What are the
requirements? Educating health care professionals and supporting doctors
rights and responsibilities in the relationship. (legal) Analysis and
documentation of the proper (BME) procedures and communication of the same.
(Medical) Information to educate your physician about cannabis as
medicine.
A Physicians Guide to OMMA
·
OMMP Rules and
Regulations
o The Process
o Contacting the OMMP; visit:
http://oregon.gov/DHS/ph/ommp/index.shtml
·
Other Organizations and
Resources for Information and Support – for medical professionals and patients.
o Cannabis as Medicine
§
Information by
Condition, Symptom
§
Patient Contacts and
Organizations
§
Professional groups
o
Legal issues –
§
See below
The Oregon Medical Marijuana Act (OMMA), a
ballot initiative approved by voters in 1998, allows patients to possess and
grow small amounts of medial marijuana. The law required DHS to create a
registry system for persons authorized to use marijuana for medicinal purposes.
Applicants must provide a statement from their physician that they have a
qualifying medical condition and that medical marijuana might alleviate their
symptoms or disease. Once their application is approved they are issued a
registration card that is renewable annually. For those who understand
the utilization of cannabis as medicine, this is an invaluable option in
therapy.
The Oregon Medical
Marijuana Act was adopted by voters at the November 3, 1998 general election
(Ballot Measure 67). The Act was amended by House bill 3052, passed
during the 1999 legislative session.
Basic Facts
- The
Oregon Medical Marijuana Act protects medical marijuana users who comply
with its requirements from state criminal prosecution for production,
possession or delivery of a controlled substance.
- "The
(state) Act neither protects marijuana plants from seizure nor individuals
from prosecution if the federal government chooses to take action against
patients or caregivers under the federal Controlled Substances Act."
- You must
be an Oregon resident to be a registered patient in the Oregon Medical
Marijuana Program (OMMP).
- You must
have a qualifying debilitating medical condition as listed on the
Attending Physician's Statement.
- Your
physician must be a Medical Doctor (MD) or Doctor of Osteopathy (DO)
licensed to practice medicine in Oregon. You must have an established
patient/physician relationship with your "attending physician."
Naturopaths, chiropractors, and nurse practitioners cannot sign the
documentation.
- The OMMP
cannot refer you to a physician. The OMMP does not have a physician
referral list.
- The
application fee cannot be waived. Partial payments cannot be accepted.
Credit card payments are not accepted.
- You must
list a grow site address on your application. You, or your designated
primary caregiver, may grow your medication. There is no place in the
State of Oregon to legally purchase medical marijuana.
- The OMMP
cannot find a designated primary caregiver for you. The OMMP does not keep
a referral list of persons who want to be caregivers for patients. (You are
not required to list a caregiver unless you are less than 18 years old.)
Your caregiver cannot be your physician.
- If you
decide to change your caregiver, it is your responsibility to notify him
or her that he or she is no longer protected under the law. The OMMP does
not communicate directly with caregivers.
- The OMMP
will only speak directly with the patient. All written requests to release
information must be signed and dated by the patient. The OMMP will not
accept written or verbal requests for information from your caregiver or
any other person without your permission.
- The OMMP
cannot supply you with seeds or starter plants, or give you advice on how
to grow medical marijuana.
Some FAQS
visit: http://oregon.gov/DHS/ph/ommp/top20.shtml
1) Can the OMMP refer me to a physician?
No. The names of
physicians who have submitted forms, letters, or chart notes for their patients
are confidential, and the OMMP does not have a physician referral list.
2) Why do I need to have a physician sign and
date the form or send a chart note to the OMMP? Why can't I just provide my
medical records?
According to the
Oregon Medical Marijuana Act (Section 4 (2)(a)), and OAR 333-008-0020(1)(a), a
physician must state in writing that the patient has a qualifying debilitating
medical condition and that medical marijuana may mitigate the symptoms
or effects of that condition. The OMMP accepts medical records as long as they
clearly state the physician is aware that medical marijuana is being used as a
treatment and he or she believes the patient may benefit from the use of
medical marijuana. The physician must sign and date the relevant portions of
medical records you send to the OMMP. The OMMP contacts each physician during
the application process to verify the patient is under the physician's care. A
signed and dated "Attending Physician's Statement," copies of chart
notes or medical records must be current within 3 months of the date of
a person's new or renewal application.
3) Why are only MDs (Medical Doctors) and DOs
(Doctors of Osteopathy) qualified to sign the "Attending Physician's
Statement" of the application? Why not naturopaths, chiropractors, or
nurse practitioners? Does the physician have to be licensed in Oregon?
The Oregon
Medical Marijuana Act states that an "attending physician" means a
physician licensed under ORS chapter 677 (OAR 333-008-0010(1)). MDs and DOs are
the physicians licensed under this chapter. The law also specifies that a
physician must be licensed in Oregon. The OMMP verifies with the Board of
Medical Examiners that each patient's attending physician has a valid license
to practice medicine in Oregon and has no disqualifying restrictions.
4) Is my confidentiality protected?
Yes. The OMMP
does not give out lists of patients or physicians. Law enforcement personnel
may call the OMMP only to verify a specific name or address of a patient or
caregiver. The OMMP will tell law enforcement staff if the patient, caregiver,
or address in question is registered, or if an application is in process. The
OMMP will disclose patient information to others only at the specific written
request of the patient. OMMP computer files are secure and paper files are kept
locked when not in use.
5) It is time to renew my card and my
physician's clinic has adopted a policy of not signing "Attending
Physician's Statements".
A renewal
application does not require a statement from a physician regarding the use of
medical marijuana; however, a renewal does require the patient to demonstrate
that his or her debilitating medical condition continues. You can submit a copy
of relevant portions of your medical records made by your physician within 3
months of your application date. The records must be signed and dated by
the physician. The OMMP urges patients to work closely with their attending
physicians throughout the application process.
Cannabis is medicine
and
has been so since mans ancestors first encountered it. Archeology tells
us more about the history of
this fascinating and versatile plant every day. Educate yourself and
others on the issues surrounding it and its utilization. Visit:
http://mercycenters.org/links/can_hist_med.htm#medicine
The IOM (Institute of Medicine) Report of 1999 is the most recent proof
of this. Visit:
www.nap.edu/catalog/6376.html
--- Sources of Information ---
Scientific Articles Online:
The International Association of Cannabis as
Medicine (IACM) Database on Clinical Studies and Case Reports www.acmed.org/english/nav/home-science.htm
GW Pharmaceuticals Research and Development
(Cannabinoid Research Institute) www.gwpharm.com/research_cri.asp
O'Shaughnessy's Journal of the California
Cannabis Research Medical Group (CCRMG) www.ccrmg.org/journal.html
1999 Institute of Medicine/National Academy
of Sciences Report "Marijuana And Medicine: Assessing The Science
Base" By Janet E. Joy, Stanley J. Watson, Jr. And John Benson Jr.,
Editors > www.nap.edu/catalog/6376.html
For more Web sites to visit see
Oregon Medical Marijuana Act (OMMA) &
Oregonians for Medical Rights (OMR) Home Page: http://www.omma1998.org/
and/or the MERCY Links page at: http://mercycenters.org/links.html
Books to get and read:
Is Marijuana the Right Medicine for You?
A Factual Guide to Medical Uses of Marijuana by Bill Zimmerman,
PhD with Rick Bayer, MD and Nancy Crumpacker, MD, ISBN#0-87983-906-6
(Keats 1998). Chapter 3: Why All the Controversy? What Does
The Research Actually Show? is online at: www.medmjscience.org/Media/pdf/chap3.pdf
Cannabis and Cannabinoids: Pharmacology,
Toxicology, and Therapeutic Potential edited by Franjo Grotenhermen, MD
and Ethan Russo, MD (Haworth Press 2002)
The Oregon Medical Marijuana Guide: A
Resource for Patients & Health Care Providers by Ed Glick, RN
(Contigo-Conmigo 2001). This is the most comprehensive guide to the
Oregon Medical Marijuana Act. It is available online at www.or-coast.net/contigo/ and
for purchase on CD - ROM or paper.
Marijuana Medical Handbook by Rosenthal,
Gieringer and Dr. Mikuriya, "A Guide to Therapeutic Use".
ISBN#0-932551-16-5 $16.95
The Emperor Wears No Clothes By Jack Herer,
The Original Hemp Bible. ISBN#1-878125-02-8 $24.95
see more at the OMMA1998 website Medical
Cannabis (Marijuana) Bibliography page: http://www.omma1998.org/omr_mmj_bibliography.html
Download the
administrative rules for printing (PDF format) by clicking here > http://oregon.gov/DHS/ph/ommp/oarrev.shtml,
or browse through the rules at the Oregon State Archives Website >
http://arcweb.sos.state.or.us/rules/OARs_300/OAR_333/333_008.html.
The Act intends:
(1) To allow
Oregonians with debilitating medical conditions who may benefit from the
medical use of marijuana to receive the benefit of their doctor's professional
advice regarding the possible risks and benefits of medical marijuana;
(2) To allow
Oregonians suffering from debilitating medical conditions to use small amounts
of marijuana without fear of civil or criminal penalties when their doctors
advise that such use may provide a medical benefit to them; and
(3) To make only
those changes to existing Oregon laws that are necessary to protect patients
and their doctors from criminal and civil penalties, and are not intended to
change current civil and criminal laws governing the use of marijuana for
non-medical purposes.
- some
important legal References -
Dr. Marcus
Conant, et al., v. McCaffrey et al.
This September 7, 2000, US District Court held that the US Government
could not punish physicians for voicing their professional opinions based on
their best medical judgment. Go to: http://oregon.gov/DHS/ph/ommp/conantmc.shtml
or see below.
Dr. Marcus
Conant, et. al., v. John P. Walters, et. al. This October 29, 2002, decision by the United States Court of
Appeals for the Ninth Circuit upheld an earlier decision that the US Government
could not punish physicians for voicing their professional opinions based on
their best medical judgment (Conant v. McCaffrey, September 7, 2000).
The Court of Appeals decision upholds the First Amendments rights of physicians
who recommend the use of medical marijuana for their patients. Go
to: http://oregon.gov/DHS/ph/ommp/conantapeal.shtml
or see below
Legal Resources –
|
ACLU of Oregon
Executive
Director: David Fidanque
P.O. Box 40585
Portland, OR 97240-0585
Phone: 503-227-3186
http://www.aclu-or.org/
|
NORML - and the
NORML Foundation
1600 K
Street, NW
Suite 501
Washington,
DC 20006-2832
Phone:
(202) 483-5500
Fax: (202) 483-0057
http://norml.org/
|
Dr. Marcus Conant, et al.,
v. McCaffrey et al.
This
information provided by the Office
of the State Public Health Officer. Dr. Marcus Conant, et al., v. McCaffrey
et al. Source=> http://oregon.gov/DHS/ph/ommp/conantmc.shtml
This
September 7, 2000, US District Court held that the US Government could not
punish physicians for voicing their professional opinions based on their best
medical judgment. According to the Court decision, "the government is
permanently enjoined from revoking a physician's DEA registration merely
because the doctor recommends medical marijuana based on a sincere medical
judgment and from initiating an investigation solely on the ground" that a
physician recommends the use of medical marijuana for a patient.
The Human Services Assistant Attorney General for the Oregon Department
of Justice, prepared this summary at the request of the Oregon Medical
Marijuana Program. This summary describes highlights of the September 7, 2000
US District Court decision and is intended for information purposes only and is not to be used for
legal purposes or reference. For more complete information please check the
transcript for the text of this decision.
Dr. Marcus Conant, et al.,
v. McCaffrey et al.
SUMMARY
Dr. Marcus Conant, et al., v. McCaffrey et al.
Nos. C 97-00139 WHA
September 7, 2000 The US District Court held that the US Government
could not punish physicians for voicing their professional opinions based on
their best medical judgment. According to the Court decision, "the
government is permanently enjoined from revoking a physician's DEA registration
merely because the doctor recommends medical marijuana based on a sincere
medical judgment and from initiating an investigation solely on the
ground" that a physician recommends the use of medical marijuana for a
patient.
The US District Court for the Northern District of California decided
this case on Sept 7, 2000. Plaintiffs (represented by Dr. Conant) were a class
of physicians who feared prosecution or loss of Drug Enforcement Administration
registration that would affect their licenses to practice medicine. The
Defendant was Barry McCaffrey, Director of the Office of National Drug Control
Policy.
On November 5, 1996, voters in California adopted Proposition 215, the
Compassionate Use Act, also known as the Medical Marijuana Initiative. The Act
provides in relevant part that: "...seriously ill Californians have the
right to obtain and use marijuana for medical purposes where that medical use
is deemed appropriate and has been recommended by a physician who has
determined that the person's health would benefit..." The California
Health and Safety Code and the Act say "[No] physician in this state shall
be punished, or denied any right or privilege, for having recommended marijuana
to a patient for medical purposes."
On December 30, 1996, the Director of the Office of National Drug
Control Policy issued a response to California's Act, stating "that a
practitioner's action of recommending or prescribing Schedule I controlled
substances is not consistent with the 'public interest' (as that phrase is used
in the federal Controlled Substances Act) and will lead to administrative
action by the Drug Enforcement Administration to revoke the practitioner's
registration." In addition, the US Inspector General for Health and Human
Services was authorized to exclude specified individuals (for example,
physicians who recommend marijuana to patients for medical purposes) from
participation in Medicare and Medicaid programs.
The US Government later clarified its position, stating that
"nothing in federal law prevents a physician, in the context of a
legitimate physician-patient relationship, from merely discussing with a
patient the risks and benefits of the use of marijuana to relieve pain or
alleviate symptoms." At the same time, however, "physicians may not
intentionally provide their patients with oral or written statements in order
to enable to obtain controlled substances in violation of federal law."
Dr. Marcus Conant, et. al.,
v. John P. Walters, et. al.
This
information provided by the Office
of the State Public Health Officer. Dr. Marcus Conant, et. al., v. John P.
Walters, et. al. Source=> http://oregon.gov/DHS/ph/ommp/conantapeal.shtml
This October
29, 2002, decision by the United States Court of Appeals for the Ninth Circuit
upheld an earlier decision that the US Government could not punish physicians
for voicing their professional opinions based on their best medical judgment
(Conant v. McCaffrey, September 7, 2000). The Court of Appeals decision upholds
the First Amendments rights of physicians who recommend the use of medical
marijuana for their patients.
Rhea Kessler, J.D., Assistant Attorney General for the Oregon
Department of Justice, approved this summary at the request of the Oregon
Medical Marijuana Program. This summary describes highlights of the October 29,
2002 decision of the United States Court of Appeals for the Ninth Circuit and
is intended for information purposes only and is not to be used for legal
purposes or reference. For more complete information please check the Internet
for the full text of this decision.
SUMMARY
Dr.
Marcus Conant, et al., v. John P. Walters et al.
No. 00-17222
D.C. No
CV 97-00139 WHA
Opinion
October
29, 2002 On
September 7, 2000, the US District Court for the Northern District of
California entered a permanent injunction to protect the First Amendment rights
of physicians (Conant v. McCaffrey, 2000 WL 1281174 N.D. Cal.). The September
2000 order prohibited the federal government from either revoking a physician's
license to prescribe controlled substances or from conducting an investigation
of a physician that might lead to such revocation, where the federal
government's action is based solely on the physician's professional
"recommendation" of the use of medical marijuana. The federal
government appealed this decision and the US Court of Appeals for the Ninth
Circuit issued a decision in Conant v. Walters (No. 00-17222) on October 29,
2002.
In Conant v. Walters, a three-judge panel of the Court of Appeals
unanimously agreed that the federal government may not investigate or revoke
the licenses of physicians who recommend the use of medical marijuana to their
patients. More specifically, the Court of Appeals voted that: (1) a
"recommendation" by a physician for a patient's use of medical
marijuana is not similar to a "prescription" for a controlled
substance; (2) a physician's anticipation that a patient will use his or her
recommendation to obtain marijuana does not translate into the physician
"aiding and abetting, or conspiracy" to obtain a controlled
substance; (3) "physicians must be able to speak frankly and openly to
patients," a need recognized through the law of doctor-patient privilege;
and (4) doctor-patient privilege reflects the "imperative need for
confidence and trust" inherent in the relationship and recognizes that
"a physician must know all that a patient can articulate in order to
identify and to treat the disease; barriers to full disclosure would impair
diagnosis and treatment." One justice cited several studies "that
indicate the potential therapeutic value" of medical marijuana for pain
relief, control of nausea and vomiting, and appetite stimulation.
In making these, and similar determinations, the US Court of Appeals
for the Ninth Circuit affirmed the September 2000 decision of Conant v.
McCaffrey to: (1) uphold the injunction to protect physicians' First Amendment
rights; and (2) prohibit the federal government from either revoking a
physician's license to prescribe controlled substances or conducting an
investigation of a physician that might lead to such revocation based on a
professional recommendation of the use of medical marijuana. The September 2000
and October 2002 decisions apply only to the states within the jurisdiction of
the Ninth Circuit Court-Oregon, Washington, California, Alaska, Hawaii, and
Nevada.
The Oregon Administrative Rules contain OARs
filed through August 15, 2005
DEPARTMENT OF HUMAN SERVICES, PUBLIC
HEALTH
DIVISION 8
MEDICAL MARIJUANA
333-008-0000
Description of the Oregon Medical
Marijuana Act
The Oregon
Medical Marijuana Act was adopted by voters at the November 3, 1998 general
election (Ballot Measure 67). The Act was amended by House bill 3052, passed
during the 1999 legislative session. The text of the combined Act and HB 3052
is included in ORS 475.300 -- ORS 475.346. The Oregon Health Division was
assigned rule-making authority necessary for the implementation and administration
of the Oregon Medical Marijuana Act.
The Act intends:
(1) To allow
Oregonians with debilitating medical conditions who may benefit from the
medical use of marijuana to receive the benefit of their doctor's professional
advice regarding the possible risks and benefits of medical marijuana;
(2) To allow
Oregonians suffering from debilitating medical conditions to use small amounts
of marijuana without fear of civil or criminal penalties when their doctors
advise that such use may provide a medical benefit to them; and
(3) To make only
those changes to existing Oregon laws that are necessary to protect patients
and their doctors from criminal and civil penalties, and are not intended to
change current civil and criminal laws governing the use of marijuana for
non-medical purposes.
Stat. Auth.: ORS 475.300
Stats. Implemented: ORS 475.300
Hist.: OHD 3-1999, f. & cert. ef. 4-29-99; OHD 18-2001, f. & cert. ef.
8-9-01
333-008-0010
Definitions
For the purposes
of OAR 333-008-0000 through 333-008-0090, the following definitions apply:
(1)
"Attending physician" means a physician who has established a
physician/patient relationship with the patient, is licensed under ORS chapter
677, and who, with respect to a patient diagnosed with a debilitating medical
condition:
(a) Is primarily
responsible for the care and treatment of the patient;
(b) Is primarily
responsible for providing medical specialty care and treatment of the patient
as recognized by the American Board of Medical Specialties;
(c) Has been
asked to consult and treat the patient by the patient's primary care physician
who is licensed under ORS Chapter 677, a Physician Assistant licensed under ORS
Chapter 677, or a Nurse Practitioner licensed under ORS Chapter 678; or
(d) Has reviewed
a patient's medical records at the patient's request, has conducted a thorough
physical examination of the patient, has provided or planned follow-up care,
and has documented these activities in the patient's medical record.
(2)
"Debilitating medical condition" means:
(a) Cancer,
glaucoma, positive status for human immunodeficiency virus or acquired immune
deficiency syndrome, agitation due to Alzheimer's disease, or treatment for
these conditions;
(b) A medical
condition or treatment for a medical condition that produces, for a specific
patient, one or more of the following:
(i) Cachexia;
(ii) Severe pain;
(iii) Severe
nausea;
(iv) Seizures,
including but not limited to seizures caused by epilepsy; or
(v) Persistent
muscle spasms, including but not limited to spasms caused by multiple
sclerosis; or
(c) Any other
medical condition or treatment for a medical condition adopted by the
Department by rule or approved by the Department pursuant to a petition
submitted under OAR 333-008-0090.
(3)
"Delivery" means the actual, constructive or attempted transfer,
other than by administering or dispensing, from one person to another of a
controlled substance, whether or not there is an agency relationship.
(4)
"Department" means the Oregon Department of Human Services.
(5)
"Designated primary caregiver" means an individual eighteen years of
age or older who has significant responsibility for managing the well-being of
a person who has been diagnosed with a debilitating medical condition and who
is designated as such on that person's application for a registry
identification card or in other written notification to the Department.
Designated primary caregiver" does not include the person's attending
physician. Each patient may have only one designated primary caregiver at any
given time.
(6)
"Marijuana" means all parts of the plant Cannabis family Moraceae,
whether growing or not; the resin extracted from any part of the plant; and
every compound, manufacture, salt, derivative, mixture, or preparation of the
plant or its resin. It does not include the mature stalks of the plant, fiber
produced from the stalks, oil or cake made from the seeds of the plant, any
other compound, manufacture, salt, derivative, mixture, or preparation of the
mature stalks (except the resin extracted there from), fiber, oil, or cake, or
the sterilized seed of the plant which is incapable of germination.
(7) "Mature
plant" means the following: A marijuana plant shall be considered mature
when male or female flower buds are readily observed on the plant by unaided
visual examination. Until this sexual differentiation has taken place, a
marijuana plant will be considered immature.
(8) "Medical
use of marijuana" means the production, possession, delivery, or
administration of marijuana, or paraphernalia used to administer marijuana, as
necessary for the exclusive benefit of a person to mitigate the symptoms or
effects of his or her debilitating medical condition.
(9) "New
application" means an application defined under OAR 333-008-0020 signed,
dated, and submitted by:
(a) A new
applicant to qualify for an initial registry identification card;
(b) A patient
after the patient's previous application has been denied or after the patient's
registry identification card has been suspended; or
(c) A patient
after the expiration date of the patient's previously issued registry
identification card.
(10) "Oregon
Health Plan" means the medical assistance program administered by the
Department under ORS chapter 414.
(11) "Parent
or legal guardian" means the custodial parent or legal guardian with
responsibility for health care decisions for the person under 18 years of age.
(12)
"Production" includes the manufacture, planting, cultivation, growing
or harvesting of a controlled substance.
(13)
"Registry identification card" means a document issued by the
Department that identifies a person authorized to engage in the medical use of
marijuana and the person's designated primary caregiver, if any.
(14)
"Renewal application" means an application as defined under OAR
333-008-0040, signed, dated, and submitted by a patient within 3 months prior
to the expiration date of the patient's current registry identification card
and no later than the expiration date of that current card. Applications
received after the expiration date of the patient's current registry
identification card must meet all criteria for a "new application"
under OAR 333-008-0010(9).
(15)
"Supplemental Security Income" means the monthly benefit assistance
program administered by the federal government for persons who are age 65 or
older, or blind, or disabled and who have limited income and financial
resources.
(16) "Usable
marijuana" means the dried leaves and flowers of the plant Cannabis family
Moraceae, and any mixture or preparation thereof, that are appropriate for
medical use. "Usable marijuana" does not include the seeds, stalks
and roots of the plant.
(17)
"Written documentation" means a statement signed and dated by the
attending physician of a person diagnosed with a debilitating medical condition
or copies of the person's relevant medical records, maintained in accordance
with standard medical record practices.
Stat. Auth.: ORS 475.005, ORS 677.010, ORS
475.302 & ORS 475.309(3)
Stats. Implemented: ORS 475.300 - ORS 475.346
Hist.: OHD 15-1998(Temp), f. & cert. ef. 12-24-98 thru 6-22-99; OHD 3-1999,
f. & cert. ef. 4-29-99; OHD 13-2000(Temp), f. & cert. ef. 12-21-00 thru
6-15-01; OHD 18-2001, f. & cert. ef. 8-9-01; OHD 19-2001(Temp), f. &
cert. ef. 8-10-01 thru 1-31-02; Administrative correction 3-14-02; OHD 6-2002,
f. & cert. ef. 3-25-02; PH 9-2003, f. 6-26-03, cert. ef. 7-1-03
333-008-0020
Registration Application and Verification
(1) The
Department shall create registration application forms and issue them to
requesting physicians, applicants, or designated primary caregivers.
(2) Except as
provided in subsection (4) of this section, the Department shall issue a
registry identification card to any person who pays a new or renewal
application fee as set forth in subsections (2)(a) and (2)(b) of this section
and who provides to the Department a completed application as set forth in
subsections (2)(c) and (2)(d) of this section.
(a) For the
period January 1, 2005 through December 31, 2006, the following fees will be
charged: $100 (fifty-five dollars) for a new application; $100 (fifty-five
dollars) for a renewal application; or, $20 (twenty dollars) for either a new
or renewal application by any patient who can demonstrate current eligibility
in the Oregon Health Plan or who can demonstrate being a recipient of current Supplemental
Security Income monthly benefits.
(A) Eligibility
in the Oregon Health Plan is demonstrated by providing a current, valid
eligibility determination statement from the Department's Office of Medical
Assistance Programs. To qualify for a reduced fee, a copy of the patient's
current eligibility statement must be provided at the time the patient submits
an application. The Department will verify the patient's Oregon Health Plan
eligibility with the Office of Medical Assistance Programs.
(B) Eligibility
for Supplemental Security Income is demonstrated by providing a copy of a
receipt of a current monthly benefit. To qualify for a reduced fee, a copy of a
receipt of a current Supplemental Security Income monthly benefit must be
provided at the time the patient submits an application. The Department will
verify the patient's current Supplemental Security Income receipt of monthly
benefits through the Department or with the Social Security Administration.
(b) The
Department will notify any patient who submits a reduced fee for which the
patient is not eligible and will give the patient 14 days from the date of
notice to pay the correct fee or to submit a current, valid eligibility
determination statement for the Oregon Health Plan, or to submit a copy of a
receipt for current Supplemental Security Income monthly benefit, as
applicable. The Department will not suspend processing of the patient's
application pending receipt of an eligibility statement. The Department will
not grant application fee refunds for any eligibility determination made on or
after the issue date of the patient's registry identification card.
(c) To supply a
completed application, the patient must provide to the Department either:
(A) completed
copies of all patient application, attending physician declaration, and
parent/legal guardian (if applicable) forms; or
(B) legible
written statements that include all information required on the Department's
forms. A copy of the relevant portions of the patient's medical record may
serve as written documentation from the attending physician as long as it
states that the patient has been diagnosed with a debilitating medical
condition; the medical use of marijuana may mitigate the symptoms or effects of
the patient's debilitating medical condition; and contains the physician's
signature and the date the medical record was made.
(d) In addition
to the information required in ORS 475.309(2), the patient and the designated
primary caregiver (if applicable) must provide a copy of current, legible photographic
identification (i.e., Oregon driver's license, Oregon identification card, or
Voter Registration card plus another current, legible photographic
identification). The designated primary caregiver (if applicable) must also
supply his or her address and date of birth. The patient must provide the
Department with the address of the site where marijuana will be manufactured or
produced, and indicate whether the property is under the control of the patient
or the designated primary caregiver of the patient.
(3) Optional
information may be added to application forms at the discretion of the
Department if such information serves the best interest of the patient and
assists agencies in the implementation of the Act. Optional information need
not be provided by the patient, attending physician, or designated primary
caregiver, and failure to provide optional information ill have no bearing on
the approval or denial of a registry identification card.
(4) The
Department shall issue a registry identification card to a person who is under
eighteen years of age if the person submits the materials required under
subsection (2) of this section, and one of the person's parents or legal
guardians signs and has notarized a written declaration that states:
(a) The person's
attending physician has explained to the person and to one of the person's
parents or legal guardians the possible risks and benefits of the medical use
of marijuana;
(b) The parent or
legal guardian consents to the use of marijuana by the person for medical
purposes;
(c) The parent or
legal guardian agrees to serve as the person's designated primary caregiver;
and
(d) The parent or
legal guardian agrees to control the acquisition of marijuana and the dosage
and frequency of use by the person.
(5) The
Department will verify information on all initial registration applications or
written documentation.
(a) The
Department will contact each patient and designated primary caregiver (if
appropriate) by telephone or by mail to confirm that the information provided
is accurate. In cases where the patient is less than eighteen years old, the
Department will also contact the parent or legal guardian to verify the
information. In cases where proof of identity is uncertain, the Department may
require a face-to-face meeting with the patient or designated primary caregiver
and/or the production of additional identification materials for verification
purposes.
(b) The
Department will verify with the Oregon Board of Medical Examiners that the
attending physician is licensed to practice in the state and is in good
standing. The Department will also contact each attending physician to confirm
that the information provided is accurate and valid, and that the physician is
an "attending physician" as defined by 333-008-0010(1).
(6) Upon annual
renewal of a registration application, the Department will verify all new
information, but may use its discretion in determining the need to verify
information that has not changed.
Stat. Auth.: ORS 475.309, 475.312 &
475.316
Stats. Implemented: ORS 475.300 - 475.346
Hist.: OHD 3-1999, f. & cert. ef. 4-29-99; OHD 13-2000(Temp), f. &
cert. ef. 12-21-00 thru 6-15-01; OHD 18-2001, f. & cert. ef. 8-9-01; OHD
19-2001(Temp), f. & cert. ef. 8-10-01 thru 1-31-02; Administrative correction
3-14-02; OHD 6-2002, f. & cert. ef. 3-25-02; PH 9-2003, f. 6-26-03, cert.
ef. 7-1-03; PH 38-2004, f. 12-22-04, cert. ef. 1-1-05
333-008-0030
Registration Approval and Denial
(1) The
Department shall verify the information contained in an application submitted
pursuant to this section and shall approve or deny an application within 30
days of receiving the fully completed application, including payment of the
designated fee.
(2) Once the
Department has verified the information in a completed application, the
Department shall issue a serially numbered registry identification card within
five days. The registry identification card shall state:
(a) The
cardholder's name, address and date of birth;
(b) The date of
issuance and expiration date of the registry identification card;
(c) The name and
address of the person's designated primary caregiver, if any; and
(d) Such other
optional information as the Department may specify.
(3) When the
person to whom the Department has issued a registry identification card
pursuant to this section has specified a designated primary caregiver, the
Department shall issue an identification card to the designated primary
caregiver. The designated primary caregiver's registry identification card
shall contain the information provided in subsection (2)(a), (b), and (d) of
this section. The designated primary caregiver's registry identification card
shall also contain the patient's name and address.
(4) In accordance
with provisions of these rules, the Department has the authority to deny a
registration application and to preclude a person from obtaining or using a
registry identification card for a period of up to six months.
(5) The
Department may deny an application only for the following reasons:
(a) The applicant
did not provide the information required as provided in ORS 475.309; or
(b) The
Department determines that the information provided was falsified.
(6) When the
Department determines that an applicant does not qualify for a registry
identification card, the Department shall send the applicant a denial letter
within 30 days of receipt of the application or renewal application. The time
periods set forth in subsection (9)(a) and (b) of this rule, that provide an
applicant an opportunity to supplement an application that does not meet all of
the requirements of ORS 475.309, do not count towards the 30-day time
limitation for processing an application. The denial letter will be sent by
certified, first-class mail to the address listed on the application form. The
letter will state the reason for denial and the date at which another
application may be submitted.
(7) Denial of a
registry identification card shall be considered a final Department action,
subject to judicial review. Only the person whose application has been denied,
or, in the case of a person under the age of eighteen years of age whose
application has been denied, the person's parent or legal guardian shall have
standing to contest the Department's action.
(8) Any person
whose application has been denied may not reapply for six months from the date
of the denial, unless so authorized by the Department or a court of competent
jurisdiction.
(9) The
Department will deny and return to the applicant a copy of the application
including the application fee if either of the conditions below applies to the
application:
(a) The applicant
did not provide all required information, and following a written request by
the Department for the missing information, did not adequately respond within
14 days; or
(b) Following an
investigation by the Department, the Department has been unable to verify that
the individual signing the application as the attending physician meets the
definition under OAR 333-008-0010(1). The applicant will be allowed 30 days to
submit written documentation and/or a new attending physician's declaration
from a physician meeting the requirements of these rules. After that time, if
no adequate response has been received, the application will be denied and
returned.
(c) Applicants
whose application is denied under (a) or (b) above may re-apply for a registry
identification card at any time.
Stat. Auth.: ORS 475.309 & 475.316
Stats. Implemented: ORS 475.300 - ORS 475.346
Hist.: OHD 3-1999, f. & cert. ef. 4-29-99; OHD 18-2001, f. & cert. ef.
8-9-01; OHD 19-2001(Temp), f. & cert. ef. 8-10-01 thru 1-31-02; OHD
21-2001(Temp), f. & cert. ef. 10-12-01 thru 1-31-02; Administrative
correction 3-14-02; OHD 6-2002, f. & cert. ef. 3-25-02; PH 12-2004(Temp),
f. & cert. ef. 4-1-04 thru 8-2-04; Administrative correction 8-19-04
333-008-0040
Annual Renewal and Interim Changes
(1) A person who
possesses a registry identification card shall register on an annual basis to
maintain active registration status.
(2) Between 30
and 45 calendar days prior to expiration, the Department shall mail
notification to the patient's address of the upcoming expiration date.
(a) The patient
must submit, prior to the expiration, the following:
(A) Written
documentation to reconfirm the person's debilitating medical condition;
(B) A copy of the
patient's current, valid Oregon Health Plan eligibility determination statement
or a copy of a receipt of the patient's current Supplemental Security Income
monthly benefit, if applicable;
(C) The name of
the person's designated primary caregiver, if a primary caregiver has been
designated for the upcoming year; and
(D) Confirmation
that existing application information has not changed.
(b) If the
application is not received by the expiration date, the patient's registry
identification card and the designated primary caregiver's card (if applicable)
will be deemed expired. The expiration date may be extended, due to personal
hardship, at the discretion of the Department.
(c) A patient
must notify the Department within 30 working days of any change in his or her
name, address, telephone number, attending physician, designated primary
caregiver, or grow site.
(d) A person who
possesses a registry identification card pursuant to this section and who has
been diagnosed by the person's attending physician as no longer having a
debilitating medical condition shall return the registry identification card to
the Department within seven calendar days of notification of the diagnosis. Any
designated primary caregiver shall return his or her registry identification
card within the same period of time.
Stat. Auth.: ORS 475.309 & ORS 475.312
Stats. Implemented: ORS 475.309 & ORS 475.312
Hist.: OHD 3-1999, f. & cert. ef. 4-29-99; PH 9-2003, f. 6-26-03, cert. ef.
7-1-03
333-008-0050
Confidentiality
(1) The
Department shall create and maintain both paper and computer data files of the
persons to whom the Department has issued registry identification cards. The
data files will include all information collected on the application forms or
equivalent information from other written documentation, plus registry
identification card, date of issue and expiration date. Except as provided in
subsection (2) of this section, the names and identifying information of
persons to whom the Department has issued registry identification cards
pursuant to ORS 475.309 and their designated primary caregivers, and the names
and identifying information of pending applicants for such cards and their
designated primary caregivers, shall be confidential and not subject to public
disclosure.
(2) Names and
other identifying information made confidential under subsection (1) of this
section may be released to:
(a) Authorized
employees of the Department as necessary to perform official duties of the
Department, including the production of any reports of aggregate (i.e.,
non-identifying) data or statistics; and
(b) Authorized
employees of state or local law enforcement agencies when they provide a
specific name or address. Information will be supplied only as necessary to
verify that a person is a lawful possessor of a registry identification card,
that a person is the designated primary caregiver of such a person, or to
supply optional information provided on the application forms, or as provided
in OAR 333-008-0060(2).
(c) Other persons
(such as, but not limited to, employers, lawyers, family members, other
government officials) upon written request given by the registered patient or
designated primary caregiver. Information will be supplied only as necessary to
verify that a person is a lawful possessor of a registry identification card,
that a person is the designated primary caregiver of such a person, or to
supply other specific information provided, as requested in writing by the
patient.
Stat. Auth.: ORS 475.331
Stats. Implemented: ORS 475.300 -- ORS 475.346
Hist.: OHD 3-1999, f. & cert. ef. 4-29-99; OHD 18-2001, f. & cert. ef.
8-9-01; OHD 19-2001(Temp), f. & cert. ef. 8-10-01 thru 1-31-02;
Administrative correction 3-14-02; OHD 6-2002, f. & cert. ef. 3-25-02
333-008-0060
Monitoring and Investigations
(1) The
Department may, at any time, contact a patient, designated primary caregiver,
or attending physician by telephone, mail or in person to verify the current
accuracy of information provided to the registration system. This authority does
not extend to allowing Department staff to routinely search the person or
property of a person who possesses a registry identification card or an
attending physician.
(2)
Notwithstanding (1) above, the Department may, when it has reason to believe a violation
of the conditions of registration exists, either conduct investigations to
collect evidence of violations of the Oregon Medical Marijuana Act, or arrange
for this responsibility to be assumed by the proper state or local authorities.
Such violations include, but are not limited to:
(a) A patient
fails to notify the Department of any change in the patient's name, address,
attending physician, or designated primary caregiver.
(b) A patient or
designated primary caregiver fails to return the registry identification card
to the Department within seven calendar days of notification of the diagnosis
that he or she no longer has a debilitating medical condition.
(c) A patient,
designated primary caregiver, or attending physician falsifies information during
the registration or registration renewal process.
(d) A patient or
designated primary caregiver is convicted of a marijuana-related offense that
occurred after the date of issuance of a registry identification card.
(3) If the
Department has reason to believe that an individual signing an application as
the attending physician does not meet the definition of attending physician
under these rules, the Department may examine the original patient medical
record in the physician's possession or a copy provided by the physician. The
sole purpose of this examination is to determine whether the physician meets
the definition of OAR 333-008-0010(1) and does not include review of any
clinical judgments such as adequacy of diagnosis or propriety of treatment. The
Department will send written notification allowing the physician 10 days to
provide additional information requested by the Department, a copy of the
patient's medical record, or the original medical record for Department review.
(4) In
determining whether to examine a patient's medical record pursuant to
subsection (3) of this section, the Department may consider, but is not limited
to, factors such as complaints from patients or family members, complaints from
health care providers, total number of applicants for whom the physician
provided documentation, and/or number of applicants for whom the physician
provided documentation during a specific time period.
(5) In
determining whether to examine a patient's medical record pursuant to
subsection (3) the Department will notify the patient of the intent to review
the medical records and request his or her authorization to conduct the review.
A patient's failure to authorize a review of his or her medical records for
investigation purposes may result in an incomplete application and the denial
of the patient's registry identification card.
(6) At any time,
the attending physician may notify the Department that the patient's condition
no longer warrants the use of medical marijuana. The Department shall then
request that the physician notify the patient of the contact.
(7) The
Department shall refer criminal and/or medical practice complaints against
patients, designated primary caregivers, or attending physicians to the
appropriate state or local authorities.
Stat. Auth.: ORS 475.309
Stats. Implemented: ORS 475.300 -- ORS 475.346
Hist.: OHD 3-1999, f. & cert. ef. 4-29-99; OHD 19-2001(Temp), f. &
cert. ef. 8-10-01 thru 1-31-02; Administrative correction 3-14-02; OHD 6-2002,
f. & cert. ef. 3-25-02
333-008-0070
Suspensions
(1) In accordance
with provisions of these rules, the division has the authority to suspend a
registration card. The division may preclude a person from using a registry
identification card for a period of up to six months, at the discretion of the
division.
(2)(a) When the
division proposes to suspend a registration card of a patient or a designated
primary caregiver, the division shall send a notice of proposed suspension by
certified and first class mail to person's address currently listed in the data
file.
(b) The notice
shall contain the information required under ORS 183.415.
(c) A registrant
(patient or designated primary caregiver) may contest the proposed suspension
of registration by submitting a request for a hearing in writing. The request
for hearing shall be addressed to: State Health Officer, Oregon Health
Division, 800 NE Oregon Street, Suite 925, Portland, OR 97232, and must be
received within twenty-one (21) days of receipt of notice of the proposed
action.
(3)(a) When the Division
obtains evidence that establishes that a registrant has committed egregious
violations of the Act, including obtaining a registration card by fraud,
committing multiple and/or continuing violations, or being convicted of a
marijuana related offense, the Division may immediately deem the registration
suspended. The Division will immediately attempt to notify the registrant by
phone and will send written notification of the action by certified and first
class mail within one working day.
(b) The notification
of immediate suspension will allow the registrant an opportunity to immediately
request a hearing on the suspension.
(c) The hearing
will be conducted as soon as practicable and will be conducted under the
provisions of ORS 183.
(4) The division
may, at its discretion, reinstate a registration card without re-application.
However, if the registration card was obtained by fraudulent means, the
Division may require the person to re-apply.
Stat. Auth.: ORS 475.316
Stats. Implemented: ORS 475.300 -- ORS 475.346
Hist.: OHD 3-1999, f. & cert. ef. 4-29-99; OHD 18-2001, f. & cert. ef.
8-9-01
333-008-0080
Permissible Amounts of Medical Marijuana
(1) A person who
possesses a medical marijuana registry identification card issued pursuant to
OAR 333-008-0030 may engage in, and a designated primary caregiver of such a
person may assist in, the medical use of marijuana only as justified to
mitigate the symptoms or effects of the person's debilitating medical
condition.
(2) A patient and
a designated primary caregiver may not individually or collectively possess
more than a total amount of one ounce of usable marijuana, if present at a
location at which marijuana is not produced, including any residence associated
with that location.
(3) A patient and
a designated primary caregiver may not individually or collectively possess
more than a total of three mature marijuana plants, four immature marijuana
plants, and one ounce of usable marijuana per each mature plant, if present at
a location at which marijuana is produced, including any residence associated
with that location.
(4) If any
individuals described in (1) possess, deliver, or produce marijuana in excess
of the amounts allowed in (2) and (3), such individuals are not excepted from
the criminal laws of the state but may establish an affirmative defense to such
charges, by a preponderance of the evidence, that the greater amount is
medically necessary to mitigate the symptoms or effects of the person's
debilitating medical condition.
Stat. Auth.: ORS 475.306 & 475.319(1)(c)
Stats. Implemented: ORS 475.300 -- ORS 475.346
Hist.: OHD 3-1999, f. & cert. ef. 4-29-99; OHD 18-2001, f. & cert. ef.
8-9-01
333-008-0090
Addition of Qualifying Diseases or
Medical Conditions
(1) The
Department shall accept a written petition from any person requesting that a
particular disease or condition be included among the diseases and conditions
that qualify as debilitating medical conditions under section 333-008-0010(2)
of these rules and be added to the list.
(2) The
Department shall, within 14 days of receipt of the petition, send a letter by
first-class mail requesting the petitioner to provide if possible:
(a) An
explanation for why the condition should be included;
(b) Any
literature supporting the addition of the condition to the list;
(c) Letters of
support from physicians or other licensed health care professionals
knowledgeable about the condition; and
(d) Suggestions
for potential expert panel members.
(3) The State
Public Health Officer or designee may make a final determination that a
petition is frivolous and deny the petition without further review.
(4) If the
petition is not denied under (3) above, the Department shall appoint an expert
panel of five to seven individuals to review a petition. The members of the
panel shall include the State Public Health Officer or designee, other
physicians licensed under ORS 677, at least one patient, at least one patient
advocate, and other professionals knowledgeable about the condition being
considered.
(a) If the
petitioner so desires, she or he shall be given the opportunity to address the
panel in person or by telephone.
(b) If the
petitioner so desires, his or her confidentiality shall be strictly maintained.
(5) The
Department shall submit the written petition to the expert panel, which shall
make recommendations to the Department regarding approval or denial.
(a) The members
of the panel may examine medical research pertaining to the petitioned
condition, and may gather information (in person or in writing) from other
parties knowledgeable about the condition being considered.
(b) The panel
members will submit individual recommendations to the State Public Health
Officer, and the meetings of the panel will not be considered to be public
hearings.
(6) The
Department will make a final determination on a petition within 180 days of
receipt of the petition.
(7) Denial of a
petition shall be considered a final Department action subject to judicial
review.
(8) In cases
where the condition in a person's petition is the same as, or is, as determined
by the Department's State Public Health Officer, substantially equivalent to a
condition that has already been denied in a previous determination, the
Department may similarly deny the new petition unless new scientific research
supporting the request is brought forward.
Stat. Auth.: ORS 475.334
Stats. Implemented: ORS 475.300 -- ORS 475.346
Hist.: OHD 3-1999, f. & cert. ef. 4-29-99; OHD 18-2001, f. & cert. ef.
8-9-01; OHD 6-2002, f. & cert. ef. 3-25-02
The official copy of an Oregon Administrative Rule is
contained in the Administrative Order filed at the Archives Division, 800
Summer St. NE, Salem, Oregon 97310. Any discrepancies with the published
version are satisfied in favor of the Administrative Order. The Oregon
Administrative Rules and the Oregon Bulletin are copyrighted by the Oregon
Secretary of State.
The most significant evidence of marijuana’s acceptance by the medical community in the United
States consists of data on the number of physicians currently recommending marijuana medical use
by their patients:
"By any reasonable definition, marijuana has "currently accepted medical use in treatment in the
United States." Eight states have officially legalized its medical use. A minimum of
35,000 patients are currently using medical marijuana legally in these states. Over 2,500
different physicians have recommended it for use by their patients. As many as 5% of all
registered physicians have recommended marijuana in Oregon and Northern California. Usage
rates vary greatly among different regions. The average usage rate in the general population
ranges from 80 to 90 per 100,000 in California and Oregon, where there are numerous patient
support groups, to fewer than 10 per 100,000 in Colorado and Nevada, where cannabis medicine
is still underdeveloped. As many as 1% of the population in Mendocino County, California, are
legal medical marijuana users, while Canadian surveys suggest illegal medical usage as high as 2% -
4% in the general population. The widespread and growing popularity of medical marijuana and
its potential for treating a wide range of conditions indicate a growing role in American
medicine. These facts refute marijuana's current Schedule One misclassification as a drug
lacking "currently accepted medical use" ” (Gieringer 2002).
A considerable number of organizations representing health care professionals, the medical
community, and the general public support granting greater access to medical cannabis for
patients in need and recognizing explicitly marijuana’s medical use both in the United States
and in the international community.” See more at:
www.drugscience.org/amu/amu_medprof.htm