Medical Cannabis Certification Course FAQ

Is there a resource that provides a brief overview of medical marijuana in Pennsylvania for my staff or patients that have questions?

In addition to the detailed information on the PA Dept of Health Office of Medical Marijuana (OMM) web site, an eight-minute slide show/video was posted on YouTube by the DOH in November 2017.

If I register as a practitioner (to make recommendations for patients), will my name be listed on the state’s web site?

Yes, once you are approved by the DOH as a practitioner, your name, medical specialty/credentials, and office address will be listed on the DOH’s public list of approved practitioners. The list is updated nearly weekly and can be downloaded from the Office of Medical Marijuana web site. At this time, there is no way to “opt out” from the public list, while still being approved to make recommendations. This is due to the DOH’s interpretation of “publicly-accessible web site” language in Title 28 PA Code Ch. 1181.25 (a) to mean that all approved practitioners must be on the public list. (The regulation states: the DOH must “maintain a practitioner registry on its publicly-accessible web site listing practitioners who are approved by the Department to issue patient certifications.”) See the FAQ below for how to request changes to the regulations.

However, if you do register online, and attend our four-hour training, you do not have to complete the steps needed for approval, if you decide you do not want to be in the Program. In other words, you can tell USciences that you prefer that we do not send notification to the DOH with your certificate of completion. (We can send the information later, if you decide you want to complete the approval process to be listed on the site.)

What should I include in my patient’s healthcare record about my assessment and recommendation?

PA Ch. 1181,28.(b)3 states that practitioners must “File a copy of the patient certification in the patient's health care record.”

The Federation of State Medical Boards guidelines provide the following recommendations in Model Guidelines for the Recommendation of Marijuana in Patient Care, Report of the FSMB Workgroup on Marijuana and Medical Regulation, (Adopted as policy by the Federation of State Medical Boards April 2016)

“The physician should keep accurate and complete medical records. Information that should appear in the medical record includes, but is not necessarily limited to the following:

  • The patient’s medical history, including a review of prior medical records as appropriate;
  • Results of the physical examination, patient evaluation, diagnostic, therapeutic, and laboratory results;
  • Other treatments and prescribed medications;
  • Authorization, attestation, or recommendation for marijuana, to include date, expiration, and any additional information required by state statute;
  • Instructions to the patient, including discussions of risks and benefits, side effects, and variable effects;
  • Results of ongoing assessment and monitoring of patient’s response to the use of marijuana;
  • A copy of the signed Treatment Agreement, including instructions on safekeeping and instructions on not sharing “ (FSMB,p.8, 2016)

How can I monitor what dose and product was dispensed to my patient at the pharmacy, since medical cannabis products will not be listed in the state’s Prescription Drug Monitoring Program (PDMP) or ABC-MAP?

Medical professionals and practitioners who register and are approved by the DOH will have access to subsequently log in to the state’s registry and search for your patient using their unique ID number. The product/dose/quantity/date dispensed is tracked in the registry software.

To get therapeutic information about your patient, you’ll need to communicate with the dispensing clinician. Dispensaries are telling providers that they will promote communication with the patient’s physician. Some dispensaries may offer optional patient health record portals.

The Office of Medical Marijuana staff can also assist practitioners in obtaining follow-up information from the registry database, if necessary, through a phone call during business hours.

How do we advocate for changes to current regulations?

Act 16 empowers the PA DOH to promulgate new medical marijuana temporary regulations on an ongoing basis and publish them in the Pennsylvania Bulletin, but they expire within 2 years and will need to be made permanent. Further changes to the regulations and to the Act 16 law can be made by the Secretary of Health on recommendation from the Medical Marijuana Advisory Board. The MM Advisory Board released this presentation after their first meeting in December 2017, which describes the Ch.12 provisions requiring the Advisory Committee to accept and review written comments from the public and submit a report with “statutory and regulatory law recommendations” no later than May 2018 to the Governor and PA Legislature for the Secretary.

You can send written comments directed to the Office of Medical Marijuana Director John Collins, OMM Deputy Director and Regulatory Subcommittee Facilitator Larry  Clark, the entire MM Advisory Board, or Dr. Rachel Levine at  RA-DHMedMarijuana@pa.gov  and the Office of Medical Marijuana, 625 Forster Street, Room 628, Health and Welfare Building, Harrisburg, PA 17120.

Upcoming Advisory Board meeting dates and Medical Marijuana regulatory announcements are published in the Pennsylvania Bulletin.

Policy advocacy is part of the mission of the SUDI at USciences, and we’ve received feedback from healthcare providers and administrators requesting that we advocate for approved practitioners to be able to opt out from the public registry. Providers have told us that they want to assess and make recommendations for current patients, but are not accepting new patients to their practices, and are therefore reluctant to be on a public list. Therefore, we believe that a public list “opt out” would increase the number of practitioners in the program, and be more efficient for patients, who would not end up needlessly calling multiple offices on the registry that aren’t accepting outside patients.

What are the steps for certifying that a patient has a qualifying diagnosis, and for the patient (or their caregiver) to get their program ID card?

The patient (or caregiver) registers online, and receives a unique ID number.

Practitioner sees the patient, establishes an ongoing physician-patient relationship, and provides the patient with a letter confirming that they have a qualifying diagnosis. The patient gives the physician their ID number.

The physician goes online and certifies that the patient has a qualifying diagnosis (requires knowing the patient’s unique ID number. The physician must re-certify the patient annually.)

The patient goes online and completes the registration process and pays the fee required.

The patient will receive their card in the mail. (The first patients to have completed this process began getting their cards in January 2018.)

Note: A patient can go to the practitioner for an appointment without having decided to register yet. However, if the patient does decide to register for the program, the practitioner will not be able to do the online certification until the patient follows through and registers, then communicates their unique ID back to the practitioner.

What does a PA patient ID card look like?

An example of the MM Program Caregiver ID card is pictured in this slide from the from the Office of Medical Marijuana YouTube overview video (November 2017).

Medical Cannabis ID Card

Does USciences offer the DOH-approved certification course online?

We are offering the four-hour training course as live webinars and live in-person continuing education activities. Our live trainings usually have three, or sometimes four expert faculty, and offer opportunities for Q&A, discussion with peers, and to review the post-test answers with the faculty.

If you signed up on the email list on the Medical Cannabis Education web page, you’ll be notified when we add training course dates, or additional CE programs or resources. 

If you are seeking to take the course immediately, the three other DOH-approved educational providers all offer the required four-hour training course in an online form that can be taken at your own pace.


Recommendations for further reading from your course faculty:

Information for Health Care Professionals: Cannabis (marihuana, marijuana) and the cannabinoids [Health Canada, 2013]

https://www.canada.ca/en/health-canada/services/drugs-health-products/medical-use-marijuana/information-medical-practitioners/information-health-care-professionals-cannabis-marihuana-marijuana-cannabinoids.html

Backes M. Cannabis Pharmacy. New York, NY: Blackdog and Leventhal Publishers.  2017

Russo, E. B. (2011). Taming THC: potential cannabis synergy and phytocannabinoid-terpenoid entourage effects.Br.J.Pharmacology 163: 1344-1364.

Shohami E and Horowitz M (ed). Cannabinoids in Health and Disease. Themed special issue, Journal of Basic and Clinical Physiology and Pharmacology 2016; 27(3).

Society of Cannabis Clinicians (cannabisclinicians.org)

American Society of Cannabis Pharmacists (ascph.org)

American Academy of Cannabinoid Medicine (AACMsite.org)

International Academy of Cannabinoid Medicine (cannabis-med.org)

The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research [The National Academies of Sciences, Engineering, and Medicine, expert committee, Jan.12, 2017, free PDF available, or purchase a hard copy book]

http://nationalacademies.org/hmd/reports/2017/health-effects-of-cannabis-and-cannabinoids.aspx

The NASEM committee arrived at nearly 100 different research conclusions related to cannabis or cannabinoid use and health, in this January 2017 report, organizing these into 5 categories: conclusive, substantial, moderate, limited, and no/insufficient evidence.

USciences Substance Use Disorders Institute

Contact:

Gail Groves Scott MPH’16 Manager
Substance Use Disorders Institute

Address:

University of the Sciences
600 South 43rd Street
Philadelphia, PA 19104-4495

Phone:

215-596-7636

Email:

g.scott@usciences.edu