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Utah Department of Health to speed up medical cannabis expansion

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SALT LAKE CITY — The Utah Department of Health announced it will speed up a planned expansion of the state's medical cannabis program.

FOX 13 first reported last month the agency missed a deadline to implement a law passed by the Utah State Legislature, allowing physicians, nurse practitioners and other health care workers to be able to recommend medical cannabis to qualifying patients. UDOH was supposed to have the "limited medical provider" program up and running by October. But lawmakers were told in mid-November that because of technological and staffing issues, it may not be until July 2022 at the earliest.

That upset patient advocates and angered some lawmakers. At a recent meeting of the state's Cannabinoid Product Board, UDOH's cannabis program director announced it would now be up and running by January.

"That’s a critical change to the program we’re excited about to increase patient access," Rich Oborn told the board.

Utah voters approved medical cannabis in 2018. The legislature implemented a tightly-controlled program run by the Utah Department of Health and the Department of Agriculture and Food.

The legislature designed the expansion to address an issue FOX 13 has reported on extensively: there are a number of qualified patients who would like to use medical cannabis as a treatment option, but not enough physicians willing to recommend it. To become a "qualified medical provider," it requires extensive training and approval from the health department. It has created a "pop-up" industry of QMPs who sometimes charge hundreds of dollars per patient to recommend cannabis and get them a state-certified card. "Limited medical providers" don't need the same training, and lawmakers designed it to get them comfortable with cannabis as a treatment option.

According to an annual report by UDOH, the state has more than 40,700 patients who have medical cannabis cards and 810 QMPs. By allowing the limited medical providers (who can recommend cannabis to up to 15 patients under the law), Oborn said UDOH estimates that would add another 16,000 health care providers.

Senate Minority Whip Luz Escamilla, D-Salt Lake City, passed the original bill to expand the program. She called the delay "unacceptable." She said getting it up and running by next month is much better.

"The commitment to the public is we want this available as soon as possible," Sen. Escamilla told FOX 13.

Oborn said UDOH is also making more changes. To help keep costs for patients manageable, the agency will start having providers publish their fees on a website.

"There’s some clinics that charge an outrageous amount and we want those clinics to report what they’re charging," he told the board. "And we believe that as that happens more and more, those prices should level down."

UDOH will also allow patients to renew their cannabis cards every six months, instead of every three months.

"What was the basis of shifting from a three-month to a six-month card?" asked Dr. Katherine Carlson, a member of the Cannabinoid Product Board.

"For some patients they felt like... it just brought in more revenue for the providers that were charging too much," Oborn said.

Members of the board were mixed on it. Dr. Ed Redd, a former state lawmaker and physician who recommends cannabis to qualifying patients, said he supported the change.

"I think the six month change is a good idea. For me, the three months was just to short to get anything done in my experience," he said.

Dr. Carlson said she had concerns.

"I just think we’re up against this kind of customer service business model versus you start someone on a new medicine, 90 days is a long time to see them," she said.

Medical cannabis advocates also expressed mixed views on some of the changes.

"The LMP program is an important step to educating doctors and keeping patients with their personal medical provider. Extending deadlines allows established patients to spend less time renewing their cards," Desiree Hennessy, Executive Director of the Utah Patients Coalition, said in a statement to FOX 13. "These changes are big wins for Utah’s patients but they are also necessary, and another step toward treating medical cannabis like any other medication."

Together for Responsible Use and Cannabis Education has called for abolishing patient caps. The group's executive director said physicians should only recommend cannabis after verifying a patient meets the qualifying conditions and send them off to a dispensary.

"Doctors shouldn't have arbitrary limitations placed on therapies they find beneficial to their patients. Patient caps mandated by legislation forces physicians to operate in a lottery scenario where they have to pick and choose who to grant access to – oftentimes to the detriment of those they’ve sworn a Hippocratic oath to protect. Any medical provider able to prescribe pharmaceuticals should be able to recommend cannabis," said Christine Stenquist.

Stenquist said she was glad to see the card renewal extended, but would prefer to see it happen every year instead of every six months.

"It creates a false reality where they believe everyday patients have the money or access to visit their doctor so frequently. This is why patient-user experience is so important in these discussions as policies and regulations are created," she said in a statement.

Sen. Escamilla said she understood the concerns about the limited medical provider patient caps, but urged patience as the program continues to roll out.

"To the advocates, I think the LMP is that first step. It may feel like it’s a little bit restrictive, but I believe it’s getting us to that place," she said. "I’m only asking them to give us the opportunity to see it rolling and I believe it will solve many of those concerns."