Oregon Patient

Table of Contents

• 1. Introduction

  2. Becoming A Patient

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

        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 Cooperatives

      6. Caregivers

      7. Housing

      8. Employment

      9. Reciprocity

      10. Law Enforcement

      11. Confidentiality

      12. Insurance

Note: Oregon Law was amended by Oregon Senate Bill 1085. Some changes have been made that supersede the information here. See Mothers Against Misuse and Abuse for more updated info.

I. Introduction

The role of the Oregon Department of Human Services, Health Services is to administer the Oregon Medical Marijuana Act as approved by the voters of Oregon State and to make the registration process work smoothly and efficiently for qualified patients.

Review the Oregon Department of Health Services (DHS) website here, or for additional questions concerning the Oregon Medical Marijuana Program (OMMP), Contact DHS/OMMP at:

Phone:

(503) 731-4002 Ext. 233

E-mail: OMMP.QA@state.or.us

FAX: (503) 872-6822

Post Office: DHS/OMMP, PO Box 14450, Portland, OR 97293-0450

The Oregon Medical Marijuana Act was passed by Oregon voters on November 3, 1998, and went into effect on December 3, 1998. The Oregon Health Services was given the responsibility of developing a registration system for patients and caregivers by May 1, 1999.

On May 21, 1999, the first registration cards were issued. Since that date, more than 900 registration cards have been issued to 600 patients and their caregivers. More than 300 physicians are participating in the program. These physicians are Medical Doctors and Doctors of Osteopathy who are in private or group practice, or are in large Health Maintenance Organizations such as Kaiser Permanente. The program operates statewide, with registered patients from every county in Oregon.

All patient and physician names and records are maintained in confidential files and a database. However, as outlined in the Act, state and local law enforcement may contact the Health Services to verify if a person is registered with the program. Law enforcement personnel must provide a specific name or address, and the Health Services may verify if the person is registered, or has an application pending.

In addition to administering the registration system, the Health Services was charged with accepting petitions to add conditions to the list of qualifying conditions/symptoms covered in the original Act. During the past year, the Division received petitions to add anxiety, depression, bipolar disorder, schizophrenia, adult attention-deficit disorder, sleep disorder, and post-traumatic stress disorder to the list of qualifying conditions. A panel of physicians, nurses, and patient advocates held meetings to consider these conditions, and have made recommendations to the State Health Officer, Dr. Grant Higginson. He will likely decide which, if any, conditions to add by the end of May.

There are still some barriers to participation in the program. The program did not receive any general funds during the last legislative budget session, so it is entirely supported by patient fees of $150 per application. This presents a financial hardship to many patients who are too ill to work. Some doctors are still reluctant to allow their patients to participate, fearing federal reprisals. Some patients are unable to grow medical marijuana at their homes, or find a caregiver to grow for them.

However, on balance, the program is working better than either the proponents, or the opponents, anticipated. With larger-than-expected patient registration and physician participation, and with no wide-scale criminal abuses, it would be safe to deem the program quite successful to date. Other states (and Canada) have requested information on Oregon's program to use as a model for their own initiatives and registration systems. The Health Services receives regular feedback from patients who tell us that the program is working well for them.

II. Becoming A Patient

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

The OMMP will review your application to make sure it is complete and all parts are current. If your application is complete, you will get a "complete letter" from the OMMP letting you know your registry identification card will be issued within 30 days after the OMMP receives verification from your attending physician. On the same day the OMMP sends you a "complete letter," we mail a "verification letter" to your attending physician.

The purpose of this letter is to verify that you are a patient of this physician, and for a new application, that you are affected by a debilitating medical condition covered by the Oregon Medical Marijuana Act, and that medical marijuana may reduce the symptoms of your condition. If you are renewing your application, the verification letter to your attending physician is to verify that you are his or her patient.

If you don't send in all the required parts of your application, the OMMP will send you an "incomplete letter" telling you what parts of your application are missing. The incomplete letter gives you 14 days from the dates of the letter to get the missing parts to the OMMP and tells you the terms under which your application may be denied. When you get all missing parts of you application to the OMMP, you will be sent a "complete letter" and the OMMP will verify your status with your attending physician.

If an OMMP patient is physically unable to sign and date the application, the patient may have someone else sign and date the application (by proxy) as long as the individual signing the OMMP application identifies him or herself as the patient's proxy next to his or her signature on the application.

B. Registration Fee

The fee for a NEW application is $150.00 OR $50.00 if you are on the Oregon Health Plan (OHP) or if you are receiving Supplemental Security Income (SSI) monthly benefits. SSI is not the same as Social Security Disability. The Application fee cannot be waived. Partial payments cannot be accepted. Credit card payments are not accepted. The fee must be paid in full with each new or renewal application. Make your check or money order payable to OMMP. You may pay in person at the State Office Building cashier's office in Portland.

The fee for a RENEWAL application is $100.00 or $50.00 if you are on the OHP or if you are receiving SSI monthly benefits. SSI is not the same as SSD.

The Oregon Health Plan (OHP) means the medical assistance program administered by the Department under ORS chapter 414. Eligibility in the Oregon Health Plan is demonstrated by providing a current, valid eligibility determination statement from the Department's OFFICE OF Medical Assistance Programs. To qualify for a reduced fee, a copy of the patient's current eligibility statement must be provided at the time the patient submits an application. The Department will verify the patient's Oregon Health Plan eligibility with the Office of Medical Assistance Programs.

Supplemental Security Income (SSI) means the monthly benefit assistance program administered by the federal government for persons who are age 65 or older, or blind, or disabled and who have limited income and financial resources. Eligibility for Supplemental Security Income is demonstrated by providing a copy of a receipt of a current monthly benefit. To qualify for a reduced fee, a copy of a receipt of a current Supplemental Security Income monthly benefit must be provided at the time the patient submits an application. The Department will verify the patient's current Supplemental Security Income receipt of monthly benefits through the department of with the Social Security Administration. See Oregon Administrative rule 333-008-0020.

C. Eligible medical conditions

"Debilitating medical condition" means:

• 1. Cancer, glaucoma, positive status for human immunodeficiency virus or acquired immune deficiency syndrome, or treatment for these conditions;

  2. A medical condition or treatment for a medical condition that produces, for a specific patient, one or more of the following:

     1. 1. Cachexia;

        2. Severe pain;

        3. Severe nausea;

        4. Seizures, including but not limited to seizures caused by epilepsy; or

        5. Persistent muscle spasms, including but not limited to spasms caused by multiple sclerosis; or

  3. Any other medical condition or treatment for a medical condition adopted by the department by rule or approved by the department pursuant to a petition submitted pursuant to ORS 475.334.

D. Written Certification must be provided to prove eligibility

According to the Oregon Medical Marijuana Act (Section 4(2)(a)), or OAR 333-008-0020(1)(a), 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. The OMMP accepts medical records as long as they clearly state the physician is aware that medical marijuana is being used as a treatment and he or she believes the patient may benefit from the use of medical marijuana. The physician must sign and date the relevant portions of medical records you send to the OMMP. The OMMP contacts each physician during the application process to verify the patient is under the physician's care. A signed and dated "Attending Physician's Statement," copies of chart notes or medical records must be current within 3 months of the date of a person's new or renewal application.

Because the federal government classifies marijuana as a Schedule I drug, which means that licensed medical practitioners cannot prescribe it. Your physician can only "recommend" the use of medical marijuana.

E. Finding a Doctor

The Oregon Medical Marijuana Act states that an "attending physician" means a physician licensed under ORS chapter 677 (OAR 333-008-0010(1)). MDs and DOs are the physicians licensed under this chapter. The law also specifies that the physician must be licensed in Oregon. The OMMP verifies with the Board of Medical examiners that each patient's attending physician has a valid license to practice medicine in Oregon and has no disqualifying restrictions. You must have a qualifying debilitating medical condition as listed on the Attending Physician's Statement. You must have an established patient/physician relationship with your "attending physician." Naturopaths, chiropractors, and nurse practitioners cannot sign the documentation.

The Oregon DHS states on it's website that "The OMMP cannot refer you to a physician. The OMMP does not have a physician referral list." The names of physicians who have submitted forms, letters, or chart notes for their patients are confidential.

F. Renewal Applications

A renewal application does not require a statement from a physician regarding the use of medical marijuana; however, a renewal does require the patient to demonstrate that his or her debilitating medical condition continues. You can submit a copy of relevant portions of your medical records made by your physician within 3 months of your application date. The records must be signed and dated by the physician. The OMMP urges patients to works closely with their attending physicians throughout the application process.

G. 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.

H. Personal Records

Oregon DHS strongly urges all OMMP patients to keep copies of everything you send to the OMMP at any time now or in the future. For example, the copy of your application is your proof of protection until you are issued a registry identification card.

III. Limitations and Protections under the Initiative

A. Possession and Growing Limitations

Under ORS § 475.306, A person who possesses a registry identification card issued pursuant to the Oregon Medical Marijuana Act (ORS § 475.309), may engage in, and a designated primary caregiver of such a person may assist in, the medical use of marijuana only as justified to mitigate the symptoms or effects of the person's debilitating medical condition. A registry identification cardholder and that person's designated primary caregiver may not collectively possess, deliver, or produce more than the following:

1. If the person is present at a location at which marijuana is not produced, including any residence associated with that location, one ounce of usable marijuana; andA patient may store (possess) up to 24 ounces of dried plant material. Patients can give marijuana to other patients, but they cannot legally buy it or sell it to anyone.

2. If the person is present at a location at which marijuana is produced, including any residence associated with that location, three mature marijuana plants, four immature marijuana plants and one ounce of usable marijuana per each mature plant.Each patient may have 18 plants under 12 inches in any direction, with no buds or flowers, and 6 plants over 12 inches high, or 12 inches wide, or in bloom.

If medical marijuana patients possess, deliver or produce marijuana in excess of the amounts allowed, such individuals are not excepted from the criminal laws of Oregon but may establish an affirmative defense to such charges, by a preponderance of the evidence, that the greater amount is medically necessary to mitigate the symptoms or effects of the person's debilitating medical condition.

The Department of Human Services shall define by rule when a marijuana plant is mature and when it is immature for purposes of this section. [1999 c.4 §7]

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 or 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

The Oregon Medical Marijuana Act does not discuss the issue of asserting medical use of "paraphernalia relating to the consumption of marijuana." However, ASA feels that paraphernalia related to medical marijuana use is inherently protected under the OMMA as such paraphernalia is necessitated by medical marijuana use.

D. Access to Medical Marijuana

There is no place in the State of Oregon to legally purchase medical 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. The Oregon Medical Marijuana Act only allows doctors to recommend medical marijuana. The Act allows patients or their caregivers to grow medical marijuana for the patient's private use but makes no provisions for a supply or source. The OMMP cannot supply you with seeds or starter plants, or give you advice on how to grow medical marijuana.

OAR 333-008-0020(1)(b) requires the patient to provide the OMMP with the address where his or her marijuana will be manufactured or produced - that is, a "grow site" address. The OMMP is aware that some patients do not plan to grow their medical marijuana and at the time of making a new or renewal application, may not yet have a designated primary caregiver and/or may not be certain where their grow site will be.

For this requirement, the OMMP offers patients two options. First, the patient knows the physical address where his or her medical marijuana will be grown and provides this address to the OMMP on the application form. Second, the patient is not certain where his or her medical marijuana will be grown and provides the physical address where the medical marijuana will most likely be grown. A PO Box is not permitted as a grow site address.

You and your caregiver are not protected from criminal laws if:

• 1. your grow site address in not registered with the OMMP;

  2. you provide the OMMP with incorrect grow site address information; or

  3. you fail to inform the OMMP of any change in grow site information within 30 days of any such change (ORS 475.316).

There is a section on the back of the application forms for you to list the names and dates of birth of another person who may be at the grow site, other than the patient and/or the designated primary caregiver. The OMMP will include this information in the patient's file and will verify these other names with law enforcement personnel only if an officer asks about a specific name(s) of a person who may be at a grow site. You are not required to list the names and dates of birth of other persons who may be at the grow site; this information is optional. OTHER PERSONS WHO MAY BE AT THE GROW SITE ARE NOT PROTECTED FROM CIVIL OR CRIMINAL PENALTIES!

E. Growing Cooperatives

The law does not address the issues of whether or not patients can form growing cooperatives. The Oregon Department of Human Services, Health Services recommends that you consult with your local law enforcement officer or an attorney. However ASA feels that the responsibility of implementation of Oregon's medical marijuana law rests with the Oregon Department of Human Services, Health Services, and as such, ASA 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 Oregon Department of Human Services, Health Services to allow for collective and cooperative operations.

F. Caregivers

The OMMP cannot find a designated primary caregiver for you. The OMMP does not keep a referral list of persons who want to be caregivers for patients. (You are not required to list a caregiver unless you are less than 18 years old.) Your caregiver cannot be your physician.

If you decide to change your caregiver, it is your responsibility to notify him or her that he or she is no onger protected under the law. The OMMP does not communicate directly with caregivers. The OMMP will only speak directly with the patient. All written requests to release information must be signed and dated by the patient. The OMMP will not accept written or verbal requests for information from your caregiver or any other person without your permission.

G. Housing

The Oregon DHS website states that: "It is up to you to decide whether or not to tell your landlord that you are a patient in the OMMP." Nothing in the Oregon Medical Marijuana Act (OMMA) specifically addresses whether or not you can be evicted because you are a patient in the OMMP, even if you have only the amount of medical marijuana allowed by law. Nothing in the OMMA specifically addresses whether or not a person can be an OMMP patient and live in subsidized housing. If you have questions about these important issues, the OMMP recommends you talk to an attorney to learn about your rights and protections.

The Oregon Medical Marijuana Act 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 there. For questions about laws other than the OMMA, the Oregon Department of Health Services recommends you to contact your local law enforcement agency for guidance.

Patients are required to tell the OMMP in writing of any changes to their mailing address, addition or removal of a designated primary caregiver, or change of grow site address, within 30 days of the change. The OMMP does not accept changes of information over the telephone. The OMMP only accepts written changes about the patient's address, designated primary caregiver, or grow site from the registered patient. You may send your changes to the OMMP by mail, by fax, or in person. At this time, if you make a change after your registry identification card has been issued, the OMMP will not issues a new card to you. You will get written confirmation from the OMMP that the change was received. Your changes will be made in our computer database and will be put in your file. You will be protected from civil and criminal penalties for these changes.

H. Employment

The Oregon Medical Marijuana Act states that employers are not required to accommodate employees who use medical marijuana. It is up to you to decide whether or not to tell your employer that you are a patient in the OMMP. The OMMP has heard that several employers treat medical marijuana like any prescription drug that might impair ability; however, this is not true in all situations. A patient may contact the OMMP in writing to ask the Program to release information about the patient's registration to an employer.

I. Reciprocity

Oregon Residents: At this time, the OMMP is not aware of any "reciprocity" agreements with any other tates to honor the Oregon 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 Oregon 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

The OMMP enforces the registration process by making sure applications are complete before issuing a registry identification card, denying incomplete or fraudulent applications, and suspending cards if persons commit violations of the OMMA. The OMMP verifies the names and addresses of patients, caregivers, and grow sites with local and state law enforcement personnel if they call the OMMP requesting such information.

Local and state law enforcement agencies enforce the OMMA around the State through checking 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 take any action they believe is necessary to enforce the criminal laws of the State, including violations of the OMMA. Local and state law enforcement actions may vary from county-to-county and district-to-district. The OMMP has no authority to direct the activities of local and states law enforcement agencies.

K. Confidentiality

The OMMP works from a locked and secure office. The OMMP keeps all computer and paper files locked and secure when not in use. OMMP staff tells officers from state or local law enforcement agencies "yes" or "no" when asked:

• 1. if a specific person has a valid registry identification card;

  2. if a specific person is a caregiver of a patient;

  3. if a specific person has a pending application, or

  4. if a specific address is a registered "grow site."

This "yes" or "no" practice is called "verification", because we only verify specific question asked us.

OMMP staff does not give out other information to law enforcement. For example, if an OMMP staff member is asked by an officer to give out the name of a patient's designate primary caregiver, the staff member tells the officer that such information is confidential and can only be verified if OMMP staff is given specific information (name or address) to verify.

The OMMP follows all Department of Human Services policies on the Health Insurance Portability and Accountability Act (HIPAA). HIPAA uses terms such as "identified data" and "de-identified" or "non-identifying data." "Identified data" means data that can specifically identify individuals, such as name or date of birth. "De-identified" or "non-identifying data" means data that protects the identity of specific individuals. For example, a count of the number of patients currently registered with the OMMP does not allow the identification of specific individuals.

When asked for information by newspaper or TV reporters, for example, the OMMP gives out only counts - not names, addresses, dates of birth, or other "identifying" information. In giving out counts, the OMMP combines small numbers. For example, if a county has fewer than 50 OMMP patients, the OMMP will combine the actual number of patients from that county with one or more other counties that have fewer than 50 patients. The OMMP then gives out a "combined" count of patients for several counties. This protects the actual identify of patients who may live in less-populated areas of the State.

The OMMP will disclose patient information to others only at the specific, written request of the patient.

L. Insurance

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