North Bay hospitals to weigh medical cannabis

An unusual proposal to use the facilities of local hospitals as dispensaries for medical marijuana is slowly gaining momentum, but even advocates acknowledge it’s a longshot – because, among other reasons, cannabis is still against federal law.

“Let’s face it, there are going to be licensed dispensaries in Sonoma Valley, and there’s some already in Santa Rosa,” said Bill Boerum, a member of the Sonoma Valley Health Care District board of directors. “Why shouldn’t the conventional health care providers do that?”

Boerum is also the current board chair of the Northern California Health Care Authority (NCHCA), a “joint powers authority” – no pun intended – representing hospitals in Sonoma, Mendocino and Humboldt counties. He has scheduled a study session on medical cannabis at the May 30 meeting of the group, to educate its members and allow the five health care districts in the organization time to evaluate new state regulations, and consider contributing to the public comment period for the state regulations.

Last month the Bureau of Medical Cannabis Regulation, within the Department of Consumer Affairs, released a set of proposed rules for cultivation, processing, distribution and sales as the state prepares to take over the medical cannabis sector on Jan. 1, 2018. The public has until June 13 to give input.

The health care authority’s study session will include presentations on both the use of medical cannabis and the proposed regulations, a Q&A and discussion period, and opportunities to consider individual and organizational next steps, primarily providing comment to the Bureau before the June 13 deadline. The session will be focused strictly on medical cannabis and not on so-called “adult use.”

Although advocates say there are legitimate uses for cannabis for treating anxiety, depression, insomnia, menstrual cramps, even epileptic seizures and a host of other ailments, real and imagined, getting engagement from the established medical industry has always been difficult.

“Even though it’s legal, it is controversial, and I’m quite sure there are diverse opinions among board members and hospital leaders,” said Jane Hirsch, the current chair of the Sonoma Valley Health Care District. “We have really not had a group discussion about any SVH involvement or possibilities.”

Kelly Mather, CEO of the Sonoma Valley Hospital, said that “… physicians are concerned about the lack of regulation and many others do not seem ready to go down this path at this time.”

For the draft strategic plan for Sonoma Valley Hospital’s current year, Boerum proposed adding cannabis. “I had the words in there under ‘pain management,’ that we were to ‘be open to alternative therapies such as medical cannabis.’” But when the draft got to the April board meeting, he said, it was dropped. “It was quickly dismissed and deleted from the plan draft simply because, it’s against federal law.”

Cannabis dispensaries and even delivery is illegal in the City of Sonoma, and has been since 2009 – a position that was re-enforced as recently as December 2015. But former Sonoma Mayor Ken Brown, who was on the City Council in 2009 – and recused himself from the 2-2 vote that denied medical marijuana dispensaries, because his wife is owner and operator of a medical marijuana dispensary in Santa Rosa – recently reminded the City Council that they had promised to take up the issue again.

“I’ve talked to all the City Council members, I’ve talked to the police chief, I’ve talked to (1st District Supervisor) Susan Gorin, and I emailed them and was assured that this would come back up on the agenda,” said Brown. At the May 15 City Council meeting, “I picked the public comment time frame to remind them I’m waiting.”

Brown is aware of Boerum’s open-mindedness about a cannabis dispensary out of SVH. “I know that Bill’s well-versed in cannabis, and he thinks the hospital would be a viable place. There’s some truth to that. It’s better than nothing.”

The idea of having medical marijuana handled through a hospital is not new. It’s a controlled location, with built-in security and air conditioning. It already has a “dispensary” – the full meaning of the word is for medical prescriptions and supplies, and it’s only a recent phenomenon that it’s become synonymous with marijuana distribution.

One big hurdle, however, is that marijuana is still a Schedule 1 drug, on the list of most restricted medications that includes heroin, Quaaludes and most psychedelics (LSD, mescaline, psilocybin and ecstasy).

For another, since it is such a regulated (read: illegal) drug, at least at the national level, getting federal programs to pay for the “medicine” is pretty much impossible: Medicare and Medi-Cal will not pay for medical marijuana. And federal health insurance programs are a significant source of income to most hospitals.

Still, even if Medicare payments could not cover a patient’s medicine, even cash transactions would bring in revenue – and revenue is something the hospital clearly needs.

“Eventually, I see this in the long-term as a potential service line,” said Boerum. He quickly admitted, however, “I don’t think any hospital is going to apply for a dispensary license. I don’t think it’s going to happen.”

However, it wouldn’t be the first time a hospital has officially engaged with medical marijuana. In 2015, the New York Times reported that a hospital group in that state had applied for a license partnership with a Colorado-based medical marijuana company. But the same article noted that most hospitals seeking medical marijuana licenses “are generally academic medical centers that could use access to the drug to research its impact on diseases like Alzheimer’s, epilepsy and cancer.”

Boerum bases his interest in the subject because of the inevitability of cannabis in the state’s medical landscape; he insists he has no other “involvement” with marijuana. But, as he says, “It’s happening.”

“They’re developing the rules of the road, the regulations of the state… I felt that the very least we could do is to offer our members and any other organizations the opportunity to learn about the regulations.” As to what he expects from the May 30 meeting of the NCHCA, Boerum is practical.

“The health care authority itself will have to decide whether it wants to issue any comments,” said Boerum. “I don’t know where the sentiment on that will be – probably the sentiment will be like the districts, which is, don’t say anything.”

Written comments on the new regulations are due by end of day on June 13; a public hearing will be held in Santa Rosa on June 8. The draft of proposed regulations does not address recreational use.

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