The state’s medical marijuana program recently received a failing grade, with nearly every patient not being issued identification cards to get the drug within the required time frame.
The Therapeutic Cannabis Program, started in 2013, aims to protect patients with debilitating medical conditions, as well as their medical providers and designated caregivers, from criminal charges related to marijuana possession and use.
According to state law, the program must approve or deny applications within 15 days of receipt, and must register identification cards within five days of approval.
However, a legislative performance audit conducted in June found 98.4 percent of cards from 2018 weren’t issued within the five days allowed. On average, cards were received in about 18 days.
This is a slight improvement from previous years, with an average of 31.4 days to get a card in 2016 and 29.3 days in 2017.
“Although the program was authorized by the Legislature, it did not initially provide a budget during the development phase, which contributed to the program’s inconsistent operations, ineffective client service, inadequate database and immature management control environment over card issuance,” the audit states.
The program had been borrowing staff from the state Department of Health and Human Services, and as of October 2018, the program had one full-time employee, one part-time employee and one program administrator, Michael Holt, to process applications and take calls.
“There was no money allotted for staffing or a [new] database. It was an unfunded program that we had to build from scratch,” Holt said.
Now, the program, which receives money from patient registry fees and Alternative Treatment Center dues, finally has a decent nest egg saved, which went toward hiring more staff and creating a new database.
Patricia Tilley, deputy director for the state’s Division of Public Health Services, said the program has five staff members specifically dedicated to the program. Three are designated to the registry unit to handle the applications, which Tilley noted may not be enough.
There were 6,480 patients in the program last year, being treated for 7,380 medically-eligible conditions.
Once the new database is installed, aimed at January 2020, Tilley said the program will have a “better understanding” of how many employees they need.
As far as the timeliness of issuing cards, Holt said there was a miscommunication on the time frame.
“The statute talks about a 15-day time period and a five-day time period … the department had interpreted that as meaning we had 20 days to issue a card,” he said.
But the program actually had five days after approval, no matter how long the approval took. For example, the audit states if a person is approved the day after their application is received, they should receive their card in five days from that date. This would equal a seven-day time period.
“Since the audit findings, we did a systematic review of our operations to align all processes with their interpretations and timelines. That’s the work we are currently undergoing,” Holt said.
But the program has been broken from the start, according to Matt Simon, New England political director for the Marijuana Policy Project.
Since medical marijuana was legalized in 2013, with the home-grow option removed, Simon said it has just been a string of delays.
Patients had to wait nearly three years until a state cannabis dispensary opened to utilize the program. Once it opened, there have been these delays in receiving cards, further frustrating patients.
“Any patient who was in a hurry either moved to another state or started fending for themselves one way or another,” Simon said.
One of those was the late Linda Horan, a terminally-ill Alstead woman who fought in court for a registry card to obtain medical marijuana in Maine. Horan, who died in 2016, won her case in 2015, allowing her to receive the card before the New Hampshire dispensaries opened the next year.
And four years later, the problems with the program are still unresolved, Simon said.
“Patients have been saying all along that there is a big delay, and given the law [the department] was tasked with implementing and not being given the tools to do it, not surprisingly it’s been a disappointment,” he explained.
Simon said its passed the point of “transitioning this program into something that will regulate cannabis more comprehensively,” and policy change needs to be enacted.
Advocates agree. There has been a continued push for the home-grow option for these patients, getting both the New Hampshire House and Senate to pass the bill on Aug. 2, but Gov. Chris Sununu vetoed it.
“New Hampshire has reasonable regulations set up to ensure that our Therapeutic Cannabis Program responsibly treats those in need while limiting the diversion of marijuana to the black market and ensuring that products meet public health standards,” Sununu wrote in his veto message.
The House will vote on Sept. 18 to override the veto, which would mark the ninth time it’s passed a home-grow policy.
The Marijuana Policy Project, along with other advocacy groups, has been working since the veto to keep both the House and Senate on board with home-grow.
Without the override, Simon said its a “pretty grim outlook” for patients.
“I’d like to go back in time and pass a better law in 2013, but lacking the time machine, certainly overriding the veto would somewhat right those wrongs,” he said.