When Ohio Gov. John Kasich effectively legalized medical cannabis in Ohio, with a stroke of a pen, the state became the 25th in the U.S. to legalize a very comprehensive medical cannabis program. This week the Ohio Board of Pharmacy has rolled out several new sets of rules for the evolving program. Finally clearing the smoke with Ohio’s medical cannabis program with some sort of focus in rules now proposed for cultivators, doctors who recommend it for patients, and for dispensaries.
The Ohio’s Pharmacy Board release of its drafted rules for dispensaries in a 66-page document, covering everything from who is allowed to operate a dispensary and where the businesses can be located to the costs of applying for a state-issued license. Ohio would issue a maximum of 40 dispensary licenses leading up to the Sept. 8, 2018 launch of the new medical cannabis program. After that, every two years the state’s Medical Marijuana Control Board would review whether more dispensaries are needed, based on the state’s population and patient demand.
Drafted rules must be first be reviewed by the 14-member Medical Marijuana Advisory Committee, followed by the state Common Sense Initiative, which is operated out of the lieutenant governor’s office. Finally, the rules then need the approval of the Joint Committee on Agency Rule Review, a panel of state legislators. House Bill 523, the medical cannabis law will allow for people with any of 21 specified diseases or conditions to get a recommendation, not a prescription, from a doctor to obtain the medical cannabis in the form of plant material only; a cannabis oil, a tincture, an edible or a patch. Under the law, cannabis can be vaped but not smoked. The medical board’s rules provide for the possibility of adding more diseases or medical conditions to the list by under section 4731.302 of the Ohio Revised Code.
Ohio Board of Pharmacy recommended that 40 dispensaries be scattered around the state’s 88 counties to sell medical cannabis to qualifying patients. That number is far fewer than the 1,150 dispensaries proposed in a medical cannabis ballot issue defeated by Ohio voters in 2015.
The second set of state rules rolled out Thursday reveals how Ohio physicians can recommend but not prescribe medical cannabis for patients. They say that for physicians to recommend they must have an active, unrestricted license “to practice medicine and surgery or osteopathic medicine and surgery.” They also must take a two-hour training course in medical cannabis. The rules also say that a physician must “establish and maintain a bona-fide physician-patient relationship that is established in an in-person visit,” and the physician must provide care for patients on an ongoing basis.
State officials proposed changes to rules initially recommended in November for growers. The revisions would double the number of small marijuana growing sites allowed to 12 from six while keeping larger growers capped at 12 locations.
Large growing sites would be increased to 25,000 square feet from 15,000; small ones would be increased to 3,000 square feet from 1,600. The revised rules also permit a one-time “build out” of growing sites to a maximum of 50,000 square feet for large ones and 6,000 square feet for small ones.
Lawmakers have said in previous weeks, the law doesn’t say where patients would get their cannabis before dispensaries are set up and open, but it’s assumed they would get it from another state or Ohio’s existing black market. But legal experts say doing so would violate state and federal laws, as well as a key provision of the federal government’s hands-off approach to regulating state medical cannabis programs. Sen. Dave Burke, a Marysville Republican who led the Senate’s efforts on the bill, said the law intentionally ignores where people can buy cannabis before dispensaries are set up because the State Board of Pharmacy will take some time setting up the parameters for what cannabis products can be sold here.
Patient advocates in Ohio say that number may be way to low to support the estimated 188,000 patients who may be eligible for medical cannabis.
“That’s not nearly enough,” said Aaron Marshall, a spokesman for Ohioans for Medical Marijuana. “That would work out to be about 4,700 patients per dispensary which is far too many. We know a lot of work still needs to be done, but this is definitely a concern.”
Additional proposed program rules that were released are:
• Dispensary owners would pay a $2,000 application fee and a biennial license fee of $80,000.
• Dispensaries couldn’t divide or repackage marijuana and marijuana products bought from a cultivator.
• Dispensaries couldn’t sell food or drinks.
• Dispensaries would have to be open for 35 hours a week, limited to operating hours between 7 a.m. and 7 p.m.
• They would have to hire a clinical director who is a pharmacist or licensed prescriber to train employees, develop patient educational materials and be on-call or on the premises during operating hours.
• Employees would also have to report all medical marijuana purchases to the state prescription database, OARRS, within 5 minutes of dispensing a product.
• Patient delivery services would NOT be allowed.
• Dispensary names, logos and advertisements would need state approval- no cartoon characters allowed.
• More dispensaries could be added after Sept. 8, 2018, if the Ohio State Board of Pharmacy determines there is need.
Some very big disappointments within Ohio’s medical cannabis program is how lawmakers have said the traditional smokeable form of cannabis and patients being able to have personal cultivation rights were off the table from the beginning. Along with not allowing patient delivery services that will neglect safe access for those home-bound patients who qualify into the program. The drafted rules released Thursday also set a fairly rigid process of adding new medical conditions to the program, requiring evidence that conventional drugs are insufficient to treat or alleviate the condition. Medical board officials said physician requirements in law are more restrictive than other states. The Board of Pharmacy is seeking public comments until Jan. 13th 2017 and you can comment on the new rules at: MMCPRules@pharmacy.ohio.gov.