216-RICR-20-10-3
216-RICR-20-10-3. Medical Marijuana Program (version Technical Revision, 01/03/2017 to 01/03/2017)
216-RICR-20-10-3
TITLE 216 - DEPARTMENT OF HEALTH
CHAPTER 20 - COMMUNITY HEALTH
SUBCHAPTER 10 - SCREENING, MEDICAL SERVICES, & REPORTING
PART 3 – MEDICAL MARIJUANA PROGRAM
3.1
Authority and Purpose
A.
These amended Rules and Regulations Related to the Medical Marijuana
Program Administered by the Department of Health are promulgated pursuant to
the authority conferred under R.I. Gen. Laws 21-28.6-5, as amended, and are
established for the purpose of updating standards for the implementation of a
medical marijuana program, and other changes mandated pursuant to R.I. Gen.
Laws Chapter 21-28.6, as amended.
Pursuant to the provisions of R.I. Gen. Laws Chapter 42-35 and Chapter 42-35.1,
as amended, the following were given consideration in arriving at the amended
regulations: alternative approaches to the regulations; (2) duplication or overlap
with other state regulations and (3) significant economic impact on small
business. Based on the available information, no known alternative approach,
duplication or overlap was identified.
3.2
Definitions
A.
Wherever used in these Regulations the following terms shall be construed as
follows:
1.
“Act” means R.I. Gen. Laws Chapter 21-28.6 entitled “The Edward O.
Hawkins and Thomas C. Slater Medical Marijuana Act.”
2.
“Authorized purchaser” means a natural person, who is at least twenty-
one (21) years old, and who is registered with the department of health for
the purpose of assisting a qualifying patient in purchasing marijuana from
a compassion center. An authorized purchaser may assist no more than
one patient, and is prohibited from consuming marijuana obtained for the
use of the qualifying patient.
3.
“Cardholder" means a person who has registered with the department of
health pursuant to R.I. Gen. Laws Chapter 21-28.6 and has been issued
and possesses a valid registry identification card or license.
4.
“Commercial Unit” means a building, office, suite or room within a
commercial or industrial building for use by one business and is rented or
owned by that business or person.
5.
“Compassion center” means a not-for-profit corporation subject to the
provisions of R.I. Gen. Laws Chapter 7-6, and registered under R.I. Gen.
Laws § 21-28.6-12 of the Act that acquires, possesses, cultivates,
manufactures, delivers, transfers, transports, supplies or dispenses
marijuana, and/or related supplies and educational materials, to patient
cardholders and/or their registered caregiver cardholder and authorized
purchaser.
6.
“Debilitating medical condition” means:
1.
Cancer, glaucoma, positive status for human immunodeficiency
virus, acquired immune deficiency syndrome, Hepatitis C, post-
traumatic stress disorder; 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: cachexia or
wasting syndrome; severe, debilitating, chronic pain; severe
nausea; seizures, including but not limited to, those characteristic of
epilepsy; or severe and persistent muscle spasms, including but not
limited to, those characteristic of multiple sclerosis or Crohn’s
disease; or agitation of Alzheimer's Disease; or
3.
Any other medical condition or its treatment approved by the
Department of Health pursuant to § 3.3.7 of this Part.
7.
"Department of Business Regulation” means the Rhode Island
Department of Business Regulation or its successor agency.
8.
“Department of Health” means the Rhode Island Department of Health or
its successor agency.
9.
“Department of Public Safety” means the Rhode Island Department of
Public Safety or its successor agency.
10.
“Dried usable marijuana” means the dried leaves and flowers of the
marijuana plant after the wet harvested leaves and flowers of the
marijuana plant have undergone the drying process.
11.
“Dwelling Unit” means a room or group of rooms within a dwelling used or
intended for use by one family or household, or by no more than three (3)
unrelated individuals, for living, sleeping, cooking and eating.
12.
“Equivalent amount” means the portion of usable marijuana, be it
extracted, edible, concentrated or any other form, found to be equal to a
portion of dried usable marijuana, as defined in Appendix A of these
Regulations.
13.
“Full assessment” means evaluation by practitioner which at a minimum
documents in the medical record: history of present illness, social history,
past medical and surgical history, alcohol and substance use history,
physical exam and documentation of therapies with inadequate response.
14.
“Marijuana” has the meaning given that term in R.I. Gen. Laws § 21-28-
1.02(26) and is as follows: all parts of the plant (Cannabis sativa, L.),
whether growing or not; the seeds of the plant; the resin extracted from
any part of the plant; and every compound, manufacture, salt, derivative,
mixture, or preparation of the plant, its seeds or resin, but shall not include
the mature stalks of the plant, fiber produced from the stalks, oil or cake
made from the seeds of the plant, any other compound, manufacture, salt,
derivative, mixture, or preparation of mature stalks, (except the resin
extracted from it), fiber, oil or cake, or the sterilized seed from the plant
which is incapable of germination.
15.
“Marijuana Infused Products” means a product infused with medical
marijuana or an extract of medical marijuana that is intended for use or
consumption other than by smoking, including, but not limited to edible
products, ointments, oils and tinctures. These products when
manufactured or sold by a licensed medical marijuana compassion center
shall not be considered a food or drug.
16.
"Mature marijuana plant" means a marijuana plant that has flowers or
buds that are readily observable by an unaided visual examination.
17.
“Medical Marijuana Program Tracking System” shall refer to any system
designated by the Department of Business Regulation and the
Department of Health designed and used to record all medical marijuana
program regulated activities with unique identifiers to track all activities
and transactions from point of origin to point of sale (“seed to sale”), “Seed
to sale” activities and transactions include but are not limited to: all
cultivation, harvest, processing, manufacturing, and packaging and
labeling; all purchases, acquisitions or third party supply of marijuana; all
sales and dispensing transactions, and any other transfers of marijuana as
permitted by the Department of Business Regulations; any instances of
destruction of marijuana; and testing compliance tracking. The Medical
Marijuana Program Tracking System may also be used to record and/or
report any other additional information directed by the Department of
Business Regulation or the Department of Health consistent with the
Department of Business Regulation regulations and/or Department of
Health regulations.
18.
“Medical use” means the acquisition, possession, cultivation, manufacture,
use, delivery, transfer, or transportation of marijuana or paraphernalia
relating to the consumption of marijuana to alleviate a patient cardholder's
debilitating medical condition or symptoms associated with the medical
condition.
19.
“Paraphernalia” , as used in these Regulations, means any equipment,
product, or material of any kind that is primarily intended or designed for
use in planting, propagating, growing, cultivating, harvesting,
manufacturing, compounding, converting, producing, processing,
preparing, inhaling, or otherwise introducing into the human body
marijuana, including but not limited to: metal, wooden, acrylic, glass,
stone, plastic, or ceramic pipes with or without screens, permanent
screens, or punctured metal bowls; water pipes, roach clips: meaning
objects used to hold burning material, such as a marijuana cigarette, that
has become too small or too short to be held in the hand; bongs; ice pipes
or chillers.
20.
“Parent or legal guardian” means the custodial parent for a person under
eighteen (18) years of age or the legal guardian with responsibility for
health care decisions for a person of any age
21.
“Practitioner” means a person who is licensed to practice medicine with
authority to prescribe drugs pursuant to R.I. Gen. Laws Chapter 5-37 or a
physician licensed with authority to prescribe drugs in Massachusetts or
Connecticut.
22.
“Primary caregiver” means a natural person who is at least twenty-one
(21) years old and is a resident of Rhode Island. A primary caregiver may
assist no more than five (5) qualifying patients with their medical use of
marijuana.
23.
“Qualifying patient” means a person who has been diagnosed by a
practitioner as having a debilitating medical condition and is a resident of
Rhode Island.
24.
“Registry identification card” means a document issued by the Department
of Health that identifies a person as a registered qualifying patient, a
registered primary caregiver, or an authorized purchaser.
25.
“R.I. Gen. Laws” means the General Laws of Rhode Island, as amended.
26.
"Seedling" means a marijuana plant with no observable flowers or buds.
27.
“These Regulations” mean all parts of Rhode Island Rules and
Regulations Related to the Medical Marijuana Program Administered by
the Department of Health.
28.
"Unusable marijuana" means marijuana seeds, stalks, seedlings, and
unusable roots.
29.
“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.
30.
“Wet marijuana” means the harvested leaves and flowers of the marijuana
plant before they have reached a dry usable state. Marijuana that has
been dried to a usable state shall be assumed to have yielded twenty
percent (20%) of the weight of the wet marijuana as defined in Appendix A
of these Regulations.
31.
“Written certification” means the qualifying patient’s medical records, and
a statement signed by a practitioner, stating that in the practitioner’s
professional opinion the potential benefits of the medical use of marijuana
would likely outweigh the health risks for the qualifying patient. 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. The written certification shall
specify the qualifying patient's debilitating medical condition or conditions.
3.3
General Requirements
3.3.1 Administration of the Program
A.
The Division of Customer Services within the Department of Health shall be
responsible for the administrative functions required to implement the provisions
of the Act and these Regulations related to qualified patients, primary caregivers
and authorized purchasers, as they apply to the implementation of the medical
marijuana program in Rhode Island.
3.3.2 Written Certifications
A.
Practitioners shall provide written certifications for their patients on such forms as
shall be provided by the Department of Health.
B.
The written certification shall specify the qualifying patient's debilitating medical
condition or conditions and include a copy of the relevant patient medical records
as specified in § 3.2(A)(31) of this Part, documenting the debilitating medical
condition or conditions.
C.
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.
3.3.3 Practitioner(s) Responsibility
A.
The certifying practitioner shall obtain three (3) hours or equivalent of Category 1
CME regarding medical marijuana every two (2) years as part of usual CME/CE
requirement.
B.
The certifying practitioner shall document in the medical record the basis for
issuance of a written certification regarding use of medical marijuana, specifically
identifying the debilitating condition(s) being met.
C.
Patient Education: The certifying practitioner shall document in the medical
record and provide in written or verbal format, that patient was educated
regarding maximum daily dose of active ingredient, minimum interval between
doses, possible drug interactions – including risk of co-ingesting alcohol.
D.
The certifying practitioner must document after examination, the patient’s
response to conventional medical therapies and explain the risks and benefits of
the use of marijuana to the qualifying patient.
E.
The certifying practitioner must be committed to the continual assessment of the
patient and the patient’s response to the use of marijuana. This must be
demonstrated through follow-up appointments, semi-annually at minimum, before
the card is renewed. The practitioner will send updates to the primary care
provider (if not the PCP), at intervals not to exceed twelve (12) months,
documenting patients progress or experience using medical marijuana.
F.
The certifying practitioner must have a current license to practice medicine, as
specified in § § 3.2(A)(21) of these regulations, and current DEA registration and
appropriate state controlled substance registration.
G.
Before issuing a written certification, a certifying physician must review the
Rhode Island Prescription Drug Monitoring Program, review the patients’
prescription history and make a judgement about the potential for drug
interaction, adverse events or untoward clinical outcome from adding medical
marijuana.
H.
Document in the medical record a full assessment as defined in § 3.2(A)(13) of
this Part
3.3.4 Addition of Debilitating Medical Conditions
A.
The Department of Health shall accept a written petition from any person
requesting that a particular disease or condition be included among the diseases
and conditions that qualify as “debilitating medical conditions” contained in §
3.2(A)(6) of this Part
B.
The petitioner shall provide to the Department of Health, as available:
1.
An explanation stating the reason(s) why the condition should be included;
2.
Any scientific peer reviewed literature supporting the addition of the
condition to the list;
3.
Letter(s) of support from physicians or other licensed health care
professional knowledgeable about the condition and its treatment;
C.
In considering such petitions, the Department shall include public notice of, and
an opportunity to comment in a public hearing, upon such petitions.
1.
The Department shall, after hearing, approve or deny such petitions within
one hundred eighty (180) days of submission.
2.
The approval or denial of such a petition shall be considered a final
Department of Health action, subject to judicial review. Jurisdiction and
venue for judicial review are vested in the Superior Court.
3.
The denial of a petition shall not disqualify qualifying patients with that condition,
if they have a debilitating medical condition as defined in R.I. Gen. Laws § 21-
28.6-3 and § 3.2(A)(6) of this Part.
3.3.5 Primary Caregiver Cardholder, Authorized Purchaser cardholder and
Patient Cardholder Possession Limits
A.
The following possession limits are established for each primary caregiver
cardholder, authorized purchaser card holder and patient cardholder:
1.
Pursuant to R.I. Gen. Laws § 21-28.6-4(e), a primary caregiver cardholder
may possess an amount of marijuana which does not exceed twelve (12)
mature marijuana plants, that are accompanied by valid medical marijuana
tags purchased from the Department of Business Regulation, and two and
one-half (2.5) ounces of dried usable marijuana or its equivalent amount
and twelve and one-half (12.5) ounces of wet marijuana for each patient
cardholder to whom he or she is connected through the Department of
Health’s registration process established pursuant to these Regulations.
2.
Notwithstanding the provisions of § 3.3.5(A)(1) of this Part, and pursuant
to R.I. Gen. Laws § 21-28.6-4(o), no primary caregiver cardholder shall
possess an amount of marijuana in excess of:
a.
Twenty-four (24) mature marijuana plants, that are accompanied by
valid medical marijuana tags purchased from the Department of
Business Regulation,
b.
Five (5) ounces of dried usable marijuana or its equivalent amount
and twenty- five (25) ounces of wet marijuana for patient
cardholders to whom the primary caregiver is connected through
the Department of Health’s registration process established
pursuant to these Regulations.
3.
Pursuant to R.I. Gen. Laws § 21-28.6-4(b), an authorized purchaser
cardholder may possess an amount of marijuana that does not exceed
two and one-half (2.5) ounces of dried usable marijuana or its equivalent
amount purchased legally from a compassion center for their designated
patient.
4.
Pursuant to R.I. Gen. Laws § 21-28.6-4(a), a patient cardholder may
possess an amount of marijuana that does not exceed twelve (12) mature
marijuana plants, that are accompanied by valid medical marijuana tags
purchased from the Department of Business Regulation and two and one-
half (2.5) ounces of dried usable marijuana or its equivalent amount, and
twelve and one half (12.5) ounces of wet marijuana. Said plants shall be
stored in an indoor facility.
5.
Pursuant to R.I. Gen. Laws § 21-28.6-4(f), a patient cardholder shall be
allowed to possess a reasonable amount of unusable marijuana, including
up to twelve (12) seedlings that are accompanied by valid medical
marijuana tags purchased from the Department of Business Regulation.
6.
Pursuant to R.I. Gen. Laws § 21-28.6-4(f), a primary caregiver cardholder
shall be allowed to possess a reasonable amount of unusable marijuana,
including up to twenty-four (24) seedlings that are accompanied by valid
medical marijuana tags purchased from the Department of Business
Regulation.
7.
Pursuant to R.I. Gen. Laws § 21-28.6-4(q), no more than twenty-four (24)
mature marijuana plants that are accompanied by valid medical marijuana
tags shall be grown or otherwise located at any one dwelling unit or
commercial unit. The number of qualifying patients or primary caregivers
residing, owning, renting, growing or otherwise operating at a dwelling or
commercial unit does not affect this limit.
3.3.6 Primary Caregiver and Authorized Purchaser Eligibility
A.
The primary caregiver and authorized purchaser applicant must apply to the
Bureau of Criminal Identification of the Department of Attorney General, State
Police, or local police department for a national criminal records check that shall
include fingerprints submitted to the Federal Bureau of Investigation. Upon the
discovery of any disqualifying information as defined in R.I. Gen. Laws § 21-28.6-
6(e)(1), and in accordance with the rules promulgated by the Director, the Bureau
of Criminal Identification of the Department of Attorney General, State Police, or
the local police department shall inform the applicant, in writing, of the nature of
the disqualifying information; and, without disclosing the nature of the
disqualifying information, shall notify the Department of Health, in writing, that
disqualifying information has been discovered.
B.
In those situations in which no disqualifying information has been found, the
Bureau of Criminal Identification of the Department of Attorney General, State
Police, or the local police shall inform the applicant and the Department of
Health, in writing, of this fact.
1.
The Department of Health shall maintain on file evidence that a criminal
records check has been initiated on all applicants seeking a primary
caregiver registry identification card and the results of the checks.
2.
The primary caregiver cardholder shall not be required to apply for a
national criminal records check for each patient he or she is connected to
through the Department of Health’s registration process, provided that he
or she has applied for a national criminal records check within the
previous two (2) years in accordance with the Act and these Regulations.
3.
The Department of Health shall not require a primary caregiver cardholder
or an authorized purchaser to apply for a national criminal records check
more than once every two (2) years.
4.
The primary caregiver cardholder must notify the Department of Health of
any disqualifying information that occurs during the two year time period
between the national criminal records check required in § 3.3.6(A) of this
Part. The disqualifying information must be reported to the Department of
Health within ten (10) days of any conviction defined in § 3.3.6(C) and §
3.3.6(E) of this Part and § 3.3.6(E) of these Regulations.
C.
Information produced by a national criminal records check pertaining to a
conviction for any felony offense under R.I. Gen. Laws Chapter 21-28 ("Rhode
Island Controlled Substances Act"), murder, manslaughter, rape, first degree
sexual assault, second degree sexual assault, first degree child molestation,
second degree child molestation, kidnapping, first degree arson, second degree
arson, mayhem, robbery, burglary, breaking and entering, assault with a
dangerous weapon, assault or battery involving grave bodily injury, and/or
assault with intent to commit any offense punishable as a felony or a similar
offense from any other jurisdiction shall result in a letter to the applicant and the
Department of Health disqualifying the applicant.
D.
The primary caregiver or authorized purchaser applicant shall be responsible for
any expense associated with the national criminal records check.
E.
For purposes of Section § 3.3.6 of this Part "conviction" means, in addition to
judgments of conviction entered by a court subsequent to a finding of guilty or a
plea of guilty, those instances where the defendant has entered a plea of nolo
contendere and has received a sentence of probation and those instances where
a defendant has entered into a deferred sentence agreement with the Attorney
General.
3.4
Application for Department of Health Registry Identification
Cards and Fees
3.4.1 Registry Identification Cards for Qualifying Patients, Primary Caregivers
and Authorized Purchasers
A.
The Department of Health shall issue registry photo identification cards to
qualifying patients, primary caregivers and authorized purchasers who submit the
following:
1.
Written certification as defined in § 3.2(A)(31) of this Part. Regulations;
2.
Non-returnable, non-refundable application or renewal fee as set forth in
the Rules and Regulations Pertaining to the Fee Structure for Licensing,
Laboratory and Administrative Services Provided by the Department of
Health for each qualifying patient, primary caregiver, or authorized
purchaser of the qualifying patient identified on the application;
a.
Provided, however, for a qualifying patient or primary caregiver who
submits satisfactory evidence to the Department of Health of being
a recipient of Medicaid, Supplemental Security Income (SSI), Social
Security Disability Insurance (SSDI), Veteran Disability, or Railroad
Disability, a non-returnable, non-refundable application or renewal
fee as set forth in the Rules and Regulations Pertaining to the Fee
Structure for Licensing, Laboratory and Administrative Services
Provided by the Department of Health shall be submitted.
3.
Name, address, and date of birth of the qualifying patient. If the qualifying
patient is homeless, no address is required.
4.
Name, address, and telephone number of the qualifying patient’s
practitioner; and
5.
Name, address, and date of birth of one primary caregiver and one
authorized purchaser, for the qualifying patient, if any.
6.
Whether the qualifying patient elects to grow medical marijuana plants for
himself or herself.
7.
Each applicant for qualifying patient registry identification card shall also
indicate if he or she would like the Department of Health to notify him or
her of any clinical studies about marijuana's risk or efficacy.
8.
Individuals licensed by the Department of Business Regulation shall
obtain registry photo identification cards from the Department of Health.
3.4.2 Registry Identification Cards for Minors
A.
The Department of Health shall not issue a registry identification card to a
qualifying patient under the age of eighteen (18) unless:
1.
The qualifying patient's practitioner has explained the potential risks and
benefits of the medical use of marijuana to the qualifying patient and to a
parent, guardian or person having legal custody of the qualifying patient;
and
2.
A parent, guardian or person having legal custody consents in writing to:
a.
Allow the qualifying patient's medical use of marijuana;
b.
Serve as the qualifying patient's primary caregiver or authorized
purchaser; and
c.
Control the acquisition of the marijuana, the dosage, and the
frequency of the medical use of marijuana by the qualifying patient.
3.5
Issuance and Renewal of Department of Health Registry
Identification Cards
A.
The Department of Health shall verify the information contained in an application
or renewal as a qualified patient, a primary caregiver or an authorized purchaser
submitted pursuant to the Act, and shall approve or deny an application or
renewal within thirty-five (35) days of receiving it.
B.
The Department of Health shall issue registry identification cards within five (5)
days of approving an application or renewal that shall expire one (1) year after
the date of issuance.
1.
If the Department of Health fails to issue a valid registry identification card
in response to a valid application submitted pursuant to the Act or these
Regulations within thirty-five (35) days of its submission, the registry
identification card shall be deemed granted and a copy of the registry
identification application shall be deemed a valid registry identification
card. Patients who are currently receiving chemotherapy or have been
admitted to hospice will be expedited and their applications will be
approved within seventy-two (72) hours.
2.
The Department of Health shall issue a registry identification card to one
primary caregiver and one authorized purchaser, if any, who is named in a
qualifying patient's approved application.
C.
The Department of Health may deny an application or renewal only if the
applicant did not provide the information required pursuant to the Act, or if the
Department of Health determines that the information provided was falsified.
D.
Rejection of an application or renewal is considered a final Department of Health
action, subject to judicial review. Jurisdiction and venue for judicial review are
vested in the Superior Court.
E.
A registry identification card shall not be transferable.
F.
Registry identification cards shall contain:
1.
The date of issuance and expiration date of the registry identification card;
2.
The name of the qualifying patient, primary caregiver or authorized
purchaser;
3.
A random registry identification number;
4.
A photograph; and
5.
Any additional information as required by these Regulations or the
Department of Health.
3.5.2 Requirements Related to Department of Health Registry Identification
Cards
A.
Persons issued registry identification cards shall be subject to the following:
1.
A patient cardholder must notify the Department of Health of any change
in the patient cardholder's name, address, primary caregiver, or authorized
purchaser; or if he or she ceases to have his or her debilitating medical
condition, within ten (10) days of such change.
2.
If a patient cardholder has ceased to suffer from a debilitating medical
condition, the card shall be deemed null and void and the person shall be
liable for any other penalties that may apply to the person's non-medical
use of marijuana.
3.
A registered primary caregiver cardholder or authorized purchaser
cardholder shall notify the Department of Health of any change in his or
her name or address within ten (10) days of such change.
4.
When a patient cardholder, primary caregiver cardholder or authorized
purchaser cardholder notifies the Department of Health of any changes
listed in § 3.3.6 of this Part, the Department of Health shall issue the
patient cardholder, primary caregiver cardholder or authorized purchaser
cardholder a new registry identification card within ten (10) days of
receiving the updated information and a non-returnable, non-refundable
fee as set forth in the Rules and Regulations Pertaining to the Fee
Structure for Licensing, Laboratory and Administrative Services Provided
by the Department of Health for each new registration card to be issued.
5.
When a patient cardholder changes his or her primary caregiver or
authorized purchaser, the Department of Health shall notify the primary
caregiver cardholder or authorized purchaser cardholder within ten (10)
days. The primary caregiver cardholder’s protections as provided in the
Act as to that patient shall expire ten (10) days after notification by the
Department of Health. If the primary caregiver cardholder is connected to
no other patient cardholders in the program, he or she must return his or
her registry identification card to the Department of Health.
6.
If a patient cardholder, caregiver cardholder or authorized purchaser card
holder loses his or her registry identification card, he or she shall notify the
Department of Health and submit a non-returnable, non-refundable fee as
set forth in the Rules and Regulations Pertaining to the Fee Structure for
Licensing, Laboratory and Administrative Services Provided by the
Department of Health within ten (10) days of losing the card. Within five
(5) days of receiving this notification, the Department of Health shall issue
a new registry identification card with new random identification number.
3.5.3 Patient Cardholder and Primary Caregiver Cardholder Marijuana Grow
Location
A.
The premise where the patient cardholder or primary caregiver cardholder elects
to grow marijuana must register with the Department of Health. The patient
cardholder or primary caregiver cardholder must notify the Department of Health
of any changes to this registered grow location information.
B.
Registered patient cardholders and primary caregiver cardholders who elect to
grow marijuana are subject to regulations promulgated by the Department of
Business Regulation.
1.
The Department of Business Regulation and the Department of Health
have jointly determined that DBR will primarily administer all aspects of
the medical marijuana plant tag program to fulfill the state obligation to
monitor and verify compliance with the statutory requirements that patients
and cardholders electing to grow and primary caregiver cardholders do not
exceed plant limits, properly tag all permitted plants, and do not grow at
more than one location.
C.
Effective January 1, 2019, if a patient cardholder chooses to alter his or her
registration with regard to the growing of medical marijuana for himself or herself,
he or she must notify the Department of Health prior to the purchase of medical
marijuana tags from the Department of Business Regulation or the growing of
medical marijuana plants.
3.6
Compassion Center Inspection
A.
Compassion centers are subject to reasonable inspection by the Department of
Health. During an inspection, the Department of Health may review the
compassion center's confidential records, including its dispensing records, which
shall track transactions according to qualifying patients' registry identification
numbers to protect their confidentiality.
1.
Pursuant to R.I. Gen. Laws § 21-28.6-12(e), a compassion center may
also be subject to inspection by the Department of Business Regulation.
B.
Compassion centers are subject to testing requirements for usable marijuana
promulgated in regulation by the Department of Health.
3.7
Protections for the Medical Use of Marijuana
A.
A practitioner shall not be subject to arrest, prosecution, or penalty in any
manner, or denied any right or privilege, including, but not limited to, civil penalty
or disciplinary action by the Rhode Island Board of Medical Licensure and
Discipline or by any other business or occupational or professional licensing
board or bureau solely for providing written certifications or for otherwise stating
that, in the practitioner's professional opinion, the potential benefits of the
medical marijuana would likely outweigh the health risks for a patient.
B.
A practitioner, nurse, nurse practitioner, physician’s assistant, or pharmacist shall
not be subject to arrest, prosecution or penalty in any manner, or denied any
right or privilege, including, but not limited to, civil penalty or disciplinary action by
a business or occupational or professional licensing board or bureau solely for
discussing the benefits or health risks of medical marijuana or its interaction with
other substances with a patient.
C.
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 patient with a debilitating medical condition, or to permit a person
to assist with the medical use of marijuana by a patient with a debilitating medical
condition, shall have the same force and effect as a registry identification card
issued by the Department of Health pursuant to the Act and these Regulations.
D.
For the purposes of medical care, including organ transplants, a patient
cardholder’s authorized use of marijuana shall be considered the equivalent of
the authorized use of any other medication used at the direction of a physician,
and shall not constitute the use of an illicit substance.
E.
No state employee shall be subject to arrest, prosecution or penalty in any
manner, or denied any right or privilege, including, but not limited to, civil penalty,
disciplinary action, termination, or loss of employee or pension benefits, for any
and all conduct that occurs within the scope of his or her employment regarding
the administration, execution and/or enforcement of the Act, and the provisions of
R.I. Gen. Laws § 9-31-8 and § 9-31-9 shall be applicable to § 3.7 of this Part.
F.
A patient cardholder or primary caregiver cardholder may give marijuana to
another patient cardholder or primary caregiver cardholder to whom they are not
connected by the Department of Health’s registration process, provided that no
consideration is paid for the marijuana, and that the recipient does not exceed
the limits specified in § 3.3.5 of this Part.
G.
The manufacture of marijuana by a patient cardholder or primary caregiver
cardholder using a solvent extraction process that includes the use of a
compressed, flammable gas as a solvent shall not be subject to the protections
specified by the Act and these Regulations.
3.8
Confidentiality Provisions
A.
Applications and supporting information submitted by qualifying patients,
including information regarding their primary caregivers, authorized purchasers,
and practitioners, are confidential and protected under the federal Health
Insurance Portability and Accountability Act (HIPAA) of 1996, as amended.
B.
The Department of Health shall maintain a confidential list of the persons to
whom the Department of Health has issued registry identification cards.
1.
Individual names and other identifying information on the list:
a.
Shall be confidential and not be considered a public record
pursuant to R.I. Gen. Laws § 38-2-2(4); and
b.
Shall not subject to disclosure, except to authorized employees of
the Department of Health as necessary to perform official duties of
the Department of Health, and pursuant to § 3.8(A)(2) of this Part.
2.
The Department of Health shall verify to law enforcement personnel
whether a registry identification card is valid solely by confirming the
random registry identification number or name. This verification may occur
through the use of shared database, provided that any confidential
information in this database is protected in accordance with § 3.8 of this
Part.
3.
All records maintained by a compassion center which pertain to one or
more registered qualifying patients, registered primary caregivers or
authorized purchasers shall be considered:
a.
Confidential health care information under applicable Rhode Island
law; and
b.
Protected health care information for purposes of the Federal
Health Insurance Portability and Accountability Act of 1996, as
amended.
4.
Pursuant to § 21-28.6-6(k) of the Act, the Department of Health may notify
law enforcement personnel about falsified or fraudulent information
submitted to the Department of Health.
3.9
Purchase and Issuance of Medical Marijuana Plant Tags
A.
Pursuant to R.I. Gen. Laws § 21-28.6-15(a), effective April 1, 2017, every
marijuana plant, possessed by a qualified patient or primary caregiver cardholder
must be accompanied by a physical medical marijuana plant tag purchased
through the Department of Business Regulation and issued by the Department of
Health. Plant tags being issued by the Department of Health shall mean the
following:
1.
The Department of Health has approved the application of the qualified
patient or primary caregiver and issued a registry photo identification card
to the applicant; or for qualified patients and primary caregivers who are
renewing their medical marijuana registration, the Department of Health
has approved the renewal application of the qualified patient or primary
caregiver and issued a registry photo identification card to the applicant.
2.
The Department of Business Regulation verifies with the Department of
Health the status of the card and any information submitted on the
Department of Business Regulation plant tag purchasing form in
accordance with R.I. Gen. Laws § 21-28.6-15(a)(2). For plant tags issued
to qualified patient cardholders after January 1, 2019 the Department of
Business Regulation will verify both the status of the card and the election
to grow with the Department of Health in accordance with R.I. Gen. Laws
§ 21-28.6-15(a)(3).
3.
The plant tag set fee is paid to the Department of Business Regulation
and the plant tag is distributed by the Department of Business Regulation
to the qualified patient or primary caregiver cardholder.
3.10 Scope of the Act
A.
The Act and these Regulations shall not permit:
1.
Any person to undertake any task under the influence of marijuana, when
doing so would constitute negligence or professional malpractice;
2.
The smoking of marijuana:
a.
In a school bus or other form of public transportation;
b.
On any school grounds;
c.
In any correctional facility;
d.
In any public place;
e.
In any licensed drug treatment facility in this state; or
f.
Where exposure to the marijuana smoke significantly adversely
affects the health, safety, or welfare of children
3.
Any person 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 or her system.
B.
Nothing in the Act or these Regulations shall be construed to require:
1.
A government medical assistance program or private health insurer to
reimburse a person for costs associated with the medical use of
marijuana; or
2.
An employer to accommodate the medical use of marijuana in any
workplace.
3.11 Practices and Procedures
A.
All hearings and reviews required under the provisions of the Act or these
Regulations shall be held in accordance with the provisions of the Rules and
Regulations Pertaining to Practices and Procedures before the Rhode Island
Department of Health.
3.12 Severability
A.
If any provision of the Act or these Regulations or its application thereof to any
person or circumstance is held invalid, such invalidity shall not affect other
provisions or applications of the Act or these Regulations, which can be given
effect without the invalid provision or application, and to this end the provisions of
the Act and these Regulations are declared to be severable.