Maine’s medical marijuana program would undergo sweeping changes under a bill approved Wednesday by the Legislature’s Health and Human Services Committee.

The bill, approved by an 11-2 vote, would increase patient access to medical marijuana by allowing medical providers to certify an adult patient for any medical reason; give registered caregivers the ability to serve more patients, hire more workers and sell out of storefronts; and let dispensaries shed their nonprofit status to better compete in the marketplace. The number of dispensary licenses would increase from eight to 14.

“If the medical cannabis program is a circle, we want to draw a sharp line around that circle,” said Sen. Eric Brakey, R-Auburn, committee co-chair. “We want a lot more freedom inside that circle for people to operate, but to make sure that things are not being diverted outside that circle to the black market.”

Brakey ended up voting against the bill, however, because he wanted to eliminate the cap on medical dispensaries altogether. He wanted caregivers who were shut out of the initial dispensary licensing process to have the opportunity to expand their business beyond 30 plants and move into the dispensary category, with all the rights and the responsibilities of that license. The committee voted to allow an unlimited number of dispensary licenses, but to delay the action for three years.

“Three years is a long time,” Brakey said after withdrawing his initial support for the dispensary compromise and voting against it. “It’s an eternity in this business.”

Committee members who wanted to delay unlimited dispensary licenses said they thought it would make the committee bill easier to promote to fellow lawmakers, many of whom oppose any and all forms of cannabis, including medical. Others worried that unlimited dispensaries might drive down the price of marijuana to the point that the small caregiver could no longer make a living at it. Some said such a radical change was unwise with the recreational market about to launch.

The bill must still go before the full Legislature for approval. The reforms proposed by the Health and Human Services Committee run parallel to work underway at a different legislative committee, which is trying to set rules for retail sales of recreational marijuana. Voters approved a referendum in November 2016 allowing adult-use pot, but lawmakers have been unable to craft a regulatory framework that has won the support of Gov. Paul LePage, who vetoed the last attempt.

At his direction, lawmakers have been looking for ways to dovetail changes in medical marijuana operations with proposed recreational marijuana rules.

DOCTOR’S OK

The committee bill would allow doctors to certify a patient to get a medical marijuana card for any therapeutic or palliative use the doctor deems appropriate, which would eliminate the existing list of qualifying conditions that must be met to get a medical marijuana card. It would let families of children with epilepsy, cancer or developmental or intellectual disabilities use medical cannabis with just one doctor’s approval, eliminating the need for a second opinion.

Currently, only people with one of about a dozen specific debilitating conditions, ranging from post-traumatic stress disorder, prolonged untreatable pain and nausea to inflammatory bowel disease, HIV and Alzheimer’s disease can get a doctor’s certification to participate in the medical marijuana program. This change grew out of the committee’s desire to allow doctors to certify marijuana use for treatment of opiate addiction.

The Maine Medical Association strongly opposes removing the list of qualifying conditions, according to President Roger J. Schlager, a family physician in Pittsfield. The MMA testified against a bill in January that would have added prescription drug addiction to the list of qualifying conditions for medical marijuana, saying there was no evidence that it worked. The MMA testified that cannabis use is a risk factor for opioid use disorder, saying it negatively affects the part of the brain responsible for judgment.

Initially, some committee members worried the bill might increase the risk of certification mills, with doctors giving out certifications that allow patients who don’t need it to get a medical marijuana card. But supporters say that professional licensing boards would have the ability to censure or revoke the licenses of any doctors found guilty of handing out inappropriate certifications.

The bill would also allow patients to buy medical cannabis from any caregiver or dispensary without designating them as their sole provider as they must do now, so long as they stay under the personal possession limits set by the recreational marijuana law of 2.5 ounces of prepared marijuana every two weeks. The bill would prohibit any out-of-state medical marijuana patient from growing marijuana in Maine or transferring their marijuana to anyone else.

CAREGIVER CHANGES

The bill would eliminate the five-patient cap on the number of cardholders that a registered caregiver can treat, allowing them to sell cannabis to as many certified patients as they want while possessing no more than 30 flowering plants at one time. It also would allow them to hire as many people as they want. Currently, caregivers can serve no more than five patients at one time, and can only have one employee who is permitted to actually touch the plant.

The bill would allow registered caregivers to operate storefront operations, something more and more of them have been doing even though opponents say it is illegal.

But with additional freedoms would come additional responsibilities. The bill would require both registered caregivers and dispensaries to institute a seed-to-sale tracking system to make it easier for the state to check tax compliance and prevent diversion into the black market. It would also require the caregivers who operate storefronts to install the same security measures as those used by dispensaries.

The bill would also allow the state to conduct unannounced inspections of caregiver grow facilities, something that caregivers had opposed when the Department of Health and Human Services sought that change. The bill also would give the state the right to require inspection before renewing a license.

The additional dispensary licenses would go to six different business entities. That would mean an existing dispensary license holder, like the Wellness Connection of Maine, could apply and get one of them. At least three of the new licenses would have to go to a newcomer, thus opening the door to caregivers who are already treating hundreds of patients a year.

The bill would also allow dispensaries to become for-profit corporations. Under current state law, dispensaries must be nonprofit corporations, which the dispensaries say has subjected them to regulatory burdens and financial restrictions that do not apply to the large caregiver storefront operations. Dispensaries tried to shed the nonprofit status through adult-use marijuana legislation, but lawmakers killed their proposal even before LePage vetoed the bill.

Penelope Overton can be contacted at 791-6463 or at:

poverton@pressherald.com

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