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PA Bulletin, Doc. No. 24-1620

NOTICES

DEPARTMENT OF HEALTH

Medical Marijuana Advisory Board's Recommendations to Change the Medical Professionals Who Can Certify Patients for Medical Marijuana to Include Certified Registered Nurse Practitioners and the Secretary of Health's Decision Not to Effectuate the Recommendation

[54 Pa.B. 7444]
[Saturday, November 9, 2024]

 Under section 1202 of the Medical Marijuana Act (act) (35 P.S. § 10231.1202), the Secretary of Health (Secretary) has discretion regarding whether to effectuate recommendations of the Medical Marijuana Advisory Board (Board) within 12 months of receipt of a report adopted at a public meeting under section 1201(j)(6) of the act (35 P.S. § 10231.1201(j)(6)) by transmitting a notice to the Legislative Reference Bureau for publication in the Pennsylvania Bulletin.

 The following reflects the Board's recommendation made under section 1201(j)(5)(i) to change the type of medical professionals who can issue certifications for medical marijuana.

Board Recommendation: During a public meeting held on January 24, 2024, the Board, through adoption of a written report, recommended that Certified Registered Nurse Practitioners (CRNP) be eligible to apply for inclusion in the registry of practitioners who can certify patients for medical marijuana for all serious medical conditions allowed by the Commonwealth within the scope of the Nursing Practice Act (Report).

Secretary's Rationale: The act does not define the term ''medical professional'' for purposes of expanding eligibility to certify medical marijuana for patients with serious medical conditions. The Secretary is guided by the narrow definition assigned to ''practitioner'' in section 103 of the act (35 P.S. § 10231.103), as well as the legislative intent conveyed in the act's declaration of policy, which provides for a balance between patient access and careful regulation of the program under section 102 of the act (35 P.S. § 10231.102). The act specifically limits practitioners to physicians under section 103. Without legislative changes to allow for expansion of that definition, as well as modifications to the act providing for the approval, discipline and oversight of new categories of certifying practitioners, the Secretary is constrained from effectuating the Board's recommendation to include CRNPs as eligible to register to issue certifications for medical marijuana to patients with serious medical conditions.

 Although the Secretary has declined to effectuate on other grounds, the Secretary has reviewed and considered the findings and recommendations contained in the Board's Report. The Secretary does not disagree with the reasoning underlying the Board's recommendation to include CRNPs as eligible to issue certifications for medical marijuana to patients with serious medical conditions. As reflected in the Report, in addition to extensive educational requirements, CRNPs diagnose, treat and have prescriptive authority for the serious medical conditions in the act, subject to their scope of practice and collaborative agreements. Based upon the similarity of their practice to that of physicians who are eligible to certify under the act, the Secretary contemplates that CRNPs could be eligible to certify medical marijuana for patients pending any required legal or regulatory changes to their scope of practice. This is not conclusive to the Secretary's decision.

 The Secretary also recognizes the importance of ensuring patient accessibility to medical marijuana where there is an identifiable gap or unmet need. This Report, while stating that ''it is important to increase patient access in the state,'' does not indicate that there is a lack of patient access to medical marijuana for treatment of serious medical conditions such that expanding eligibility to certify to CRNPs would be necessary to meet patient needs. Based upon the foregoing considerations, the Secretary would decline to include CRNPs as eligible to register to issue certifications for medical marijuana to patients with serious medical conditions at the current time.

 The Secretary recognizes that there may be changes to the law or other considerations that may warrant reconsideration of this issue in the future under the provisions of sections 1201(j)(5) and 1202. Should a new report be submitted, the Secretary reminds the Board that any materials relied upon in support of its recommendations, including but not limited to journals, news articles, webpages, written comments or similar sources, must be presented to the full Board for review and consideration as part of the written report (for example, by means of citation, link or document copy). Submission of a new or amended report does not guarantee future approval of a recommendation.

 For additional information, including an alternative format of this notice (for example, large print, audiotape, Braille), contact the Bureau of Medical Marijuana, 625 Forster Street, Room 628, Health and Human Services Building, Harrisburg, PA 17120, (717) 547-3047, or for speech and/or hearing-impaired persons, call the Pennsylvania Hamilton Relay Service at (800) 654-5984 (TDD users) or (800) 654-5988 (voice users).

DR. DEBRA L. BOGEN, 
Secretary

[Pa.B. Doc. No. 24-1620. Filed for public inspection November 8, 2024, 9:00 a.m.]



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