Americans For Safe Access released its 2021 State of the State report and the results were pretty disappointing. Only two states received a rating in the B category, with no states getting an A. The two states scoring B’s were Illinois and Maine. Early medical marijuana states like California and Colorado only managed to get C+ grades. The group noted that its grade for each state’s medical cannabis program is based on how well it meets the needs of patients in six categories, plus a seventh category to deduct points based on issues that can harm patients.
The grades descriptions are as follows:
A: The state program is comprehensive and provides substantial patient rights and protections. The state may require a few adjustments, but for the most part, patients are exceptionally protected, and access is not a problem.
B: The state has a good medical cannabis program but requires a few major adjustments to ensure that patients are protected.
C: The state has a fair medical cannabis program that provides at least some access and protections for cannabis patients, but requires substantial improvement in one or more areas.
D: The state typically has a medical cannabis law on paper, but there are critical and substantial deficiencies in access and/or patient rights that must be addressed immediately.
F: The state either has a non-existent or critically flawed medical cannabis program. Policymakers in these states should prioritize legalizing medical cannabis and ensure that no patient is left behind.
The report said that each state was scored based on how well their current law and regulations accommodate patient needs, as broken down into seven general categories:
1. Patient Rights and Civil Protection
3. Program Functionality
5. Health and Social Equity
6. Consumer Protection and Product Safety
Maine scored the highest of the 52 states with a B. The report said, “As the adult use market enters its second year open to the public, Maine legislators have responded to concerns among the state’s medical cannabis caregivers of being sidelined by the growing retail market: LD 1242 “An Act To Ensure Appropriate Oversight of Maine’s Medical Marijuana Program” was passed as an emergency measure in June 2021. The new law gives the state’s caregivers a say in regulatory decisions made by the Maine Office of Marijuana Policy and requires any future changes to the medical cannabis program be made by the state legislature. This is important for the small operators of Maine who had previously expressed concerns over getting squeezed out by the larger retail industry.”
“Even as adult use stores finally open their doors to the public, Maine’s medical cannabis patient registry had a year of exceptional growth. With over 30,000 new patients, Maine’s per capita participation rate has increased to over 7% of the population. This is likely due to the high cost of cannabis at adult use stores compared to what are some of the most affordable products in the country at one of the states’ many mom-and-pop run caregiver storefronts. ASA recommends extending the stricter adult use third-party testing standards to products
intended for consumption by patients. Additionally, the state should consider allowing multiple yearlong registrations to avoid burdening patients with unnecessary paperwork.”
Illinois came in second with a B-. The report said, “In June 2021, there was a statewide computer glitch with the state’s track and trace software. The glitch created an error in processing patient data which meant dispensaries couldn’t serve patients without a breach of compliance. The glitch highlights a central issue with the state program in Illinois that forces patients to choose a single dispensary to be their point of access. When this single point of access failed, patients were forced to shop alongside adult use consumers and pay markups on products alongside 30% more in taxes. Despite major access issues stemming from a computer glitch, 2020-2021 was a period of exceptional growth for Illinois’ patient enrollment. Since our last report, we have seen over 36,000 new patient registrations. Illinois did not extend delivery or curbside pickup options to patients as a measure to improve access during the COVID pandemic. ASA strongly recommends that state legislators look at the success with which these policies were deployed across the country and consider adding these options for patients to acquire their medicine. We also recommend that the state extend reciprocity measures so that visiting patients have access to medical cannabis products.”
Despite being the original legalized medical marijuana state, California only scored a C+. The report stated, “In March 2021, California regulators announced a $15 million grant program to expand economic justice opportunities for communities most impacted by decades of cannabis prohibition. In cooperation with the Governor’s Office of Economic and Business development, the Bureau will issue a series of low-zero interest grants to be awarded by selection from local jurisdictions. This grant is coming in on top of an existing $40 million in cannabis equity funding; the stated goal of these grant campaigns has been to move capital into the hands of individuals who may not have access to it due to the intentional destruction of their families and livelihood brought by the War on Drugs.
The City of San Francisco chose to delay the imposition of their local tax ordinance on cannabis products set at between 1 and 5%. City officials were concerned about competition with the illicit market and felt the move could help them compete. Because cannabis is so heavily taxed in California, the cities’ decision to hold off on the taxes will only impact a small portion of the total taxes imposed by other rules, but it is a step in the right direction for Californians who want access to clean and safe cannabis affordably.
In 2022, ASA encourages California lawmakers to address the gaps in civil protections provided to patients in employment, DUI discrimination, and housing. Patients must be protected from facing discrimination in the workplace due solely to their status as a patient. This extends to barring employers from hiring/firing based on use and stopping employers from unfairly drug screening patients. As it stands, though patients cannot be denied a lease based on their status, individual leases can be written to keep patients from being allowed to dose at home. Patients must be able to take their medicine in the comfort of their own home without being able to worry about eviction. Additionally, the state must stop police officers from unfairly discriminating against patients with roadside sobriety tests. Based on their status as a patient, an individual should be exempt from any roadside test looking for impairment due to cannabis. Finally, lawmakers should identify strategies to overcome local resistance to extending legal medical access to patients because too many localities across the state have made access difficult for patients. ”
Colorado also only managed to get a C+ grade. The report said, “Colorado’s legislators had a busy year when it came to modifying existing cannabis rules. Governor Polis signed four separate bills in 2021; the first bill, HB 1216 gives licensed operators the ability to redesignate products in their inventory from medical to adult use and vice-versa. This could severely impact product availability for patients as retailers look to make higher margins on adult use products. HB 1301 clarifies statutory definitions and rules surrounding outdoor cultivation and seeks to keep the state’s industry competitive in a hypothetical national market by tasking state regulators to assess current rules and tax policy. SB 56 makes efforts to expand existing rules regarding access to cannabis at school for minors by allowing school staff like nurses or professional volunteers to administer doses on school grounds. This is an important step forward in providing a safe and fair public education for Colorado’s citizens and will take a great burden off of the state’s parents who have been responsible for dosing up to this point.
Finally, HB 1317 is perhaps the single biggest rollback of patient rights by inflating their program related fees and forcing patients through multiple rounds of physician certification. During the certification, physicians will now be required to recommend maximum daily doses which the patient will be limited to at the point of sale. The bill will also limit cannabinoid content by adding potency restrictions to products and block patients under 21 from acquiring concentrates.
ASA is disturbed by the direction Colorado policymakers have chosen to take in amending cannabis laws. ASA recommends an emergency session be called to issue an immediate repeal of HB 1317 before it devastates the state’s patient population and creates a crisis of access. If legislators and regulators are genuinely confused about what will work to improve the quality of life for patients, they should create an advisory council of physicians and patients that can help them understand the issues. If state legislators want to continue improving conditions for patients in 2022, they should seek to address the gaps that exist in protecting patient civil rights. As it stands, based solely on their status as a patient, an individual in Colorado can still lose custody of their children and their job; they can also be discriminated against in the case of organ transplants and unfair roadside sobriety tests. Additionally, although patients cannot be denied housing based on their status, individual leases may prevent them from dosing in the comfort of their own home. Landlords should not be allowed to keep a patient from using their medicine safely in their own home.”