Colorado Patient

Table of Contents

• 1. Introduction

  2. Becoming A Patient

     1. 1. How to become a medical marijuana patient in the state of Colorado

        2. Registration Fee

        3. Eligible medical conditions

        4. Written Certification Must be Provided to Prove Eligibility

        5. Finding a Doctor

        6. Renewal Applications

        7. Age Limits

        8. Personal Records

  3. Limitations and Protections under Initiative

• • • 1. Possession and Growing Limitations

      2. Consumption of Medical Marijuana

      3. Paraphernalia associated with medical use

      4. Access to Medical Marijuana

      5. Growing/Dispensing Collectives and Cooperatives

      6. Caregivers

      7. Housing

      8. Employment

      9. Reciprocity

      10. Law Enforcement

      11. Confidentiality

      12. Insurance

I. Introduction

In November of 2000, voters of the state of Colorado passed Amendment 20 to the state's constitution which effectively legalized medicinal marijuana. Since then, the Colorado Board of Health has created a set of rules and regulations relating to medical use of marijuana. These rules create a confidential statewide registry of medical marijuana patients and caregivers with ID cards for all registered patients. Any patient with a valid registry card may legally use marijuana for medicinal purposes and their caregiver, if one should exist, may assist them in doing so.

Under Amendment 20, patients, as well as primary and alternate caregivers, have an affirmative defense to criminal prosecution under the state's marijuana laws. Physicians are also protected against any kind of punishment for advising a patient about medical marijuana or providing a patient with a signed statement allowing them to be included in the state's medical marijuana registry.

Contact Information for inquiries to the Colorado Department of Public Health and Environment:

Medical Marijuana Registry

Colorado Department of Public Health and Environment

HSVR-ADM2-A1

4300 Cherry Creek Drive South

Denver, Colorado 80246-1530

Phone:

(303) 692-2184Email: medical.marijuana@state.co.us

For general information about medical marijuana law for the State of Colorado, go to: http://www.cdphe.state.co.us/hs/medicalmarijuana/marijuanafactsheet.html. See also Colorado Rules and Regulations from 2004.

II. Becoming A Patient

A. How to become a medical marijuana patient in the state of Colorado

• 1. Identification card: A patient diagnosed with a debilitating condition that may be alleviated by the medical use of marijuana may apply to the Colorado Department of Public Health and Environment (the Department) for a Medical Marijuana Registry identification card.

  2. Five days after verifying medical information of the applicant the department shall issue a serially numbered registry identification card to the patient. The card shall state the following:

     1. 1. The patient's name, address, date of birth, and social security number;

        2. That the patient's name has been certified to the department as a person with a debilitating medical condition, whereby the person may address such condition with the medical use of marijuana;

        3. The date of issuance of such card and the date of expiration, which shall be one year from the date of issuance;

        4. The name and address of the patient's primary care-giver, if any is designated at the time of application;

        5. How to notify the department of any change in name, address, medical status, physician, or primary care-giver.

  3. How to apply: In order to be placed in the registry and to receive a registry identification card, an adult applicant must reside in Colorado and submit an application form supplied by the Department.

  4. The adult applicant must perform the following, in order to satisfy the application process:

• • • 1. A completed application form with the Physician Certification form or other documentation provided by the physician and the non-refundable $90.00 application fee must be sent to:

         1. 1. Medical Marijuana Registry

            2. Colorado Department of Public Health and Environment

            3. HSVR-ADM2-A1 4300

            4. Cherry Creek Drive South

            5. Denver, Colorado 80246-1530

      2. Payment by check or money order must be made payable to CDPHE. Do not send cash.

• • 1. The Registry will verify the licensure status of the physician and will contact the physician to verify the certification. Verifications will occur within 30 days of receipt of the application. The Registry will mail the patient and his/her primary caregiver (if applicable) Medical Marijuana Registry identification cards within 5 days after the verification.

    2. The patient will be notified within 5 days after the verification process if the application has been denied.

    3. Except for minor applicants, where the department fails within thirty-five days of receipt of application to issue a registry identification card or fails to issue verbal or written notice of denial of such application, the patient's application for such card will be deemed to have been approved. "Receipt" shall be deemed to have occurred upon delivery to the department or deposit in the United States mail.

    4. The Department shall deny the application if it determines that information has been falsified or it cannot verify the medical information. A patient whose application has been denied by the department may not reapply during the six months following the date of denial. The denial of a registry identification card shall be considered a final agency action.

• 5. Change in applicant information: When there has been a change in the name, address, physician or primary care-giver of a patient who has been issued a registry identification card, that patient must notify the department within ten days. A patient who has not designated a primary caregiver at the time of application to the department may do so in writing at any time during the effective period of the registry identification card, and the primary care-giver may act in this capacity after such designation.

  6. A patient who no longer has a debilitating medical condition, as defined by the Colorado Medical Marijuana Law, shall return his registry identification card to the department within twenty-four hours of receiving such information by his or her physician.

  7. Penalties: In addition to any other penalties provided by law, the department shall revoke for a period of one year the registry identification card of any patient found to have willfully violated the provisions set forth in the medical marijuana law of Colorado.

B. Registration Fee

Full payment of the non-refundable $90.00 application fee must be made at the time of submitting the application to the Registry. The fee must be paid with the renewal application each year. The fee cannot be waived, and the Registry cannot accept installment payments.

C. Eligible medical conditions

Debilitating medical conditions are defined as:

• 1. Cancer;

  2. Glaucoma, and;

  3. Positive status for human immunodeficiency virus;

  4. Patients undergoing treatment for such conditions are defined as having a debilitating medical condition;

  5. A chronic or debilitating disease or medical condition other than HIV, cancer or glaucoma; or treatment for such conditions, which produces for a specific patient one or more of the following, and for which, in the professional opinion of the patient's physician, such condition or conditions may reasonably be alleviated by the medical use of marijuana:

     1. 1. Cachexia;

        2. Severe pain;

        3. Severe nausea;

        4. Seizures, including those that are characteristic of epilepsy; or

        5. Persistent muscle spasms, including those that are characteristic of multiple sclerosis.

Patients who have had a diagnosis of a debilitating medical condition in the past but do not have an active disease and are not undergoing treatment for such condition are not considered to be suffering from a debilitating medical condition for which the medical use of marijuana is authorized.

Beginning June 1, 2001, the Department began accepting physician or patient petitions to add debilitating medical conditions to the list provided in this regulation. The Department shall determine if a public rulemaking hearing to modify this regulation is appropriate, and if so, shall petition the Board of Health to set a date for such hearing within 120 days of receipt of the patient or physician petition.

If the Department determines that a public rulemaking hearing is not appropriate, it shall notify the petitioner of its action within 180 days of receipt of submission of the petition. In making its determination, the department will consider whether there is information that the proposed condition is chronic, debilitating, and may be specifically diagnosed, and whether there is scientific evidence that treatment with marijuana may have a beneficial effect. To date, no additional debilitating conditions have been added.

D. Written Certification Must be Provided to Prove Eligibility

The patient must obtain certification from a physician licensed in Colorado that he/she has been diagnosed with a debilitating condition that may be alleviated by the medical use of marijuana.

A sample form is provided with the application packet on the Colorado State website. The certifying physician should keep a copy of the certification and other documentation supporting the diagnosis in the patient medical record.

E. Finding a Doctor

The State of Colorado cannot refer patients to doctors for the purpose of receiving a medical marijuana evaluation. It is the responsibility of the patient to work with a physician with whom s/he has a bona fide doctor-patient relationship.

F. Renewal Applications

To maintain an effective registry identification card, a patient must annually resubmit to the Department, at least thirty days prior to the expiration date, updated written documentation of the required information shown above, and full payment of the non-refundable $90.00 application fee. Additionally, the patient must provide the name and address of the primary care-giver, if any is designated at such time.

G. Age Limits

An "adult applicant" is defined as a patient eighteen years of age or older. A "minor applicant" is defined as a patient less than eighteen years of age. In order for a minor applicant to be placed in the registry and to receive a registry identification card, the minor applicant must reside in Colorado, and a parent residing in Colorado must consent in writing to serve as the minor applicant's primary caregiver. Such parent must submit an application form supplied by the Department.

The parent of the minor applicant must provide the following information with the application:

• 1. The applicant's name, address, date of birth, and social security number;

  2. Written documentation from two of the applicant's physicians that the applicant has been diagnosed with a debilitating medical condition as defined above and each physician's conclusion that the applicant might benefit from the medical use of marijuana;

  3. The name, address, and telephone number of the two physicians who have concluded the applicant might benefit from the medical use of marijuana;

  4. Consent from each of the applicant's parents residing in Colorado that the applicant may engage in the medical use of marijuana; and

  5. Documentation that one of the physicians has explained the possible risks and benefits of medical use of marijuana to the applicant and each of the applicant's parents residing in Colorado.

H. Personal Records

Americans for Safe Access strongly urges all patients to keep copies of all paperwork they have related to their status as a medical marijuana patient as proof of legal status. This is meant to protect patients from possible future encounters with law enforcement agents.

III. Limitations and Protections under the Initiative

A. Possession and Growing Limitations

Amendment 20 authorizes a patient or a primary caregiver who has been issued a Medical Marijuana Registry identification card to possess:

1. No more than two (2) ounces of a usable form of marijuana; and

2. Not more than six (6) marijuana plants, with three (3) or fewer being mature, flowering plants that are producing a usable form of marijuana.

B. Consumption of Medical Marijuana

The Colorado Medical Marijuana Law specifically states that patients are not permitted to engage in the medical use of marijuana in a way that endangers the health or well-being of any person. Engaging in the medical use of marijuana in plain view of, or in a place open to the general public is also prohibited. Additionally, using medical marijuana while driving is not permitted.

A patient may engage in the medical use of marijuana, with no more marijuana than is medically necessary to address a debilitating medical condition. A patient's medical use of marijuana, within the above shown limits is lawful. For quantities of marijuana in excess of those amounts, a patient or his or her primary caregiver may raise as an affirmative defense to charges of violation of state law that such greater amounts were medically necessary to address the patient's debilitating medical condition.

In addition to any other penalties provided by law, the state health agency shall revoke for a period of one year the registry identification card of any patient found to have willfully violated any of these provisions.

C. Paraphernalia associated with medical use

"Medical use" means the acquisition, possession, production, use, or transportation of marijuana or paraphernalia related to the administration of such marijuana to address the symptoms or effects of a patient's debilitating medical condition.

D. Access to Medical Marijuana

Medical marijuana patients cannot go to a pharmacy to fill a prescription for medical marijuana. Pharmacies can only dispense medications that are prescribed. Unfortunately, medical marijuana is classified by the federal government as a Schedule I drug which means that it cannot be "prescribed" by any health care professional.

Amendment 20 allows doctors to "recommend" marijuana, and that allows patients to grow their own medical marijuana for their private use. The Medical Marijuana Registry is not authorized to provide information on the acquisition of marijuana. Therefore, the State of Colorado cannot assist in getting seeds or plants to start growing medical marijuana.

E. Growing/Dispensing Collectives and Cooperatives

There are numerous questions that have arisen surrounding interpretation of statutory language. The law does not clearly state where marijuana plants may be grown, how many patients one caregiver may care for, or if two or more patients and/or caregivers may share one growing space. Statutory language also places certain burdens upon local and state law enforcement officers, such as the requirement of keeping alive plants that are confiscated until a resolution is reached (i.e. a decision not to prosecute, the dismissal of charges, or an acquittal). However, selling or distributing marijuana remains illegal.

This confusion regarding Colorado's approach to dispensing collectives and cooperatives may leave the door open for their possible establishment. It is up to the medical marijuana patients in Colorado to decide whether or not to pursue this avenue of obtaining medicine. Americans for Safe access strongly recommends that any patients who are interested in forming a dispensing collective or cooperative consult an attorney before doing so.

F. Caregivers

"Primary care-giver" means a person, other than the patient and the patient's physician, who is eighteen years of age or older and has significant responsibility for managing the well-being of a patient who has a debilitating medical condition. If a patient so chooses, they may choose to select one primary caregiver, who may legally grow, posses, and distribute to the patient marijuana as is medically necessary.

There is no restriction to the number of patients which one primary caregiver may serve, as long as the caregiver:

• 1. Is 18+ years of age; and

  2. Has significant responsibility managing the well-being of a patient.

To become a primary caregiver, a patient may either:

• 1. Name the primary caregiver on their registry application, OR

  2. Inform the state registry in writing of their primary caregiver at any time as long as they have a valid registry card.

The caregiver's name and address will appear on the patient's registry ID.

G. Housing

The Colorado medical marijuana law does not addresses whether or not a qualified patient can be evicted because of their status as a medical marijuana patient, even if that patient has the amount of medical marijuana allowed by law. Therefore, it is up to each patient to decide whether or not to tell his/her landlord about their status as a medical marijuana patient.

Additionally, nothing in Colorado's medical marijuana law specifically addresses whether or not a person can be a registered patient and live in subsidized housing. However, under federal law, HUD has clear regulations prohibiting ANY marijuana use in federally subsidized housing. If a patient has questions about these important issues, Americans for Safe Access recommends that the patient speak to an attorney to learn about their rights and protections.

Colorado medical marijuana law also does not address the issue of whether or not patients who live within 1000 feet of a school, AKA a "drug free zone" can still grow and/or possess medical marijuana.

H. Employment

The Colorado medical marijuana law:

• 1. Does not require any employer to accommodate the medical use of marijuana in any work place. It is not specified whether or not this regulation concerning accommodation pertains only to on-the-job medical marijuana use, or more generally, to the employment of any individual who engages in the medical use of marijuana;

  2. Does not discuss the issue of employment-related drug testing.

I. Reciprocity

Colorado Residents: Colorado currently has no reciprocity agreements with other states to honor Colorado's medical marijuana law. This includes even those states that currently have medical marijuana laws of their own.

However, in Montana, medical marijuana patients from other states who are valid medical marijuana patients under that state's law are protected under Section 4(8) of the Montana Medical Marijuana Act [Sec. 50-46-201(8), MCA]. A registry identification card or its equivalent issued by another state government to permit the medical use of marijuana by a qualifying patient or to permit a person to assist with a qualifying patient's medical use of marijuana has the same force and effect as a registry identification card issued by the Department of Public Health and Human Services in Montana. Therefore, medical marijuana patients from Colorado should be protected in Montana under Montana state law. See the Montana Patients Guide for details on the protections and limitations that Montana state law affords medical marijuana patients.

Additionally, in Rhode Island, The Edward O. Hawkins and Thomas C. Slater Medical Marijuana Act (MMA) protects patients and primary caregivers from outside Rhode Island who have a state issued medical marijuana ID card, or its equivalent. The MMA states, A registry identification card, or its equivalent, issued under the laws of another state, U.S. territory, or the District of Columbia to permit the medical use of marijuana by a qualifying patient, or to permit a person to assist with a qualifying patient's medical use of marijuana, shall have the same force and effect as a registry identification card issued by the department.  Therefore, medical marijuana patients from the other medical marijuana states that have state issued cards should be protected in the state of Rhode Island. See the Rhode Island Patients Guide for more information.

In states with no medical marijuana program, marijuana use, regardless of a doctor's recommendation, is illegal. You may be arrested and charged with civil or criminal offenses in those states.

J. Law Enforcement

Authorized employees of state or local law enforcement agencies shall be granted access to the information contained within the Department's registry only for the purpose of verifying that an individual who has presented a registry identification card to a state or local law enforcement official is lawfully in possession of such card. The Department shall report to authorized state or local law enforcement officials whether a patient's registry identification card has been suspended because the patient no longer has a debilitating medical condition.

Additionally employees of state or local law enforcement agencies are directed to immediately notify the department when any person in possession of a registry identification card has been determined by a court of law to have willfully violated the provisions set forth in the Colorado medical marijuana law, or has pled guilty to such offense.

Any property interest that is possessed, owned, or used in connection with the medical use of marijuana or acts incidental to such use, will not be harmed, neglected, injured, or destroyed while in the possession of state or local law enforcement officials where such property has been seized in connection with the claimed medical use of marijuana. Under Colorado's medical marijuana law, any such property interest will also not be forfeited under any provision of state law providing for the forfeiture of property other than as a sentence imposed after conviction of a criminal offense or entry of a plea of guilty to such offense.

Marijuana and paraphernalia seized by state or local law enforcement officials from a patient or primary caregiver in connection with the claimed medical use of marijuana shall be returned immediately upon the determination of the district attorney or his or her designee that the patient or primary caregiver is entitled to the protection contained in this section as may be evidenced, for example, by a decision not to prosecute, the dismissal of charges, or acquittal.

Any officer or employee or agent of the department who violates this regulation by releasing or making public confidential information in the registry shall be subject to any existing statutory penalties for a breach of confidentiality of the registry.

K. Confidentiality

The confidentiality of medical marijuana patients in the State of Colorado is protected by law and by the procedures used by the registry. No lists of patients or doctors are given out to anyone. Law enforcement may only call to verify the information on a specific identification card. The Registry database resides on a stand-alone computer and is password protected. The office and all files are locked at night and when the Registry administrator is out of the office.

The department may release information concerning a specific patient to that patient with the written authorization of such patient.

L. Insurance

Under Colorado state law, no governmental, private, or any other health insurance provider shall be liable for any claim for reimbursement for the medical use of marijuana.