By Kay Lazar
Doctors at Massachusetts community health centers have been advised not to authorize any of their more than 638,000 patients to obtain marijuana for medical purposes because the centers fear they would lose their federal funding.
The Massachusetts League of Community Health Centers has advised its 36 federally funded facilities to hold off on issuing patient marijuana certifications under the state’s new medical marijuana law, because use remains illegal under federal law.
Health center physicians who believe marijuana might be beneficial for certain patients and authorize its use could be committing a “potential violation of federal law and could result in legal and financial exposure for community health centers,” according to a statement from the League.
This disconnect between state and federal marijuana law is cropping up in other areas as well; some rules restrict tenants who use medical marijuana from living in federally subsidized housing, or prevent Veterans Administration hospitals and clinics from authorizing medical marijuana.
Voters approved a ballot initiative in November, making Massachusetts one of 20 states, and the District of Columbia, that allow medical marijuana use. Community health centers in other states also have advised doctors against authorizing patients to use marijuana.
It is not just federal funding at stake if the centers certify patients for marijuana use, but also loss of malpractice insurance, covered by a federal program known as the Federal Tort Claims Act.
Also, should a community health center physician be convicted under federal law for certifying a patient, the physician could be shut out of the Medicare and Medicaid programs, the insurance that covers many who use health centers.
The National Association of Community Health Centers is unaware of any center or center physician that have faced federal sanctions for prescribing medical marijuana, but the threat of prosecution or funding loss looms large.
“Community health centers have been providing access to care for decades, but there is no assurance that they would not come under federal investigation or that their physicians would not face trouble for certifying medical conditions under state medical marijuana programs, given it is an unsettled area of the law,” said Kathryn Watson, an attorney at Feldesman Tucker Leifer Fidell, a Washington-based law firm that advises the national group.
With health insurance unlikely to cover medical marijuana treatments, state regulators tried to ensure that lower-income people would be able to afford medical marijuana. State-licensed cannabis dispensaries must offer discounted or free marijuana to patients with documented financial hardship, but the community health centers’ stance could undermine that goal.
Among these patients is Gary, a 61-year-old disabled former church outreach worker who received a certification for medical marijuana use this year from his primary care physician at the Joseph M. Smith Community Health Center in Allston. A few puffs before meals helps pique his appetite, which, along with his weight, has shriveled because of hepatitis C, a disease that attacks the liver.
Gary asked that his last name not be used for fear of losing his publicly subsidized apartment, where medical marijuana use is prohibited.
In July, Gary received notice from the health center that his marijuana certification was being rescinded because the center was worried about losing federal funding, which accounts for about 10 percent of the facility’s funding.
“I am in a Catch-22 position,” Gary said. “I have a [doctor’s certification] that may or may not be valid.”
He has been buying marijuana on the street, bargaining prices between $200 and $300 for an ounce, and eagerly awaiting the opening of dispensaries,where he could get reduced-cost or free marijuana, as well as edible or vapor options, which would be gentler on his scarred lungs.
Paola Ferrer, grants and development director at the Allston health center, said the organization cannot risk its federal funding and care for 12,000 patients by writing certifications for a small number.
“We are really tied to the federal government and the funding stream, and until the legal issues are adequately resolved, we are not at liberty to do this,” Ferrer said.
Regulations issued by the Massachusetts health department in May require people who want to legally buy medical marijuana to receive a physician’s written certification that they have a “debilitating medical condition” that would benefit from marijuana use.
Like patients treated at community health centers, those who receive care at Veterans Affairs facilities face challenges obtaining certification. In a 2011 memo, the Department of Veterans Affairs reminded its physicians that it prohibits them from “completing forms seeking recommendations or opinions regarding a veteran’s participation in a state marijuana program.”
The memo, however, said department policy does not prohibit veterans who legally participate in a state marijuana program from also receiving other treatment at VA centers.
More confusing is a 2011 memo from the US Department of Housing and Urban Development to public housing authorities. It directs them to establish standards and leases that prohibit new tenants, and those with new subsidized housing vouchers, from using “state-legalized medical marijuana,” but gives authorities discretion to allow medical marijuana use by current residents and “to determine continued occupancy policies that are most appropriate for their local communities.”
An August memo from the US Department of Justice to federal prosecutors has also left many lawyers and health administrators unsettled.
The department attempted to clarify its policy by listing eight priorities, such as preventing marijuana sales to minors. The priorities do not specifically mention selling, growing, or authorizing patients to get marijuana for medical use.
The department is “committed to using its limited investigative and prosecutorial resources to address the most significant threats in the most effective, consistent, and rational way,” the memo states.
It concludes by noting the department still has authority to enforce federal laws “including federal laws relating to marijuana, regardless of state law.”
by Liz Hallroan
When the Obama administration recently announced it wouldn't challenge the decision by Colorado and Washington voters to fully legalize marijuana, criticism rained down.
The administration's position, complained one Colorado congressman, was tantamount to allowing states to opt out of the federal law banning pot possession, cultivation and sale.
Other anti-legalization activists predicted that the administration was waving the white flag in the war on drugs.
The first claim is essentially true: The states will be creating their own regulatory regimes.
As for the idea of a surrender in the war on drugs, the reality is a little more complicated.
Whatever its effect, the administration's hands-off position in Colorado and Washington will reverberate well beyond those states. And it could actually end up imposing some semblance of order in what drug law expert Mark Kleiman describes as the "Wild West" of medical marijuana.
"And that would be a potentially very, very good result," says Kleiman, who previously worked in the Justice Department's criminal division and is author of Marijuana Legalization: What Everyone Needs to Know.
"Medical marijuana is a free-for-all in many states," he says. "On Venice Beach in California, you have guys in medical scrubs and with stethoscopes walking around offering to give you a prescription."
"The administration's decision may actually mean a crackdown on that kind of business," he says.
So how does a move not to enforce federal drug law in Colorado and Washington help control medical marijuana sales and use in the 18 other states and the District of Columbia where it's legal?
Simple, says Kleiman.
To keep federal drug prosecutors at bay, Colorado and Washington have to come up with what Deputy Attorney General James Cole described this week to members of the Senate Judiciary Committee as "strict regulatory schemes" that are tough in practice and meet eight federal enforcement priorities.
The priorities address everything from the distribution of marijuana to minors and transporting pot across state lines to drugged driving and using marijuana sale proceeds for criminal activities.
Don't meet those priorities? Sorry — your state is going to be in trouble with the feds, Cole says.
The Senate committee has advised Cole to come up with metrics by which the DOJ can measure state performance in meeting the priorities.
What's already happening is that some states with legal medical marijuana are devising regulatory schemes that would also satisfy federal priorities. They view it as the path to keeping federal drug prosecutors off their backs and also to full legalization.
Cole issued a memo in 2011 that gave U.S. attorneys more authority to aggressively pursue medical marijuana distributors but also served to discourage local officials from adopting medical marijuana regulations.
"Suddenly, the politics of this has reversed," Kleiman says, "and a lot of marijuana advocates are saying, 'Let's do something about the medical marijuana business; let's clean it up.' "
Now, for the first time, the feds have provided an incentive for states to more tightly regulate medical marijuana.
California is contemplating legislation to create new oversight by a medical marijuana agency that would develop and enforce regulations for commercial medical marijuana activity, including for production and distribution. Businesses already operating legally under city or county laws would be grandfathered in.
Other states that permit medical marijuana have gotten busy, too, armed now with a blueprint for how to clean up a messy industry.
Federal officials also have more work ahead: The administration and Congress still need to figure out how to adapt federal banking and tax laws to account for the new cannabis-related businesses in Colorado and Washington.
District Judge Daniel Kaup ruled today that the three medical marijuana dispensaries in Loveland suing the city and state because of a citywide ban have not proved they are entitled to an injunction allowing them to remain open.
Kaup said granting the injunction would be against the will of the voters and be a disservice to the public.
Attorneys representing the city of Loveland and state of Colorado presented closing arguments today, along with the plaintiffs' attorney, Rob Corry.
The defendants are Rocky Mountain Kind, Magic's Emporium and Colorado Canna Care, plus John and Jane Doe, medical marijuana patients. During Corry's closing argument, Kaup told him Amendment 20, which Colorado voters passed to legalize medical marijuana, does not apply to everyone.
Check back at LovelandConnection.com for more on this story.
Shouts of protest filled the streets of downtown Missoula on Saturday as medical marijuana advocates, angered by the raids of cannabis facilities across Montana last week, rallied in support of their right to use marijuana for medical purposes.
"DEA, go away!"
It was a line repeated over and over as more than a hundred people wielding signs that read "No Plant Left Behind," "We are not criminals" and "Feds Hands Off My Meds" marched from Caras Park to the Missoula County Courthouse and back. There were families, veterans, college students and medical marijuana caregivers. At times, a faint scent of marijuana drifted through the crowd.
Doug Chyatte, founder of Montanans for Responsible Legislation and one of the rally organizers, used a bullhorn to encourage people to "come out of the shadows and into the streets" - a message of standing up in support of medical marijuana.
The rally was in response to federal agents on Monday issuing 26 search warrants on medical marijuana shops and producers in a handful of cities across Montana, seizing cash and plants. The raids generated fear and anger in an industry that's under the microscope of state lawmakers working to regulate the industry.
Montana legalized the medical use of marijuana in 2004, and the number of cannabis patients and providers soared after U.S. Attorney General Eric Holder issued a memo in 2009 stating that the prosecution of medical marijuana programs in states where it's legal is not an effective use of the use of federal resources.
Dozens of medical marijuana caregivers destroyed their plants in a panic following last week's raids, said Chyatte, who called the raids a "political move" and a "scare tactic" - the most vocal medical cannabis distributors were the ones targeted, he said.
The rally aimed to send a message to state and federal officials that medical marijuana advocates are not backing down and they're not scared.
Drawing guns on people watering plants is wrong, said Katrina Farnum, of Garden Mother Herbs and an MRL member. "It's not a time to divide; it's a time to stand together," she said.
Chyatte referred to the raids as "a war that we didn't choose but a war that no doubt ended up at our front doors."
"I know many of you are angry," Chyatte said. "I'm angry, too. But today, we stand united ... Without embarrassment or shame, we will demand equal rights. This community has had enough of the hatred and bigotry."
Last week's raids coincided with state lawmakers in Helena taking executive action on House Speaker Mike Milburn's bill to repeal Montana's medical marijuana law passed as a referendum by voters in 2004. There are other bills circulating through the Legislature that would regulate the industry.
One of the places targeted last week was Montana Cannabis, which is where retiree Bob Wolf of the Plains area used to shop. Now, he has to search for another provider. That's one of the reasons he decided to join the rally on Saturday.
"Believe me, it's not dope," said Wolf, who says he suffers from spinal arthritis. "It's medicine."
Chyatte encouraged the crowd to come out about their medical marijuana use to family, friends and employers and register to vote. The rally generated a large number of honks from supporters driving by on Higgins and Broadway avenues.
MRL is calling for the resignation of Missoula Police Chief Mark Muir for testifying as a Missoula city representative in support of the bill to repeal Montana's medical marijuana law - a move that later drew criticism from Missoula City Council members. His testimony was "incredibly inappropriate," Chyatte said.
Subsequently, the City Council on Monday will vote on a resolution that would show the city's opposition to House Bill 161 to repeal the state's medical marijuana law. Currently the bill remains stuck in the Senate Judiciary committee on a tie vote.
Reporter Chelsi Moy can be reached at 523-5260 or at email@example.com.
Thought from the editor: In this country, if you want to work, potential employees have to pass a drug test, but if you want to collect welfare, unemployment or housing assistance, just sign on up....WTF?!.....
Wal-Mart employee fired for medical pot loses case
Fri Feb 11, 2011 11:51pm EST
Reporting by Clare Baldwin, additional reporting by Jonathan Stempel; Editing by Ron Popeski)
* Wal-Mart justified in firing employee for positive test
(Reuters) - A federal judge in Michigan on Friday upheld Wal-Mart Stores Inc's dismissal of an employee for testing positive for marijuana, even though he was using the drug under the state's medical marijuana law.
Judge Robert Jonker wrote that while the state law was meant to provide some limited protection for medical marijuana users from state arrest and prosecution, it does not regulate private employers.
Former Wal-Mart employee Joseph Casias said he was using the marijuana to treat pain from an inoperable brain tumor and sinus cancer, and was doing so legally, with a medical marijuana registry card.
After twisting his knee at work, Casias submitted to a drug test, administered under a Wal-Mart policy requiring tests for all employees injured on the job. When he tested positive, he was fired.
Casias worked at a Wal-Mart store in Battle Creek, Michigan from 2004 to 2009. (Reporting by Clare Baldwin, additional reporting by Jonathan Stempel; Editing by Ron Popeski)
Second person to recieve medical marijuana speaks at NORML event
By Kendall Bierer, Central Florida Future
Published: Monday, February 21, 2011
The 58-year-old stockbroker has smoked 10-12 cannabis sativa cigarettes every day for more than 28 years.
Rosenfeld, who was the second person to get medical marijuana ever and NORML's third speaker for Medical Marijuana Month, spoke to the UCF community on Feb. 16 from 7 p.m. to 9 p.m. in the Key West Ballroom.
In 1971, his first year of college, Rosenfeld was introduced to marijuana for the first time. As a young man who'd had numerous surgeries and chemical drugs to treat his rare bone disease, Rosenfeld did not understand why a healthy person would need to use illegal drugs. He admitted that he had been an advocate against it.
At that time, Rosenfeld was prescribed to take more than 30 pills a day including but not limited to morphine, Quaalude and Valium to treat his multiple congenital cartilaginous exostoses, which he's had since he was 10 years old. His body had more than 200 tumors in it and even after his growth plates had halted, a second rare disease, pseudopseudohypoparathyroidism, developed. His doctors told him it was a death sentence.
Before using marijuana medically, his use was purely social even though he didn't agree with it.
"It was a way of making friends, and even though I thought it was garbage, I liked being able to make friends through the use of it," Rosenfeld said.
The tenth time he smoked was the first time he'd sat for more than 10 minutes without discomfort and medication.
"Once I discovered that cannabis was the medicine I needed, I knew I would be arrested and I would be sunk if caught with it," Rosenfeld said. "I am not a criminal, I am a patient."
Since age 21 Rosenfeld has not had another tumor form. His doctors were astounded and couldn't figure out why, but Rosenfeld knew it was because of his recently discovered medication.
He decided to drop out of college after his third semester and move back to Virginia to take on the Federal government. He gained support from his family and doctor and started the persistent fight to gain access to his medicine, a battle that would last 10 years.
In 1982, Rosenfeld, who has the Federal right to smoke his cannabis sativa cigarettes wherever smoking is permitted, received his first tin canister of 320 cigarettes. The government refers to his medication as an experimental new drug that only four patients currently have access to.
When it came time for his doctor to write a report on the success of his use, Rosenfeld knew how it'd be received.
"I told him the truth," Rosenfeld said of the conversation with his doctor. "Any positive report was going to be buried because the government has no interest in the positive aspects of cannabis."
On the report written after that, his doctor decided to write on every page in big red letters "it's working."
The government said nothing.
"The truth is that the government only gave me medicinal cannabis because I backed them in a corner," Rosenfeld said. "They have no interest in continuing this program once the patients are gone."
As stated in his book, My Medicine, the program will terminate when the patients do. He realized four years ago that he needed to share his story; otherwise, it would die with him.
"I know I am taking a risk with the Federal government and my book, but I need to educate people," said Rosenfeld. "The government doesn't want to know and that's what we are up against. I went public so I could be the face of the medical marijuana movement."
Rosenfeld made sure to distinguish between the words ‘cannabis' and ‘marijuana.'
"What I get every 25 days is cannabis sativa, not marijuana," he said. "By using the word ‘marijuana' or ‘pot' you demonize the drug. Every time we use the word ‘pot', we are playing into their hands."
Rosenfeld is creating a new company, Medical Cannabis Solutions, which is going to attempt to achieve something never done before, write its own state law. As the face of the movement, Rosenfeld has credibility when speaking about the battle for his medicine and the necessity to make it available to all patients. He estimates that it will take about six months to a year to complete the project.
Music education junior Chelsey Sprouse can personally attest to the benefits of marijuana used as medicine. Sprouse, who suffers from inflammatory bowel disease, was prescribed eight pills a day by her doctor, but has opted to use marijuana instead.
"Now I get home and I take one hit of cannabis and instantly I am better," said Sprouse. "It helps me eat. It is almost a miracle because it is something nothing else has been able to do. Cannabis is a better choice."
Rosenfeld hopes his work will make cannabis a choice for others.
"This battle is a lot longer and harder than any of us realized, but we are a step closer than we were before."