ARIZONA'S MEDICAL-MARIJUANA LAW TAKES EFFECT

Health Officials Are Concerned About Certification
Mills

Arizona's medical-marijuana law takes effect today, but patients
already have been lining up to pay hundreds of dollars in some cases
for pot recommendations from clinics that opened in recent weeks for
just that purpose.

Health officials are concerned that so-called certification mills
could quickly turn a medical program into a recreational one, but they
have limited recourse.

Starting today, people can apply with the state Department of Health
Services for permission to use marijuana to treat debilitating medical
conditions, including cancer, glaucoma, HIV/AIDS and Alzheimer's disease.

The online-only application requires a photo of the patient, a copy of
his or her driver's license, a signed statement promising not to give
the marijuana to anyone and certification from a physician that the
patient would benefit from using pot.

State rules finalized last month by DHS require a health professional
licensed by one of four Arizona boards - allopathic, osteopathic,
naturopathic or homeopathic - to conduct a physical exam, review one
year of medical records, confirm a debilitating diagnosis and check
the patient's other prescriptions through an online database.

While much of the attention in the marijuana debate has focused on
dispensaries, which won't go online until later this year, a small
industry has sprouted to help patients qualify.

DHS Director Will Humble said the rules were written to regulate the
industry as tightly as possible without running afoul of the law
voters passed in November as Proposition 203. But he said it will only
take a handful of physicians writing casual recommendations to explode
the program.

"What I'm afraid of is there will be enough of them that just check
the boxes but don't really do it (a thorough exam). Or do a cursory
drive-by . . . collect the money and move on to the next patient,"
Humble said.

"I'm concerned that enough of them will end up turning this into a
program that we didn't intend for it to become."

Humble said the health department will work with the Arizona Medical
Board and other licensing boards to check up on doctors who appear to
be issuing medical-marijuana recommendations outside the law. Red
flags might be similar demographics or medical conditions, he said.

The first draft of rules required physicians to have a one-year
relationship with a patient, but now a doctor could recommend pot to
someone the same day they meet.

"What appears to be happening already is you've got a small group of
doctors who are doing exclusive medical-marijuana recommendations to
patients who are new to them," said Lisa Wynn, executive director of
the Arizona Medical Board. "They're arriving at the answer before
they've even met the patient."

Sue Sisley, a Scottsdale internist in private practice, supported
Proposition 203 but believes many doctors will opt out of the
recommendation business for fear of jeopardizing their practices.

"I know tons of docs who won't come near this program," said Sisley,
whose practice doesn't include anyone who would qualify. "That's what
lends itself to these certification mills. That's what we were hoping
to avoid by the rule-making."

Jay Reis, director of Arizona Medical Marijuana Certification Centers,
runs three clinics in Scottsdale, Tucson and Cottonwood and is the
process of opening three more. The centers charge $150 for a same-day
certification but require three years of patient records, though the
law only requires one.

Reis said he launched the business in January because he believes
medical marijuana can bring relief to suffering patients. He said he's
offended by mobile-certification outfits set up in hotel rooms or
trailers by newcomers to Arizona, who give clinics like his a bad name.

"They're coming in here, putting doctors in a hotel room and not even
giving you a physical," he said. "They're just here for the money."

Humble said he doesn't care where the exams are done, only that all
the requirements are complied with.

"I don't care whether the assessment happens in the park," Humble
said. "The question is, is the physician acting in the best interest
of the patient?"

The DHS will have 15 working days to process the applications and has
hired 10 temporary workers in hopes of avoiding a backlog.

Humble said the agency can handle up to 500 applications a day.
Patients whose certifications aren't processed within the timeframe
will have the $150 health-department fee waived.

Since there are not yet any licensed dispensaries in Arizona, patients
who receive medical-marijuana ID cards also will have authorization to
grow their own pot.

Patients can cultivate up to 12 marijuana plants. The plants must be
grown indoors in a locked room or outdoors surrounded by a concrete
wall and a locked steel gate.