qualifying patient who has specified that the primary caregiver will be allowed under state law to cultivate marihuana for the qualifying patient, 12 marihuana plants kept in an enclosed, locked facility.

(c) Any incidental amount of seeds, stalks, and unusable roots.

(3) An individual may simultaneously be registered as a qualifying patient and as a primary caregiver.



Rule 333.131 Review panel for reviewing petitions for additional medical conditions or treatments.

Rule 31. (1) The department shall appoint a panel of not more than 15 members to review petitions to add medical conditions or treatments to the list of debilitating medical conditions under R 333.101 (5). A majority of the panel members shall be licensed physicians, and the panel shall provide recommendations to the department regarding whether the petitions should be approved or denied.

(2) Members of the review panel shall include, but not be limited to, the Michigan chief medical executive and 7 appointed members of the advisory committee on pain and symptom management as described in MCL 333.16204a. The 7 review panel members from the advisory committee on pain and symptom management shall include 4 licensed physicians and 3 non-physicians.

(3) The department shall provide staff support to the review panel to assist with the scheduling of meetings, conference calls, dissemination of petition-related materials, and to perform other administrative duties related to the performance of the panelâ??s review.

(4) A quorum of the review panel shall concur with the recommendation in order to be considered an official recommendation of the panel. For the purposes of this subrule, a majority of the members appointed and serving on the review panel constitutes a quorum.



Rule 333.133 Petition to add qualifying diseases or medical conditions; review panel; recommendations.

Rule 33. (1) The department shall accept a written petition from any person requesting that a particular medical condition or treatment be included in the list of debilitating medical conditions under R 333.101.

(2) The department shall submit the written petition to the review panel. Within 60 days of receipt of the petition, the panel shall make a recommendation to the department regarding approval or denial of the petition.

(3) Upon receipt of a recommendation from the review panel, the department shall do all of the following:

(a) Post the panelâ??s recommendations on the departmentâ??s website for public comment for a period of 60 days.

(b) Give notice of a public hearing not less than 10 days before the date of the hearing.

(c) Hold a public hearing within the 60-day time period that the recommendation from the panel is posted on the departmentâ??s website.

(4) After a public hearing, the department shall forward comments made during the hearing to the panel for review. If, based on a review of the comments, the panel determines that substantive changes should be made to its initial recommendation, the petition shall be denied, the department shall provide the petitioner with a copy of the initial recommendation and an explanation of the substantive changes, and the petitioner may resubmit the petition to the department at any time. If no changes are made to the initial recommendation or the changes are minor and do not affect the general content of the recommendation, the department shall forward the recommendation to the department director for a final determination on the petition.

(5) Within 180 days of the date the petition is filed with the department, the department director shall make a final determination on the petition. The approval or denial of the petition shall be considered a final department action subject to judicial review under the act.

(6) If the petition is approved, the department shall create a document verifying the addition of the new medical condition or treatment to the list of debilitating medical conditions identified under R 333.101. Until such time as these rules are amended to officially recognize the medical condition as a qualifying debilitating medical condition, the department shall develop a policy that allows the new medical condition to be used as a qualifier for a registry identification card.