Pubdate: Mon, 30 May 2016
Source: Boston Globe (MA)
Copyright: 2016 Globe Newspaper Company
Contact: http://services.bostonglobe.com/news/opeds/letter.aspx?id=6340
Website: http://bostonglobe.com/
Details: http://www.mapinc.org/media/52
Author: Kay Lazar

MASS. MEDICAL MARIJUANA SHOPS FACE SCRUTINY

Massachusetts regulators are pledging to crack down on medical 
marijuana dispensaries after several shops placed low-income patients 
on waiting lists for discounted products - creating delays that run 
afoul of state law.

A Globe review found that the delays were often months long, 
effectively denying those low-income patients the discounts state 
regulations require for anyone with a verified financial hardship, 
with no cap on the number.

The dispensaries had contended their financial hardship programs were full.

The state Department of Public Health said it will now scrutinize 
dispensary hardship programs as part of the agency's regular 
inspections to make sure they comply with state regulations.

"Any dispensary that is in violation of the state regulations may be 
required to submit a plan of correction," said Scott Zoback, 
spokesman for the department. The statement did not address whether 
violators would face fines, and how or when patients would be 
notified they are no longer on waiting lists.

It remains unclear how many patients had languished on the lists. The 
Health Department has not collected data from the dispensaries on 
their hardship programs, Zoback said.

At least three of the six dispensaries open in Massachusetts were 
using waiting lists, the Globe found.

The issue highlights continued growing pains for the industry, and 
for state regulators, more than three years after Massachusetts 
voters approved marijuana for medical use.

Just six dispensaries have opened, even though state law allowed as 
many as 35 to open in 2013, when the law took effect. Two additional 
dispensaries, in Quincy and Newton, received permission this month to 
start growing marijuana but won't open for months.

More than 160 other applicants are inching their way through the 
regulatory process.

Patients, grateful to finally have a handful of dispensaries in 
business, often don't realize the facilities are required to offer 
discounts, said Nichole Snow, executive director of the Massachusetts 
Patient Advocacy Alliance.

State regulations make discounts available for people on Medicaid, 
elderly or disabled residents who receive Supplemental Security 
Income, or patients whose annual incomes don't exceed $11,880 for one 
person, or $24,300 for a family of four.

The rules do not stipulate the amount of marijuana dispensaries must 
offer at a discount, nor the price reduction, leaving that to each 
company's discretion.

The state's rule requiring discounted marijuana for low-income 
patients is unusual. Massachusetts is one of just three states, 
including New Hampshire and Vermont, and the District of Columbia, 
that require such discounts, according to Americans for Safe Access, 
a Washington, D.C., organization that promotes marijuana for medical use.

Some Massachusetts dispensaries post information about discounts on 
their website, and also gave notice of waiting lists.

New England Treatment Access, known as NETA, operates dispensaries in 
Brookline and Northampton, and the patient handbook posted on its 
dispensary website states that the company reserves the right to 
limit the number of patients enrolled in the financial hardship program.

Workers who recently answered phone calls at both locations said the 
programs were full, and offered a waiting list.

Jeannine Timlin, a 45-year-old Methuen mother of four with Crohn's 
disease, is familiar with NETA's waiting list. Timlin, who is on 
Medicaid, said she applied for the company's hardship program in 
early February, shortly after the Brookline dispensary opened, and 
was told she was placed on a waiting list.

"I have asked them about it three times since then, and each time, 
they tell me I am number 22," Timlin said.

Marijuana, she said, is more effective than her prescription 
medication in easing severe stomach cramps from Crohn's. But the 
price, especially without a discount, runs about $50 for one-eighth 
of an ounce of marijuana at NETA every two weeks, she said.

Timlin said she didn't realize it was illegal for dispensaries to cap 
enrollment in the discount program, and also didn't realize another 
dispensary, Patriot Care in Lowell, opened much closer to her home, 
and reports no waiting lists.

When asked about its waiting lists by the Globe, NETA issued a 
statement saying, "We are immediately removing all patients from the 
waiting list, placing them in the hardship program, and restructuring 
our current hardship program in collaboration with the state."

The company said more than 100 patients were in the hardship program 
at both dispensaries, but was unable to say how many were on waiting lists.

A Brockton dispensary, In Good Health, said it has no waiting lists, 
and offers discounts ranging from 10 to 20 percent for low-income patients.

The executive director of Central Ave Compassionate Care in Ayer, 
John Hillier, declined in a statement to say whether his dispensary 
placed patients on waiting lists.

"Our focus is on building a financially stable operation that is able 
to serve all the registered patients dependent upon us, including 
those who do not qualify for the program," he said.

Alternative Therapies Group in Salem, the first dispensary to open 
last June, had a waiting list but stopped May 2, according to its 
executive director, Christopher Edwards.

In a notice to patients, Edwards said the waiting list allowed the 
company to offer "meaningful discounts ranging from 20 to 50 
percent," but that state regulators adopted a "slightly different 
legal interpretation," and determined the lists were no longer allowed.

Now, he said, the dispensary will offer low-income patients discounts 
of just 10 percent, but those who were already approved for larger 
discounts will receive them for the remainder of their one-year contract.

Even as Alternative Therapies placed patients on waiting lists for 
months, state regulators last fall started alerting applicants for 
dispensary licenses that capping enrollment in discount programs is prohibited.

Alternative Therapies had proposed waiting lists when it applied in 
September to open two more dispensaries.

Companies can spend hundreds of thousands of dollars on dispensary 
licensing fees and construction, and were concerned patient hardship 
programs would sap profits.
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MAP posted-by: Jay Bergstrom