Finally Got Certified for FL Medical - Issues and New Processes

[His_Highness]

It was really frustrating since we painstakingly followed the instructions to the letter and ran into a myriad of issues. Took a couple months with a lot of follow up and perseverance. Tried email and phone calls. The phone approach is the only thing that worked but it was common to be on hold for over an hour and many times after holding for more than an hour the line just went dead.

Here's the issues (NOTE: We weren't contacted in any way about what the issues were even though we provided a phone number and an email address in the initial form). The check for the $75 fee was cashed well over a month before we got it all straightened out):
- Supply a passport level photo. Got them professionally done at Walgreen and included two in the info package/form we sent in. Supplying a photo in the mailed in application was the required approach. Months went by and the web site continued to say no photo provided. When we finally got through on the phone we were told the photos were coming out blurred so we needed to use one of the new methods for supplying a photo. No way it was the photos we supplied. Had to have been a glitch with their scanner or whatever they were using. I finally uploaded one through the web site after using photo software to get a picture down to the 192 x 192 pixels required.
- The name of our town had been changed a few years ago and they compared it to the driver license. Since the license had the old town name we were told we had to change the name of the town using the web site so it agreed to the driver's license.

There have been NEW processes added that may mitigate the above going forward:
- The passport quality photo issue may be resolved by a new direction. Here's the description "The Registry is now connected to the Division of Highway Safety and Motor Vehicle’s State ID system. If there is a match to the information supplied by your Physician your State ID or Driver’s License photo is automatically added to your online application". To be honest....there's something worrisome about connecting the certification to the driver's license. Assuming this connection is bi-directional it could become an instantaneous heads-up to the police when you're driving that you are also a MJ user.

 

[psychonaut]

Out here in Colorado when we get pulled over and there is herb smell in the car, the police will ask when the last time you consumed was, and based on how they feel I guess, it is accepted or questioned. My step son was pulled over for doing 15 over in a school zone (yes I lectured him), and he had pot on him and clearly smelled but was sober and it was a non-issue. Granted, where I live it is recreationally legal so in a medical only state there will likely be a question of displaying your medical card to avoid unlawful possession.

It's sucha shame but this is a transition period and everyone has to cooperate with each other. That mess they had for your picture is absurd, it's like they put the system together and either a) nobody said, hey lets put in a system to automatically process any picture of good quality into a format our system uses or b) they said fuck these guys, let them do all the work, this is for the demon weed after-all. I try not to be cynical but it's hard.

 

[szai]

The Id photo thing is part of some system the state government hat been using for a while I think. Look on your driver's license if theirs a gold start on it it means that state had your birth certificate and photo on record.

 

[Silver420Surfer]

Congrats @His_Highness
That sucks you had to jump thru so many hoops and such. It would seem that LEOs having access to your medical card would be some kind of a HIPAA breach or violation.

I got pulled over by Colo State Police once coming home from my job at growhouse(legal not black market lol) REAKING like fresh flower. He asked if I had been smoking, told him I just got outta work and showed my MED badge(cannabis industry ID) and he then ran my plates, gave warning to slow down, and sent me on my way with no issues whatsover. Sigh. I love Colorado.

 

[Tranquility]

Out here in Colorado when we get pulled over and there is herb smell in the car, the police will ask when the last time you consumed was, and based on how they feel I guess, it is accepted or questioned. My step son was pulled over for doing 15 over in a school zone (yes I lectured him), and he had pot on him and clearly smelled but was sober and it was a non-issue. Granted, where I live it is recreationally legal so in a medical only state there will likely be a question of displaying your medical card to avoid unlawful use.

In CA, possession in the vehicle alone would be a crime unless it was in a sealed container. (Basically, the same issue as an open container of alcohol.) I'd think it would be the same in CO. He may have dodged a bullet. Have him get the trunk monkey to hold it when travelling. (Even if in a sealed container. Don't leave things up to the discretion of the officer as to what a sealed container is for probable cause.)

It's sucha shame but this is a transition period and everyone has to cooperate with each other. That mess they had for your picture is absurd, it's like they put the system together and either a) nobody said, hey lets put in a system to automatically process any picture of good quality into a format our system uses or b) they said fuck these guys, let them do all the work, this is for the demon weed after-all. I try not to be cynical but it's hard.

I agree it is a terrible idea to link things up through the driver's license. Out in CA, there is always some do-good MADD-fearing legislator that wants to make drunk driving convictions be a notation on the license--just so cops can check harder if they pull over the person. Like checking for warrants or parole/probation conditions, it is a trivial task for a cop to check on the computer for things to get more information to deal with the situation. Linking it to the license might lead to greater scrutiny to status than action. Rather than seeing a crime and enforcing the law, the officer sees a person and looks for the crime.

Since some medical use might be to deal with a "disability" under federal and state law, wouldn't any linkage be discrimination based on disability? Has anyone sued FL over the linkage yet?

The Id photo thing is part of some system the state government hat been using for a while I think. Look on your driver's license if theirs a gold start on it it means that state had your birth certificate and photo on record.

I think that is required with the "Real ID Act". Federal law purported to make sure people have good identification. CA does not conform--yet. There are rumors that, at some point, CA residents will have to go through increased processing at the airport because their ID does not comport with the act. (Unless they bring other good ID like a passport.)

 

[His_Highness]

Next step is actually purchasing something. Only certified for low dose though. I'll update this thread with those experiences too.

I know some folks who are thrilled with low dose alternatives because they are pain management patients who would have been taken off their meds if they tested positive for MJ.

Baby steps.....

@OldNewbie - I don't know if the disability link would work. Hope we never have to find out.

 

[Silver420Surfer]

Colorado only requires meds to be in an "exit"(think large white child-proof zip-lock-type bag that holds ur cannabis purchased from a dispensary) bag and have the receipt for cannabis with it. Haven't ever had anyone check me personally, but I think its up to officer discretion at this point.

 

[psychonaut]

That is a good point @OldNewbie which is why I generallly carry my cannabis and paraphanelia in my anonymous bag supplied by my caregiver, it has a key and lock and is not entirely stink proof but when zipped up it holds air fairly well!

http://www.anonymousbags.com/

Highly recommended to patients for transporting cannabis, putting this in your trunk would also make it about as good as it gets from a legal perspective.

 

[Tranquility]

Colorado only requires meds to be in an "exit"(think large white child-proof zip-lock-type bag that holds ur cannabis purchased from a dispensary) bag and have the receipt for cannabis with it. Haven't ever had anyone check me personally, but I think its up to officer discretion at this point.

I believe that is supposed to be the "sealed container" the law requires. CA legal-regulated uses the same type of bag while quasi (medical cooperative) tends toward putting cannabis in a container in a paper bag that is stapled shut--again with the hope it would qualify as a sealed container.

 

[Tuck]

What is your condition of you don't mind me asking? I'm torn on putting my name on that list.

 

[CarolKing]

We had a bill in WA state that would have required cannabis stores to have to provide medical locked containers to the medical patients. It looked like the stores would need to pay for them. Not something that the stores should have to provide IMO. I don’t think it ever came to a vote this year so far. The legislative season is almost over.

 

[Baron23]

It was really frustrating since we painstakingly followed the instructions to the letter and ran into a myriad of issues. Took a couple months with a lot of follow up and perseverance. Tried email and phone calls. The phone approach is the only thing that worked but it was common to be on hold for over an hour and many times after holding for more than an hour the line just went dead.

Here's the issues (NOTE: We weren't contacted in any way about what the issues were even though we provided a phone number and an email address in the initial form). The check for the $75 fee was cashed well over a month before we got it all straightened out):
- Supply a passport level photo. Got them professionally done at Walgreen and included two in the info package/form we sent in. Supplying a photo in the mailed in application was the required approach. Months went by and the web site continued to say no photo provided. When we finally got through on the phone we were told the photos were coming out blurred so we needed to use one of the new methods for supplying a photo. No way it was the photos we supplied. Had to have been a glitch with their scanner or whatever they were using. I finally uploaded one through the web site after using photo software to get a picture down to the 192 x 192 pixels required.
- The name of our town had been changed a few years ago and they compared it to the driver license. Since the license had the old town name we were told we had to change the name of the town using the web site so it agreed to the driver's license.

There have been NEW processes added that may mitigate the above going forward:
- The passport quality photo issue may be resolved by a new direction. Here's the description "The Registry is now connected to the Division of Highway Safety and Motor Vehicle’s State ID system. If there is a match to the information supplied by your Physician your State ID or Driver’s License photo is automatically added to your online application". To be honest....there's something worrisome about connecting the certification to the driver's license. Assuming this connection is bi-directional it could become an instantaneous heads-up to the police when you're driving that you are also a MJ user.

Wow, for five years I thought my state of Maryland was the poster child for how state government can f' up a MMJ program implementation, but recently we are finally open while news from FL and NY is just shocking. FL in particular is egregious in that this was voted for by direct democracy (referendum on constitutional amendment) and was enshrined in the state's constitution. And what does FL state goverment immediately do....why they work frantically to mitigate and impeded this MMJ program to the maximum extent possible. These people should be kicked out of elected office and bureaucrats should be sent packing. Its a travesty.

Now in MD's new program, all flower needed to be pre-package (which is a drag). However, the state just published regs on how dispensaries can run "deli style" sales where the flower is weighted out in front of the customer from a larger bulk container....which is not a drag, IMO! hahaha

Have a great day, all.

 

[hibeam]

Next step is actually purchasing something. Only certified for low dose though. I'll update this thread with those experiences too.

I know some folks who are thrilled with low dose alternatives because they are pain management patients who would have been taken off their meds if they tested positive for MJ.

Baby steps.....

@OldNewbie - I don't know if the disability link would work. Hope we never have to find out.

Yes, Flim-Flam-Florida.... Recent reports of doctors gouging patients by hiking rates midstream, and from the beginning the DOH had to come out with a caveat public statement about fake doctors. Not quite funny is as unprofessional as my doc's office is run, considering it is the most expensive game in town, I got the high thc dose I wanted in my first rec, and a much better turnaround time for DOH approval than many many people. These mmj docs seem to be lawyers and marketers rather than wellness experts. @C No Ego knows way more about the EC system than my "pain specialist" doc does!

Maybe one problem is the climate here could support a free crop of ditch weed head and shoulders above the competition. Is Florida even better than CA for outdoor cannabis/hemp crops?

I agree with @psychonaut about a transition period. Too bad any grassroots patient advocacy are either driven by court settlements or infiltrated by the "enemy."

 

[C No Ego]

Yes, Flim-Flam-Florida.... Recent reports of doctors gouging patients by hiking rates midstream, and from the beginning the DOH had to come out with a caveat public statement about fake doctors. Not quite funny is as unprofessional as my doc's office is run considering it is the most expensive game in town, I got the high thc dose I wanted in my first rec, and a much better turnaround time for DOH approval than many many people. These mmj docs seem to be lawyers and marketers rather than wellness experts. @C No Ego knows way more about the EC system than my "pain specialist" doc does!

Maybe one problem is the climate here could support a free crop of ditch weed head and shoulders above the competition. Is Florida even better than CA for outdoor cannabis/hemp crops?

I agree with @psychonaut about a transition period. Too bad any grassroots patient advocacy are either driven by court settlements or infiltrated by the "enemy."

thanks for the compliment ! I think I'm just more curious is all LOL

But- you would want mold resistant strains for Florida... some wild land race genetics or outdoor sativas with Lemon ( kind a fits, FL ) ... even a lemon skunk might have enough mold resistance... lemon skunk is kind of an odd strain though with myrcene and limonene... I helped grow an Amnesia lemon that was really wild man! most strains if you get seeds are bred for indoors and they cannot handle moistness etc...

 

[His_Highness]

What is your condition of you don't mind me asking? I'm torn on putting my name on that list.

24/7 migraines. Documented thoroughly for over 5 years. Included a brain surgery. Still, even with all the history the certification is only for low dose THC.

In other news....To add to the frustration of pushing the certification rock up the hill....after receiving the news that the certification for low dose has been approved we called a dispensary and asked some questions since this would be our first dispensary visit. The dispensary looked at the current certification and said there was no prescription assigned but that they could see the certification was approved AND that we would have to get the certifying doctor to enter a prescription. Called the certifying doctor's office and was told we'd have to come in to have a prescription entered. WTF?!??! When I asked why we would have to come in to see the same doctor who approved the certification for low dose we were told "It's the law". Something doesn't smell right here. Kind of feels like the doctor is pumping office visits. The interview he put us through for the certification included reviewing the 5 years of history and was very thorough. Under normal circumstances it should only take 30 days from the certification interview to be FL certified. So why would we have to go back to get a prescription entered after all of the above? As I already mentioned ... when I asked why the doctor can't just enter the prescription based on the very thorough certification interview we were told "it's the law".

 

[Tranquility]

24/7 migraines. Documented thoroughly for over 5 years. Included a brain surgery. Still, even with all the history the certification is only for low dose THC.

In other news....To add to the frustration of pushing the certification rock up the hill....after receiving the news that the certification for low dose has been approved we called a dispensary and asked some questions since this would be our first dispensary visit. The dispensary looked at the current certification and said there was no prescription assigned but that they could see the certification was approved AND that we would have to get the certifying doctor to enter a prescription. Called the certifying doctor's office and was told we'd have to come in to have a prescription entered. WTF?!??! When I asked why we would have to come in to see the same doctor who approved the certification for low dose we were told "It's the law". Something doesn't smell right here. Kind of feels like the doctor is pumping office visits. The interview he put us through for the certification included reviewing the 5 years of history and was very thorough. Under normal circumstances it should only take 30 days from the certification interview to be FL certified. So why would we have to go back to get a prescription entered after all of the above? As I already mentioned ... when I asked why the doctor can't just enter the prescription based on the very thorough certification interview we were told "it's the law".

Under 64-4.011(7):

(7) If there is no initial order by the patient’s authorized physician at the time of the approval of the patient or legal representative’s Compassionate Use Registry identification card, the Department will provide a temporary verification email which may be printed and used, with a photo ID, to obtain low-THC cannabis, medical cannabis, or a cannabis delivery device until the patient or legal representative receives the Compassionate Use Registry identification card.​

The rest of the regulations really don't give too much guidance with a casual look. ( http://www.floridahealth.gov/progra...arijuana-use/rules-and-regulations/index.html ) But, the access seems designed to prevent research so I can't be sure there isn't anything directly related to the doctor's concern. It might be under some ethical guidelines in the state for doctors making cannabis recommendations.

If you're really concerned, send a short letter with the background and ask which law is preventing you from getting the medication you need. You can ask over the phone, but I suspect you will get into a do loop with an "it's the law" result. In writing, people don't answer as casually.

 

[hibeam]

I had to go back for my 1st rec (129.00) a month after my cert interview (265.00). Then I had to go back for a dosage assessment only 45 days later (129.00) because "it is a serious drug and a lot can happen in the beginning of its use". Then I have to go back seventy days later for a rec renewal/revision. I don't know when I will have to go back after that.

I hope no sooner than 70 days times 3, the max the DOH allows: A qualified physician may not issue a physician certification for more than three 70-day supply limits of marijuana. The department shall quantify by rule a daily dose amount with equivalent dose amounts for each allowable form of marijuana dispensed by a medical marijuana treatment center. The department shall use the daily dose amount to calculate a 70-day supply. (http://www.leg.state.fl.us/statutes...ng=&URL=0300-0399/0381/Sections/0381.986.html)

Pumping? Do any docs let you go for 210 days at a time from the first appt? Or, do they all really need to check your blood pressure every 70 days to cover their liabilities?

edit: am migraineur too

 

[Tranquility]

@hibeam gave me another avenue to look. (70 days) In the actual statute ( http://www.leg.state.fl.us/statutes...ng=&URL=0300-0399/0381/Sections/0381.986.html ), the rules are:

(c) A qualified physician may not issue a physician certification for more than three 70-day supply limits of marijuana. The department shall quantify by rule a daily dose amount with equivalent dose amounts for each allowable form of marijuana dispensed by a medical marijuana treatment center. The department shall use the daily dose amount to calculate a 70-day supply.
1. A qualified physician may request an exception to the daily dose amount limit. The request shall be made electronically on a form adopted by the department in rule and must include, at a minimum:
a. The qualified patient’s qualifying medical condition.
b. The dosage and route of administration that was insufficient to provide relief to the qualified patient.
c. A description of how the patient will benefit from an increased amount.
d. The minimum daily dose amount of marijuana that would be sufficient for the treatment of the qualified patient’s qualifying medical condition.
2. A qualified physician must provide the qualified patient’s records upon the request of the department.
3. The department shall approve or disapprove the request within 14 days after receipt of the complete documentation required by this paragraph. The request shall be deemed approved if the department fails to act within this time period.
(d) A qualified physician must evaluate an existing qualified patient at least once every 30 weeks before issuing a new physician certification. A physician must:
1. Determine if the patient still meets the requirements to be issued a physician certification under paragraph (a).
2. Identify and document in the qualified patient’s medical records whether the qualified patient experienced either of the following related to the medical use of marijuana:
a. An adverse drug interaction with any prescription or nonprescription medication; or
b. A reduction in the use of, or dependence on, other types of controlled substances as defined in s. 893.02.
3. Submit a report with the findings required pursuant to subparagraph 2. to the department. The department shall submit such reports to the Coalition for Medical Marijuana Research and Education established pursuant to s. 1004.4351.
(e) An active order for low-THC cannabis or medical cannabis issued pursuant to former s.381.986, Florida Statutes 2016, and registered with the compassionate use registry before June 23, 2017, is deemed a physician certification, and all patients possessing such orders are deemed qualified patients until the department begins issuing medical marijuana use registry identification cards.
(f) The department shall monitor physician registration in the medical marijuana use registry and the issuance of physician certifications for practices that could facilitate unlawful diversion or misuse of marijuana or a marijuana delivery device and shall take disciplinary action as appropriate.
(g) The Board of Medicine and the Board of Osteopathic Medicine shall jointly create a physician certification pattern review panel that shall review all physician certifications submitted to the medical marijuana use registry. The panel shall track and report the number of physician certifications and the qualifying medical conditions, dosage, supply amount, and form of marijuana certified. The panel shall report the data both by individual qualified physician and in the aggregate, by county, and statewide. The physician certification pattern review panel shall, beginning January 1, 2018, submit an annual report of its findings and recommendations to the Governor, the President of the Senate, and the Speaker of the House of Representatives.
(h) The department, the Board of Medicine, and the Board of Osteopathic Medicine may adopt rules pursuant to ss. 120.536(1) and 120.54 to implement this subsection.

 

[His_Highness]

Thanks @OldNewbie ! Thanks @hibeam !

I'm not going to be able to stand for this garbage since it's only low dose. I may just keep the certification going and forego the dispensary/purchase if it remains as such.

They're keeping cannabis as a second class medical citizen. May as well have the pill mills and dispensaries use the same location to save on the overhead.

Can you imagine the fallout if you went to a doctor and got a full work up and then were told ... come back in 30 days and we'll write you a script.

 

[Silver420Surfer]

The FL regulations are so far from what John Morgan and United for Care activists(myself included) fought so long and hard for. It's really a shame and I hope that the future brings brighter days for FL med cannabis patients.

 

[Silver420Surfer]

@His_Highness or any other nearby FL members

Gonna be in the St. Pete area thru the weekend. Holler if any one is nearby and wants to sesh.

 

[His_Highness]

Hope this thread helps others in FL:

Recap....We got certified and then were told to come in again for a brief review and to get the recommendation entered for method and dose that we could take to the dispensary.

Went to the neurologist for the recommendation. After reviewing the prior history and asking a few catch-up questions the neuro said the recommendation would be for the low dose (CBD to THC 20:1 through 30:1) and method suggested was capsules. I reminded the neuro that when the migraines kick in they come with severe nausea so edibles, tinctures or capsules weren't going to work. I suggested inhalation and the neuro agreed. I reiterated that his recommendation was almost pure CBD and that we already tried pure CBD and it didn't work. He said try it for 30 days and if it doesn't work he would increase the THC side of the dosage. I forgot to ask him how high he could go on the THC percentage. The recommendation/script is good for 70 days.

Went to the Trulieve dispensary after reading their web site FAQs and noting which products were a fit for the recommendation. After driving all the way across town like that we were told they hadn't had any low dose products in MONTHS. MONTHS?!?!?! When I suggested that the web site be updated so a patient in severe pain wouldn't have to travel all this way for nothing I was told "we don't update the web site with that information". I didn't waste my breath telling them that several products on their web site were highlighted in bold red letters as being out of stock.

We called the Knox dispensary and they had low dose product in stock. The agent at Knox was patient, personable, professional, informative and the prices weren't bad at all. The e-cig 510 threaded pen/battery was free and the cartridge for 30 days worth was $45.

The Knox agent (They don't sell flower so bud-tender as a name is frowned upon) mentioned:
- How surprising it was that the neuro was using our BCBS health insurance and that he saved us between $250 to $500 that way when compared to others because most don't go through standard health insurance.
- How surprising it was that with 24/7 migraines and a related brain surgery the "lowest" dose product was recommended instead of a THC to CBD of 1:1 or higher but that it might be because he was using our health insurance. When I mentioned that I thought only terminally ill patients qualified for the higher THC doses the agent told me that for the THC to CBD of 25:1 and above that was "mostly" true but it wasn't uncommon for someone with the severity of pain we were trying to fix to go right to the 1:1 dosage. As a recreational user I have tried distillate at both THC to CBD of 25:1 and 1:1 and actually preferred the 1:1. The 25:1 was a little racy for me.
- The good news was that using the low dose product CBD to THC (25:1 or 30:1) and driving is not against the law.
- Keeping the certification card or temporary certification email with the patient at all times when carrying the products. Common sense.

As expected the CBD to THC product we have (30:1) didn't help even after vaping with it most of the day. The next day I broke out the Herby and some Animal Cookies instead and the pain level was at a 10 but 15 minutes after the Animal Cookies the pain level was at a 5 and the nausea was gone. So medical cannabis is a fit here if I can get the neuro to up the THC to 1:1.

I'll update this thread as we move through the process......

 

[Silver420Surfer]

I cant beleive they said driving is ok using a 20:1 cbd/thc product. I dont know what FL threshold is in nanometers, but that sounds odd to me. Esp if you are using other meds(animal cookies flower), you WILL more than likely test over that threshold. No med card or recommendation will save you at that point. Even if you have the "ok to drive" in writing from a dr. Be careful.

Vape pens are not medicating devices Florida(well, maybe if you have like nil tolerance). It's a shame that all the good work John Morgan and United for Care did, and the state of FL is still being ignorant cunts about proper medicine for patients.

 

[His_Highness]

I cant beleive they said driving is ok using a 20:1 cbd/thc product. I dont know what FL threshold is in nanometers, but that sounds odd to me. Esp if you are using other meds(animal cookies flower), you WILL more than likely test over that threshold. No med card or recommendation will save you at that point. Even if you have the "ok to drive" in writing from a dr. Be careful.

Understood. Low dose percentages are CBD to THC 20:1 through 30:1. Knox only had 30:1. I didn't ask but maybe 30:1 is "drive-able" but 20:1 is not. You could puff away at this shit all day long and not get "euphoric".

Once we get past the 30 days and request/get approved for the higher percentage THC products and go back to the dispensary...... I'll ask if the agent can point me to the documentation that states it's legal to drive with a low dose product. It's already legal to drive if using a pure CBD product and these low dose products aren't going to get you happy so maybe that's the out.

 

[Tuck]

Thank you for the updated info. I'm waffling on all of it. Right now, I don't want to put my name on that list and I have cancer. I would be considering it more if Florida would let us have flowers.

So if I have a card and am prescribed a certain dosage, I'm no longer supposed to drive? Or just not supposed to drive while I'm medicated?