216 R.I. Code R. 216-RICR-20-10-3.4

Current through December 26, 2024

Section 216-RICR-20-10-3.4 - General Requirements

3.4.1Administration of the Program

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.

3.4.2Written 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 § 3.3(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.

3.4.3Practitioner(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 § § 3.3(A)(21) of this Part, 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 § 3.3(A)(13) of this Part

3.4.4Addition 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 § 3.3(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 § 3.3(A)(6) of this Part.

3.4.5Primary 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 § 3.4.5(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.

3.4.6Primary 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 § 3.4.6(A) of this Part. The disqualifying information must be reported to the Department of Health within ten (10) days of any conviction defined in § 3.4.6(C) and § 3.4.6(E) of this Part.

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.

216 R.I. Code R. 216-RICR-20-10-3.4

Amended effective 8/16/2020