1. Smoking in the Rockies Colorado’s Medical Marijuana Registry Ron Hyman, State Registrar

2. History  Amendment - November 2000  Statute – C.R.S. § 25-1.5-106  Regulation – 5 CCR 1006-2  July 2001 – Registry established  May 2010 – Additional statutes to license dispensaries and define MD- patient relationship

3. Key Players  Patient – person who has a debilitating medical condition  Physician – doctor of medicine who maintains, in good standing, a license to practice medicine issued in CO  Primary Care-giver – person, other than the patient and the patient’s physician, who is 18 years of age or older and has significant responsibility for managing the well being of a patient

4. Patient  Applies to the Department for registration with the program Supplies written documentation from a physician showing diagnosis of a debilitating medical condition and a recommendation that the patient might benefit from the use of medical marijuana Name, address, date of birth, SSN of patient Identifies primary care-giver, if the patient has one

5. Debilitating Medical Conditions  Cancer  Glaucoma  HIV/AIDS  Cachexia  Severe Pain  Severe Nausea  Seizures  Muscle Spasms

6. Primary Care-givers  Defined as a person 18 years of age or older – not a business/corporation  Significant responsibility  Dispensaries Proliferation New statute to license (Dept of Rev)

7. Confidentiality  Patients, primary care-givers and physicians all protected from identification by the Amendment  Law enforcement limited to seeking confirmation from the Department of registry identification cards presented to them by patients and primary care-givers

8. Protections of the Program  Amendment affords patients and primary care-givers the following rights in the criminal realm: If physician has diagnosed a patient with a debilitating medical condition and recommended marijuana, patient and primary care-giver can raise an affirmative defense to criminal charges If patient or primary care-giver are in lawful possession of a registry identification card, an exception from criminal laws exists (i.e. no charges filed)

9. Registrations – 2004 to 2010 *Projected

10. Registrations - 2009 by Month *Projected

11. Mail Received by Month 2009-10

12. Conditions Severe pain26,650 Muscle spasms8,907 Severe nausea5,225 Seizures619 Cancer698 Cachexia572 HIV/AIDS252 Glaucoma292

13. Gender and Age Group Age GroupMaleFemale <252,813762 25-346,1381,655 35-444,4031,303 45-543,2971,732 55-642,8871,251 65+1,994838 Total21,5327,541

14. Typical Day  Mail – 1,000 pieces Good Applications – 600 Bad Applications – 200 Other - 200  Phone – 200  Email – 100  Verifications (law enforcement) - 20

15. Work Flow  Packet: App, MD, ID, $  Triage: Reject, New, Renewal, Change  Money deposited  Data entry/update  Exceptions handling  Card Issued  Scanning/Filing

16. Staffing  Current – 3 perm, 10 temp  Added – 5 perm, 8 temp  Needed 60+ to keep up 120 to reduce backlog within six months

17. Revenue  Annual fee to patient - $90  Fees adjusted periodically based on costs to operate program  Fees retained by program Except when the legislature takes  Authority to spend  Indigent waiver

18. Growth  From a portion of an FTE to a full blown program with multiple units, supervisors, manager  Backlog – storage, lockbox  Impact on service counter  Constructed new office space  Already looking into expansion space

19. Legal Issues  Lawsuits by advocate community  Testifying in court cases  Public hearings  Legislative committees  US Attorney  Last year my legal bill was >$200K

20. Other Challenges  Staff morale  Fraud  Number and frequency of changes  Maintaining confidentiality  Verifications for law enforcement  Federal law enforcement

21. Conclusion  A money-maker  Challenging customers  Politics