Medical Cannabis: Key Components of Utahs Program Presented by - - PowerPoint PPT Presentation

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Medical Cannabis: Key Components of Utahs Program Presented by - - PowerPoint PPT Presentation

Dec 28, 2022 35 likes •275 views

Medical Cannabis: Key Components of Utahs Program Presented by Steve Ipsen, RN, MSN Center for Medical Cannabis Utah Department of Health HEALTHIEST PEOPLE | OPTIMIZE MEDICAID | A GREAT ORGANIZATION PROGRAM PURPOSE Working with

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HEALTHIEST PEOPLE | OPTIMIZE MEDICAID | A GREAT ORGANIZATION

Medical Cannabis: Key Components of Utah’s Program

Presented by Steve Ipsen, RN, MSN Center for Medical Cannabis Utah Department of Health

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HEALTHIEST PEOPLE | OPTIMIZE MEDICAID | A GREAT ORGANIZATION

PROGRAM PURPOSE

Working with trained medical professionals, qualified patients will receive a recommendation for quality-controlled cannabis products from a licensed pharmacist in a medicinal dosage form.

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TRANSITION PHASE

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Transition Phase: Dec 3, 2018 – Dec 31, 2020 Individuals are not guilty of use or possession of medical cannabis under Utah law if, at the time of the arrest:

  • the individual has been diagnosed with a qualifying condition and

had a pre-existing provider-patient relationship with a Utah-licensed APRN, physician, or physician assistant who believed that the individual’s illness could benefit from the use in question; and

  • the medical cannabis was in a medicinal dosage form in a quantity

not to exceed specified limits. *Medical cannabis cards and qualified medical provider registration are not required during this transition period.

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UTAH MEDICAL CANNABIS ACT SYSTEM

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UTAH MEDICAL CANNABIS ACT

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Utah Department of Agriculture and Food

  • Cultivation
  • Processing
  • Lab Testing
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QUALIFYING CONDITIONS

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  • Pain lasting longer than two weeks

if it is not adequately managed by a non-opioid or physical intervention after at least two treatment attempts

  • HIV or AIDS
  • Alzheimer’s Disease
  • Amytrophic Lateral Sclerosis (ALS)
  • Cancer
  • Cachexia
  • Persistent nausea under certain

conditions

  • Crohn’s Disease / Ulcerative Colitis
  • Epilepsy / debilitating seizures
  • Multiple Sclerosis (MS) or

persistent muscle spasms

  • Post Traumatic Stress Disorder (PTSD)

which is treated by a licensed mental health therapist and has been diagnosed by either the VA or through an evaluation by a doctoral level psychiatrist, psychologist, LCSW, or APRN

  • Autism
  • Terminal illness with less than 6

months to live

  • A condition resulting in the patient

receiving hospice care

  • A rare condition or disease that affects

less than 200,000 individuals in the US and is not adequately managed by a non-opioid or physical intervention. Individuals who do not have a “qualifying condition” may submit a petition to the Compassionate Use Board (CUB) for review with help from their QMP. All patients under age 21, regardless of their medical condition, must have their application approved by the CUB.

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COMPASSIONATE USE BOARD

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  • Board members appointed by the Executive Director of the Utah Department of

Health and confirmed by the Utah State Senate for 4 year terms

  • Comprised of 7 physicians including at least 2 pediatricians
  • Board members to be board certified in at least one of the following: neurology, pain

medicine and pain management, medical oncology, psychiatry, infectious disease, internal medicine, pediatrics, or gastroenterology.

  • First meeting expected to be in Fall 2019
  • Meetings expected to be monthly at beginning of program, possibly more frequent
  • Petitions must be reviewed and approval or denial determined within 90 days of

electronic submittal

  • Board is required to submit an annual report to the Health and Human Services

Interim Committee

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QUALIFIED MEDICAL PROVIDERS

  • Must be a Utah licensed physician, physician

assistant or APRN with a controlled substance license

  • Must complete at least 4 hours of education in

medical cannabis during every two year renewal cycle

  • May recommend cannabis treatment to no more

than 175 patients at the same time. QMPs who are board certified in anesthesiology, gastroenterology, neurology, oncology, pain, hospice and palliative medicine, physical medicine and rehabilitation, rheumatology, or psychiatry may recommend to no more than 300 patients. With approval from DOPL, QMPs may recommend up to 600 patients at one time.

  • Cannot advertise they recommend cannabis for

treatment, but may communicate on a website: a green cross; a list of qualifying conditions they treat; or a scientific study regarding medical cannabis use.

HEALTHIEST PEOPLE | OPTIMIZE MEDICAID | A GREAT ORGANIZATION

  • For complete information about qualified

medical provider requirements, see Utah Code 26-61a-106.

  • May only recommend medical cannabis

treatment to a patient in the course of a physician-patient relationship after they have completed and documented in the patient’s medical record a thorough assessment of the patient’s condition and medical history based on the appropriate standard of care for the patient’s condition.

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QUALIFIED MEDICAL PROVIDERS

  • When a QMP recommends medical cannabis to

a patient, they may choose to recommend it without specifying a dosage type and dosage amount.

  • If a QMP recommends but does NOT specify

dosage type and amount, they are required to submit to the electronic verification system (EVS):

  • an evaluation of the qualifying condition

underlying the recommendation;

  • a description of prior treatment attempts

with cannabis and cannabis products; and

  • the patient's current medication list.

HEALTHIEST PEOPLE | OPTIMIZE MEDICAID | A GREAT ORGANIZATION

For complete information about qualified medical provider requirements, see Utah Code 26-61a-106.

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QUALIFIED MEDICAL PROVIDERS

If a QMP recommends without specifying a dosage type and/or amount, the dosage type and/or amount will be determined by the pharmacy medical provider (pharmacist or physician registered by UDOH) at the cardholder’s chosen medical cannabis pharmacy. When making this determination, the pharmacy medical provider (PMP) must:

  • review pertinent medical records, including the

qualified medical provider documentation submitted to the EVS; and

  • after completing the review and consulting with

the recommending QMP as needed, determine the best course of treatment through consultation with the cardholder regarding:

  • the individual’s qualifying condition

underlying the recommendation from the qualified medical provider;

  • indications for available treatments;
  • dosing parameters; and
  • potential adverse reactions.

HEALTHIEST PEOPLE | OPTIMIZE MEDICAID | A GREAT ORGANIZATION

For complete information about qualified medical provider requirements, see Utah Code 26-61a-106.

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MEDICINAL DOSAGE FORMS

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  • Tablet
  • Capsule
  • Concentrated oil
  • Liquid suspension
  • Topical preparation
  • Transdermal

preparation

  • Cube
  • Resin or wax under

certain conditions

  • Unprocessed

cannabis flower in a blister pack No edibles, such as brownies, or unprocessed flower outside of the blister pack. For complete information about legal dosage forms, see Utah Code 26-61a-102 (29). No smoking of cannabis.

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MEDICINAL DOSAGE FORMS

HEALTHIEST PEOPLE | OPTIMIZE MEDICAID | A GREAT ORGANIZATION

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MEDICINAL DOSAGE FORMS

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PROHIBITED FORMS

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PROHIBITED FORMS

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DISPENSING LIMITATIONS

A medical cannabis cardholder whose primary residence is less than 100 miles from the nearest medical cannabis pharmacy or local health department, in any one 12-day period, may purchase no more than the lesser of:

  • an amount sufficient to provide 14 days
  • f treatment on the dosing parameters

that the relevant QMP recommends; or

  • 56 grams by weight of

unprocessed cannabis that is in a medicinal dosage form; or

  • Cannabis in medicinal dosage form

that contains, in total, greater than

10 grams of total composite THC. HEALTHIEST PEOPLE | OPTIMIZE MEDICAID | A GREAT ORGANIZATION

For complete information about medical cannabis pharmacy requirements, see Utah Code 26-61a-502.

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DISPENSING LIMITATIONS

A medical cannabis cardholder whose primary residence is more than 100 miles from the nearest medical cannabis pharmacy or local health department, in any one 28-day period, may purchase no more than the lesser of:

  • an amount sufficient to provide 30 days
  • f treatment on the dosing parameters

that the relevant QMP recommends; or

  • 113 grams by weight of

unprocessed cannabis that is in a medicinal dosage form; or

  • Cannabis in medicinal dosage form

that contains, in total, greater than

20 grams of total composite THC. HEALTHIEST PEOPLE | OPTIMIZE MEDICAID | A GREAT ORGANIZATION

For complete information about medical cannabis pharmacy requirements, see Utah Code 26-61a-502.

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MEDICAL CANNABIS PHARMACIES

  • 7 licenses available, one year renewal cycle
  • Licenses to be awarded through a public RFP

process

  • Must have a licensed pharmacist registered

with UDOH onsite during business hours at all times to consult with patients.

  • May only sell cannabis product in a medicinal

dosage form, medical cannabis devices, or educational material related to medical use of cannabis

  • To enter pharmacy, must be a card holder

(patient, guardian, or caregiver) and at least 18 HEALTHIEST PEOPLE | OPTIMIZE MEDICAID | A GREAT ORGANIZATION For complete information about medical cannabis pharmacy requirements, see Utah Code 26-61a-305.

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MEDICAL CANNABIS PHARMACIES

May not advertise in any medium but may have a website that includes information about:

  • the location and hours of operation of the

medical cannabis pharmacy;

  • a product or service available at the

medical cannabis pharmacy;

  • personnel affiliated with the medical

cannabis pharmacy;

  • best practices that the medical cannabis

pharmacy upholds; and

  • educational material related to the

medical use of cannabis.

HEALTHIEST PEOPLE | OPTIMIZE MEDICAID | A GREAT ORGANIZATION

For complete information about medical cannabis pharmacy requirements, see Utah Code 26-61a- 301.

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MEDICAL CANNABIS PHARMACIES

  • All employees required to register as

medical cannabis pharmacy agents, pass background checks

  • Equipped with security system
  • Use of cannabis on premises not

allowed

  • Cannot give samples
  • May have signage that includes a

green cross, name of pharmacy, and hours of operation

  • Must follow product labeling

requirements

HEALTHIEST PEOPLE | OPTIMIZE MEDICAID | A GREAT ORGANIZATION

For complete information about medical cannabis pharmacy requirements, see Utah Code 26-61a- 301.

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STATE CENTRAL FILL PHARMACY

  • Must meet most medical cannabis

pharmacy requirements.

  • Receives requests for shipments from

patients with verification through the electronic verification system (EVS) or from qualified medical providers (QMP) directly through the EVS.

  • All payments are made electronically.
  • Consults directly with the patient over the

phone when the QMP recommending a medical cannabis treatment does not provide dosing parameters.

  • Delivers all patient orders to a local health

department location (no customer pick up at state central fill location).

HEALTHIEST PEOPLE | OPTIMIZE MEDICAID | A GREAT ORGANIZATION

For complete information about the state central fill medical cannabis pharmacy requirements, see Utah Code 26-61a-601.

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CARDHOLDER NON-DISCRIMATION

  • For purposes of medical care, a patient’s

use of medical cannabis is:

  • considered the equivalent of the

authorized use of any other medication used at the discretion of a physician; and

  • does not constitute the use of an

illicit substance or otherwise disqualify an individual from needed medical care.

  • Unless a state or local employee’s use of

medical cannabis jeopardizes federal funding for the employee’s position, the state or local government shall treat the use of medical cannabis in the same way the employer treats employee use of

  • pioids and opiates.

HEALTHIEST PEOPLE | OPTIMIZE MEDICAID | A GREAT ORGANIZATION

For complete information about the cardholder non-discrimination, Utah Code 26-61a-111.

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IMPLEMENTATION TIMELINE

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June 2019 Award RFP for Electronic Verification and Inventory Control System July 2019 Approved medical provider education courses posted on website UDAF awards 10 cultivation licenses Sept 2019 Medical providers begin applying online to become qualified medical providers First meeting of Compassionate Use Board Administrative rules become effective Oct 2019 Award 7 private medical cannabis pharmacy licenses Nov 2019 Patients begin applying online for medical cannabis registration cards Dec 2019 Compassionate Use Board begins reviewing patient applications Jan 2020-Mar 2020 Private pharmacies open and patients begin purchasing medical cannabis in Utah Apr 2020 - July 2020 State Central Fill Medical Cannabis Pharmacy opens with certain local health department locations acting as distribution points Jan 2021 Medical cannabis cards required for legal possession of medical cannabis

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QUESTIONS?

HEALTHIEST PEOPLE | OPTIMIZE MEDICAID | A GREAT ORGANIZATION

Contact Information Utah Department of Health Medical Cannabis Program (801) 538-6504 medicalcannabis@utah.gov health.utah.gov/medical-cannabis sipsen@utah.gov