Access to Medical Marijuana for Low Income Patients

A Memo by John Sajo to the Patient Access Subcommittee of the Oregon Cannabis Commission

From: John Sajo

This committee is charged with recommending changes that will ensure that low income patients have safe affordable access to medical marijuana products that will benefit their health. Oregon voters legalized marijuana four years ago and access to reliable, tested marijuana products for adults has been established. At the same time access to marijuana has become harder for thousands of patients who cannot afford to shop at OLCC regulated stores.

For twenty years the Oregon Medical Marijuana Program has relied on patients designating growers who provided them with free or inexpensive marijuana. This program has successfully provided free medicine worth millions of dollars to patients, at no expense to taxpayers. At its peak a few years ago 77,000 patients were served by a combination of designated growers and OHA regulated medical dispensaries, who were supplied by designated growers. Fees paid by these designated growers also generated $25.2 million dollars in revenue for OHA over the prior two bienniums. The tax collected at OLCC stores may raise $80 million this year but the revenue from OMMP growers is disappearing as growers drop out from over regulation.

The number of registered OMMP patients has dropped to 39,000. Surveys are necessary to fully understand why patient registrations have plummeted, but it is likely because patients have lost their designated grower who couldn’t keep up with increasing fees and red tape. The drop in patient registrations followed the source of the marijuana supply shifting from OMMP growers to OLCC producers. There is plenty of marijuana in inventory in Oregon (over 1 million pounds) but apparently it is no longer going to low income patients.

The remaining OMMP gardens that supply low income patients are under threat. Four years of statutory and administrative rule changes have made it almost impossible for the gardens that supported these patients to continue. There are now only 700 OMMP growsites growing for more than two patients. Most of these gardens will drop out in the next year unless rules are streamlined. Many of these growers hoped to recover some of their garden expenses by being able to sell up to twenty pounds into the OLCC system but water rights requirements and other hurdles have blocked any of these gardens from selling any of their excess to recoup expenses. Without a legitimate way to cover garden expenses, these gardens are likely to go bankrupt. That will mean thousand more patients will lose their supply.

There are limitations to a system that relies on designated growers to supply patients, but we need this system until something better is developed. These growers can usually only supply marijuana flowers to patients and not the hundreds of other products that are now available in the stores. Patients that can afford to buy them benefit from edibles, concentrates, extracts, salves and countless new marijuana products being developed. Low income patients should have access to these products as well. Oregon needs to create a medical marijuana supply system for qualified low-income patients that provides access to ALL the advanced medical marijuana products that are being manufactured here.

Despite these limitations, the OMMP designated grower system has clear benefits. The patients often get their medicine delivered to them for free, at no taxpayer expense. Sometimes the growers assist the patients in ways far beyond providing their medical marijuana. A tradition of patients helping each other has developed over the twenty years of the OMMP. It would be a mistake to allow these benefits to be destroyed. Allowing the designated grower system to collapse before an alternative system is developed and implemented amounts to throwing patients under the bus. The best policy is to streamline and improve this system and make the following specific legislative changes that will allow it to serve some patients until something better exists.

What would a better, more comprehensive system look like? What are the goals? The primary goal should be to provide the best medical marijuana products available to all low-income patients who could benefit from their use but cannot afford to buy them. A secondary goal can be to use the information generated by tracking this distribution for research to advance the best practices for using cannabis medically.

The following outline proposes legislative changes that will enhance the system of designated growers and develop a new system based on OLCC producers and processors contributing a percentage of their inventory for patient use.

This new system will raise new questions. What is “low-income”? Should there be graduated fees to patients based on income? When will patients be able to pick up their medical cannabis products at pharmacies? When will patients in hospitals be able to use medical cannabis conveniently? How will we protect the increasing amount of patient data that will be generated from being inappropriately used?

A plan to maintain access to medical marijuana for qualified low-income patients

I) Protect remaining designated OMMP growers and enhance their ability to assist patients while also developing a more comprehensive system.

a. Allow any OMMP grower to transfer medical marijuana to any qualified OMMP patient or caregiver.

b. Allow the 700 OMMP Metrc tracked gardens access to the OLCC market.

1. The current 20-pound limit is completely unreasonable and must be modified.

2. Exempt existing gardens from water rights requirements unless there is a specific water rights issue. Any new garden would require water rights, but current gardens would be grandfathered in. (The impact on Oregon water issues from this is miniscule. The impact to patients if these gardens are bankrupted by this red tape will be thousands more patients losing their supply of medicine.)

c. Allow Metrc tracked OMMP growers to transfer more than 20 pounds to OLCC processors to create advanced marijuana products for the grower to transfer to their garden’s patients.

d. Identify ways to simplify Metrc reporting for OMMP growers.

e. Reduce OMMP grower fees.

f. Reduce fees OMMP growers pay to participate in the Metrc system.

II) Develop a new comprehensive system to provide the best medical marijuana products to patients who cannot afford retail store prices.

a. Create the supply of medical marijuana by requiring every OLCC producer and processor to contribute a percentage of the inventory of all the products they produce to a pool to be available to low income patients. This percentage would be set by OLCC based on overall inventory in the OLCC system and ongoing data indicating how much medical marijuana would need to be contributed to ensure a supply for all qualified patients.

b. Concept: Patients should have access to the highest quality medical products available.

c. OLCC producers and processors could contribute via several pathways:

1. Donating directly to OMMP patients or caregivers in transactions tracked in Metrc.

2. Donating to OLCC retail stores which would be required stock and transfer the products to patients at their retail stores in transactions tracked in Metrc.

3. Donating to regulated nonprofit organizations that would assist patients with obtaining and most effectively utilizing medical marijuana. The services that need to be provided include:

i. Delivering to patients who are physically unable to travel to stores.
ii. Assisting patients who need help administering medical marijuana.
iii. Assisting patients in residential care facilities.
iv. Providing ongoing information and education regarding the multitude of medical marijuana products and delivery systems.

© 2018 John Sajo. All rights reserved. Shared by special permission.