Rhode Island Patient

Table of Contents

• 1. Introduction

  2. Becoming A Patient

     1. 1. How to Become a Medical Marijuana Patient in the State of Rhode Island

        2. Written Certification Must be Provided to Prove Eligibility for the Registry ID Card

        3. Registry Identification Card

        4. Finding a Doctor

        5. Caregivers

        6. Eligible medical conditions: "Debilitating Medical Condition"

        7. Age Limits

        8. Personal Records

  3. Limitations & Protections

• • • 1. Possession and Growing Limitations

      2. Access to medical marijuana

      3. Consumption of medical marijuana

      4. Law Enforcement

      5. Paraphernalia associated with medical use

      6. Reciprocity

      7. Housing

      8. Employment

      9. Education

      10. Confidentiality

      11. Insurance

      12. Protection for Friends and Family

I. Introduction

On January 3, 2006 the Rhode Island legislature passed The Edward O. Hawkins and Thomas C. Slater Medical Marijuana Act, which made Rhode Island the 11th state to legalize marijuana for medical use. At first the law was set to expire on June 30, 2007, but the state legislature came together to make it permanent. Governor Donald Carcieri vetoed the permanent version of the Act, but again the legislature backed patients and overrode the Governor's veto. The final law can be found here.

The Edward O. Hawkins and Thomas C. Slater Medical Marijuana Act (MMA) is codified in Rhode Island General Laws Chapter 21-28.6 is now in effect and patients can contact the Rhode Island Department of Health (DOH) to apply for a patient registry identification card.

The MMA is similar to the other state medical marijuana laws. Patients must have one of several specific conditions to qualify, however patients may petition the DOH to add other conditions to the current list of debilitating conditions. Only patients may legally use marijuana for medical purposes and only patients and and their caregivers are permitted to legally possess, cultivate, and transport marijuana for medical purposes.

Patients in Rhode Island are required to receive written certification from their doctor and a registry identification card from the DOH. A patient is NOT entitled to the protections of the MMA without possessing a state-issued identification card.

Rhode Island's medical marijuana law has several provisions that provide unique protections for patients, caregivers, and their friends and family. The MMA protects patients' and caregivers' property from state forfeiture laws. Any property seized, including cannabis, must be immediately returned to the patient upon determination by the court and/or prosecutor that they are entitled to the protections of the MMA. Furthermore, no person shall be subject to arrest or prosecution of a cannabis related offense for being in the presence of medical cannabis use permitted under the MMA.

Qualifying patients and their primary caregivers are protected from any civil penalty or disciplinary action by a business or occupational or professional licensing board or bureau, for the medical use of marijuana.

Furthermore, no school, employer or landlord may refuse to enroll, employ or lease to or otherwise penalize a person solely for his or her status as a registered qualifying patient or a registered primary caregiver.

Rhode Island's medical marijuana law further prohibits any physician from being punished, or denied any right or privilege, for having recommended marijuana to a patient for medical purposes.

II. Becoming A Patient

A. How to Become a Medical Marijuana Patient in the State of Rhode Island

Under Rhode Island's medical marijuana law, the DOH is required to set up a medical cannabis registry system. The DOH issues the registry ID cards and the registry ID card is mandatory for patients to be protected under The MMA.

To be a qualified patient you must be a resident of Rhode Island who has been diagnosed by a physician as having a debilitating medical condition and has received written certification and a registry identification card issued pursuant to the MMA. The physician must be a practitioner licensed in Rhode Island to prescribe and administer drugs that are subject to the Controlled Substances Act.

B. Written Certification Must be Provided to Prove Eligibility for the Registry ID Card

Written certification requires the patient's medical records and a signed statement that, in the practitioner's professional opinion, the patient has a debilitating medical condition AND the practitioner believes that the potential health benefits of the medical use of cannabis would likely outweigh the health risks for the patient. A full assessment of the qualifying patient's medical history and a bona-fide practitioner-patient relationship are required. The written certification must also specify the qualifying patient's debilitating medical condition(s).

C. Registry Identification Card

A qualified patient or a primary caregiver shall be granted the full legal protections of the MMA if the patient or caregiver is in possession of a registry identification card.

If the qualified patient or primary caregiver is not in possession of a registry identification card, the patient or caregiver shall be given an opportunity to produce the registry identification card before any arrest or criminal charges or other penalties are initiated.

The DOH shall issue registry identification cards to patients, and their primary caregiver if any, who submit the following:

• 1. written certification;

  2. Application or renewal fee

  3. the name, address and date of birth of the qualifying patient; (no address is required if the patient is homeless)

  4. the name, address and telephone number of the patient's practitioner; and

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

The DOH shall verify the information contained in the application and shall approve or deny an application within fifteen (15) days of receipt. The DOH may deny an application or renewal only if the applicant did not provide the information required or if the DOH determines that the information provided is false. A person whose application has been denied can appeal the decision in the superior court.

The DOH shall issue a registry identification card within five days of approving an application, and a card shall expire two years after the date of issuance. A registry identification card shall contain:

• 1. The date of issuance and expiration date of the registry ID card;

  2. A random registry ID number;

  3. A photograph; and

  4. Any other information as required by regulation or the DOH

A person who possesses a registry identification card shall notify the DOH of any change in the person's name, address, or primary caregiver. If the patient loses their registry ID card or ceases to have his/her debilitating medical condition they must notify the DOH within ten (10) days of the change. Patients and their primary caregivers must be careful to provide these updates to the DOH because failure to do so can result in a civil fine of $150 and/or loss of all protection under the MMA. Once the updated information is provided the DOH will issue a new registry ID card fro a $10 fee.

Currently, the application and renewal fee is $75. However, qualifying patients who submit satisfactory evidence to the DOH of being a recipient of Medicaid or Supplemental Security Income (SSI), may pay a reduced fee of $10.

Patients should be aware of the expiration on their written certification and registry identification card in order to renew the documents in a timely fashion.

D. Finding a Doctor

Patients should discuss the possibility of using medical marijuana with their primary care physician. A written certification shall be made only in the course of a bona fide practitioner-patient relationship after the practitioner has completed a full assessment of the qualifying patient's medical history.

A practitioner shall not be subject to arrest or prosecution, penalized in any manner or denied any right or privilege for recommending the medical use of cannabis or providing written certification for the medical use of cannabis pursuant to the MMA. Furthermore, a practitioner nurse or pharmacist shall not be subject to arrest, prosecution or penalty in any manner, or denied any right or privilege solely for discussing the benefits or health risks of medical marijuana or its interaction with other substances with a patient.

Americans for Safe Access recommends that any patient desiring to receive written certification for the medical use of marijuana be forthright with their doctor. There is nothing illegal or immoral with using medical cannabis or discussing medical cannabis use with a doctor.

If a patient is considering discussing medical marijuana use with their doctor, that patient should be prepared to tell his or her doctor specifically what condition or symptoms he or she treats with cannabis. This means that the patient should honestly describe the amount of cannabis they use, how often, and by what delivery method. The patient should then proceed to ask for written certification for the medical use of marijuana.

E. Caregivers

The MMA also protects a qualified patient's primary caregiver from arrest and prosecution.

"Primary caregiver" means a person who is at least twenty-one (21) years old and has agreed to assist with a person's medical use of marijuana and who doesn't have a felony drug conviction. However, the DOH may allow a person to serve as a primary caregiver if he/she was convicted solely for conduct that is permitted under this act or if he/she is a close relative of a patient and his/her felony conviction was ten (10) or more years ago.

A primary caregiver may assist no more than five (5) qualifying patients with their medical use of marijuana. A qualified patient may have no more than two (2) primary caregivers. A primary caregiver, who has in his/her possession, a registry ID card shall not be subject to arrest, prosecution, or penalty in any manner, or denied any right or privilege for assisting a qualifying patient to whom he/she is connected through the DOH registration process with the medical use of marijuana; provided, that the primary caregiver possesses an amount of marijuana which does not exceed twelve (12) marijuana plants and two and one-half (2.5) ounces of usable marijuana for each qualifying patient they are a primary caregiver for.

The primary caregiver shall not possess an amount of marijuana in excess of twenty-four (24) marijuana plants and five (5) ounces of usable marijuana irrespective of the number of qualifying patients to whom he or she is serving. A primary caregiver may receive reimbursement for costs associated with assisting a registered qualifying patient's medical use of marijuana. Compensation shall not constitute sale of controlled substances.

F. Eligible medical conditions: "Debilitating Medical Condition"

"Debilitating condition" means all of the following medical conditions, or the treatment of these conditions:

• 1. Cancer

  2. Glaucoma

  3. HIV +

  4. AIDS

  5. Hepatitis C

  6. Any other medical condition or treatment, approved and added to this list by the DOH in the future

  7. 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, debilitating, chronic pain;

        3. severe nausea;

        4. seizures, including but not limited to, those characteristic of epilepsy;

        5. severe and persistent muscle spasms, including but not limited to, those characteristic of multiple sclerosis or Crohn's disease; or

        6. agitation of Alzheimer's Disease

G. Age Limits

If the person is less than 18 years of age, the qualified patient's practitioner must explain the potential risks and benefits of the medical use of cannabis to the qualified patient and to a parent, guardian or person having legal custody of the qualified patient. The parent/guardian must consent in writing to:

• 1. allow the qualified patient's medical use of cannabis;

  2. serve as one of the qualified patient's primary caregivers; and

  3. control the acquisition of, dosage and the frequency of the medical use of cannabis by the qualified patient.

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 & Protections

A. Possession and Growing Limitations

The MMA allows qualified patients and their primary caregivers to collectively possess twelve (12) marijuana plants and up to two and one half (2.5) ounces of usable marijuana. The plants must be grown/stored indoors.

"Usable marijuana" means the dried leaves and flowers of the marijuana plant, and any mixture or preparation thereof, but does not include the seeds, stalks, and roots of the plant.

The primary caregiver shall not possess an amount of marijuana in excess of twenty-four (24) marijuana plants and five (5) ounces of usable marijuana irrespective of the number of qualifying patients to whom he or she is serving.

B. Access to medical marijuana

Medical marijuana patients cannot go to a pharmacy 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.

Under the MMA, doctors may only "recommend" marijuana, and that allows patients to grow their own medical marijuana for their private use. The state of Rhode Island does not provide information on the acquisition of marijuana. Therefore, the State of Rhode Island will not assist in getting seeds or plants to start growing medical marijuana.

The MMA does not mention dispensaries, collectives, or licensed producers. Only qualified patients and/or their primary caregivers may cultivate cannabis for medical use.

C. Consumption of medical marijuana

Qualified patients are not protected from criminal prosecution or civil penalty for smoking medical marijuana:

• 1. in a school bus or public vehicle;

  2. on school grounds;

  3. in any correctional facility

  4. in any public place

  5. in any licensed drug treatment facility

It is very important to note that qualified patients in Rhode Island are not protected by the MMA when they use medical cannabis in a public place. Patients should limit their consumption to private in home use.

Qualified patients are also not permitted to undertake any task under the influence of marijuana, when doing so would constitute negligence or professional malpractice; to operate, navigate, or be in actual physical control of any motor vehicle, aircraft, or motorboat while under the influence of marijuana. However, a registered qualifying patient shall not be considered to be under the influence solely for having marijuana metabolites in his/her system. In addition, employers are not expected to accommodate the medical use of marijuana in any workplace.

D. Law Enforcement

A qualified patient who possesses a registry ID card shall not be subject to arrest, prosecution or penalty in any manner for the medical use of marijuana. A qualified patient's primary caregiver shall not be subject to arrest, prosecution or penalty in any manner for the possession of cannabis for medical use by the qualified patient. Both patient and caregiver, in prosecutions involving marijuana, may also assert a medical marijuana defense in a motion to dismiss and the charges shall be dismissed following a successful evidentiary hearing.

There is a presumption that a qualifying patient or primary caregiver is engaged in the medical use of marijuana if the qualifying patient or primary caregiver:

• 1. Is in possession of a registry identification card; AND

  2. Is in possession of an amount of marijuana that does not exceed the amount permitted

Such presumption may be rebutted by evidence that conduct related to marijuana was not for the purpose of alleviating the qualifying patient's debilitating medical condition or symptoms associated with the medical condition.

A person who makes a fraudulent representation to a law enforcement officer about the person's participation in a medical use of cannabis program to avoid arrest or prosecution for a cannabis-related offense shall be punishable by a fine of five hundred dollars ($500) which shall be in addition to any other penalties that may apply for making a false statement for the non-medical use of marijuana.

Possession of or application for a registry identification card shall not constitute probable cause or give rise to reasonable suspicion for a governmental agency to search the person or property of the person possessing or applying for the card.

E. Paraphernalia associated with medical use

The MMA defines medical use of marijuana as "the acquisition, possession, cultivation, manufacture, use, delivery, transfer, or transportation of marijuana or paraphernalia relating to the consumption of marijuana to alleviate a registered qualifying patient's debilitating medical condition or symptoms associated with the medical condition."

Paraphernalia possession is specifically protected under the MMA.

F. Reciprocity

The 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.

Rhode Island currently has no reciprocity agreements with other states to honor its 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 Rhode Island 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.

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.

G. Housing

Furthermore, no landlord may refuse to lease to or otherwise penalize a person solely for his or her status as a registered qualifying patient or a registered primary caregiver. This also suggests that landlords may not rightfully evict a qualified patient from her/his housing solely because of patient status. Nonetheless, it is up to each patient to decide whether or not to tell his/her landlord about their status as a medical marijuana patient.

However, under federal law, HUD has clear regulations prohibiting ANY marijuana use in federally subsidized housing (the federal government does not recognize marijuana as being medicine), so medical marijuana patients in Rhode Island HUD housing should avoid possession, cultivation, and even use if at all possible. If a patient has questions about these important issues, Americans for Safe Access recommends speaking to an attorney to learn about their rights and protections.

Rhode Island's 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 school zone" can still grow and/or possess medical marijuana.

Patients and primary caregivers are protected from state asset forfeiture (i.e. your house). Under General Laws § 21-28.6-4(g) of the MMA, any interest in or right to property that is possessed, owned, or used in connection with the medical use of marijuana, or acts incidental to such use, shall not be forfeited, as long as the patient can demonstrate that the use was medical.

H. Employment

Furthermore, no employer may refuse to employ or otherwise penalize a person solely for his or her status as a registered qualifying patient or a registered primary caregiver. This also suggests that employers may not rightfully terminate a qualified patient from her/his employment solely because of patient status. However, employers are not expected to accommodate the medical use of marijuana in any workplace.

I. Education

No school may refuse to enroll or otherwise penalize a person solely for his or her status as a registered qualifying patient or a registered primary caregiver.

J. Confidentiality

Rhode Island's current confidentiality protocols are as follows:

Applications and supporting information submitted by qualifying patients, including information regarding their primary caregivers and practitioners, are confidential and protected under the federal Health Insurance Portability and Accountability Act of 1996.

The DOH shall maintain a confidential list of the persons to whom they have issued registry ID cards and shall notify local and state law enforcement of the number of qualified patients in any given city or town. Individual names and other identifying information on the list shall be confidential, exempt from the provisions of Rhode Island Access to Public Information, chapter 2 of title 38, and not subject to disclosure, except to authorized employees of the DOH as necessary to perform official duties of the DOH.

The DOH shall verify to law enforcement personnel whether a registry ID card is valid solely by confirming the random registry identification number. It shall be a crime, punishable by up to one hundred eighty (180) days in jail and a one thousand dollar ($1,000) fine, for any person, including an employee or official of the DOH or another state agency or local government, to breach the confidentiality of information obtained pursuant to this chapter. Notwithstanding this provision, DOH employees may notify law enforcement about falsified or fraudulent information submitted to the DOH.

K. Insurance

Rhode Island's medical marijuana law does not require a governmental, private, or any other health insurance provider or health care service plan to be liable for any claim for reimbursement for the medical use of marijuana.

However, patients receiving state assistance should inquire into discounted registration fees for the registry ID card.

L. Protection for Friends and Family

Any interest in or right to property that was possessed, owned, or used in connection with a person's use of marijuana for medical purposes shall not be forfeited if the person or the person's primary caregiver demonstrates the person's medical purpose for using marijuana pursuant to this section.

No person shall be subject to arrest or prosecution for constructive possession, conspiracy, aiding and abetting, being an accessory, or any other offense for simply being in the presence or vicinity of the medical use of marijuana as permitted under the MMA or for assisting a registered qualifying patient with using or administering marijuana.

For more info: RI Dept. of Health (http://www.health.state.ri.us/)

Application form available at www.health.ri.gov/hsr/mmp/index.php or by visiting room 104 at the Health Department, 3 Capitol Hill, Providence, RI

More helpful information can be found at the Rhode Island Patient Advocacy Coalition (http://ripatients.org/).