Proposed changes to the state’s medical marijuana program do not address problems that hamper people from registering for the program, according to patients and advocates who testified Tuesday at a crowded public hearing in Boston.
The proposals are part of a larger initiative by the Baker administration to review and update all state regulations, according to the Massachusetts Department of Public Health, which oversees the marijuana program.
But advocates, who praised some of the proposals, said the department has ignored more vexing issues that have plagued the marijuana program. They said the online system for registering — a requirement to shop in marijuana dispensaries — is so cumbersome that many patients, particularly older patients who are not computer savvy, get discouraged and quit.
“Streamline the registration process, not just for the department, but for terminally ill hospice patients who cannot plunge through pages of bureaucracy and then wait three to six weeks for a plastic card to arrive in the mail,” said Nichole Snow, executive director of the Massachusetts Patient Advocacy Alliance.
Hobbled by missteps when it was created four years ago, the program has grown considerably since then, with more than 38,000 registered patients and nine open dispensaries, according to the latest state data.
But patient advocates say recent action by state lawmakers to delay the likely opening date for recreational marijuana stores in Massachusetts by half a year, from January to July 2018, creates urgency for regulators to fix problems in the medical marijuana program.
“The process for a patient to actually access their medicine can take weeks or months from the time I write a recommendation, and that is unacceptable,” said Dr. Uma Dhanabalan, a Natick physician who specializes in marijuana treatment. State rules require patients to receive a written recommendation from a physician to be eligible to register for the program.
Advocates said the department’s online registration system requires patients to enter information and click through roughly two dozen pages to complete the process. It also requires patients to have a government-issued identification card, such as a driver’s license or passport, something many older patients who no longer drive do not have, they said.
“We have patients coming into our office in tears, needing help navigating the state’s registration system,” said Kathleen McKinnon, director of operations at Canna Care Docs, a company with eight Massachusetts locations that specialize in screening and approving patients for marijuana use.
Tom Lyons, a spokesman for the Department of Public Health, said the current waiting time is about two weeks from when a patient completes the registration process and is issued a card for entry into the program.
“We’ll take this feedback and look to see if we can make changes to improve patient access while at the same time balance public safety concerns,” he said.
One proposed rule change that drew sharp criticism would require independent laboratories in Massachusetts to only test marijuana for dispensaries, and not individuals. That action that would shut out patients who might want to have their purchases screened to ensure they are not tainted with mold or other contaminants, advocates said.
Dispensaries are required to have their products screened by independent laboratories to ensure purity. But some patients still buy their marijuana on the street, or grow their own, which is allowed under state rules if a patient can prove that transportation to a dispensary is onerous because of a physical ailment.
Michael Kahn, president of MCR Labs in Framingham, said labs should be able to provide services directly to patients.
“Hardship cultivation patients really need to test whether they are producing something that is safe,” Kahn said.
He told regulators about cases in which patients have produced marijuana-infused edible products on their own, thinking they contained a certain level of THC, the psychoactive ingredient in marijuana, only to find out later the product contained 10 times that amount.
“I do consider it a threat to public health,” to deny people access to these services, Kahn said.
Advocates said other proposed changes in the rules would improve patient access. The rules would allow nurse practitioners to certify patients for marijuana use, similar to the way such nurses already write prescriptions for other medicines.
Now, only physicians can certify patients for medical marijuana use.
The proposed rules would also allow Massachusetts dispensaries for the first time to post prices of products on their websites, which means patients could comparison shop.
The proposals also include a provision permitting dispensaries to deliver products to patients in nursing homes, hospices, and other health facilities. Currently, dispensaries can make deliveries only to patients’ homes.