BY MIKEL WEISSER
Even though it was kept under the radar until after Governor Ducey signed it, the two-year card provision of SB1494 seems like it had to be good news for all involved. Patients get their annual cards extended to two years, literally cutting their card costs in half. DHS saves on their administrative costs and labor as well. Dispensaries have fewer patients worrying about affording their medicine.
Sounded like a win all around, except for the folks actually recommending the cards, the certification clinics. When it comes to certification clinics, the reality of this change means their customers will only be buying half as many certifications. Half.
With over 200,000 people in the AZ medical marijuana program, certifications have become big business. In most industries, cutting the customer base in half would be devastating, but AZ’s certification clinics are working on adapting. In a state with the 3rd largest patient base in America, there are literally hundreds of thousands of patients depending on the clinics to get their recommendations.
As the calendar nears the Aug 27 kick off for the new two-year cards, some patients with expiration dates in late July or early August are considering delaying their renewals till after the 27th, despite the risk. According to AZ law enforcement, expired cards offer zero protection from cannabis charges.
There are almost 20 certification clinics in the PHX metro area, and dozens more scattered around the state. We talked to several clinics to see how they’re holding up.
“As Soon as We Knew the Change Was Coming, We Started Adjusting”
Jeff Riedel with Sun Valley Health (formerly Sun Valley Certification Clinics) says his company has been expecting the change and had already been retooling, starting with the name change.
“As soon as we knew the change was coming, we started adjusting and doing new hires. We have 30 doctors on staff who specialize in things other than MMJ certifications. Folks like acupuncturists, naturopaths, chiropractors and sports medicine specialists. Our plan is to go forward with the full range of services we can provide.”
Opened in 2013, with four locations in the PHX area and one in Tucson, Sun Valley Health is not only one of the largest certification clinics chains in the state, but they also have clinics in WA, OR, MO, and New Jersey, franchises in FL, plus provide telemedicine patient services in California.
“Pull up a map of places with a medical program and you will find we’re either there, been there or on the way there,” Riedel laughs. “There are some newer clinics that are likely to struggle and make rash, bad decisions. We just want to help patients avoid making bad decisions.” To encourage patients, whose cards expire before the 27th, Sun Valley has halved its prices and will only charge $75 for their clinic fees through August.
Messaging to the Canna-Curious
Green Star Doctors owner, Liz Valentine has high expectations for the future of the medical program thanks to the card extensions. Green Star Doctors of Scottsdale is also currently offering a $75 rate and has been expanding their programs as well. In addition to their currently reduced $75 clinic fee, each Green Star patient also receives a bag full of dispensary coupons that more than offsets the cost of the card.
Starting last month, Green Star launched their “Lunch n Learn Saturday series” featuring guest lecturers like superstar cannabis defense lawyer, Sonia Martinez. Valentine has also created a monthly hemp product market there at their south Scottsdale Road location. Her next event is Aug 10th.
“There are so many new products people aren’t seeing,” Valentine explains, “we decided to take the time and bring all these products together in one place. Sometimes people don’t feel right about buying hemp or CBD products in a generic retail store with no customer service or additional product information. We can bridge that gap.”
Valentine believes CBD’s explosive popularity can inspire the larger public to learn more about cannabis medicine. “It brings the ‘canna-curious’ in a safe way, so they can begin to learn the truth about cannabis instead of the mass media misperception.”
Liz believes the extended medical card law will be a boon to the program and that patient counts could even double. “The actual numbers of the program are kind of fuzzy. People enter and leave after one year, others let their cards expire, then renew and get counted as new unique patients. We know some people will take the chance, let their cards expire and go back to their underground dealers, but the fact is possession is still a felony. It’s a safety point. It’s protection.”
“It Has Literally Made Me Lose Sleep”
Cannabis Certification Centers-Medical Marijuana Card Doctors of Scottsdale sees the extended cards as a great thing for patients, but would have preferred reducing card pricing over extending card length. As office manager Ron Bogardus explains, “The state requires that patients have medical records from within the past year. Many of the patients we see avoid using traditional medicine, so they won’t have medical records from within the past year. So, in the end, they may be saving $75 off the state fees, but they’ll still have to pay extra for new doctor evaluations and medical records each time they come in.”
Steve Sharp of Arizona Green Life (2 locations) feels the change should have been done a long time ago, but agrees with Bogardus, the certification clinics are taking a hit with the extension and would have preferred lowering card costs over extending card length. As Arizona rushes toward 2020 and the legalization effort, Sharp worries the card cost reduction will have the unintended consequence of lowering, not just the cost, but the inherent value of medical cards.
“I understand it was the politics that made this take so long. So many politicians are afraid of being accused of making marijuana more available, it took this method to get it done. I think it’s great for patients, it’s great for dispensaries, but it was definitely a slight to the certification clinics. I don’t think any of us were even consulted about the law change.”
Like many of the clinics, AZ Green Life is a small family owned operation. “It has literally made me lose sleep. Our margins are already so thin and there’s so much competition. Now that the stigma is wearing off, we even have regular doctors getting into the field,” Sharp explained in a phone interview.
“Health wise I have concerns,” Sharp continued, “Some people won’t even see a health care professional for the whole two-year period and then will have to get re-evaluated and that will cost them more than visiting once a year. How can you have a valid doctor patient relationship when you only see each other once every two years?”
Like many other clinics, Arizona Green Life has already started diversifying their business model. With AZ’s new industrial hemp program launching in June, Sharp and his team have acquired a hemp processing license and already have CBD product lines in both dispensaries and smoke shops.
“We literally bank on people coming back every year, it’s how I feed my family. If we go through our whole list of regularly returning patients renewing all at once and then its crickets for the second year, we will be threatened and may have to change our rates.”
Other Modalities
Of course, for some doctors who do certifications, cannabis patients represent just a portion of their overall clientele. At the Burns Integrative Wellness Center, her north PHX clinic, Dr Jennifer Burns provides a wide variety of traditional and alternative therapies. “I already have patients who I treat with other modalities besides medical marijuana, so as a business I am not worried.”
“We’ve started offering the nasal ketamine for depression. We’re even doing mitochondrial detoxification, which improves brain health, especially for ADD and anxiety. We’re identifying which parts of the brain are inflamed and treating the specific regions. It’s quite promising.”
Still, Burns champions the new lowered card costs. “I am just glad we’re finally doing something for people with chronic issues. I would be okay if things got a little busier, but I already had other plans in the works. That said, when the bill was signed into law, I was shocked. I had no idea it was coming.”
Meanwhile in Rural Arizona …
Meanwhile in rural Arizona, many certification facilities are connected to local dispensaries. In the Kingman area, local chiropractor Dr. Barbara Dorf has partnered with Medusa Farms dispensary owner Evan Peiser and Dr. Anderson to provide certification clinic services through Dorf’s office. Peiser’s facility faces an unusual dilemma of sitting within 30 miles of Nevada’s wide-open adult use dispensaries. “Being this close to both California and Nevada, we think of ourselves as a border town. People just cross the line to get their medications and often skip the certification process,” Peiser explains.
Evan says he expects to see a jump in the number of patients they have getting certified and is already working on expanding the clinic’s services. “Right after Prop205 failed in 2016, we suffered a tremendous drop off in certifications. It’s a lower income area also,” Peiser continued, “So we weren’t getting much retention and second-time card buyers. We had people who spent less on their medication than they spent on getting the card. But since the new law, business has started to pick up, people are excited to be getting their cards again.”
Dr Reeferalz of Phoenix and Tucson’s Tumbleweeds and Dr Heather Moroso were contacted for this article but declined to comment.
—Mikel Weisser edits the Arizona Cannabis News and is the state director of Arizona NORML