High fees hobble California marijuana ID card program

More patients favor cheaper local cards, or just doctor's recommendations
by John Simerman, San Jose Mercury News
December 13th, 2010

A flurry of competing ads touting low-cost medical marijuana evaluations shouts the obvious: California is awash in pot patients. By some estimates, they number as many as 350,000.

Yet only a tiny fraction has signed on to a state ID card program meant to protect them from arrest or seizure of their weed. That doesn't appear likely to change, say marijuana advocates, patients and some county health officials who administer the program locally. Not when the cost of the cards can't compete with privately issued cards or even doctors' recommendations. When the state created the program in 2003 and launched it two years later, officials figured 100,000 patients would sign on for the optional cards. But the state issued just 12,659 to patients and caregivers last fiscal year, the first time virtually the entire state participated in the program after several counties held out over legal challenges.

Three years earlier, when only 28 counties participated, the state issued 10,274 cards. State cards issued in Contra Costa County rose this year, but other Bay Area counties have seen a slide. San Francisco, which issues more of the state ID cards than anywhere else does, has seen a nearly 30 percent decline in three years, while the number of state cards issued in Alameda County dropped nearly 60 percent.

The culprits: high cost and low need.

Alameda County first tried to insist that pot dispensaries accept only patients bearing the state card, but the county determined it could not legally require it, since Proposition 215, which legalized medical marijuana in California in 1996, requires only a doctor's recommendation.

In 2007, the state raised its card fee from $13 to $66, saying the program needed to pay for itself. The counties add their own fees, raising the price for cards that must be renewed annually.

Alameda and San Francisco counties charge $103, including the state fee. The cost is $120 in Contra Costa. Medi-Cal patients pay half as much.

Add a general mistrust of handing personal information to the government, and for many patients the cards aren't worth it, said Pam Willow, who oversees the card program for Alameda County.

"The kind of people who access the state ID card are people who want to dot all the I's and cross all the T's. They tend to skew a little bit older than the general population, a little more conservative," she said.

The same issues arose in San Francisco. The state cards lost their luster in 2008 when the city let pot clubs issue their own, said Dr. Joshua Bamberger, the city's medical director for housing and urban health. They are free at some pot dispensaries there.

"It's really a financial thing. If it's $103 versus less, or nothing, that's pretty straightforward," he said. "There are still people who want the state card. Somebody must think they have greater protection, but I have no evidence "... I don't know why anyone would spend the money now."

Whether the state can justify its $66 fee is unclear. State law allows the program to set fees to cover expenses, which now run $389,000 a year, according to the state agency. Last fiscal year, the agency collected about $740,000 in card fees.

The agency uses the extra revenue to repay a $1.5 million startup loan for the program, said spokesman Matt Conens. Without loan payments, the state could charge $35, or $17.50 for Medi-Cal patients, to cover its expenses, based on the number of cards issued last year.

A request for annual budget and revenue figures for the program, and an accounting of the startup loan payments, went unmet.

One Oakland man, who was handing out a local dispensary's marijuana menu on Broadway, said he couldn't see the benefit of a state card.

"I don't understand the protection the state card is implying, and I just can't afford it. I certainly don't have the extra $100," said Kenny, who declined to give his last name. Instead, he carries a folder with a letter from a medical firm that includes an image of his driver's license and a 24-hour number that law enforcement can call to verify his status.

Others see a value to the state cards. Willow called it "the gold standard in terms of the type of protection you can get from it." She and other health officials, and some marijuana advocates, said highway patrol officers have been specifically instructed to accept the cards, making arrests and seizures less likely.

CHP policy tells officers to accept the state cards, local cards or physicians' written recommendations and, if possible, call the doctor or card issuer to verify the medical recommendation.

"There is not one form of proof that is preferred. The officer is supposed to use his or her best (sound) judgment," said CHP spokeswoman Jaime Coffee

One advantage to the state cards: Officers can plug the card number into the state website to easily verify it. One advocate said the state cards seem to make things easier during traffic stops and other law enforcement contacts.

"We get calls routinely from patients who obtain privately issued cards, and law enforcement regularly refuses to recognize those cards," said Kris Hermes, spokesman for Americans for Safe Access. "Police aren't necessarily recognizing the state-issued ID card either. However, in many more instances, they're refusing to recognize a private card."

Hermes blamed the weak participation on a struggle to get the program started statewide, poor marketing and the rise in cost.

"Ultimately if the purpose is to assist law enforcement and reduce the number of unlawful seizures and arrests, it would make sense to have a well-functioning card system."