Smoking in the Rockies

1. Smoking in the Rockies Colorado’s Medical Marijuana Registry Ron Hyman, State Registrar

2. History • Amendment - November 2000 • Statute – C.R.S. § 25-1.5-106 • Regulation – 5 CCR 1006-2 • July 2001 – Registry established • May 2010 – Additional statutes to license dispensaries and define MD-patient relationship

3. Key Players • Patient – person who has a debilitating medical condition • Physician – doctor of medicine who maintains, in good standing, a license to practice medicine issued in CO • Primary Care-giver – person, other than the patient and the patient’s physician, who is 18 years of age or older and has significant responsibility for managing the well being of a patient

4. Patient • Applies to the Department for registration with the program • Supplies written documentation from a physician showing diagnosis of a debilitating medical condition and a recommendation that the patient might benefit from the use of medical marijuana • Name, address, date of birth, SSN of patient • Identifies primary care-giver, if the patient has one

5. Debilitating Medical Conditions • Cancer • Glaucoma • HIV/AIDS • Cachexia • Severe Pain • Severe Nausea • Seizures • Muscle Spasms

6. Primary Care-givers • Defined as a person 18 years of age or older – not a business/corporation • Significant responsibility • Dispensaries • Proliferation • New statute to license (Dept of Rev)

7. Confidentiality • Patients, primary care-givers and physicians all protected from identification by the Amendment • Law enforcement limited to seeking confirmation from the Department of registry identification cards presented to them by patients and primary care-givers

8. Protections of the Program • Amendment affords patients and primary care-givers the following rights in the criminal realm: • If physician has diagnosed a patient with a debilitating medical condition and recommended marijuana, patient and primary care-giver can raise an affirmative defense to criminal charges • If patient or primary care-giver are in lawful possession of a registry identification card, an exception from criminal laws exists (i.e. no charges filed)

9. Registrations – 2004 to 2010 *Projected

10. Registrations - 2009 by Month *Projected

11. Mail Received by Month 2009-10

12. Conditions

13. Gender and Age Group

14. Typical Day • Mail – 1,000 pieces • Good Applications – 600 • Bad Applications – 200 • Other - 200 • Phone – 200 • Email – 100 • Verifications (law enforcement) - 20

15. Work Flow • Packet: App, MD, ID, $ • Triage: Reject, New, Renewal, Change • Money deposited • Data entry/update • Exceptions handling • Card Issued • Scanning/Filing

16. Staffing • Current – 3 perm, 10 temp • Added – 5 perm, 8 temp • Needed • 60+ to keep up • 120 to reduce backlog within six months

17. Revenue • Annual fee to patient - $90 • Fees adjusted periodically based on costs to operate program • Fees retained by program • Except when the legislature takes • Authority to spend • Indigent waiver

18. Growth • From a portion of an FTE to a full blown program with multiple units, supervisors, manager • Backlog – storage, lockbox • Impact on service counter • Constructed new office space • Already looking into expansion space

19. Legal Issues • Lawsuits by advocate community • Testifying in court cases • Public hearings • Legislative committees • US Attorney • Last year my legal bill was >$200K

20. Other Challenges • Staff morale • Fraud • Number and frequency of changes • Maintaining confidentiality • Verifications for law enforcement • Federal law enforcement

21. Conclusion • A money-maker • Challenging customers • Politics