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Department of Human Services
Oregon Medical Marijuana Program
Advisory Committee on Medical Marijuana (ACMM)
March 23, 2006, 9:00 AM –
10:00 AM
800 NE Oregon St. Suite 120C
The Oregon Medical Marijuana Program (OMMP) Advisory
Committee on Medical Marijuana (ACMM) provides an opportunity for public to
discuss administrative issues with the OMMP management.
Handouts: Proposed Meeting Agenda, December 14, 2005 Meeting
Minutes, Draft Bylaws of the ACMM.
Meeting
called to order by Dr. Grant Higginson at 9:15 AM.
Dr.
Higginson welcomed group and invited introductions.
The group was asked to review the meeting minutes. Ed Glick, RN, noted he requested a statement to document the complaint the group was not allowed to present information and he was contesting that; the minutes reflect what was requested and were deemed approved.
·
Created
from Senate Bill 1085, the ACMM replaced the Administrative Workgroup.
·
The
ACMM members consist of: Richard Bayer, MD, Leland Berger, Sandee Burbank, Todd
Dalotto, Laird Funk, Darryl George, DO, Chris Iverson, Jim Klahr, Madeline
Martinez, Stormy Ray, and John Sajo.
·
A
sub-committee drafted the ACMM Bylaws.
Comments and Discussion:
·
Sandee
Burbank would like the annual input to also include quarterly meetings,
regarding Article II (2) Mission. The program has made a commitment to discuss
the status of the program quarterly; at any time the ACMM may make a
recommendation to the program regarding the status, however, once a year the
ACMM is required to provide input.
·
The
committee would like to make two modifications for clarification: the officers
are members of committee and notifications of media contacts are related to
committee issues. It was clarified a chair would have to be a member of the
committee. It was also further clarified if the media concerning issues not
related to the ACMM contacted the members, they do not need to notify a
committee official regarding the contact.
OFFICERS – ELECTION
·
According
to the Shannon O’Fallon, the AAG, the DHS Director assigns term lengths. Some
committee members will be long term, keeping in mind the composition of the
committee.
·
Based
on a history of experience, Dr. Bayer was nominated by Ms. Burbank as Chair.
Ms. Martinez seconded the nomination and was approved unanimously.
·
Mr.
Funk nominated Ms. Burbank for Vice Chair. Dr. Bayer seconded and was approved
unanimously.
Foundation Assembly
Adjourned at 9:38 am.
DHS OMMP INAUGUAL MEETING
Advisory Committee on Medical Marijuana (ACMM)
March 23, 2006, 10:00 AM –
12:00 AM
800 NE Oregon St. Suite 120C
The Oregon Medical Marijuana Program (OMMP) Advisory Committee on Medical Marijuana (ACMM) provides an opportunity for public to discuss administrative issues with the OMMP management.
Handouts: Proposed Meeting Agenda, December 14, 2005 Meeting
Minutes, January 31, 2006 Financial Statement, Draft Bylaws of the ACMM, 2005
Oregon Revised Statutes, Spanish Application Forms.
Meeting called to order by Dr. Richard Bayer at 9:40
AM.
AGENDA
SURVEY GROUP
EFFORTS
·
Ed
Glick, RN, discussed how the Survey Group is separate from the group attempting
to add new debilitating conditions. However, the two groups were considered as
one group and dismissed. The Survey Group was constituted and created at the
September 15, 2005, meeting; the group formed a protocol and information for
data collection regarding a variety of complicated issues, including the
complaints from patients involving the program level of customer service. The
Survey Group created two surveys: PTSD survey and a follow-up renewal
questionnaire, in order to collect scientific information.
·
Mr.
Glick, RN, felt that at the December 14, 2005, meeting the Survey Group and the
attempt to add new conditions overlapped and were dismissed together. The
attempt to share data collected on a variety of broad issues was not allowed at
the meeting. Additionally, he illustrated the survey group did find useful
information, which he wished to share with the committee.
·
Further,
he would like the committee to consider what type of data collection they wish
to have and if the Survey Group still exists to be recognized in some official
way.
Comments and Discussion:
·
Dr.
Bayer noted the advantages of recognizing the Survey Group to present valid
information and he agreed the discussion to add new conditions overshadowed
discussion from the Survey Group and would like to make sure the Survey Group
efforts are not ignored.
·
The
Committee unanimously agreed to continue the Survey Group and encourage
discussion for the goals of the group including patient participation. The
Committee appointed Mr. Glick, RN, to lead the Survey Group with Mr. Dalotto as
ACMM liaison. Shannon O’Fallon, AAG, reminded the committee that all
subcommittees previously formed must be re-appointed and must be voted on by
the committee in a public meeting.
·
Dr.
Higginson noted that previous workgroups and committees would need to be
transitioned with the ACMM vote, per Article VII.
·
Additionally,
Dr. Higginson clarified the department and program’s position. An outside group
may request to use the OMMP database to conduct research on issues outside of
the scope of the program, such as expanding the number of conditions. Dr.
Higginson noted that due to the confidentiality provisions of the OMMP, any
research using identifiable data or relying on call-back would need to obtain informed
consent from patients involved and would likely require Institutional Review
Board approval. The program would be happy to participate in the surveys that
investigate the administration of the program, such as application materials
and customer service.
·
Mr.
Dalotto asked if there is a policy and procedure regarding DHS practices with
outside survey groups. Dr. Higginson explained there might not be a set policy
regarding study practices, but he will research the topic using Vital
Statistics as an example.
ALBANY MEETING
·
Dr.
Bayer introduced the topic regarding House Bill 2693, including his testimony
against it to the senate. HB 2693, sponsored by Associated Oregon Industries
(AOI) would have allowed an employer to terminate employees who are not
impaired but have inactive marijuana metabolites in the urine. . He said it is
a myth that urine metabolites are an indication of impairment. If HB 2693
passed, patients in the program may not be able to work or drive.
·
Dr.
Bayer further spoke about an invitation with guest opinion from DHS that was
authorized by the DHS Office of Mental Health and Addiction Services (OMHAS)
and was distributed by DHS last fall as courtesy to Workdrugfree, a DHS
contractor that works with employers for a drug-free policy. He feels that DHS
OMHAS interferes with the administration of OMMP by frightening and
discouraging patients from registration in the OMMP. Attendees at the Albany
workshop stated the DHS sponsored event presented the anti-medical marijuana
point of view identical to the AOI sponsored HB 2693, specifically that
cannabis metabolites in the urine indicate impairment. They would not allow
counter argument according to attendees. This and a newspaper article in the
Albany Herald-Democrat echoing the DHS guest opinion gave the appearance that
DHS was acting as a public relations agent for AOI.
·
In
response, Dr. Bayer would like DHS to clarify. . He also asked the Committee to
invite a representative from the OMHAS to attend the next meeting. If we ignore
this, Dr. Bayer is concerned that frightened patients may ask political
representatives to have the DHS budget cut or may choose to avoid the OMMP
registry because patients no longer feel they can trust DHS.
·
Additionally,
Dr. Bayer has written letters to administration asking for an investigation of
DHS’s role, any money and or grants from DHS to parties that sponsored the
Albany event, and the role of DHS in partisan political bills such as HB 2693.
He concludes that that DHS cannot become a tool of AOI, otherwise the Committee
needs to talk to our legislators, Dr. Goldberg, and others.
Comments and Discussion:
·
Per
ORS 475.303(6), Mr. Funk motioned the committee to formally request information
regarding the grants and funding of the DHS Office of Mental Health and
Addiction Services. Ms. Martinez and Mr. Iverson seconded the motion.
·
Ms.
Burbank spoke about the Governor’s Council on Alcohol and Drug Abuse Programs
and how it would be a good opportunity to request an appointment by the
governor, appointing a member to attend those meetings representing ACMM. Mr.
Iverson advised the committee to develop a strategy not to defend or offend.
·
Mr.
Glick, RN, commented that Workdrugfree also includes the Oregon Nurses
Association (ONA) and Oregon Nurses Foundation (ONF) and would like to invite a
representative of ONA and ONF to the ACMM meetings.
·
The
ACMM decided to invite representatives from the DHS Office of Mental Health and
Addiction Services and the Governor’s Council to attend meetings for response,
clarification, and discussion. As the Chair, Dr. Bayer will write a formal
letter to Dr. Higginson requesting a representative from Mental Health and
Addiction Services attend the next ACMM meeting. Additionally, Dr. Bayer will
include this topic on the agenda for future meetings indefinitely.
·
Mr.
Sajo directed a discussion to Dr. Higginson and Ms. O’Fallon regarding how the
OMMP cannot advocate for the program, but DHS affiliates are working against
the OMMP, along with the topic of conducting a questionnaire to accumulate
scientific information.
·
Dr.
Higginson withheld his response regarding the anti-marijuana programs, as their
answer still needs to be received. He clarified the role of the program is
written in the statute what the responsibility of the program is. Currently,
the program’s responsibility is to run a registry program, not to advocate for
the use of medical marijuana.
Break from
10:25 am to 10:35 am.
PROGRAM
STAFFING UPDATE / PROCESSING TIMES
·
Pamela
Salsbury, the Program Manager, updated the Committee of program staffing. As of
the meeting, there are 12 staff members: 1 Program Manager, 5 Administrative
Specialist 1, 3 limited duration Administrative Specialist 1, and 3 temps to
assist with getting caught up.
·
Ms.
Salsbury explained the on going issues, including mending the database. Grow
cards have been issued out slower than anticipated due to the database issues;
Law Enforcement is aware that the program is behind in issuing grow cards.
Further, processing about 12,000 patient’s paperwork for the grow cards created
stacks of incoming mail are backlogged for processing. Again due to the
database mending, the program is unable to track the number of grower cards
issued. Guardianship had to be removed to include the grower tab. The program is
hoping to implement a registry database program, Licensing 2000, which some
Boards are currently using in June of 2006.
·
The
program continues to meet the statutory requirement (30-days) for processing
new and renewal applications.
·
As
of the meeting, there are 11,592 patient cardholders, total of 13,048 with
pending applications. Ms. Salsbury assumes the program continues to grow. From
February 23, 2006 to March 23, 2006, the program received 301 new applications,
358 renewal applications, 870 cards were issued, and 32 denials or terminates.
·
Ms.
Salsbury explained the program is not pursuing patients’ responses in 14 days
or expiration of cards as stated on the letter from the mail-out for grower
cards. Once the backlog is reduced, the program will run reports to identify
which patients do no have a grower listed and will then attempt to contact
patient one more time; if there is still no response from the patient, the
program will have to terminate or expire cards, according to the statutes.
Comments and Discussion
·
Denied
or Terminated applications are usually due to incomplete information. Ms.
Salsbury clarified that renewing patients who have done the Criminal History
Request (CHR) form within about 3-4 months are not required to resubmit the CHR
form with the renewal application.
·
Mr.
Clifford Spencer recommended giving patients about a month for response due to
the distance in locations between patients, caregivers, and growers. Ms.
Burbank commented how extending time may not make any difference. Ms. Salsbury
will make note of giving patients 30 days and discuss at a later time.
·
Mr.
Dalotto suggested including a Release of Information in the application packet
to allow the caregiver and person responsible for marijuana grow site to find
out important registry information. . Ms. Salsbury stated the program did look
into including the release of information in the packets and will look into it
again. Ms. O’Fallon included that an application and a release of information
needs to be a separate document. It was requested the standard DHS release of
information form be included in application packets, along with an instructions
for completing the form.
·
Regarding
the letter to return previous caregiver registry identification cards in 7
days, Ms. Salsbury explained the process of voiding the previous caregiver card
in order to issue the new caregiver card, according to the statute requirement
to return previous cards. If in the case of destroyed cards, patients need to
submit it in writing the attempt to return the card.
·
Christian
Grorud, the program support manager, explained the OMMP Financial Statement at
January 31, 2006 using the Financial Statement handout. Due to being out of the
office, Mr. Grorud focused on a few items, the cash balance reflecting the
current fee scheme, the proposed budget in Column B based on fee change, and a
few specific line items.
·
The
cash balance on January 31, 2006 was $11,071; however, in December the program
was running in the red. As of January 31, 2006, the revenues were at 22% and
expenditures at 24%. It was reviewed on a monthly basis and currently the
program does not need any advice to make changes.
·
The
largest budgeted expenditures were Personal Services costs. On a straight-line
about $30,000 under spent, the reasons for factoring in an unknown amount for
staff fee increases due to a desk audit and classification higher pay. The
second largest category was Cost Allocation and Administrative charge, the
administrative charge DHS has on all programs. The remaining large budgeted
expenditure item was Postage/Printing costs and Office Supplies due to new
forms and mail outs, which can be attributed to one-time implementation of
SB1085 start-up costs.
Comments and Discussion:
·
There
was a question if there was an accounting of the costs from conducting the CHR
checks, including the mail out, personnel time, and processes. Mr. Grorud
explained the ability to go into accounting and extract data like does not
exist, if there are specific events that Ms. Salsbury can provide, then he can
research on that.
·
The
process of CHR checks is included with processing data entry applications.
There would be difficulty of determining the cost for CHR checks because not
one person works exclusively on running the CHR checks.
·
Ms.
Burbank pointed out another section was supposed to be on the report to include
the projection if the program included for the lower fee, patients who qualify
for food stamps. Mr. Grorud found he had trouble locating the figures, but he
will continue to find another way.
HANDBOOK
·
Melodie
Silverwolf updated the Committee with the cardholder handbook status; the
handbook is nearly finished and possibly ready for distribution by summer when
the 2005 ORS is available online. The handbook will be included with the
application packets.
1085 ORS –
AVAILABILITY
·
The
2005 ORS are available in print and on the Oregon State Legislature website.
24/7 Law
Enforcement Data System (LEDS) VERIFICATION UPDATE
·
Ms.
Salsbury announced that police could now check cardholder status 24 hours per
day and 7 days per week with any LEDS terminal.
Comments and Discussion:
·
The
OMMP has access to a report that accounts each check that is run by an
officer’s DPSST and what location. The program would be able to detect if an
officer was searching.
It was requested that Ms. Salsbury investigate if information could be released, such as how many times officers are accessing the system. A report every quarterly meeting showing the number of inquiries by county was requested; Ms. Salsbury will research this topic. Ms. Burbank pointed out that in the past we had received this information and this is the second request asking for continuation of this report.
SPANISH
APPLICATION FORMS AVAILABLE
·
Spanish
application materials are available for application instructions, new
application form, renewal application form, change request form, and criminal
history request form. These forms are available online and upon request. Ms.
Salsbury encouraged clinics to take copies of the Spanish forms for feedback.
·
Additionally,
the ORS 475.300 – 475.346 and OAR 333-008-0000 – 333-008-0120 are available in
audio format, in the form of cassette tape and audio CD.
OMMP ADVOCATE
AND LAW ENFORCEMENT TRAINING ON SB 1085
·
The
program has been providing training to Law Enforcement agencies regarding SB
1085 changes and wants to extend the training to advocate groups as well. The
trainings are set up to explain the application process changes from 1085
without giving advice.
·
The
program has given only a few LE agencies training presentations, but would like
to do more; a cover letter will be distributed letting more LE agencies know
this training is available.
Comments and Discussion:
·
It
was determined that the program will be available in the future for patient
meetings to provide training presentations.
OTHER
·
The
Fourth National Clinical Conference on Cannabis Therapeutics in Santa Barbara,
California was announced to take place on April 6-8, 2006. Ms. Burbank was
asked to submit an official report regarding the conference to present at the
next meeting.
·
An
advocate meeting was scheduled to take place May 24, 2006 at the PSOB from 11
am to 2 pm.
·
Ms.
O’Fallon stated if there was a meeting relating to ACMM business, with a quorum
of six or more Committee members present, and then it has to be a public
meeting and the Committee has to comply and provide notice under public meeting
laws.
·
Mr.
Funk motioned the idea for time restriction on agenda topics; Dr. Bayer
disagreed on the basis that that would allow for no flexibility and the quality
of discussion outweighs the quantity.
·
Mr.
Funk also motioned the ACMM meet every other month to have six meetings a year
for more productivity; Mr. Klahr seconded the motion and communicated more
meetings would use fees before the cash balance is taken away and the issues
between patients and caregivers could be discussed more often. Mr. Sajo
conveyed that he leans more for six meetings in a year because items for
discussion are sometimes forgotten in three months time.
·
Ms.
Burbank referenced the Bylaws of the ACMM, Article VI subsection 5 relating
that special meetings may be called and stated scheduling difficulties may
arise. Mr. Iverson mentioned the planning and preparation each meeting requires;
he suggested remaining with quarterly meetings and calling special meetings
when needed or for all-day meetings. Mr. Dalotto included that expenses, such
as all day travel, patient fees, and program fees, need to be justified.
·
Due
to difficulty in scheduling rooms for meetings, Ms. Salsbury informed the
committee that they would need to be flexible when scheduling locations and
time.
·
It
was commented patients’ problems and issues are not being addressed at meetings
and there should be more meetings and or longer meetings. Ms. Burbank mentioned
the purpose of ACMM is to be the official body representing the patient
regarding administrative issues.
Patients, advocates, and interested parties were encouraged to contact
the ACMM in writing with problems, issues, and concerns.
·
It
was decided to place contact information for board members of the ACMM on the
program’s website. The idea of an additional page for ACMM on the program’s
website and including contact information in application packets will be
addressed at another time.
·
Dr.
Bayer encouraged discussion and this topic will be tabled until next meeting,
including the idea to meet more often or have longer meetings and different
variables for practicality.
·
The
ACMM requested DHS submit a press release regarding the formation of ACMM.
CRIMINAL
BACKGROUND CHECKS
·
Clifford
Spencer inquired about how the checks are performed in the office, including
the security, the efficiency of filling out the form, and if courts can notify
the program instead of doing the checks. Prior to SB 1085, if a patient was
convicted of a marijuana related offense, it was the court’s responsibility to
inform the OMMP of the violation and the patient’s card could be suspended.
Further, Mr. Spencer stated the program does not have the authority to perform
criminal background checks in SB 1085.
·
Shannon
O’Fallon, the AAG, did not respond regarding the legal advice given. She stated
the interpretation of SB 1085 was that it required criminal background checks
and the Department of Justice found the authority to do that.
·
Ms.
Salsbury stated WebLEDS is used for conducting the criminal background checks
via the internet with two secure firewalls. LEDS has access to a report that
tracks inquiries made by each staff; currently, three OMMP staff are able to
run criminal background checks using WebLEDS. LEDS may only run the report to
ensure that all inquiries made follow strict rules and policies. No information gained from the report may be
shared and would only be used for auditing purposes if they found the program
to be abusing the WebLEDS system.
Thursday, June 22nd
1:00 PM – 4:00 PM
State Archives Building
800 Summer St NE
Salem OR 97310
Meeting
adjourned at 12:05 p.m.
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