The October meeting of the Act 230 Legislative Working Group tasked with improving the laws and regulations overseeing Hawai‘i’s medical cannabis industry came to a close today, on October 25, 2017. In the audience were almost a dozen members of the Hawai‘i Dispensary Alliance, representing every aspect of the industry. The Committee heard from each of its subcommittees about their progress and preliminary recommendations. The Department of Health gave a brief update on the status of the registry system, the dispensary system, and laboratory certification. The meeting allowed various stakeholders to engage in an extensive questions and answers period about topics discussed at previous meetings.
The University of Hawai‘i Public Policy Center administers the operations of the working group and posts all documents generated by and for the committee to their website. If you would like to sign up for the working group’s email list, email your request to Act230wg@gmail.com.
This article will cover everything that happened in the meeting today in a detailed narrative, much like a Q&A, organized according to the meeting agenda. This record is not verbatim, but it is as close as our notes will allow. This meeting was not broadcast on Olelo or on the legislature’s internal broadcast network and will likely not be available outside of this record and the minutes that will be posted to the Act 230 Working Group site sometime in November.
Panel Members Present
The meeting began with a brief introduction of all of the committee members. The list of participants at today’s meeting and their affiliation include:
Present Panel Members
- Senator Rosalyn Baker, Co-Chair
- Representative Della Au Belatti, Guest Co-Chair filling in for John Mizuno
- Senator Will Espero
- Representative Joy San Buenaventura
- Christopher Garth, Hawai‘i Dispensary Alliance
- Carl Bergquist, Drug Policy Forum
- Wendy Gibson, Medical Cannabis Coalition of Hawai‘i
- Richard Ha, Lau Ola, Hawai‘i County Dispensary
- Karen Kahikina, Department of Transportation, Airports Division
- John Paul Bingham – CTAHR
- Ally Park – Clinical Laboratories/AEOS Labs
- Stacy Kracher, APRN/RX
- Patricia Wilson – HPD
- Shana Metsch – Parent of a patient who is a minor
- Keith Ridley – DOH
The Working Group is administered by Dr. Susan Chandler and the University of Hawai‘i Public Policy Center, with assistance from Center Director Collin Moore, Dr. Michelle Ibanez, and Joy Agner, policy assistant. A guest moderator, Jose Barzola from the Public Policy Center, managed the October meeting in place of Dr. Chandler who is on sabbatical.
Review of Minutes – Rep. Della Au Belatti. We have copy of the September 20th, 2017 meeting minutes. Thank you to Joy and Public Policy Center for staying on top of the minutes. Any questions, concerns?
Correction: It was not Jari Sugano at the last meeting, it was Shana Metsch (parent of a patient who is a minor) on the phone.
Accepted as amended
DOH Monthly Update
Since all of the dispensaries have presented on their status and upcoming plans over the last eight months, DOH started the meeting with its monthly update on the progress of the Registry, the Dispensaries, and the Laboratories.
Patient Registry Program
Please check the DOH website – Patient counts are updated monthly.
You have the report in front of you, but I will go over it very quickly. We also have Dr. A. Christian Whelen, from the State Laboratory Division, here to speak on the laboratory status. I will be addressing the registry and dispensary status.
The Registry website is available for everyone’s reference. We would appreciate any input from the public or other stakeholders to help us clean up the website and make it as useful as possible.
At the end of August, the registry showed 18,619 registered patients, a 3.4% increase over July numbers. In July there was a 3% increase in patient numbers. This is perhaps a modest tick up in the number of registered patients. We are not sure if the opening of the dispensaries contributed to the uptick, but we do except the number to continue to increase.
We process an average of ~1,700 applications per month.
Turnaround time for applications is now 6 business days instead of 3-4 business days. This is due to an uptick in the number of patients and to a staff person transitioning out of the office. We hope to be back on track for the next report.
DOH held its first public hearing today on adding new conditions: ALS and general anxiety disorder.
DOH Program Update
The Department of Health’s report is in the notes that are being passed out (and available here).
This report should be pretty brief – It is really just an update to the prior report which was more comprehensive regarding the status of the dispensaries. This is just an update.
As usual, we will start with the Patient Registry Program.
There are over 19,000 patients as of the end of September. A 3% increase. There has been a fairly steady monthly increase of about 3% per month for all of 2017.
The patient registry program receives an average of 1,567 applications per month.
The turnaround time has ticked up to 7 business days.
This is because the Registry Program lost another person last month, that is what is accounting for the uptick.
Pono Life Sciences Maui was provided with notice to proceed to begin retail sales.
Now both Maui dispensaries are authorized to open for retail.
Manoa Botanicals changed its name to Noa Botancials and opened for retail sales on October 2nd. They are the second licensee on Oahu to open.
Now half of the licensees across the state are open.
I also wanted to give an idea about what we know and what we have seen that is happening with dispensaries in terms of their maturity level. Here is some information.
- 8 Production centers (out of 16) are authorized and running.
- 4 Retail locations (out of 16) are authorized to sale product.
- Plant inventory. Out of a possible 3,000 plants per operating production center, the current total plant count in the tracking system is 16,000 (out of a possible 24,000).
We are seeing continued movement and improvement regarding the certification of laboratories. Pharmlabs Hawaii received its provisional certification on Oct 16 to begin commercial test of plant material. It is working on further testing authorizations. (Editor’s note: This is different information than presented in DOH’s press release about Pharmlabs Hawaii which stated that the lab was certified to test both flower and manufactured products).
We expect the 3rd lab, AEOS Labs (an off-shoot of Clinical Laboratories) to submit pesticide studies in December. A tentative onsite inspection of their laboratory is scheduled for January.
Staffing – The Registry Program experienced a second turnover last month in addition to the program director moving to the mainland in September. The Registry Program is currently down two people. We are recruiting for those positions.
Peggy Leong, former head of the dispensary program, has taken another position in the state government and transferred this week. We will be meeting with DOH leadership to discuss these vacancies.
(Editor’s note: There no open job opportunities for any of these positions currently posted on the DOH job website. We will monitor the site and update the industry as soon as those jobs are posted).
We have issued the latest Medical Cannabis Update. It includes a little more detail on the information I have provided today.
DOH Questions & Answers
Q. Senator Rosalyn Baker – Do we have laboratories on all islands with operating dispensaries?
A. Keith Ridley – Yes, for Maui and Oahu, since they are the only two islands with retail sales. Yes. There are no labs yet on Kauai and Hawaii island.
Q. Senator Rosalyn Baker – Hawaii island is not close to starting retail sales?
A. Keith Ridley – Yes.
Q. Senator Rosalyn Baker – Is it anticipated that by the time they go to retail that there will be a lab there?
A. Keith Ridley – Yes, we are hoping the third lab will be prepared by that time. We also have had inquiries from 3rd parties and have encouraged them to open on Big island.
Q. Senator Rosalyn Baker – But not on Kauai?
A. Keith Ridley – Nothing on Kauai. There has been no interest as of yet.
Q. Senator Rosalyn Baker – The two labs can test buds. What about concentrates, tinctures, and topicals.
A. Keith Ridley –Right now just Steepill can test manufactured products. Pharmlabs Hawaii is still doing their studies.
Q. Senator Rosalyn Baker – Who is the only one testing things besides concentrates?
A. Dr. Wanda Chang – UH Laboratory Division – Steephill Labs on Oahu has provisional certification to test plants, tinctures, and concentrates.
Q. Senator Rosalyn Baker – Have any tinctures, concentrates, or topicals that they have permission to test, have any of those been approved for retail sales?
A. Dr. Wanda Chang – I Don’t know if they have samples or the status of those tests or sales.
Q. Senator Rosalyn Baker – Does Steephill have to certify or do anything else before those products can be sold?
A. Dr. Wanda Chang – No, we are not part of the process after the laboratory receives its certification.
Q. Senator Rosalyn Baker – But I assume, if someone is purchasing medicine in a retail establishment that they know the medicine is approved?
A. Keith Ridley – That is correct, we have the validation studies. The labs are certified to test the products. Once they receive samples from licensees, they can test, and then the licensees can sell those products.
Q. Senator Rosalyn Baker – But none of the tinctures, concentrates, or topicals are being sold in Hawaii yet?
A. Keith Ridley – We don’t know.
Q. Senator Rosalyn Baker – (Looking at audience) Can anyone can answer?
A. Brian Goldstein – Noa Botancials and Maui Grown Therapies are both selling concentrates right now.
Q. Senator Rosalyn Baker – Are those concentrates certified?
A. Brian Goldstein, Noa Botanicals – The products are appropriately labeled per the admin rules requirements.
Q. Senator Will Espero – Labels are required?
A. Keith Ridley – Yes.
Q. Senator Rosalyn Baker – In the next report, please include the types of products being sold.
Q. Senator Rosalyn Baker – For the dispensaries that are selling other types of products. Do you have any feedback from clients? Are they happy? Are you able to keep things stocked?
A. Brian Goldstein – We’ve had concentrates since last week. Tinctures next week. Topicals the week after. There is a great deal of interest for orally administered nonsmoker type of products. Feedback has been good, very positive.
Q. Senator Rosalyn Baker – Are any of the laboratories able to test for patients or caregivers?
A. Brian Goldstein – Yes, Steephill offers services for patients and caregivers. $50 per a test. They are quite busy, Dana reported on it recently. They’ve been getting interesting results. Over 90% were testing positive for pesticides.
Q. Senator Rosalyn Baker – I’m wondering if that is the case, is there a way to advise folks on how to avoid pesticides. Aside from just buying from a dispensary?
A. Brian Goldstein – Growing in Hawaii is challenging because of humidity. The easy way to respond is with pesticides.
Q. Carl Bergquist, Drug Policy Forum – I am interested in the status of sales and product types. Can you provide that on a regular basis?
A. Keith Ridley – Yes.
Q. Senator Rosalyn Baker – Please share it so the group can find out.
Q. Carl Bergquist – I’m sorry to hear about Peggy Leong. That was unexpected. She was just speaking for DOH at the William S. Richardson School of Law two weeks ago. How is the turnover time in finding her replacement?
A. Keith Ridley – Finding a replacement quickly would be great for the program. It is hard to anticipate the turnaround time. She gave two weeks notice.
Q. Carl Bergquist – Regarding turnaround time for card issuance – Can we look in other agencies for comparable applications. What is a normal wait time? It is still longer than we’d like to see. Is this wait time typical across issues or specific to the cannabis industry?
A. Keith Ridley – I’ll make a comparison.
Q. Wendy Gibson, Medical Cannabis Coalition of Hawaii – What about turnaround time for hospice patients. Are there any provisions for special populations?
A. Keith Ridley – Hospice and cancer patients have a special screening and prioritization process. But for the turnaround, we aren’t keeping statistics by patient condition.
A. Tamara Whitney, Registry Program – If physicians contact us through email, and request expedited cards for their patients, I personally check that email and ensure those applications are prioritized for cancer, minors, and hospice.
Q. Carl Bergquist – How frequent are those requests?
A. Tamara Whitney – They are not very frequent. Once in a great while.
Q. Stack Kracher, APRN – Regarding turnaround time. Do you track turnaround time for patients kicked back for errors. Sometimes their turnaround time could be extremely long.
A. Tamara Whitney – We don’t track it, but when we do send an application back we notify the patient via email. If they don’t respond in two weeks, we follow-up with a hard-copy letter.
Q. Stack Kracher, APRN – Just wondering if we can track turnaround time on error applications a little better.
Q. Carl Bergquist – Following up – Can we include that in the cross-departmental comparisons that I requested earlier? In other programs, when there are errors, how does it impact turnaround times?
A. Representative Della Au Belatti – I’m not sure it is that simple to draw that stuff up. The information is so different than other application processes. DOH can do it, but not sure it is useful.
A. Senator Rosalyn Baker – The more you ask them to do, the longer the turnaround time for the patients.
Q. Representative Della Au Belatti – Is there a similar application request process?
A. Keith Ridley – Maybe death records or other kinds of records requests. Maybe in the developmental disabilities areas.
A. Stacy Kracher, APRN – In behavioral health – you have turnaround time between applying to crisis services and being linked up with a provider.
Q. Representative Della Au Belatti – Can you think of similar ones?
A. Carl Bergquist – No. I just find that the issue continues to confound us. Not the average turnaround time, but it is when there is an error. It speaks to the issue and the potential for temporary certificates. Especially for those who are visiting APRN’s and doctors or for renewals.
Q. Brian Goldstein – I misspoke earlier. We are bringing infused organic olive oil for cooking next week. Topicals are a few weeks out.
Q. Representative Della Au Belatti – So we had a window of time for about two months where certified labs were getting samples transported to them by the dispensaries. There were no reported problems. Would the Department be open, and maybe law enforcement, to allow for the continued transport of material for laboratory purposes. Is that an area of the law we could relax. It is a market thing. So now you can give the labs a way to compete. Right now if you have a lab on your island, you can’t choose which lab to use. That cuts off market forces. Reactions?
A. Keith Ridley – We need to include our attorneys. I can’t say that off-island transport for testing purposes would work, only than I don’t see it being a problem. But we need to check with our legal counsel.
Q. Representative Della Au Belatti – Can the Department come back with recommendations?
Q. Representative Joy San Buenaventura – I agree with the premise of transportation for testing purposes. If we are going to do that, we should take into account weights and amounts. We don’t want to set off DEA alarms. We don’t want caregivers sending off multiple batches.
A. Representative Della Au Belatti – Caregivers cannot do that currently. They are not allowed.
Q. Representative Joy San Buenaventura – Its just an example. If a caregiver or patient is sending in batches that could trigger alarms. We don’t want a confrontation at this time with the federal government. I agree with the premise, we don’t want confrontation at this time with DEA.
A. Representative Della Au Belatti – To clarify, right now you can’t send product from a patient or a caregiver to a lab. You can’t do that. We don’t want to do that. Patient testing can happen on each island. But they can’t ship.
Q. Senator Rosalyn Baker – That is why we want labs on each island.
A. Ally Park – Clinical Laboratories/AEOS Labs – When AEOS is approved, patients will be able to walk into any Clinical Labs location. But to put artificial numbers on weight. It is problematic either way. It is a state thing, rather than for NED purposes.
A. Representative Della Au Belatti – I’m just voicing my concern that if we lift restrictions to early, we don’t want to see multiple amounts that trigger DEA alarms. Not with the current federal environment. We don’t want a confrontation at this time.
Q. Shana Metsch, parent of a patient who is a minor – My daughter uses cannabis for epilepsy. To DOH, how many samples that have been submitted show trace levels of illegal substances. What happened to batches that fail? Are they sold, retested, destroyed?
A. Keith Ridley – Batches that fail a test cannot be sold by the dispensaries.
A. Senator Rosalyn Baker – So if a sample is from a dispensary and tested badly, then nothing from that batch can be sold. But what we were talking about regarding things that had tested positive were those tests brought in by a caregiver.
Q. Shana Metsch – So if it is from a dispensary, failed tests are destroyed. But if from a patient, there are no consequences.
A. Keith Ridley – Correct.
Q. Shana Metsch – So there is nothing DOH is doing if a patient’s sample fails, but if a dispensary sample fails, the batch is destroyed.
A. Senator Rosalyn Baker – Correct, individual patients are not required to have their product tested. Only dispensaries that can sell the product.
Q. Representative Della Au Belatti – Follow-up for DOH – How many batches have been destroyed? What are the reasons for those failures?
A. Keith Ridley – I don’t know.
Patients Subcommittee – Carl Bergquist, Chair
- Chris Garth
- Michael Takano
- Karen Kahikina
- Rob Lee
- John Paul Bingham
- Jari Sugano
- Michael Lee
I spoke to the Chairs before the meeting, we will submit lengthy final report prior to the November meeting so that you can consider these recommendations before the final meeting. The report will recommend new statutory language and administrative rules changes. There are specific areas that we believe should be addressed.
Access to medical cannabis for patients without a current valid ID. We are looking at how it works in other states. We have a limited way of renewing state ID cards or licenses for patients in Hawaii with certain physical or intellectual limitations. For instance, you have to be over the age of 80, etc… so we are limited. I need more demographics to figure out how to help. But there are ways to help.
Regarding patients/caregivers traveling inter-island with samples for testing. We are also looking at patients and caregivers traveling with their own medicine. It is currently prohibited. Thanks to DOT, we have information from other states. Alaska has similar geographical issues. We are looking for how to change the rules or some other creative solution. Personally, I find that restricting the travel of those with personal medicine supplies is bad.
Discrimination by landlords. This has been addressed in previous bills, but there are still some issues, especially in public housing. We hope Hawaii public Housing Authority can come out with appropriate guidance. There are some Department of Labor memos that say landlords have more leeway then they actually do. Some landlords and tenants think they have the ability to terminate a lease, but they do not.
Employee discrimination. Recent case law is more promising as to the right for patients to be users and to be employed. Does it need to be a blanket ban? Obviously not for driving or impairment on the job. Some states have such protections and similar laws in other states are promising.
Some discussion on insurance coverage. Are there ways to encourage/compel insurance coverage of cannabis medicine. Maybe for certain conditions there is a way to encourage them to help pay for cannabis under state law.
DOT is looking at the drunk driving issue. There is no change yet. Just continuing to educate law enforcement. There is currently still no automatic linkage between THC level and impairment. THC vs alcohol in blood are very different. We need a holistic test.
We are working on expanding the number of medical card providers. Thanks to Stacy Kracher.
Finally, adding new qualifying conditions. DOH has a process. But we shouldn’t just leave it up to that. There is a reason only two conditions were submitted to that process this year. It is time consuming and otherwise difficult. We added PTSD through legislation and that was successful for a lot of people.
In two weeks there will be a final report.
Q. Senator Rosalyn Baker – We want make a similar request to all Subcommittees. Reports must be in a couple of weeks before the votes. It is unfair to just show up with no discussion.
Q. Senator Rosalyn Baker – One question, my understanding is that there is no state with a test for impairment from using medical or recreational cannabis. I’m thinking that there may be a need to do something. Does anywhere have a test?
A. Carl Bergquist – No.
A. Karen Kahikina, Department of Transportation – Right now they must rely on the experience and training of officers. No breathalyzer. Chemical tests can show recent usage, but not related to impairment. So you have to rely on officer observations. The 12 step DRE process.
A. Bill Richardson, Hawaiian Ethos – A company is testing a pupil dilation test.
A. Karen Kahikina – That is a part of the DRE process as well.
Q. Representative Della Au Belatti – Is there any update on the applications for new conditions reported last month.
A. Keith Ridley – No decision has been made yet.
A. Tamara Whitney – A decision is required 90 days after the public hearing. Around December 20th.
Q. Senator Rosalyn Baker – The hearing only dealt with those 2 conditions?
A. Keith Ridley – Yes.
Products Subcommittee – Michael Takano, Chair
Senator Rosalyn Baker – Michael Takano, Chair of the Subcommittee was not able to be here. Please pass out the draft report, and he’ll be here next month for us to consider it. (DRAFT REPORT AVAILABLE HERE).
Licensee Subcommittee – Representative Joy San Buenaventura, Chair
- Keith Ridley
- Richard Ha
- Christopher Garth
There are only a few of us, and we could only agree on one thing:
That the existing schedule for examining the need for and issuing new licenses detailed in HRS 329D-2 should remain. It is up to the Department of Health of the State of Hawaii to determine if it will reopen the application process. Currently there are no obstacles to opening the process. None of the legal challenges apply to the current factors of the application review process. There should be no new problems.
The second recommendation, which I thought we all agreed on, was that there be a new Working Group in 2018 to evaluate a horizontal system. HDA thinks we should just push forward.
I think maybe we need another working group so we can go into additional licenses like production and other non-retail licenses. That is why the Attorney General would be part of that working group. If we do have a working group, HDA wants a seat as well as a seat for a patient.
That is it, no further agreement.
Q. Representative Della Au Belatti – So the notion of separate production licenses. Is that something the subcommittee is letting go of?
A. Representative Joy San Buenaventura – No, that is what the new Working Group is for. It is not horizontal, it is a modified vertical. That is what the second working group would be for. Not to necessarily compare with current retail establishments, but to allow other farmers to be involved. To make sure they have expertise, know how, and money. We would still require all of the current security requirements. Whether or not they will be viable farmers, that is another thing to be hashed out among the people in that new working group
Q. Representative Joy San Buenaventura – A third thing we didn’t agree on. Which is the potential to increase license fees. Currently there is not enough money for current activities at DOH, and there is definitely no money for education. Hopefully DOH has recommendations so they can fund their activities going forward.
Reciprocity Subcommittee – Representative Della Au Bellati, Chair
We’ve come to agreement around 3 things.
- For patients traveling to Hawaii. If they have a condition on the Hawaii list, then DOH should respect that designation. Regarding how to verify the doctor in the home state. Dr. Yim explained related verification procedures. Verification can be done by a third party. A dispensary or other doctor service. Literally a doctor who calls and asks. That qualifies as third-party verification. This might require a technical law change to allow 3rd party verification.
- There may be somewhere in the process to propose a fee for the eligibility verification service.
- We still need to look at path ways for international patients and patients from states with no certifications. We need to look for an expedited process. But this raises question of expedited processes for visitors vs. residents. We are still considering.
Q. Senator Rosalyn Baker – If we ever join the compact for licensing doctors. It would solve the doctor verification issues. Be careful using the word reciprocity. In medical terms, since we are not a part of the compact, doctors from other states cannot practice here, that is also called reciprocity.
Education Subcommittee – Stacy Kracher, APRN, Chair
- Christopher Garth
- Wendy Gibson
- Michael Takano
- Rob Lee
- Thomas Wills
- Karen Kahikina
- Richard Ha
We’ve been meeting for a year in various ways to go over recommendations for education. The goals were to find out what people know and don’t know. We started identifying key stakeholders in the state who could be good sources for providing education. We identified those stakeholders and made recommendations.
The stakeholder list includes about 27 names. Confirmed by members from hospital law enforcement, law, etc… mostly people involved in the business. We sent out a survey to stakeholders. It will be attached to the report for reference. We distributed the survey and followed-up to get responses.
We only received three responses. Even after direct contact via phone.
Two significant stakeholders opted out of survey. 7 people looked at it and didn’t complete it.
We were disappointed we didn’t meet our objectives. We feel there is a high level of stigma and fear of association with the industry. The stakeholders felt it was not a good fit to be associated with the industry.
Some of the subcommittee members felt we need to expand our reach into the stakeholders and find different people in the organization. Maybe the survey didn’t meet the needs of the stakeholders. Maybe it focused on medical benefits, not necessarily questions the stakeholders could answer. Maybe it was too subjective.
So we have recommendations we are still working on. For instance, increased funding to DOH to increase education for stakeholders and the general public. Information regarding cannabis may be better received when supported by the Department of Health. We want different recommendations regarding trainings hosted by dispensaries and open to the public. We need education in different forms for different audiences – internet, in public, etc…
We need to determine types of education and come up with a strategic plan. So many types needs to be shared across the state. We need to diversify education across Stakeholder groups and include information about the transportation of cannabis.
The training should be consistent with the information in a report included with this subcommittee report. Consistent with the Cole memo.
Training should include information on operating vehicles and on intoxication.
We need to offer CEU and CME’s.
The National Department of Highway Safety made some detailed recommendations. To increase training of law enforcement to detect and measure levels of impairment. Continuing research to enable development of impairment standards. Other training and support of law enforcement officers.
We are still working on the report
Wendy Gibson – Education announcements
Hawaii’s first local CME – Open to public – Put on by the John A. Burns School of Medicine – “Medical Cannabis and the Science Behind It”. Nov 4, Saturday, 1-4 pm. $10 per person. (Click here for more information).
Also on Nov. 4. The Epilepsy Foundation of Hawaii. “I Aloha Someone with Epilepsy” is an all day event. A large portion is cannabis presentations, starting around 12:30. There will be number of presenters, including Wendy Gibson and Shana Metsch. (Click here for more information).
Q. Carl Bergquist – I went to Noa Botancials open house. It was great. It highlights this recommendation that dispensaries can host these classes. DOH has the authority. Dispensaries are on par with that. But you can’t go into dispensary. Can they host after hours or on weekends?
A. Brian Goldstein – No.
Q. Carl Bergquist – Can we change that rule to provide venues to educate people?
A. Senator Rosalyn Baker – A lot of the dispensaries, even before they were open, they were hosting informational sessions. Just not on the dispensary site. They have excellent educational materials in the community. That should be open to the public irrespective of getting someone on the dispensary property for classes.
A. Brian Goldstein – Hawaii is the only state that requires every person that walks into a controlled facility to be fingerprinted and background checked. HEALTH is making a recommendation that that requirements be limited to employees and contractors that come into contact with the plant. We want to invite the community as well as bankers, insurance, etc… to come in to facilities and see that they are professional, well run organizations. To destigmatize. Otherwise they will never go through the background process just to tour a dispensary. We are hoping the upcoming legislative session will change that. But the current statute is very clear, if not a patient or no background check through DOH, there is no entering the facility.
Q. Representative Della Au Belatti – What in the Cole Memorandum should be included in the training?
A. Stacy Kracher – That came from Rob Lee. Not sure. I’ll clarify it with him.
Q. Representative Della Au Belatti – The Cole Memo just has kind of general public education recommendations about not mixing drugs and driving. General public health information, not specific information.
A. Karen Kahikina – When he contacted other states’ airports, he was referred to it. He mostly just wants us to be aware and inline. He is not recommending training on the Cole Memorandum itself.
Public Q&A and Wrap-Up
Q. Paul Klink, Honolulu Wellness Center – You mentioned looking for a state licensing program that would be similar medical cannabis license. Only thing would be where the end user has to choose a qualified officiant. Marriage licensing is the only similar process.
Regarding patient registry turnaround time. I follow-up and track all of my patient’s cards. Our patients are getting their cards in 5-6 days. They are happy they are getting it so quickly.
How does it look for adding Generalized Anxiety Disorder. Any advice before the announcement date?
A. Keith Ridley – No.
Q. Anonymous – When a batch is turned down by DOH for a biologic. But it could be fixed in a concentrate. Can the dispensaries hold on to it and not destroy it?
A. Keith Ridley – If in the manufacturing process the material that failed the test is destroyed and doesn’t create additional impurities and then passes the manufactured product test. Then it is fine. But the manufactured product still has to pass all the tests.
Q. John Paul Bingham, CTAHR – If the situation that something is being used or reused arises, it might add an additional compound that might be toxic that is not tested for.
A. Keith Ridley – Thank you.
Q. Senator Rosalyn Baker – But my understanding is that if you test a batch with pesticide it must be destroyed.
A. Keith Ridley – Not if you run a process that destroys the pesticide.
A. Tai Cheng, Aloha Green – Flash chromatography.
Q. John Paul Bingham – Doesn’t that add solvents?
A. Tai Cheng – Yes. But the solvents are being tested for.
Q. Representative Della Au Bellati – The laboratories are testing for those?
A. Tai Cheng – Yes.
A. Ally Park, AEOS Labs – The labs are not certifying the final product. Just the cannabis. Any add-ins are not tested.
Q. Senator Rosalyn Baker – But the labs have to certify the efficacy of the final product. So it must be tested after the additives are added. That has to be tested.
A. Ally Park – Correct, but the labs are still only testing for the tests required by law. We obviously can’t make edibles, but there are comparable food tests that we are not doing.
Q. Representative Joy San Buenaventura – So infused olive oil. Is that tested?
A. Brian Goldstein – Yes. Nothing in the statute says no edibles. It only says what we can sell. Olive oil is an oil. And the lab is testing the final product. They are testing the plain olive oil and the infused olive oil. And the final products in the dispensary are tested and certified by the lab.
Q. Senator Rosalyn Baker – One could argue that a lozenge is an edible. For most people in the discussion – you mean baked goods, candies. Not oils, tinctures, lozenges, capsules. Some people argue that if you have capsules that are dosed and can be pulled apart, you wouldn’t need edibles.
A. Brian Goldstein – We will sell olive oil and coconut oil dosed for cooking with instructions.
A. Senator Rosalyn Baker – So if that is the case, whether we jump into the array of edibles, that might not be important if you have these other products available.
Q. Representative Della Au Belatti – So going back to Shana’s question earlier – If a product is from a dispensary, you have a batch that tested positive for pesticides. It is not destroyed?
A. Keith Ridley – If it is not used for anything else the dispensary destroys it. And logs the destruction in the tracking system. Or they have to prove they went through the refining process and resubmit for new testing.
Q. Representative Della Au Belatti – That is a different answer to Shana’s question earlier.
Q. Representative Della Au Belatti – Can you say how many batches fail as dried flower. I’m comfortable with the process. But others might not be if the product has latent/initial pesticides.
A. Brian Goldstein – Pesticides are a bad example. They are usually concentrated in the manufacturing process, so they can’t be fixed. Microbial or moisture issues in the flower are better examples that can be fixed in the manufacturing process.
Q. Representative Della Au Belatti – But I don’t know if patients would be comfortable if at some point it did fail the test?
A. Tai Cheng – On the microbial side – we reprocess the flower in a way that kills microbes and is still usable. Then the product goes back through all of the testing again before it can be sold.
Q. Representative Joy San Buenaventura – Can we limit product that failed the first test so that it then becomes only for topical use, not ingestion.
A. Brian Goldstein – No.
A. Tai Cheng – Talking to the licensees and labs. Pesticides and heavy metals are not issues. Yeast, mold, moisture are the issues. Plants have 10-12% moisture on the mainland. We are seeing 13-15% . We are testing ok for everything else, but moisture is high. This can lead to yeast and mold. Water activity is a better measure. It is hard to grow mold in dry cookies, faster in wet products. Yeast and mold are removed by heat and pressure and easy to fix in manufacturing. Pesticides are not an issue. We aren’t using them and they are too easy to potentially tip off the 1 ppm on the test.
Q. Senator Rosalyn Baker – Where is the moisture?
A. Tai Cheng – In the dried flower. We are experimenting with labs to find where the moisture is coming from. Maybe the transportation. Maybe the humidity, the weather? Also caregivers are used to a wetter product, some patients return it. Wetter is a smoother product, but we are trying to get it even dryer. Under 12% moisture, less problems in testing.
Q. Carl Bergquist – Let me ask a question to Dana. Before you were here someone said you had interesting results from patient testing regarding pesticides?
A. Dana Ciccone, Steephill Laboratories – There are always interesting results!
Q. Carl Bergquist – Regarding patients using the labs for testing, some have gone to Steephill. It was said those results were interesting, they had more pesticides?
A. Dana Ciccone – Most local samples are full of pesticides and 99% have yeast and mold. Local weed is super dirty. Hawaii’s dispensary weed (Brian Goldstein interjects, “we call it cannabis.”) is the cleanest in the nation.
Q. Wendy Gibson – Does it vary depending on whether the patient is growing indoor or outdoor?
A. Dana Ciccone – Yes. Outdoor grows are really covered in pesticides, but indoor as well.
Q. John Paul Bingham – What about arsenic levels?
A. Dana Ciccone – We haven’t seen high levels.
Q. Senator Rosalyn Baker – Are there any pesticides that are better than others?
A. Dana Ciccone – No.
Q. Senator Rosalyn Baker – Is there any cannabis being grown that qualifies as organically grown cannabis.
A. Dana Ciccone – There are a few local people that are organic and very clean.
A. Richard Ha, Lau Ola – When it comes to organic. It is a federally controlled definition and cannabis is federally illegal. So no validity to organic label.
A. Dana Ciccone – Agreed. They are just very clean.
Q. Shana Metsch – There is a USDA certification for organic cannabis for a grower in Colorado. Hope Foundation.
A. Senator Rosalyn Baker – That is hemp.
A. Shana Metsch – But it has THC.
A. Senator Rosalyn Baker – It is still different.
Q. Richard Ha – The organic program for cannabis is illegal under USDA. So how did they get certification for an illegal product?
A. Shana Metsch – Its on their website.
A. Senator Rosalyn Baker – Hemp and cannabis are both illegal. It is weird.
A. Carl Bergquist – There are federally approved hemp programs; but just the one federally approved cannabis program in Mississippi.
Q. Stacy Kracher – Do you provide education to patients that come to the labs?
A. Dana Ciccone – We do follow-calls, we talk with them. We focus on the yeast and mold and pesticides.
Q. Representative Della Au Belaltti – What is reaction of patients?
A. Dana Ciccone – Egos. They get hurt and they fight with you because they claim they don’t use pesticides. Generally the public is starting to grasp the whole program. We made it reasonable in pricing and not scary. It is like an authority figure issue, learning that we won’t take their product. We are happy to answer questions about how to improve their grow. We do a lot of public education. $50 for potency testing, $25 for terpenes, more for the rest. They can call back anytime. UH supposedly had some supposedly tainted coleslaw/pulled pork we tested, but it was clean.
Q. Representative Joy San Buenaventura – You said you had 1 sample that tested clean out of how many?
A. Dana Ciccone – Not just one was clean, but only one was outstanding. Out of 100 tests.
Q. Stacy Kracher – How much of the plant do they bring? What’s the minimum amount?
A. Dana Ciccone – 2 grams. We really only need 1. But 2 for extra in case we need to restest. The public doesn’t want to test for everything. They just want to test for potency. There are a few who are really interested and they do the full gamut. But very few. The main reason we did pesticides was for validation studies. That was one of our largest difficulties. Finding clean weed for validation studies. Now we have one guy. Maybe that will change in the future.
Q. Stacy Kracher – Are you considering expanding in the future – big island, Kauai?
A. Dana Ciccone – We are considering, but those markets are small, there are not a lot of options. What we are working on is working for us for now.
Q. Dana Ciccone – Regarding sampling. Some people want their samples back instead of destruction. Even the dispensaries. Its in the rules to allow that, but nothing in Biotrack allows for that.
A. Senator Rosalyn Baker – But it is not a lot of material.
A. Brian Goldstein – For concentrates it is a lot. They take twice as much so they can retest. But if you pass, for concentrates, that’s $60 + a gram sitting there. 10, 20 samples sitting there, I want it back.
A. Dana Ciccone – We want to give it back, but nothing in Biotrack allows us to.
A. Keith Ridley – We have asked Biotrack about this. Maybe the dispensary can just manifest it back? We are working on how to say that in the tracking system.
Q. Representative Della Au Belatti – can we have an update in a month?
Q. Michael Rollins – PharmLabs Hawaii – We are expected to collect two samples in case of more testing. We don’t know how long we need to keep the second sample. What’s the shelf-life. We are also asked to do routine testing/proficiency testing that occurs frequently, every 20 tests. Where should the labs get that material?
A. Representative Della Au Belatti – Dana –Did you find that to be a problem?
A. Dana Ciccone – No, I’ll have to ask my science guys.
Q. Senator Rosalyn Baker – We don’t want the labs to keep all of this inventory. It is someones inventory and cash. If not utilized it should go back into circulation.
A. Dana Ciccone – We agree on concentrates. But it is less important on the flower side.
Q. Pamela Lichty, Drug Policy Forum – The DOH process for approving new conditions has been in the law since 2000, but it was not activated until this year. I thought the publicizing of this process was inadequate. We only heard about it a few days before the applications were due. Only a few people were able to show up. There is a lot of interest in adding new conditions, but I think DOH needs to step up its game with this process as research opens up new conditions. Another educations process.
I still think there is a need for edibles that can come straight out of a package. Lots of patients can’t just cook with it. For those who need pain control throughout the night for instance. I’d like to see us have edibles available.
Regarding this working group, will it be pau by the beginning of this next session?
A. Representative Della Au Belatti – It goes till the end of next session.
Q. Pamela Lichty – It seems clear that there will be ongoing questions and a need for something else after that.
A. Senator Rosalyn Baker – Part of the reason we have this instead of strict sunshine law board is that we had a lot of things to work on, and it would be burdensome to DOH. We are ultimately supposed to dissolve and there should be a Board of Cannabis. Eventually.
Q. Pamela Lichty – I’m on the board of syringe exchange. There are always issue popping up, especially with opioids. I’m saying I would like to see some sort of entity continue moving forward. Even to help the legislature draft legislation.
A. Senator Rosalyn Baker – You can do that with and without this group.
Q. Board Member of Drug Policy Forum – One thing I noticed in the discussion. There is lots of ambiguity around travel issue and the certification of patients. You could really use guidance from the AG. If the baseline is to facilitate patient access to needed medications, in California they had immediate, temporary documents 30 days, two weeks it expired. They were physician authored and notarized. It was proof to law enforcement. On the interstate issue, I know the AG likes to take Trump to court, but the status right now is that until December, they can’t interfere with state marijuana laws. And that may be permanent in December. Please ask the AG for clarity for this group, the State House, and the public would appreciate clarify to help create public buy-in.
A. Senator Rosalyn Baker – Even if we had something. This administration says it will do something by executive order and ignore congress. So it might not hold-up. That being said, that is what the cards are about is to provide that assurance. I am particularly sensitive, we have providers authorizing patients to get a card who are not doctors – APRN’s so they have options.
Next Steps and Announcements
Announcement: To get on the email list, go to Act230wg@gmail.com. All updates are also posted to the Act 230 website.
The next meeting will occur on November 21st, from 1pm to 4pm. This will allow time for discussion of the subcommittee recommendations.
Representative Della Au Belatti – Subcommittees – Good work on the recommendations. Please finalize and drill down to specific recommendations and language. There is a lot of disagreement in one committee. If no consensus, should they bring forward discussed recommendations?
Senator Rosalyn Baker – I only think we can only bring forward recommendations with consensus. If there is division it will interrupt other progress in this group.
Representative Della Au Belatti – Please finalize reports by November 14th. Submit to the Chairs.
Now it is your turn! The Alliance has a role on the Committee and access to each of the subcommittees – Products, Education, Patients, Reciprocity, Licenses, and Laboratories. We need your thoughts, comments, and detailed considerations for any and all of these committee priorities that you would like to see action or deliberation on. What did we miss? What do you think we should emphasize? The Legislative Oversight Committee will generate the successful legislative and administrative progress the industry needs in the coming years, and this is your opportunity to guide our hand.
We want to know what you think! Email us at email@example.com if you have any suggestions or comments, find us on Facebook, Contact Us through this website, or give us a call anytime. You are invited to be as broad or specific with your submissions as possible.
Mahalo nui for your continued support as we build a better future for Hawai‘i’s legitimate cannabis industry!
It is the Alliance’s mission to provide up-to-date and relevant industry information to the patients, dispensary applicants, and related businesses of Hawai‘i’s growing medicinal cannabis industry. If you are not yet an Alliance member, join today to receive the HDA Cannabis Insider every month and to take an active role in the future of Hawai‘i’s medical marijuana industry. Contact us today and we will send you the Winter 2017 edition of the HDA Industry Update absolutely free to say thank you for your interest!