Missouri releases draft rules for marijuana doctor paperwork, transportation companies

Correction: This news report has been updated to reflect accurate information about physician recommendations for patient medical marijuana up to the monthly 4-ounce limit.

Late Friday, Missouri officials released drafts of medical marijuana rules for physicians who will write certifications so patients can access medical marijuana, along with proposed rules for transportation facilities handling marijuana.

Missouri's medical marijuana system was approved by voters in November 2018. By a wide margin, they chose Amendment 2 among three rival ballot initiatives.

The amendment sets out a timeline for making medical marijuana a part of everyday life for Missouri patients and caregivers. By law, Missouri officials must finish drafting rules by June 4. Patients may begin applying for ID cards allowing them to get medical marijuana on July 4.

What does Amendment 2 say about doctors?

It's a medical amendment, so it uses the words "physician" or "physicians" 27 times. It defines "physician" as "an individual who is licensed and in good standing to practice medicine or osteopathy under Missouri law." That means MDs and DOs can give patients medical marijuana certifications, not other kinds of healthcare providers. Don't ask your chiropractor.

The amendment also specifically outlines the rights of patients and doctors to discuss treatment with medical cannabis and for doctors to recommend it.

What does Amendment 2 say about doctor paperwork for a medical marijuana card?

The certification, or paperwork needed to get a medical marijuana patient card, is defined on the amendment level as "a document, whether handwritten, electronic or in another commonly used format, signed by a physician and stating that, in the physician’s professional opinion, the patient suffers from a qualifying medical condition" allowing marijuana treatment.

FAQ: How is Missouri going to pick who gets a medical marijuana dispensary license?

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What about the proposed rules? Can my doctor hand-write a marijuana certification for me?

The new rules are more specific than the text of Amendment 2. They say physicians will submit patient certifications to the state through an online system, or an alternative format provided by the state should there be a "system failure."

Certifications must include some basic information, including the physician's name and license number, information about the doctor's MD or DO degree, the qualifying patient's biographical data including Social Security number, and the qualifying health condition that justifies giving the patient cannabis as treatment.

Physicians must date a certification on the day the doctor met and examined a qualifying patient, and make a statement to that effect, rules that would seem to not only require a face-to-face appointment but also tamp down the prospects of fraudulent certifications — an issue that has cropped up in multiple medical marijuana states.

Will every patient be allowed to get the maximum 4 ounces of marijuana per month authorized by Amendment 2?

Yes. If a patient is certified, that person will be allowed to get the maximum 4 ounces of marijuana per month. Physicians may recommend a lower amount of cannabis, but that does not mean the recommended amount is all a patient can get.

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What about certifications for kids under 18?

Patients who are minor children are guaranteed access to medical marijuana, but they must have a physician certification and the written consent of a parent or legal guardian who serves as the primary caregiver.

What about the transportation facilities?

Missouri's proposed rules for state-licensed marijuana transport companies won't look too much like The Guy riding his bicycle on HBO's "High Maintenance."

Every marijuana delivery would need to be made by two employees carrying state-issued facility agent ID cards.

Missouri wants to compel companies to keep vehicles used to carry cannabis free of markings that would indicate marijuana is aboard the vehicle.

The vehicles would need lockboxes or locking cargo areas with "smooth, hard surfaces" that are easy to clean, along with a lockbox to store payments and video monitoring equipment.

Video monitoring would be required for the vehicle's driver, passenger and medical marijuana areas, along with GPS tracking.

Transport companies have to file a trip plan for every marijuana delivery and keep those records for five years. The driver must have a copy of the trip plan nearby while traveling, along with an inventory document and "a means of communication" available at all times. Any traffic crash, loss or theft must be reported.

The state would allow transportation licensees to store marijuana at their primary place of business along with off-site warehouses that comply with security requirements.

Those requirements include security training that includes HIPAA information and ways marijuana transport company employees should respond to issues like theft, unauthorized intrusions, fire or natural disaster.

Transportation facilities have to be sited at least 1,000 feet away from schools, day cares and churches, unless a local government chooses to make the buffer zone smaller.