Tuesday, December 14, 2010

Notes From The Underground Part (44)

Chapter 94E

Section 1 Says sections 1 thru 10 comprise Massachusetts Medical Marijuana Act

Q* > this will indicate comments or questions I have.

Q* no federal supports threatened inc housing subsidies, section 8 etc?

Section 2 defines
(a) cardholder      Q*fee?

(b) Medical Treatment Center   Q*can a patient be his or her own MTC?
(c) debilitating medical condition
      1. cancer, glaucoma, immunodeficiency+, AIDS, HIV, HepC, ALS, Crohn's,
           agit of alz, nail patella, or treatment of
      2. cachexia, wasting synd, severe pain, severe nausea, seizures i.e. epilepsy,
          muscle spasms incl MS
      3."Any Other"

Q*asthma, AS, fibromyalgia, spinal cord injury, depression, anxiety disorder, PTSD,thyroid, sleep disorders, OCD, ADD & ADHD (child and adult) autism, addiction treatment, harm reduction programs, autoimmune overactive diseases ie lupus? does every disease need to be approved by dept? what merits approval? clinical evidence of efficacy (doctor's observation?)? will anecdotal testimony of patient (reports relief) plus docs approval  be deemed valid by dept or no?

(d) Dept  means Dept of Public Health
(e) Enclosed Locked Facility
(f) Marijuana defined as per Chapter 94C Section 1
(g)Medical use defined
(h) Practitioner 94C Section 18
(i) Primary caregiver

Q* no violent crime record, don't sanction former felons for peaceful use, possession, sale or purchase of MJ or non violent civil disobedience

(j)Qualifying Patient
(k) Usable marijuana
(l) Visiting QP can use valid out of state card for first 30 days in MA
(l)? typo, is this part of (l) or is it (m) Written certification

Chapter 94E Section 3 Protections

Q* Concerns iterated by Norman:
      Registering is tantamount to identifying as a federal felon, so fear of arrest and reluctance to be publicly stigmatized may prevent many qualifying patients from obtaining cards. Can these protections be trusted?

What if patient can't pay?
How will costs be set?
If patient has valid card from out of state why has to register here after 30 days?

(a)QP w/ registry card not subject to arrest etc.
     QP may posses 12 plants & 4 oz usable MJ
(b) schools employers landlords

Q* including HUD, Section 8?

(c) Primary caregiver may posses 12 plants & 4 oz per up to 5 QP

Q* Can one be both a QP and a PC?
   *What is the registration process?

(d) presumption that QP and PC are on the up & up
      (1)possess cards
      (2) within possession amt limits
(e) PC may receive reimbursment for costs
      Q* How are costs determined?

(f) practitioner not subject to arrest for giving written or oral opinion to QP
     that benefits may outweigh risks
(g) paraphenalia protected
(h) bystanders protected
(i) MDs RNs protected speech
(j) out of state cards, valid in MA for 30 days, after 30 days here need MA
(k) No Primary Caregiver or visiting QP other than a MTC shall posses more than 24 plants & 8 0z usable MJ
Q* apparently contradicts 94E Section 3C? or is this in ref only to visitors whose out of  state cards certify possession of amts diff from MA limits? Language unclear!

(l)a registered cardholder or visiting QP may give MJ to another cardholder or a MTC they are not officially connected to thru dept's registration process only if no $ exchanged and if recipient does not exceed 94E Section 3(a) amount limits
(m) QP use of MJ not considered "illicit"

Chapter 94E Section 4 Dept to Issue Regulations

(a) not later than (90) days after the effective date of this chapter. Dept will promulgate Regs in which it shall consider petitions from the public to add more medical conditions. After hearing dept has 180 days to approve or deny petitions. If denied, petition goes for review in superior court. denied person may raise defense

Q* awful awful awful oppressive and awful. medical treatment decision must remain twixt patient and doctor, not at the mercy of dept or costly time consuming court system. awful. clean up earlier language to specify and protect that right of patient & doc and dont assume this much power belongs to the dept. 

(b)not later than 90 days dept must show regs for how it'll register & bestow cards set fees... (fees?)

Q* can language of this bill specify these details so that things arent held up for 90 days plus after passage of law? what if we don't sit well w/ the way they do registration or disagree with fee rates? how long would these arbitrarily set regs take to contest?

fees generate revenues to offset the cost of registering people.

Q* so this is a program to generate the money to pay for itself? is there a simpler approach? cost cutting strategies? I'd like to see  actual cost determined ahead of time and accountability assured for  how the collected fees get spent. This delicate detail of the bill needs to be a model of accountability and transparency and fairness in govt.  and not an excuse after law passes for beaurocratic bogdown.

Dept. "may" use sliding scale

Q* Dept had jolly well better use sliding scale, as well as free option for Mass health and Medicaid patients

Dept may take donations from private sources to reduce the fees

Q* again, must be accountable, maybe public website that publishes all this monetary info? Donor may choose to remain anonymous but may public know what revenues are generated, from what sources and and how they get used?

Would the Dept demonstrate ethical leadership and use this bill to innovate public access to its bookkeeping, to account openly and in good faith to the public for its MMJ revenues, improving MA citizens' assurance of govt agency revenue accountability ? Would they post revenue stats and donation figures to a public health website?

(Am I asking a lot? Too much? freedom of info? I'd really like to know how much money is generated by this system and have a means, right on the Dept website enabling MMJ card carriers  to participate and vote on  how the revenues generated get spent, as well as assurance that the money really gets to where it is allocated by this excercise of direct democracy. This would be taxation* with* representation, a fundamental Dan'l Shays style post-revolutionary era principle of American rights I believe I am iterating.) 

Chapter 94E Sec 5

(a)dept will issue cards to QPs who submit
     1.written cerification as per 94E Sec2(i)
     2.Application or renewal fee
     3.Name, address, DOB unless homeless, no addy req'd (cool!)
     4.Name address & phone# of QP's practitioner
     5. Name address DOB of each PC of the QP if any
(b) No card if under 18 unless
     1.practitioner explains risks vs benefits to patient's parent or guardian
     2.par or guar gives written consent to
        (i)allow QP's use
        (ii)serve as one of QP's PCs
        (iii)control over patient's acquisition dosage etc...
             Q* seems good but par or guar must understand dosage requirement may best be determined subjectively by patient's sense of well being.. should be no such thing as saying to a kid you haven't taken enough medicine or you have to wait if young patient feels need to medicate more than parent deems sufficient. seems like one for child rights advocates...

(c) dept will verify info approve or deny within 15 days.
(d) dept can register up to 2 caregivers per QP
(e) card must be issued within 5 days of approval expires in 2 yrs
      Registry ID cards contain
     (1)Date of issuance and expiration date
     (2) Random Number
     (3)photo if dept decides to require
Q*why? no photo on Mass Health or foodstamp EBT cards

     (4) any addtl info required by regs or Dept
(f) card carrying QP must
     (1)notify of changes within 10 days
     (2) failure to notify punishable up to $150 if debilitating condition improves card null and void p becomes subject to penalties like non med user

Q* steep fine! too maybe not patient's job but physician's job to report significant improvement, also to determine whether patient may continue to benefit from use of MMJ upon improving, so fine doc if he or she is found to be underreporting cures , do not take away meds if patient's chronic condition is improved, would dept have the right to tell a depressive to stop medicating if anti depressants were working and fine him if he refused to quit?
     (3)fines on card carriers who fail to give notice of changes


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