December Meeting Notes of the Act 230 Working Group – Final Recommendations

Aloha Alliance!

The December 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 December 13, 2017. In the audience were almost a dozen members of the Hawai‘i Dispensary Alliance, representing every aspect of the industry. The Committee’s chief concern was discussing and voting on the Committee’s recommendations for legislation in the upcoming 2018 session. Today’s recommendations will shape the likely contours of the future of Hawai‘i’s cannabis industry, and today’s discussion gives an in-depth tour of the minds of our legislative body regarding Hawai‘i’s cannabis industry.

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 at some point in the future.

If you have any questions about the meeting, or about how to get involved in the industry, email the Hawai‘i Dispensary Alliance at info@hawaiidispensaryalliance.org or find us on Facebook.

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
• Rep. 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
• Stacy Kracher, APRN/RX
• Michael Takano – Pono Life Sciences Maui
• Shana Metsch – Parent of a patient who is a minor
• Keith Ridley – DOH
• Gregg Yim – Physician
• Bryson Ponce – Assistant Chief – Kauai PD, Sitting in for Officer Contrades

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 December meeting in place of Dr. Chandler who is on sabbatical.

Working Group Discussion & Consideration of Subcommittee Recommendations

Rep. Della Au Belatti – We will jump right into where we left off last week with the Patient Subcommittee.

Patients Subcommittee Recommendations, Discussion, Votes

Q. Carl Bergquist, Drug Policy Forum, Subcommittee Chair – I’m not sure how to start.

A. Rep. Della Au Belatti – We just went through the first recommendation last time?

A. Carl Berquist – I think I summarized all of them.

A. Rep. Della Au Belatti – We do have copies of the Patients Subcommittee Report, please pass it around.

Q. Rep. Della Au Belatti – Were there any additions from last month?

A. Carl Berquist – Yes – The last page with the section on drunk driving. The Department of Transportation and the rest of the Subcommittee are in agreement on it. It is a similar section to the Education Report, but with a slightly different recommendation. The Subcommittee is in agreement. So with the Chairs’ permission, we should go though each recommendation.

Q. Rep. Della Au Belatti – So one recommendation at a time and we’ll take a vote. Start with #1.

Q. Carl Bergquist – Recommendation #1. For those who don’t have access or lack a state ID with which to get a 329 card. You see here recommendations for specific revisions to the HRS. It helps to make it easier for those under 80 to get a state ID. Removing the arbitrary age restrictions. Another component is to revise the HAR regarding renewal by mail. There is a possibility of renewing by mail now, but the process could be streamlined. Especially for hospice patients, we want to make it easier for those patients to use.

Q. Rep. Della Au Belatti – Discussion? A question for Carl, the recommendation is to allow renewal by mail for those below the age of 80? Is this saying that all patients can renew by mail instead of online and does it expand the renewal process for ID cards from 1 to 2 years.

A. Carl Bergquist – This is just for the ID cards, not for the cannabis cards. The statute says if an ID card is expired for a year, you can’t renew by mail. We just make it two years rather than one, like other states. In reviewing these sections of the HRS, it refers to specific types of patients. Not for all patients. We are just changing the length of time and the age, it opens it up to other people in the statute, but it is still restricted to those who are barred or have obstacles to renewing in person or online. This is not about the 329 cared but about the state ID, and this just makes it easier to renew the state ID, not the driver’s license.

Q. Sen. Baker – There may be an issue since the state ID now, if it is to be useful for most everything, must be Real ID compliant. So you may be setting yourself up where you have the ID valid for medical cannabis but it will not be good for anything else. I don’t know if it will effect things?

A. Carl Bergquist – I understand things. By changing the expiration period and age it won’t cross Real ID requirements. To my understanding, Real ID compliance requirements are chiefly for travel, these people won’t travel.

Q. Sen. Baker – You’re making an assumption.

A. Carl Bergquist – We did consider Real ID, and it is compliant. It matches other states that are Real ID compliant.

Q. Sen. Baker – I don’t know if you can renew such an ID by mail.

A. Carl Bergquist – You can currently, if over 80 and it has not expired beyond a year.

Q. Sen. Baker – I mean a Real ID. My belief is that you can’t renew a Real ID by mail. I don’t know, I’m just asking the question?

A. Carl Bergquist – Sure. My understanding is that the current statute allowing for renewal by mail is Real ID compliant and changing it in the way we suggest would maintain compliance and increase access for those under 80 whose ID has expired for a slightly longer period of time.

Q. Sen. Espero – We can revisit this later – There are more pressing issues than ID. I think we should take it up, I don’t think most of the people in the audience are here for this issue.

A. Rep. Della Au Belatti – Thank you. We haven to decide ourselves.

Q. Rep. Della Au Belatti – So we allow for renewing the 329 card by mail?

A. Carl Bergquist – No, they can’t apply because they won’t have a state ID. So we are changing the law so that more people have access to a state ID card so that they can get a 329 card.

Q. Rep. Della Au Belatti – Members, do you want to take up the recommendation?

A. Christopher Garth, Hawaii Dispensary Alliance – I motion.

A. John Paul Bingham – I second.

Recommendation #1. Access to Medical Cannabis for Patients without a Current/Valid ID.

Yes Votes

• Senator Will Espero
• Christopher Garth
• Carl Bergquist
• Wendy Gibson
• Richard Ha
• Karen Kahikina
• John Paul Bingham
• Stacy Kracher
• Michael Takano
• Shana Metsch
• Keith Ridley
• Gregg Yim
• Bryson Ponce

No Votes

• Senator Rosalyn Baker
• Representative Della Au Belatti

Q. Rep. Della Au Belatti – Recommendation #2. Patient travel in state with legally grown or purchased cannabis.

Q. Carl Bergquist – Currently state law explicitly prohibits travel for patients and caregivers. Whether for personal use or for caregivers to deliver to patients. State law also prohibits patient testing on other islands. The recommendation is to remove the prohibitions to make the law silent on the issue. The explanations as to why this is OK according to current case law are included. We are criminalizing the practice, but if we remove it, then it avoids criminalizing patients and caregivers who travel for personal use and testing. Other states with similar geographies don’t have that prohibition and have found ways to work around it. Washington, Oregon, Alaska, Massachusetts. That has not attracted federal attention in violation of the Cole memo.  So we recommend just removing the legislation and making the law silent.

Q. Rep. Della Au Belatti – Questions? I’ll express my concerns. I understand where you are coming from. The legislation crafted was a compromise to ensure a strictly regulated program. I think the compromise that was struck to allow patients to remain on their islands, it is a compromise that should be respected. This is a difficult one. I understand, it is difficult, we have people who are testing this and the limits. And then people will cry foul if they test and are caught, and then they want protections. But there are no protections. If there is a valid prosecution they won’t have protection of the law. That is my concern.

Q. Sen. Baker – Reminder to guys on the phone to mute devices.

A. Carl Bergquist – If I can address the point. It is well taken, it was a compromise legislation. These asterisks are all over the law, yes you are complying in state law and can’t protect from federal enforcement. That is inherent. The patients are unlikely to be targeted at the federal level. This is an approach we should take.

Q. Keith Ridley, DOH – DOH is in a quandary on this as well. We’ve read the statues in other states. There seems to be concern and dispute between lawyers and law enforcement as to whether it is allowable or not. My only thought is that if the recommendation is to go through and become part of a bill, then we can have others in the public and lawyers weigh in at that time.

Q. Rep. Della Au Belatti – The recommendations are simply recommendations. Once we enter the legislative timeline, and I suspect that people at this table will put on your own hats and speak on the proposals. Recommendations will come out of the group, but they are not a restriction on anyone.

Q. Sen. Baker – The purpose of the working group is to delve into the issue and provide recommendations for people to say yay or nay too. The devil is in the details and legislative language can look way different than the English. What Della and I hope for is a set of recommendations with a general consensus that we could get drafted, introduced, then the working group can evaluate and other people can weigh in, and we’ll have something that, at the end of the day, can be added to or subtracted from the medical cannabis law.

Q. Bryson Ponce, Kauai PD – From a law enforcement perspective, we have 5 officers able to check with DOH if someone has a permit. If it is after hours or a patrol officer, they have no way to verify with DOH if someone is complying. One suggestion if you do move forward is to allow TSA to check through DOH instead of calling local law enforcement because it is a drain on our resources.

A. Carl Bergquist – I’m not sure I’m opposed. Currently TSA is to defer to local law enforcement. Looking at the statue, they only have limited access. So I understand what you mean with only 5 officers who are able to access the database.

A. Karen Kahikina, DOT – I’m with Highways and not able to talk for Airports. We have a unique situation at our airport, where once you are through TSA you can travel anywhere, whereas other states they have domestic and international in different terminals. There is no way to ensure that people actually stay in the state with cannabis. Because you can’t travel with cannabis across state lines.

A. Carl Bergquist – In the state of Oregon, the airport policy across the state is that regardless of the airport, traveling with medical or legal weed, there is a check prior to security to determine whether traveling domestic or international, and then they are allowed to proceed. We don’t want to facilitate illegal travel. But there is a workable solution I think.

Q. Rep. Della Au Belatti – Any discussion from those on the phone?

Phone – “No.”

Q. Rep. Della Au Belatti – Are the members ready to vote? – Options are yes, no, abstain.

Recommendation #2. Travel within the State with Legally Grown or Purchased Medical Cannabis

Yes Votes

• Senator Will Espero
• Rep. Joy San Buenaventura
• Christopher Garth
• Carl Bergquist
• Wendy Gibson
• Richard Ha
• John Paul Bingham
• Stacy Kracher
• Shana Metsch
• Keith Ridley

No Votes

• Senator Rosalyn Baker
• Representative Della Au Belatti
• Gregg Yim
• Bryson Ponce
• Karen Kahikina

Abstain

• Michael Takano

Q. Rep. Della Au Belatti –  Next recommendation.

Q. Carl Bergquist – Next issue, Recommendation #3, continued discrimination of renters by landlords. The first recommendation is really regarding the public housing authority. Skipping over that, the specific recommendation is to reviews HRS 489 to increase coverage to include places of public accommodation. This change, with an exception for smoking, would protect individuals looking for a place to live and consume their medicine. Affirmative defense when consuming in public, but not smoking.

Q. Rep. Della Au Belatti – So there are two recommendations. Asking for guidance from Hawaii Public Housing Authority, second, is to broaden use allowances in “places of public accommodation”?

Q. Sen. Espero – What does “places of public accommodation” mean?

A. Sen. Baker – Hotels.

Q. Carl Bergquist – This is the statutory expression. The idea is to protect patients who want to consume their medicine.

A. Sen. Baker – So long as they are not smoking.

A. Carl Bergquist – Yes.

Q. Rep. Della Au Belatti – How about a specific example – schools are places of public accomodation?

A. Carl Bergquist – But there is an explicit ban at schools, so that is not an issue.

Q. Rep. Della Au Belatti – What about in a bar?

A. Carl Bergquist – Yes, they would be able to use in a bar. But it is just an affirmative defense, not explicit permission. It helps protect renters. The idea is to give them some place to consume in these places of public accommodation.

Q. Rep. Della Au Belatti – Again, there was a compromise, this will change the program and expand it to a lot more places. Beach, bar, restaurant. I think this is going to be, I mean if you are a patient, you will take your medicine at home. As I understand this product, you can take it in many forms. I don’t know. This borders on advocates wanting to decriminalize. That is a separate discussion. It moves away from the compromises we struct as a society.

Q. Sen. Espero – Anther example on the other side, if you are with family or friends, and someone wants to go to the beach and have a homemade edible and be with their family. That would be allowed.

A. Carl Bergquist – Yes. I see Rep. Belatti’s point.But I’m on a prescription that requires me to take my medicine with food. If I’m at home or at library or work I cannot use my medicine if it is cannabis. I can take my medicine anywhere, but not cannabis. This recommendation would offer some protections for patients in similar circumstances. That is the rationale, but I understand the compromise issue.

Q. Keith Ridley  – Chairs, can we split the recommendations? One for guidance from the Hawaii Public Housing Authority and one regarding public accommodations.

Q. Rep. Della Au Belatti – Agreed. I have no problem asking for requiring guidance from HPHA.

Q. Rep. Della Au Belatti – Any further discussion?

Q. John Paul Bingham – Places of accommodation includes facilities – they are specifically delineated. Can we just specify a few places and only allow cannabis use in specific places of public accommodation. For instance rental property?

Q. Rep. Della Au Belatti – Carl, did ya’ll discuss potential limitations?

A. Carl Bergquist – No, but we are open to it.

Q. Christopher Garth, Hawaii Dispensary Alliance – Part of this came from the discussion from earlier oversight meetings, regarding reciprocity. Where could those patients use?

A. Sen. Baker – That discussion is premature.

Q. Christopher Garth, Hawaii Dispensary Alliance – But we need to discuss it because we are discussing reciprocity too, and this piece is a result of that.

A. Sen. Baker – You misinterpret me. I’m not proposing providing reciprocity.

Q. Sen. Espero – But if a local patient were to go to a weekend in a hotel, that is illegal today.

A. Rep. Della Au Belatti – That is an open question. I think a hotel room is a residence while you are in it. So I think it is incorrect to assume that a hotel doesn’t allow for the use of medical cannabis.

A. Michael Takano – I asked a manager of Hyatt that question, you are right, but it can be prohibited by the hotel in their specific policies.

Q. Carl Bergquist – The only idea here is to put protections for the patient that they do not have. To make it explicit.

A. John Paul Bingham – Also for rentals, those that are in rentals or looking for rentals vs. discriminatory landlords once they find out they will, or may, or do use.

Q. Sen. Espero – The biggest issue is smoking which is prohibited. If looking at it like medicine, there is not a restriction on prescription drugs.

Q. Bryson Ponce, Kauai PD – From law enforcement perspective. We get calls of people smoking in their rooms. As a result if we respond, the extra burden to check if they are permitted is huge. If you allow smoking in public, you are close to recreational use.

A. Sen. Baker – This is not for smoking. We are keeping the Keep Indoor Air Clean Act intact. It would seem to me that using medical cannabis creates a situation where one becomes a public nuisance. If one is overly rowdy or interferes with the peace of others, we can’t support that. But if a patient is using an oil, tincture, lozenge, and is not rowdy, then it is not an issue. What are we trying to protect, under normal circumstances, if I’m not smoking it, there are no smells that would trigger people to be concerned. If you are drinking too much alcohol and get rowdy you can be dealt with. I’m just wondering if we are trying to parse this too much, leading to something else that is not on the agenda.

Q. Carl Bergquist – The idea is that yes, in most cases, patients would go about their business and be undetected. But if they are, they can be discriminated against for consuming their medicine and they should be equally protected instead.

Q. Rep. Della Au Belatti – Further discussions?

Recommendation #3, continued discrimination of renters by landlords – HPHA required to provide guidance.

Vote: Unanimous

Recommendation #3, continued discrimination of renters by landlords – broaden use allowances in “places of public accommodation.”

Yes Votes

• Senator Will Espero
• Rep. Joy San Buenaventura
• Christopher Garth
• Carl Bergquist
• Wendy Gibson
• Richard Ha
• John Paul Bingham
• Stacy Kracher

No Votes

• Senator Rosalyn Baker
• Michael Takano
• Gregg Yim
• Bryson Ponce
• Keith Ridley

Abstain

• Rep. Della Au Belatti
• Karen Kahikina

Q. Rep. Della Au Belatti – Next recommendation, discrimination by employers.

Q. Carl Bergquist – Next issue, Recommendation #4, Discrimination by Employers of Medical Cannabis Patients. Again, there are two recommendations. First, that DLIR work with the Attorney General and DOH to draft a fact sheet about the current state of employment law both in Hawaii and nationally in both federal and state law. The Massachusetts Supreme Court recently ruled in favor of patients. There has not been an accommodation in the past, but the trend is to provide accommodations. There is a lot of confusion. HR and insurance companies are giving their recommendations to employers, but a state fact sheet would be a welcome occurrence.

Second recommendation, we want to include protection for discrimination by employers against being a patient and failing a drug test. Those protections have been in and out of recent bills frequently. The language is easy to do, we already have it. It is not a novel concept. Even since that time, many other states have explicit protections for the status of being a patient and for failing a drug test. If we don’t criminalize it and don’t have explicit protections, it allows for discrimination. Of course, there will be lots of exceptions for certain occupations, but to have no protections dissuades people from using the program. With the compromise there is a way to insert protections with various carve-outs.

Q. Rep. Della Au Belatti – Discussion on Recommendation #1?

Q. Sen. Espero – Looks good. Education.

Q. Rep. Della Au Belatti –  I’m nervous or concerned about this one because anything that is put out by our departments becomes guidance and the law, and I think that whatever we do, the law will continue to evolve and be litigated.

A. Sen. Espero – Here we are just stating the facts of the cases that have already happened.

Q. Rep. Della Au Belatti – But I don’t know the purpose?

A. Carl Bergquist – To provide a summary of current case law, this is what is going on. Not a statement of our law, but a summary providing information to lawyers and patients so they know it is a gray zone. We want to show that it is a gray zone, the landscape is changing, and we want to support the program.

Q. Rep. Della Au Belatti – It looks like you’re asking for an AG opinion for the public which we don’t do.

A. Sen. Baker – Typically when you ask for FAQ’s it is on a settled issue. Here, you could write something that will be out of date in 6 months. And people base their hiring decisions on this. I’m afraid we won’t see it from the AG and I see pushback from DLIR.

A. Karen Kahikina – I think it would be difficult to have a general fact sheet. Unions and others have different rules. I work for DOT, but I am federally funded so we have to guarantee a drug free environment. So hard to have a general fact sheet for everyone to follow.

A. Carl Bergquist – Of course state and federal and contractors are exempted. We are not asking for a formal AG opinion, but that might be a good idea.

Q. Sen. Espero – But any group can write this?

A. Sen. Baker – But he wants the imprimatur of the state. Creating reliance and the state backing up what is in the guidance. We’ve seen this with workers’ comp. It is problematic at this juncture.

Q. Michael Takano – DOH has priority for education. Perhaps we can amend recommendations to include this topic in their education mandate. Because it is a moving education topic.

A. Sen. Baker – I don’t think DOH is the proper agency.

A. Carl Bergquist – That is why I said DLIR.

A. Sen. Baker –  But they are not here, did anyone ask them?

Q. Rep. Della Au Belatti – Final thought, when I see what DLIR does, like for minimum wage, there is fact sheet, not crafted as a formal opinion, but close because of its content. And people follow those.

A. Carl Bergquist – In that case, flip the recommendations, put in our own protections, and then have them do a fact-sheet.

Q. Wendy Gibson – Why not a pro-con with disclaimer about being true to a specific date?

Q. Sen. Espero – We will have a tough time in the legislature.

Q. Rep. Della Au Belatti – We want to have a discussion on inserting protections against termination.

Q. Rep. Della Au Belatti – Carl, this would only say that only those with disabilities could receive assistance through HCRC?

A. Carl Bergquist – For background, we talked to them last time something like this was introduced. So they toned down employment discrimination to only those that are disabled. So HCRC can only protect disabled, but their language is not clear, so they provided language to change that. We can also put in protections for employment discrimination in addition to protections for the disabled.

Q. Sen. Espero – I certainly feel that know one should be fired for failing a drug test as a patient. I think that is the primary focus.

A. Sen. Baker – I don’t have a problem with that.

A. Carl Bergquist – That law was before the legislature in 2015. We are bringing it back.

Q. Rep. Della Au Belatti – Did you discuss exceptions? Like Karen said, there are jobs that are zero tolerance.

A. Carl Bergquist – Of course. As in the report, numerous exceptions for zero-tolerance policy places. State, federal, etc… This is just protections for other patients, and then the discussion should go to where state employees are protected.

Q. Sen. Baker – There are some occupations where your coworkers don’t want you impaired by anything.

A. Carl Bergquist – Absolutely. And in the instances of people losing their job, none of them have been impaired, they have lost it just for being a patient or failing a drug test. Our recommendation would not restrict employers from terminating impaired workers.

Q. Sen. Baker – Maybe if the recommendation were worded differently I could support it. But I have a hard time with a blanket protection. You may have a disability that allows you to only do certain kinds of work.

Q. Rep. Della Au Belatti – If you’re going to extend the defense, why would you concede to HCRC to only protect the subgroup?

A. Carl Bergquist – The recommendation would protect all. As authorized in 2015, the Commission said they could not cover all patients, only disabilities. So the protections go to all patients, with carve-outs, and HCRC would have responsibility for a specific subset. They believe those patients should be protected. They want to be involved, but they don’t want responsibility for all cases.

Q. Christopher Garth – What is Baker’s amendment to gather more support?

A. Sen. Baker/Sen. Espero – No one should be terminated from a job for having a card and failing a drug test. Because if you have a card and are using it you will fail.

Q. Carl Bergquist – Sure. I apologies for confusing the group about the background. We agree and say we should do exactly that.

Q. Rep. Della Au Belatti – The recommendation?

A. Sen. Espero – Is that no one who is an employed medical marijuana patient and fails a drug test shall be fired.

Q. Sen. Baker – Close.

Q. Christopher Garth – Has to be for failing a drug test for medical cannabis.

Q. Sen. Baker – Correct. Possession of a 329 card and failure of a drug test for use per that card is not sufficient grounds for termination.

Recommendation #4.1 – DLIR will create a fact-sheet regarding state and federal case law pertaining to employment discrimination and cannabis

Yes Votes

• Carl Bergquist
• Wendy Gibson
• Rep. Joy San Buenaventura

No Votes

• Senator Rosalyn Baker
• Rep. Della Au Belatti
• Karen Kahikina
• Michael Takano
• Gregg Yim
• Bryson Ponce
• Keith Ridley
• Senator Will Espero
• Richard Ha
• John Paul Bingham

Abstain

• Christopher Garth
• Stacy Kracher

Recommendation #4.2 – Adding new language to protect 329 cardholders from firing for the act of having a card or failing a drug test for medical cannabis, except in certain industries/occupations/zero-tolerance policy workplaces.

Yes Votes

• Carl Bergquist
• Wendy Gibson
• Christopher Garth
• Stacy Kracher
• Senator Rosalyn Baker
• Rep. Della Au Belatti
• Michael Takano
• Gregg Yim
• Senator Will Espero
• Richard Ha
• John Paul Bingham

No Votes

• Bryson Ponce

Abstain

• Keith Ridley
• Rep. Joy San Buenaventura
• Karen Kahikina

Q. Rep. Della Au Belatti – We love each other in this group. Good discussion. Democracy in action.

Q. Carl Bergquist – Thanks to Michael Takano for weighing in on this. These recommendations are pretty novel. Similar to the employment situation, there is some developing case law. Like in Connecticut. For reasonable and necessary medical treatment.  Three recommendations.

Recommendation #5

1. Proclamation declaring cannabis is a reasonable and necessary medical treatment for insurance purposes – but I’m not really sure who would make it.
2. Amend Luke’s Law for autism to include cannabis as a treatment so it will be covered by insurers
3. Adding cannabis to workers compensation law alongside prescription drugs

Q. Carl Bergquist – Right now lots of patients are excluded from use because they can’t afford it. This is a way for insurance for patients.

Q. Michael Takano – A little context and background. One of the reasons that stakeholders like HEMIC decided not to participate in providing services for the industry is because of the indeterminacy of state and federal law. There is a lot of case law about employees getting injured and finding relief in medical cannabis. In those states, there is not a prohibition against cannabis. Then in the case, the court decides the patient should be reimbursed. Looking at Hawaii, our recommendation doesn’t force the insurers to reimburse, but it does establish a grounds for it to be possible. If we were not to put in this path, then a specific instance in the future could ban it for everyone. If we are to be leader on the issue in providing high quality protections, then our recommendation is to provide this option.

Q. Sen. Baker – I want to address one aspect of #5.2 – Many of the folks that helped with autism services are not medical providers and cannot certify that someone has a condition for which medical cannabis may be helpful. I would be very much opposed to putting that in to Luke’s Law because none of the people identified in Luke’s law to work with autism are medical providers with the ability to recommend that people use medical cannabis. So, before that, we need to have a lot of other discussions.

Q. Rep. Della Au Belatti – Is autism a condition now?

A. Crowd – No.

A. Rep. Della Au Belatti – That to me is the first step, rather than doing it this way.

Q. Sen. Baker – I would want to look carefully at the research, making sure we are not trying to hold out something that may not work for an autism patient. It just merits further consideration.

Q. Rep. Della Au Belatti – The question – is there any insurance or state that is reimbursing?

A. Michael Takano – Not just yet for insurance companies – but there are cases where workers comp have reimbursed patients. Not a policy, but specific cases.

A. Carl Bergquist – For instance Connecticut recently compelled reimbursement. We could find ourselves in that situation or add it to the statute, since the state already recognizes cannabis as a medicine. We do it for prescription drugs.

Q. Sen. Baker – But there is a distinction there. Our statute doesn’t have anyone prescribing medical cannabis because they would lose their license. So they are only certifying a condition for which medical cannabis may be helpful. We have to keep that distinction in mind or the medical boards will oppose us. In the desire to make things equal, we have to recognize the inherent inequities. Maybe we don’t want to do that until we have more discussion with the provider community or else we will get all kinds of pushback.

A. Carl Bergquist – And that is where the language would underscore that they are not prescribing. That is certainly how the system operates in Connecticut as well. Just a way to compensate in places where they are certified, we could get in front of the issue.

Q. Rep. Della Au Belatti – Question to dispensary representatives. I’m not opposed to the concept of reasonable and necessary. Anything on the national level about fee schedules? Insurance works on set prices, what is happening nationwide as these issues arise?

A. Michael Takano – A huge role of this committee is patient issues. We have to look at it from that perspective. But the way the language that has been written doesn’t require physicians to step up and say it is reasonable and necessary, but gives them the option. The American Journal of Health in 2015 said that a majority, 70%, of physicians are not opposed to cannabis. There are lots of situations where medical cannabis reduces prescription use, that might make it reasonable and necessary. So the language just allows doctors an opportunity moving forward.

Q. Rep. Della Au Belatti – We know pharmaceuticals are creating total CBD products. Those are covered?

A. Michael Takano – True, but they don’t work as well as the natural products.

Q. Sen. Baker – There are a whole range of issues around how a certain product gets reimbursed. For many prescription drugs you need a generic otherwise you have to pay. I’m not sure if other states have looked at that and processed how that is working?

A. Carl Bergquist – Not to my knowledge.

Q. Sen. Baker – This is a subject that needs to be explored in standing on its own. We need a study group or work group or something, bringing in the insurance commissioner, pharmacists, etc that have knowledge about how this works. A lot of the pharmacists are being engaged in making recommendations. Then we have a solid basis for recommendations next session.

Q. Gregg Yim – I agree with the statements about Luke’s Law. First, define autism as a qualifying condition, then based in literature, then decide if should be compensated. I think it should be compensated, but I’m not sure if this is the right answer.

A. Michael Takano – The tactic with the legislation is inserting language so that it can’t be prohibited. It doesn’t say that it must be included, just that it could be. But it takes an effort to reduce the ability to prohibit.

Q. Christopher Garth – Doesn’t HB2707 state that cannabis cannot be covered by insurance. This is a chance to repeal that. There is another case in New Jersey where the patient needed to be rewarded by the employer. New York is moving to require to cover or reimburse. That will be active next year.

A. Carl Bergquist – So the obstacle is the explicit prohibition.

A. Christopher Garth – Correct, it is already prohibited.

Q. Michael Takano – So then, it is up to employers?

A. Christopher Garth – Yes.

Q. Sen. Baker – There are a lot of things that go into it. We don’t want the dispensaries to gatekeep for everything. I’m just a little iffy on charging ahead and putting language in that if it were in a larger bill might derail everything. I think we would be better off looking at all of the possible ramifications. Pharmaceutical drugs are a hard topic. Pharmacists are not getting reimbursed. They are going out of business. This could have tremendous value and I think we haven’t had all of the appropriate stakeholders at the table. What are we going to do to the cost of insurance, will it need a kind of rider? As someone very famous said “its complicated.”

A. Richard Ha – I agree. I’m not an expert by any means. But I’ve heard, its counter intuitive. I’m in favor, but its complicated.

Q. Sen. Baker – I think we should explore. We have a robust plan to deal with opioids. There may be an opportunity for opioids. Until people can be “Comfortable with the science behind it” (air quotes) we might have some push back. Until we get more education, we need those opportunities.

A. Michael Takano – Workers comp already covers alternative treatments.

Q. Sen. Baker – Yes, narrowly. And some providers say that is what is driving costs up. We need to go further down the road.

Q. Michael Takano – Great. That is the purpose of working group. Need to memorialize the background. But my view and for patients, it shouldn’t be excluded. It only takes a little bit of guidance and inclusion in the laws to make it not prohibited.

Q. Rep. Della Au Belatti – Good discussion. So:

Recommendation #5.1 – Taken off the table

Recommendation #5.2?

A. Carl Bergquist – If I could say, I‘d like to revisit. It is not meant to replace autism or a form of autism with a specific definition as a qualifying condition. That is the way to go about it. The hope is that this will be complementary. Maybe Luke’s Law is not the proper method. So lets’ table for now.

Recommendation #5.3?

A. Carl Bergquist – Along the lines of the Senator’s recommendation. Get all of the stakeholders in the room. Requesting all of the stakeholders in the room to look at workers’ compensation and insurance.

A. Rep. Della Au Belatti – That is a good idea. You can work out the fee schedule for the rest of the nation.

A. Carl Bergquist – Just by having a working group on the issue we would be ahead of the curve.

Recommendation #5.3 – A working group to study including medical cannabis alongside “prescription drugs” for insurance purposes.

Vote: Unanimous

Q. Sen. Baker – I will take responsibility, if members of the Working Group want to provide the input and language, we will draft the bill for introduction.

Q. Rep. Della Au Belatti – Now, the recommendation for opioid use.

Recommendation #6 – New Debilitating Medical Conditions for the Use of Medical Cannabis

Q. Carl Bergquist – We recommend adding opioid use disorder by statute as a condition. Like we did with PTSD. Some 7-8% of registered patients now have PTSD as a qualifying condition. It is inline with the state opioid plan. Sometimes we are some of the first, sometimes the last or the middle, here we would be among the first. As far as medical justification, all of the members of the medical advisory board in New Mexico are physicians. They have medical expertise. This is why we singled out this condition. We could mention autism, but just opioids for now.

Q. Keith Ridley – The Department’s position is to use the current process via petition.

Q. Rep. Della Au Belatti – Did we get a decision on the other conditions?

A. Keith Ridley – We are expecting a decision in the next couple of days or several weeks.

Recommendation #6 – New Debilitating Medical Conditions for the Use of Medical Cannabis

Yes Votes

• Carl Bergquist
• Wendy Gibson
• Rep. Joy San Buenaventura
• Christopher Garth
• Stacy Kracher
• Senator Rosalyn Baker
• Rep. Della Au Belatti
• Michael Takano
• Gregg Yim
• Senator Will Espero
• Richard Ha
• John Paul Bingham

No Votes

• Bryson Ponce
• Keith Ridley

Abstain

• Karen Kahikina

Recommendation #7 – A comprehensive education campaign and a recommendation against introducing a per se or zero tolerance standard for THC presence.

Q. Carl Bergquist – Next Section, very simple, regarding drugged driving. In cooperation with DOT, a campaign to educate. This is also what is recommended by the National Highway Traffic Safety Administration. We are already doing education on this issue and want to further it. The second recommendation is a preemptive negative one. A lot of states have adopted a zero tolerance standard, we want to not do that in case anyone was tempted. The National Travel Safety Administration’s report to Congress emphasizes that such a zero tolerance policy would be a bad idea.

Q. Sen. Baker – Isn’t that an issue that no one has been able to come up with a good solution to? There is no good test for cannabis impairment?

A. Carl Bergquist – Correct- The Education Subcommittee goes into that detail about how officers can look at it. Problem is that if we go with these tests, we will label people impaired which is problematic.

A. Michael Takano – The technologies are getting better. It is not a static issue, it could be possible, but doesn’t exist yet.

A. Karen Kahikina, DOT – Presence of THC doesn’t indicate impairment, and it affects people differently. Not like alcohol. There is no scientific reason behind a zero tolerance policy.

Recommendation #7.1 – A comprehensive education campaign

Vote: Unanimous

Recommendation #7.2 – Recommendation against introducing a per se or zero tolerance standard for THC presence.

Yes Votes

• Carl Bergquist
• Wendy Gibson
• Rep. Joy San Buenaventura
• Christopher Garth
• Stacy Kracher
• Senator Rosalyn Baker
• Rep. Della Au Belatti
• Michael Takano
• Gregg Yim
• Senator Will Espero
• Richard Ha
• John Paul Bingham
• Karen Kahikina

No Votes

• Bryson Ponce

Abstain

• Keith Ridley

Q. Sen. Baker – Adding a corollary that the Working Group and other parties will continue to look for a test that will help to better predict impairment.

Recommendation #8 – Functionality of DOH Patient Registry

Q. Carl Bergquist – Final Recommendation – The functionality of the DOH medical cannabis registry. I sent these to the registry and they are addressing the concerns. I’m comfortable with tabling this for now. They responded in detail. As far as I’m concerned, these are all in the process of being addressed. I don’t anticipate the need for  a specific recommendation.

The only thing is the concern with the delay in getting the card and the fact that you can’t grow unless you receive it by mail. Other states allow temporary cards. We don’t have that provision. We can resolve administratively. Don’t need to change the law to do that. We do see the processing time fluctuate. This past weekend an article said 10 days. That is longer than it has been, and it is a long time for individuals, say if they wanted to switch from opioids, but now they have to wait 10 days.

We are currently working with the Registry Program, so no need for a specific recommendation.

Q. Rep. Della Au Belatti – Tabled.

Products Subcommittee Recommendations, Discussion, Votes

Q. Michael Takano, Chair – We covered our recommendations in the August and October meetings. So I will go over fairly quickly then you can comment.

Recommendation #1 – Update the definition of “transdermal patches” to “transdermal devices”. This way we don’t exclude other devices that deliver through the dermis that are not patches.

Q. Rep. Della Au Belatti – Discussion?

Recommendation #1

Vote: Unanimous

Recommendation #2 – Adds Suppositories

Q. Michael Takano – Adds suppositories – Another mode that is highly effective, especially for patients that can’t ingest orally.

Q. Rep. Della Au Belatti – Can we drop “Cannabinoid”?

A. Michael Takano – Sure.

Q. Sen. Baker – Note that we made a change to #7 and #1 as listed. We’ll make everything consistent.

Recommendation #2

Yes Votes

• Carl Bergquist
• Wendy Gibson
• Rep. Joy San Buenaventura
• Christopher Garth
• Stacy Kracher
• Senator Rosalyn Baker
• Rep. Della Au Belatti
• Michael Takano
• Gregg Yim
• Senator Will Espero
• Richard Ha
• Karen Kahikina
• Bryson Ponce
• Keith Ridley

No Votes

• John Paul Bingham

Recommendation #3 – Vaping

Q. Michael Takano – This is a deep topic.

A. Sen. Baker – Not as deep as suppositories.

*Laughter*

Q. Michael Takano – We’ve talked about vaping. Public safety. How to differentiate. The discussion went to problem solving, how to characterize it, what could the Committee vote on. We settled on at home, non-portable, non-handheld, medical grade devices. Description here. Example #1 is like the volcano. Example #2 is a hands free digital noncombustible device. Example #3 is like a keurig type pod. If there were a way to allow inhalation, we should discuss something that is more precise. The recommendation is to allow for this, and DOH is allowed to navigate us in regards to other devices.

Q. Sen. Espero – Volcano?

A. Michael Takano – It is a brand. 10-inch wide and 12-inch long. An inhaler, not a bong, no combustion.

Q. Sen. Espero – Digital device?

A. Michael Takano – Hands free, not an ecigarette or vape pen

Q. Sen. Espero – Keurig?

A. Sen. Baker – Like a vaporizer, just drop it in the device.

Recommendation #3

Yes Votes

• Carl Bergquist
• Wendy Gibson
• Rep. Joy San Buenaventura
• Christopher Garth
• Senator Rosalyn Baker
• Rep. Della Au Belatti
• Michael Takano
• Gregg Yim
• Senator Will Espero
• Richard Ha

No Votes

• John Paul Bingham
• Stacy Kracher
• Keith Ridley
• Bryson Ponce

Abstain

• Karen Kahikina

Recommendation #4 – Edibles

Q. Michael Takano – #4 is edibles. Big topic. Part of the description of the Working Group so we have to discuss. We did research across the states that have laws for medical cannabis. This is not a recommendation. Just a documentation of research for future discussion. Two-thirds of 29 states that have public policy for legal cannabis have policies for edibles.

We selected the most conservative states and policies, specifically Florida, another vertically integrated state. It is provided. Along with a model policy by Americans for Safe access. Overtime as the issue comes out, we have to address the issue of expanding products and it may include this category. This is our attempt to memorialize where we are and where things are going. 50% of sales on mainland are products including edibles. Three years ago, Whole Foods CEO said they could see a cannabis aisle. Our point at this time was to fulfill our responsibility to address the issue and provide information for consideration for future policy.

Q. Sen. Baker – The other thing to consider and what I’ve seen in the literature is the over consumption or overdosing. Typically through edibles and not other types of things, that is a concern with children. Other people tell me that as long as you are allowing pills that come apart, you have a method of making your own. So it is an area we can continue to discuss. You can take the oil and put it into shape. There are other products on the market. One of the things I’ve looked at and no offense to the people in DOH, but to allow a manufacturing license for food items will require a whole lot of other regulations in the department a certified kitchen and new packaging. I think there are a lot of other options available and I think this one is a minefield and I’m glad to see that we are just discussing information.

Q. Carl Bergquist – Point of clarification. Exhibit A is changing HRS. But DOH can change Admin to add other products, can we change admin rules too?

Q. Sen. Baker – Dani (DOH) I’m looking at you for this. If there is not an allowance in the statute, the rules can’t make new law.

Q. Sen. Espero – Reciprocity might begin in 2018, could we as a pathway to edibles task DOH to work on admin rules that may allow edibles by 2020?

A. Sen. Baker – We have to establish in statue, not a good idea in administrative rules.

Q. Sen. Espero – That is a long way off still.

A. Sen. Baker – You obviously haven’t worked with the legislature.

Q. Sen. Espero – I have. If DOH is so against smoking, how do you ingest?

A. Sen. Baker – We gave people options. Pills, oils. You can create your own edibles.

Q. Sen. Espero – They are already out there. We would like to formalize edibles.

A. Sen. Baker – Who is we? You?

A. Sen. Espero – “WE” is “Will Espero.” *Laughter*

Q. Sen. Espero – Can’t we put a 2020 aspiration start date like the dispensary start date for edibles. Because without a deadline, things drag on.

Q. Rep. Della Au Belatti – I’m looking to the Subcommittee Head to see if he wants to revise to include a deadline?

A. Michael Takano – I think there are other places we can do this. Lets keep it as is.

Recommendation #4 – Consider creating legislative pathways for edibles.

Yes Votes

• Carl Bergquist
• Wendy Gibson
• Rep. Joy San Buenaventura
• Christopher Garth
• Senator Rosalyn Baker
• Rep. Della Au Belatti
• Michael Takano
• Gregg Yim
• Senator Will Espero
• Richard Ha
• Karen Kahikina
• John Paul Bingham
• Stacy Kracher

No Votes

• Keith Ridley
• Bryson Ponce

Q. Carl Bergquist – The quicker path is to fix the rules.

 

Education Subcommittee Recommendations, Discussion, Votes

Stacy Kracher, Chair

Q. Rep. Della Au Belatti – Stacy, you are up next with the Education Subcommittee.

A. Stacy Kracher (phone) – Christopher Garth and Karen Kahikina will be presenting for the Education Subcommittee.

Q. Rep. Della Au Belatti – Everyone has the recommendations. Go ahead Chris.

A. Christopher Garth, Hawaii Dispensary Alliance – The Education Subcommittee has five recommendations.

Recommendation #1 – DOH Education Initiatives

Q. Christopher Garth – The first is a legislative change to provide direction to DOH to handle education. Section 321-30.1—we would like to amend section A to require DOH to publicly announce when they will hold educational events. In the past they’ve been engaged in conversations more on the private side having individual meetings. While this does great justice for the program, the general public is left in the dark and not filled in on what the program is accomplishing and what DOH is doing. We’d like to require the Department comply with posting these events to make them more public.

Further, we’d like to require that two full-time staff members be dedicated to education, requiring two quarterly public events to cover, not limited to, responsible medical cannabis use, safe access solutions, dosing suggestions, program updates, and programmatic participation requirements for service providers, the dispensaries, or even the patients.

Q. Sen. Baker – How do you anticipate having a professional or nonprofessional person make dosing suggestions?

A. Christopher Garth – I was speaking with a group called CanMed yesterday, who is about to engage with JABSOM to handle their CME and collaborate with them. One issue we discussed is dosing. There’s not a direct number of CBD or THC or any other active agent to solidify how it interacts with an individual, but there is a generally acceptable range for individuals and products. As we move to come up with more concrete numbers, this is best we can do.

Q. Sen. Baker – Has anyone done a search of what places have been doing it longer?

A. Christopher Garth – There is the groups in Isreal that CanMed works with directly that have been involved in development of THC and CBD for the last fifty plus years. The guests in their coming events will be those individuals.

Q. Karen Kahikina – Can you clarify what kind of events? Please be specific.

A. Christopher Garth – At the Department’s discretion, requiring them to hold two public events quarterly. Anything related to these two specific quarterly things. Let’s have two people handle it, let’s have two events so it’s not just O‘ahu-centric, allowing funding for the department to travel to neighbor islands. It needs to reach neighboring counties.

Q. Rep. Della Au Belatti – Are you concerned that it’s everything under the sun and makes it impossible for the department to do?

A. Christopher Garth – I want to make sure it is the group over which Keith Ridley presides.

Q. Keith Ridley – I don’t think anything about medical cannabis registry or funding or public education is in 321. I think it’s in 329 D under the medical cannabis dispensary area. I’m just confused about which statute you want to place this under. 321 is under the Department of Health and many of these are under our program. I’m not sure this is the right place for it. My other concern was 501 C. The department doesn’t go out and do education on other kinds of medical treatment. They do diet, exercise and smoking, but not education on use of medical products or access or dosing. My thought is that the provider community would be concerned DOH is getting into care issues.

A. Christopher Garth – I understand. Perhaps the intent is to more firmly guide hand of the Department to fulfill the obligations that have been set forth statutorily. Our subcommittee feels the Department has let down the patient population and general public that has more questions about medical cannabis than any of the information that has been provided.

Q. Sen. Baker – I think you’re asking for something that may be difficult for medical people to provide and even more difficult for non-medical people to provide. There are prohibitions for MDs and APRNs to prescribe. When you look at the folks doing the most education to the patients, it’s done in the dispensary by people who are not healthcare providers per say, but have been trained and are passing this on. I’m a little concerned about the direction you want the Department to go in because I don’t think they can. And if you directed APRNs and MDS to do it they could potentially lose their license. Maybe you want the Department in conjunction with the dispensaries to have information. Or maybe we enable the dispensaries to conduct meetings because they work with the products and know best how to recommend.

A. Gregg Yim – I agree. That would put medical professionals in a tough situation. It’s a good thing your suggesting, to increase education about the products and how to use it, but this is not the right avenue to ask DOH to do this. From a medical view, it might not make sense.

A. Christopher Garth – Our biggest consideration is that here we have a position that is funded and tasked with education on medical cannabis within the Department of Health. And so far on the patient side there’s very little buy in or support for the medical cannabis program. I’m amenable to finding a solution to encourage that position to be more well defined in their duties if we are going to continue to fund them, which we can all agree that they should be funded because it serves a public good.

Q. Sen. Baker – Maybe it’s better to enable the dispensaries, facilitated by the Department of Health, to talk about the education issues they’re faced with and how can they work together to get the information out to the public. So that there’s a more informed set of folks dealing with patients. My belief is that we have to change some of the statutes to allow that type of collaboration and working with the community. One of the dispensaries on Maui prior to starting had open houses. I was under the impression that once they started as a business, they couldn’t use the dispensary property as an education venue. You had to go somewhere else. I’m wondering if some of that is prohibitive.

A. Keith Ridley – The licensees have asked us if they could do education programs off property and that’s fine.

Q. Sen. Baker – Maybe we should be encouraging that as part of our recommendation and in conjunction with the Department of Health.

A. Carl Bergquist – To answer Mr. Ridley’s question about the statutory reference, 321 30.1 is the Medical Cannabis Regulations Special Fund, and one of the things it’s supposed to fund is public education as required by the dispensary law and it gets fees from the patient $35 registration fee and from the dispensaries, so the money from the dispensaries and the patients is already going to the Department to fund public education. Whether then we want it to go back to the dispensaries to do the education, we can discuss that. I want to clarify that the statutory reference is correct.

Q. Sen. Baker – Keith, can you please provide the status of what’s in the fund and what it’s being used for.

A. Keith Ridley – I think that’s one of the reports that I owe you.

A. Gregg Yim – The issue is not whether it has to be at the dispensary site or not, it is whether the dispensaries can sponsor these educational events. That would be a legitimate use of the funds

A. Carl Bergquist – A report would be welcome for what’s happening in that fund

Q. Rep. Della Au Belatti – Can I suggest an amendment? Strengthen public education efforts in collaboration with licensees to include two Department sponsored events per year with notice provided and consider additional staff members or appropriate use of education staff.

A. Christopher Garth – We already have one and that one staffer is not appropriately used. It seems we need more or to eliminate the position.

Q. Sen. Baker – We might want to redefine the position.

A. Sen. Espero – Increasing public education is the crux. Lets come up with bills to strengthen public education.

Q. Christopher Garth – DOH has been tasked with education, but holding conversations, by just a single individual doesn’t count towards a boarder scheme of increased education. Which is why we asked for 2 quarterly so its not so Oahu-centric. That the neighbor islands have opportunities.

A. Keith Ridley – We have an FTE, five staff, four vacancies, and split that up with the staff.

Q. Sen. Espero – Chris, your point is well made.

Recommendation #1 – as amended 

Vote: Unanimous

Recommendation #2 – Coalition for Medicinal Cannabis Research

Q. Christopher Garth – Next is to establish and support with funding a Coalition for Medicinal Cannabis Research. This is following Florida rule to ask the state to engage in greater research and education in cannabis.

Q. Rep. Della Au Belatti – Any discussion?

Q. Sen. Baker – If its done like this no one will own it and nothing will happen.

Q. Stacy Kracher – In HB2707 under the 304A research program – it allocates UH to establish an MMJ testing and research program. Should we revise this section to add other stakeholders?

A. Rep. Della Au Belatti – It says may, not that they have to.

A. Sen. Baker – That’s not a requirement.

A. Rep. Della Au Belatti – We were trying to empower them.

A. Gregg Yim – We are moving forward.

Q. Christopher Garth – We will table that.

Recommendation #3 – APRNs and physicians that qualify patients must complete 4 hours annually CE or CME on medical use of cannabis.

Q. Christopher Garth – Right now APRNs and MDs are required to participate in CE and CME. This says if you provide these certifications, it’s a minimum for CE and CME in medical cannabis

Q. Keith Ridley – DOH does not require physicians to take CME or CE to certify.

Q. Sen. Baker – I don’t think it’s a bad thing but Keith’s right, the licensing agencies.

A. Stacy Kracher – It doesn’t have to say required.

Q. Rep. Della Au Belatti – Revised to encourage APRN at least to complete 4 hours annually. People that might certify aren’t gonna do this and you might lose a doctor.

Q. Sen. Baker – The medical board is not going to do it because its an illegal substance. If people are interested in it, they need to come together to provide info that they may have got in another state and then make that available and deliver it here in the state.

A. Christopher Garth – JABSOM will be engaged in a CME program.

Q. Sen. Espero – Make it 2 hours annually, at least one class a year.

Q. Gregg Yim – Or even removing hours. What’s the medical basis for having certain number of hours?

Q. Sen. Baker – This ought to go into a resolution.

Q. Rep. Della Au Belatti – We can table this.

Recommendation #4 – UH should study cannabis

Q. Stacy Kracher – We can table this as well  – Recognizing that UH is doing something.

Recommendation #5 – Public Safety Education

Q. Karen Kahikina, DOT – Our recommendation is to recommend with funding, implementation of widespread education initiatives to address public safety concerns.

I think this touches upon previous discussions, concerns about technology to detect impairment, and working with dispensaries to provide education, and we provide some drug driving statistics as well: Pre and post medical cannabis regulation. There may have been other contributing factors in system. And statistics don’t say that THC caused the fatality. It says there was fatality and thc in the system.

Q. Sen. Baker – When looking at statistics, did it say any other kind of drug or opioid in there?

A. Karen Kahikina – Data collection of the years has changed. And with other statistics, data collection isn’t as good as we want it to be.

Q. Sen. Baker – Anything we can do to make data collection better? Are you guys following formula for data collection?

A. Karen Kahikina – There are federal guidelines for what to collect and how to collect it. Hopefully we’ll get better data with that.

Q. Rep. Della Au Belatti – Lets vote on this one.

Recommendation #5

Vote: Unanimous

Licensing Subcommittee Recommendations, Discussion, Votes

Q. Rep. Della Au Belatti – Moving along to recommendations from Rep. Joy San Buenaventura. I’ll do that.

Recommendation #1 – New Dispensary Licensees Schedule 

Q. Rep. Della Au Belatti – First recommendation is that the schedule not be changed as to when new dispensaries might open, basically you want us to not extend it any further.

Vote: 12 Yes, 2 No, 2 Abstain

Recommendation #2 – Working Group for New Production Licenses 

Q. Rep. Della Au Belatti – Second one is to recommend another working group to discuss need for more non-retail licenses. Basically another working group to determine need for production, for non-retail dispensary license. This is exploring whether or not there could be more production, an intermediate not for retail, a separate license. This would support

Vote: 12 Yes, 1 No, 1 Abstain

Reciprocity Subcommittee Recommendations, Discussion, Votes

Q. Rep. Della Au Belatti – There are two papers going out, recommendations from Reciprocity Committee and a paper summarizing other states reciprocity laws.

I apologize to members of the Reciprocity Committee – my assistant just completed this. Even though other states recognize it we would be leading the charge on it. Recommendations don’t have a basis in other states. In the memo you see some people in the community pointed to Nevada, but not now with recreation, anyone can access it. Nevada is making a requirement that other jurisdictions can maintain a database and they can access it, which is a barrier.

Recommendation #1 – State should respect home doctor recommendation

Q. Rep. Della Au Belatti – We recommend that the state respects the home doctor recommendation and verify the condition with a third party, basically.

Q. Sen. Baker – And that recommendation allows them to go to a dispensary and purchase?

A. Rep. Della Au Belatti – Yes.

Vote: 11 Yes, 2 No, 1 Abstain

Recommendation #2 – Impose a fee to cover the verification service

Q. Sen. Baker – How is the fee collected? By the dispensary?

A. Rep. Della Au Belatti – We don’t know, that is why we are exploring as an option. At some point they would intersect with the state registry.

Q. Carl Bergquist – More money for the public education fund.

Vote: 12 Yes, 1 No, 1 Abstain

Recommendation #3 – Creation of Pathways for Recognition of International Patients

Q. Carl Bergquist – What’s the basis for these patients to have a separate track?

A. Rep. Della Au Belatti – Just to call out international patients. Do other countries have a database?

Q. Sen. Baker – Typically if traveling in another country, you are subject to those laws. Not unusual for us today, you have to do something.

A. Rep. Della Au Belatti – Just recommend exploring the option for international patients to be recognized.

Vote: 11 Yes, 1 No, 1 Abstain

Laboratory Subcommittee Recommendations, Discussion, Votes

Q. Rep. Della Au Belatti – There was a recommendation made publicly to amend the law to allow for dispensaries to test basically at any of the labs. Because some labs only have locations on one island. Right now you have to use the lab on island. This allows dispensaries to access more labs. Because no problems in transporting samples, I’m comfortable in supporting.

Q. Sen. Baker – Is there anything from DOH?

A. Keith Ridley – No.

Vote: 11 Yes, 1 No, 1 Abstention

Review of Minutes and Final Thoughts

Q. Rep. Della Au Belatti – Approval of minutes and adoption of minutes for October 25 and November 21.

A. Keith Ridley – Note I was in attendance on the 21st.

Q. Rep. Della Au Belatti – Approved and adopted.

Q. Sen. Baker – This is a copy of a Washington State cannabis tourism map – You might be interested in seeing it. It talks about places you can go, answers questions, definitely a professional piece. Not suggesting we go that route now, just sharing it.

Q. Keith Ridley, DOH – The key thing we are working on is filling the vacant positions, some people have approached us, highly qualified, and we’re having discussions and there are others we’ve approached. We haven’t hired anyone yet. No timeline yet, the discussions are continuing. The people have come with high qualifications and have issues with pay and scope of work. We also know that we do have a potential sustainability issue, so all questions of costs for adding or bringing additional staff on are part of that.

Q. Sen. Baker – Have we got any revenue from sales at dispensaries, any state statistics or taxation yet?

A. Kieth Ridley – I can’t speak for Taxation on what they collected. We have provided DBEDT with gross sales revenue for their development of a report on the impacts.

Q. Sen. Baker – Can you get that for us?

A. Kieth Ridley – I can ask them, I don’t know if they can give it to me.

Q. Rep. Della Au Belatti – We will memorialize the recommendations and get them out to you after Christmas. Once that has circulated there’s no need for us to meet after this. We’ve bonded and I want to see you again in January. Once the recommendations go out, this is our last formal meeting, it is a good time to end. UH Public Policy Center has been a  true partner in this.

Q. Sen. Baker – Its been a pleasure working with everyone and I’m hoping we will be able to do follow-up work, but not during session, once bills are out or we get minutes, there may be an opportunity before session opens, maybe we could have a meeting to touch base and see where to go from there.

Q. Sen. Espero – In a year, we might have one of the best medical cannabis programs in the nation.

Next Steps and Announcements

Announcement: All updates are also posted to the Act 230 website.

 

Adjournment

Conclusion

And that’s it, the final recommendations.

Now it is your turn! We need your thoughts, comments, and detailed considerations for any and all of these recommendations that you would like to see action or deliberation on in the 2018 session.

What do you think we should emphasize?

It is up to us to 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 info@hawaiidispensaryalliance.org 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!