Montana Patient

Table of Contents

• 1. Introduction: Montana Medical Marijuana Act, I-148

  2. Becoming a Patient

     1. 1. How to register as a medical marijuana patient with the state of Montana

        2. Registration Fee

        3. Eligible medical conditions

        4. Written Certification must be provided to prove eligibility

        5. Finding a Doctor

        6. Age Limits

        7. Personal Records

  3. Limitations and Protections under Initiative I-148

• • • 1. Possession and Growing Limitations

      2. Consumption of Medical Marijuana

      3. Paraphernalia associated with medical use

      4. Access to Medical Marijuana

      5. Growing Cooperatives

      6. Caregivers

      7. Housing

      8. Employment

      9. Reciprocity

      10. Law Enforcement

      11. Confidentiality

      12. Insurance

I. Introduction: Montana Medical Marijuana Act, I-148

In November 2004, Montana voters by a significant margin (62 percent) passed Initiative I-148, allowing certain patients with specific medical conditions to alleviate their symptoms through the limited use of marijuana under medical supervision.

The new law, effective immediately upon passage, also allows qualified patients and their caregivers to grow and possess a restricted number of marijuana plants and amount of dried marijuana.

Montana is the 11th state to pass a medical marijuana law. To use or grow marijuana under the Montana law, patients and caregivers must first register with the quality Assurance Division of the Department of Public Health and Human Services.

Montana's medical marijuana law serves 5 primary functions:

• 1. It allows terminally and seriously ill patients who find relief from marijuana to register to use it with their doctor's approval.

  2. Once terminally and seriously ill patients obtain registry ID cards, it will protect them from being arrested and prosecuted for taking their medicine.

  3. It permits registered patients or their caregivers to cultivate their own marijuana for their medical use, with limits on the amount they could possess.

  4. It allows patients and their caregivers who are arrested to raise a medical defense in court even if they have not registered.

  5. It restricts the medical use of marijuana in public and while driving under the influence of marijuana.

II. Becoming A Patient

A. How to register as a medical marijuana patient with the state of Montana

"Qualifying patients" must register with the Montana Department of Public Health and Human Services, Licensure Bureau, 2401 Colonial Drive, P.O. Box 202953, Helena, MT, 59620-2953. Phone:

406-.... To register, the patient must submit the following forms:

• • Patient/Caregiver Application Form in Word or PDF format

  • Attending Physician's Statement in Word or PDF format

  • Change Request Form in Word or PDF format

These forms must be accompanied by the following:

• 1. Written Certification from a physician licensed in the state of Montana that the person is a qualifying patient;

  2. An application or renewal fee paid to the Montana Department of Public Health and Human Services;

  3. The name, address, and birth date of the qualifying patient;

  4. The name, address, and telephone number of the qualifying patient's physician; and

  5. The name, address, and birth date of the qualifying patient's caregiver, if any.

B. Registration Fee

The fee for applying or the annual renewal of a state medical marijuana registration is $50 a year. Presently, there is no sliding-fee scale. Full payment, by check or money order, must be made at the time of the initial application and at renewal each year. The fee cannot be waived, and the department cannot accept installment payments.

The Medical Marijuana Policy Project of Montana has created a Medical Marijuana Financial Assistance Program for seriously ill Montanans who have little or no income and who are unable to afford the $50 fee.

C. Eligible medical conditions

Patients must suffer from a debilitating medical condition, defined as:

• 1. cancer, glaucoma, or positive status for human immunodeficiency virus (HIV), acquired immune deficiency syndrome (AIDS), or the treatment of these conditions;

  2. a chronic or debilitating disease or medical condition or its treatment that produces one or more of the following:

     1. 1. cachexia or wasting syndrome;

        2. severe or chronic pain;

        3. severe nausea;

        4. seizures including but not limited to those caused by epilepsy; or those caused by multiple sclerosis or Crohn's disease; or

  3. any other medical condition or treatment for a medical condition adopted by the department by rule.

(NOTE: To date, the department has not added to the list by administrative rule.)

D. Written Certification must be provided to prove eligibility

A doctor must certify in writing that you have a debilitating medical condition and that the benefits of using marijuana for medical purposes would likely outweigh the risks. As part of the registration process, the Department provides a form for the attending physician to sign stating that it is his/her professional opinion that the qualifying patient has a debilitating medical condition and the potential benefits from the medical use of marijuana will likely outweigh any health risks. The doctor makes the recommendation for the medical use of marijuana in the course of a bona fide physician-patient relationship, only after having completed a full assessment of the qualifying patient's medical history and current medical condition.

The federal government classifies marijuana as a Schedule I drug, which means that licensed medical practitioners cannot "prescribe" it. However, your physician can "recommend" the use of medical marijuana and must provide written certification of a "debilitating medical condition."

E. Finding a Doctor

The Montana Medical Marijuana Act states that an .attending physician. means a physician licensed under MCA Title 37, Chapter 3. M.D.s and D.O.s are the physicians licensed under this chapter. The statute is specific to physicians licensed in Montana. Naturopaths, chiropractors, and nurse practitioners are NOT qualified to sign the physician's "written certification."

There is no published list of doctors available. It is the responsibility of the patient to work with a physician with whom he/she has a bona fide doctor-patient relationship.

The Department of Health and Human Services cannot make a medical referral regarding medical marijuana. It is the responsibility of the patient to work with a physician with whom he/she has a bona fide doctor-patient relationship.

Under both Montana state law and the First Amendment to the United States Constitution, doctors cannot get in trouble for discussing medical marijuana. A physician may not be arrested, prosecuted, or penalized in any manner, or be denied any right or privilege, including but not limited to civil penalty or disciplinary action by the Board of Medical Examiners or the Department of Labor and Industry, for providing written certification for the medical use of marijuana to qualifying patients. According to the Medical Marijuana Act, a physician must state in writing that the patient has a qualifying debilitating medical condition and that medical marijuana may mitigate the symptoms or effects of that condition.

F. Age Limits

Registered caregivers must be 18 or older. Patients under age 18 must have the consent of their parent or guardian responsible for medical decisions. The parent or guardian must the registered caregiver of the minor patient.

G. Personal Records

It is prudent to keep copies of everything you send to the department including a copy of the application and your doctor's recommendation.

III. Limitations and Protections under Initiative I-148

A. Possession and Growing Limitations

A "qualifying patient" who is approved and registered by the state may grow medical marijuana - up to a limit of six plants and one ounce of dried marijuana in possession.

A qualifying patient and a qualifying patient's caregiver may each possess six marijuana plants and one ounce of usable marijuana. "Usable marijuana" means the dried leaves and flowers of marijuana and any mixture or preparation of marijuana.

B. Consumption of Medical Marijuana

Presuming you are registered with the state patient registry and carrying your registry identification card, you may consume medical marijuana on your property or elsewhere.

However, the law does NOT permit any person to operate, navigate, or be in actual physical control of any motor vehicle, aircraft, or motorboat while under the influence of marijuana. Nor does the law allow the smoking of marijuana in a school bus or other form of public transportation; on any school grounds, in any correctional facility; or at any public park, public beach, public recreation center, or youth center.

Assuming you are registered with the state patient registry and carrying your registry identification card, the law does not specifically prohibit the use of medical marijuana in a nursing home, assisted living facility, or a retirement home. However, the facility of home may have prohibitions. Therefore, you must verify with the facility if using medical marijuana is permitted and under what circumstance or conditions.

C. Paraphernalia associated with medical use

In Section 7 of the Medical Marijuana Act, asserting medical use of your "paraphernalia relating to the consumption of marijuana" is an affirmative defense, provided that you have a qualifying condition and possess an amount reasonably necessary for personal use as defined by the Montana Medical Marijuana Act. In Section 4, the act restricts the amount that may be possessed at any one time to no more than six marijuana plants and one ounce of usable marijuana.

D. Access to Medical Marijuana

The Medical Marijuana Act allows a patient or caregiver to grow no more than six plants or possess no more than one ounce of usable marijuana. The state does not give advice or referrals to obtain a supply of marijuana.

Qualified Medical Marijuana Patients cannot go to a pharmacy to fill a prescription for medical marijuana. Pharmacies can only dispense medications that are prescribed. Marijuana is currently classified by the federal government as a Schedule I drug, which means it cannot be prescribed by any health care professional. Initiative I-148 only allows doctors to recommend medical marijuana. The Medical Marijuana Act allows patients or their caregivers to grow medical marijuana for the patient's private use. The Montana Medical Marijuana Act makes no provisions for a supply or source.

E. Growing Cooperatives

The law does not address the issues of whether or not patients can form growing cooperatives. Although the Department of Public Health and Human Services recommends that you consult with your local law enforcement officer or personal attorney, ASA feels that the responsibility of implementation of Montana's medical marijuana law rests with the Department of Public Health and Human Services and as such, recommends against patients and caregivers consulting with law enforcement. Instead, it is the position of Americans for Safe Access that pressure should be put on the Montana Department of Public Health and Human Services to allow for collective and cooperative operations.

F. Caregivers

The Medical Marijuana Act provides for a system of designated caregivers. The caregiver's name, address, and birth date must be provided to the state at the time of a patient's registration. The department will issue a registry identification card to the caregiver who is named by a qualifying patient on his/her application.

The caregiver must sign a statement agreeing to provide marijuana only to the qualifying patients who have named the individual as their caregiver. The department may not issue a registry identification card to a proposed caregiver who has previously been convicted of a felony drug offense. The department will verify through a background check with a Department of Justice that the designated caregiver has no disqualifying felony drug convictions.

To be a caregiver, you will need to register your personal information including your name, address, and birth date with the state A qualifying patient must name you at the time he/she registers as a patient. Individuals convicted of a felony drug offense are not eligible to be caregivers. You may be a caregiver for more than one patient.

G. Housing

Nothing in the act specifically addresses whether you can be evicted because you are using medical marijuana, even if you have only the amount of medical marijuana allowed by law. Nor does the act directly address a patient living in subsidized housing. However, under federal law, HUD has clear regulations prohibiting ANY marijuana use in federally subsidized housing. Section 4(1) of the act [Sec. 50-46-201(1), MCA] does state that a "qualifying patient or caregiver who possesses a registry identification card issued pursuant to [section 3] may not be arrested, prosecuted, or penalized in any manner or be denied any right or privilege.for the medical use of marijuana or for assisting in the medical use of marijuana if the qualifying patient or caregiver possesses marijuana but not in excess of the amounts allowed in subsection (2)." If you have questions about these important issues, the department recommends you talk to an attorney to learn about your rights and protections.

The Medical Marijuana Act does not address the issue of whether or not you can grow or possess medical marijuana within 1,000 feet of a school, which is a "drug-free zone." The department recommends that for questions about laws other than the act, please contact your local law enforcement agency for guidance or consult with your personal attorney.

H. Employment

It is up to the employer to decide whether or not you can use medical marijuana at work. Even if you are a registered patient, your employer may still forbid medical marijuana use in the workplace.

The Medical Marijuana Act does not discuss whether employers are required to accommodate employees who use medical marijuana. It is up to you to decide whether to tell your employer. Questions about testing should be discussed with your personal attorney.

Although the Montana Medical Marijuana Act does not specifically address employment discrimination, a qualified patient typically has better chances for remedy if terminated from an existing job, than the same patient would have if discrimated against (as a result of a positive drug test) before being hired.

I. Reciprocity

Montana Residents: The Montana Medical Marijuana Act is only recognized within Montana. Currently, there are no reciprocity agreements with any other states to honor The Montana Medical Marijuana Act. This includes those other 10 states that have medical marijuana laws of their own. Possession of marijuana in states with no medical marijuana program is illegal, and you may be arrested and charged with civil or criminal offenses.

Residents from Other States: 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.

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

Under Montana law the police cannot search you just for having a patient registry card. Possession of, or application for, a registry identification card does not alone constitute probable cause to search the person or property of the person possessing or applying for the card to inspection by any governmental agency, including a law enforcement agency.

The department enforces provisions of the act that are concerned with registration, such as making sure applications are complete before issuing a registry identification card, denying incomplete or fraudulent applications, and suspending cards if individuals violate the act. Local and state law enforcement agencies may check to see if patients or caregivers possess or are growing the amount of medical marijuana allowed by law.

Local and state law enforcement personnel may also take any action they believe necessary to enforce the criminal laws of the state, including violations of the Montana Medical Marijuana Act. Local and state law enforcement actions may vary. The department has no authority to direct the activities of local and state law enforcement agencies.

K. Confidentiality

The state will maintain a confidential list of "qualified patients" and "approved caregivers" to whom the department has issued registry identification cards. Individual names and other identifying information on the list must be confidential and is not subject to disclosure except to a) authorized employees of the department as necessary to perform official duties of the department; or b) authorized employees of state or local law enforcement agencies, only as necessary to verify that a person is a lawful possessor of a registry identification card.

L. Insurance

The law specifically excludes government and private insurance entities from being required to cover any costs associated with medical marijuana.