DEPARTMENT OF COMMUNITY HEALTH

                            DIRECTOR'S OFFICE

                        MICHIGAN MEDICAL MARIHUANA 


(By authority conferred on the director of the department of community health 
by section 5 of  initiated  law  1  of  2008,  MCL  333.26421  and  executive 
reorganization order numbers 1996-1, 1996-2 and  2003-1,  MCL  330.3101,  MCL 
445.2001 and MCL 445.2011)


R 333.101   Definitions.	
  Rule 1.  As used in these rules:
  (1)  "Act" means the Michigan medical marihuana act,  Initiated  Law  1  of 
2008, MCL 333.26421. 
  (2)   "Applicant"  means  a  qualifying  patient  applying  for  a  medical 
marihuana registry identification card on a form provided by  the  department 
of community health. 
  (3)  "Code" means 1978 PA 368, MCL 333.1101.
  (4)  "Conviction" or "convicted" means a criminal conviction of an  offense 
by a guilty verdict from a judge or jury, plea  of  guilty,  or  plea  of  no 
contest.
  (5)  "Debilitating medical condition" means 1 or more of the following: 
  (a)  Cancer, glaucoma, positive status for  human  immunodeficiency  virus, 
acquired  immune  deficiency  syndrome,  hepatitis  C,  amyotrophic   lateral 
sclerosis, Crohn's disease, agitation of Alzheimer's disease,  nail  patella, 
or the treatment of these conditions.
  (b)  A  chronic  or  debilitating  disease  or  medical  condition  or  its 
treatment that produces, for a specific patient, 1 or more of the  following: 
cachexia or  wasting  syndrome;  severe  and  chronic  pain;  severe  nausea; 
seizures, including but not limited to those characteristic of  epilepsy;  or 
severe and persistent muscle spasms,  including  but  not  limited  to  those 
characteristic of multiple sclerosis.
  (c)  Any other medical condition  or  treatment  for  a  medical  condition 
approved by the department pursuant to a petition submitted under R 333.133. 
  (6)  "Department" means the department of community health. 
  (7)  "Enclosed, locked facility" means a closet, room,  or  other  enclosed 
area equipped with locks or other security devices that permit access only by 
a registered primary caregiver or registered qualifying patient.
  (8)  "Marihuana" means that term as defined in section 7106 of the code. 
  (9)  "Medicaid health plan" means the medical assistance program managed by 
the department. 
  (10)   "Medical  use"  means  the  acquisition,  possession,   cultivation, 
manufacture, use, internal possession, delivery, transfer, or  transportation 
of marihuana or paraphernalia relating to the administration of marihuana  to 
treat or alleviate a registered  qualifying  patient's  debilitating  medical 
condition or symptoms associated with the debilitating medical condition.  
  (11)  "Paraphernalia"  means  any  item  defined  as  "drug  paraphernalia" 
pursuant to section 7451 of the code.
  (12)  "Parent or legal  guardian"  means  the  custodial  parent  or  legal 
guardian with responsibility for  health  care  decisions  for  a  qualifying 
patient who is under 18 years of age. 
  (13)  "Petition" means a written request for  the  department  to  add  new 
medical  conditions  or  treatments  to  the  list  of  debilitating  medical 
conditions under R 333.101(5).
  (14)  "Physician" means an individual licensed as a  physician  under  part 
170 or 175 of the code.   For  purposes  of  the  act,  neither  a  physician 
assistant nor a nurse  practitioner  is  authorized  to  sign  the  statement 
attesting to the patient's debilitating medical condition.
  (15)  "Primary caregiver" means a person who is at least 21 years  old  and 
who has agreed to assist with a patient's medical use of  marihuana  and  who 
has never been convicted of a felony involving illegal drugs.
  (16)  "Public place" means a place open to the public.
  (17)  "Qualifying patient" means a person  who  has  been  diagnosed  by  a 
physician as having a debilitating medical condition.
  (18)  "Registry  identification  card"  means  a  document  issued  by  the 
department that identifies a person as a  registered  qualifying  patient  or 
registered primary caregiver.
  (19)  "Supplemental Security Income" means the monthly  benefit  assistance 
program administered by the federal government for persons who are age 65  or 
older, or blind, or disabled  and  who  have  limited  income  and  financial 
resources.
  (20)  "Usable  marihuana"  means  the  dried  leaves  and  flowers  of  the 
marihuana plant, and any mixture or preparation thereof, but does not include 
the seeds, stalks, and roots of the plant.
  (21)  "Visiting qualifying patient" means a patient who is not  a  resident 
of this state or who has been a resident of this state for less than 30 days.
  (22)  "Written certification"  means  a  document  signed  by  a  physician 
stating the patient's debilitating medical condition and stating that, in the 
physician's  professional  opinion,  the  patient  is   likely   to   receive 
therapeutic or palliative benefit from the medical use of marihuana to  treat 
or  alleviate  the  patient's  debilitating  medical  condition  or  symptoms 
associated with the debilitating medical condition. 
  (23)  Terms defined in the act have the same meanings when  used  in  these 
rules. 
 
  History: 2009 MR 6, Eff. Apr. 4, 2009.


R 333.103   New registration  application;  qualifying  patient  and  primary 
caregiver. 
  Rule 3.  A qualifying patient applying for a registry  identification  card 
shall comply with all of the following:
  (a)  Submit a completed application on a form provided by  the  department, 
together with the requisite fee. The completed application shall include  all 
of the following:
  (i)  Name, address, and date  of  birth  of  the  qualifying  patient.  The 
address for the qualifying patient shall be a  physical  address  located  in 
this state. A qualifying patient who is homeless shall  not  be  required  to 
provide a physical address.
  (ii)  Name, address, and  telephone  number  of  the  qualifying  patient's 
physician.
  (iii)  The name, address, and  date  of  birth  of  the  patient's  primary 
caregiver, if applicable.  A  qualifying  patient  may  designate  1  primary 
caregiver to assist with his or her medical use of marihuana.
  (iv)  A designation of whether the  qualifying  patient  or  the  patient's 
primary caregiver, if applicable, will be allowed to possess marihuana plants 
for the qualifying patient's medical use.
  (v)  An attestation by the primary caregiver named on the application  that 
he or she agrees to serve as the patient's primary caregiver.
  (vi)  A primary  caregiver  shall  authorize  the  department  to  use  the 
information provided on  the  application  to  secure  his  or  her  criminal 
conviction history to  determine  if  he  or  she  has  a  felony  conviction 
involving illegal drugs. 
  (b)  Submit photographic identification of both the qualifying patient  and 
the patient's primary caregiver, if applicable. If the qualifying patient  is 
under the age of  18  and  does  not  have  photographic  identification,  no 
photographic identification is required. Photocopies of the  following  shall 
be considered acceptable forms of identification: 
  (i)  Current driver's license or identification card, with photo, issued by 
a state. 
  (ii)  Identification card  with  photo  issued  by  a  federal,  state,  or 
government agency.
  (iii)  Current military identification card.
  (iv)  Current passport.
  (v)  Current student identification card with photo. 
  (vi)  Native American tribal identification with photo
  (vii)  Permanent resident card or alien registration receipt card.
  (c)  Submit a written certification, as defined in R 333.101(22), signed by 
a licensed physician. If the qualifying patient  is  under  the  age  of  18, 
written certifications from 2 physicians are required.
  (d)  If the qualifying patient is under the age of 18, submit a declaration 
of person responsible form.

  History: 2009 MR 6, Eff. Apr. 4, 2009.


R 333.105   Declaration of person responsible form.
  Rule 5.  A declaration of person  responsible  form  is  required  for  any 
qualifying patient who is under the age of 18. The form shall include all  of 
the following:
  (a)  A statement that the qualifying patient's physician has  explained  to 
the patient and the patient's parent or legal guardian  the  potential  risks 
and benefits of the medical use of marihuana.
  (b)  Consent of the qualifying patient's parent or legal guardian to  allow 
the qualifying patient's medical use of marihuana.
  (c)  Consent of the qualifying patient's parent or legal guardian to  serve 
as the patient's primary caregiver and to control  the  acquisition,  dosage, 
and frequency of use of the marihuana by the patient.

  History: 2009 MR 6, Eff. Apr. 4, 2009.


R 333.107 Incomplete application.
  Rule 7.  If an applicant fails to provide the information required under  R 
333.103 or R 333.105, as applicable, the application  shall  be  denied.  The 
department shall notify the applicant of the information that is  missing  in 
the event the applicant wishes to reapply. An applicant may  reapply  at  any 
time.

  History: 2009 MR 6, Eff. Apr. 4, 2009.


R 333.109   Verification of information.
  Rule 9.  The department  shall  verify  the  information  contained  in  an 
application and the accompanying documentation, which may include, but is not 
limited to, the following:
  (a)  Contacting each applicant  by  telephone  or  by  mail.  If  proof  of 
identity cannot be determined with reasonable reliability, the department may 
require the production of additional identification materials.
  (b)  Contacting the parent or legal guardian of a qualifying patient who is 
under the age of 18.
  (c)  Verifying that a physician is licensed to practice in the state.
  (d)  Contacting the certifying physician directly to confirm  the  validity 
of the written certification.

  History: 2009 MR 6, Eff. Apr. 4, 2009.


R 333.111   Fees; reduced fees; renewal.
  Rule 11. (1)  The fee for a new or renewal application is $100.00, unless a 
qualifying patient can demonstrate his  or  her  current  enrollment  in  the 
Medicaid health plan or  receipt  of  current  Supplemental  Security  Income 
benefits, in which case the application fee  is  $25.00.  To  qualify  for  a 
reduced fee, an applicant shall satisfy either of the following requirements:
  (a)  Submit a copy of the qualifying patient's current Medicaid health plan 
enrollment statement.
  (b)  Submit a copy of the qualifying patient's current monthly Supplemental 
Security Income benefit card, showing dates of coverage.
  (2)  The department shall deny the application of a qualifying patient  who 
submits a reduced fee for which he or she is not eligible  and  shall  notify 
the qualifying patient of the application denial. A  qualifying  patient  may 
resubmit the correct fee with his or her qualifying documentation at any time.
  (3)   The  fee  for  a  revised  or  duplicate  copy  of  the  registration 
identification card for the qualifying patient or the  primary  caregiver  is 
$10.00. If a duplicate card is requested, the qualifying patient  or  primary 
caregiver shall submit to the department the fee with a  statement  attesting 
to the loss or destruction of the card.

  History: 2009 MR 6, Eff. Apr. 4, 2009.


R 333.113   Registration approval; denial.
  Rule 13.  (1)  Pursuant to section 6(c) of the act,  the  department  shall 
approve or deny an application  within  15  days  of  receiving  a  completed 
application and the requisite fee. 
  (2)  If an  application  is  approved,  within  5  days  of  approving  the 
application, the department shall issue a registry identification card to the 
registered qualifying  patient  and  the  registered  primary  caregiver,  if 
applicable. The  registry  identification  card  shall  include  all  of  the 
following: 
  (a)  The name, address, and date of  birth  of  the  registered  qualifying 
patient. 
  (b)   If  the  registered  qualifying  patient  has  designated  a  primary 
caregiver, the name, address, and date of birth  of  the  registered  primary 
caregiver.
  (c)  The issue date and expiration  date  of  the  registry  identification 
card. 
  (d)  A random and unique identification number.
  (e)  A clear designation showing whether the registered  primary  caregiver 
or the registered qualifying patient will be authorized to possess  marihuana 
plants for the registered qualifying patient's medical use.  The  designation 
shall be determined based  solely  on  the  registered  qualifying  patient's 
preference.
  (3)   When  a  registered  qualifying  patient  has  designated  a  primary 
caregiver, the department shall issue a registry identification card  to  the 
registered primary caregiver. The  registered  primary  caregiver's  registry 
identification card shall contain the information specified in subrule (2) of 
this rule, as appropriate. 
  (4)  The department shall deny an application for any of the following:
  (a)  The applicant did not provide the physician's written certification.
  (b)  The  department  determines  that  any  information  provided  by  the 
applicant was falsified.
  (c)  An applicant fails to provide  a  physical  address  located  in  this 
state. This provision shall not apply if the applicant is homeless.
  (d)  The applicant failed to meet the requirements of R 333.107.
  (5)  If the department denies an application, the department shall mail the 
applicant a denial  letter  within  15  days  of  receipt  of  the  completed 
application. The denial letter shall be sent by certified mail to the address 
listed on the application form and shall state the  reasons  for  denial  and 
when the applicant may reapply. 
  (6)  Denial of a registry identification card shall be considered  a  final 
department action, subject to judicial review. 

  History: 2009 MR 6, Eff. Apr. 4, 2009.


Rule 333.115   Primary caregiver; number of qualified patients; compensation.
  Rule 15. (1)  The department shall issue a registry identification card  to 
the primary caregiver, if  any,  who  is  named  in  a  qualifying  patient's 
approved application. A registered primary caregiver may assist not more than 
5 qualifying patients with their medical use of marihuana.
  (2)  A registered primary caregiver  may  receive  compensation  for  costs 
associated with assisting a registered qualifying patient in the medical  use 
of marihuana. Any such compensation  shall  not  constitute  the  sale  of  a 
controlled substance.

  History: 2009 MR 6, Eff. Apr. 4, 2009.


R 333.117   Annual renewal; expiration of registry identification card; fee.
  Rule  17.  (1)   Pursuant  to  section  6(e)  of  the   act,   a   registry 
identification card shall be renewed on an annual basis  to  maintain  active 
status as a registered qualifying patient or a registered primary caregiver.
  (2)  A registry identification card shall expire on the first  day  of  the 
month 1 year following issuance of the card.
  (3)  An applicant for renewal  of  a  registry  identification  card  shall 
submit an application and information as provided in R  333.103(a),  (c)  and 
(d).
  (4)  If an applicant fails to comply with subrules (1) and (3) of this rule 
by the expiration date on the  registry  identification  card,  the  registry 
identification card shall be considered null  and  void  and  of  no  further 
effect. The applicant may submit a new application to the department. 
  (5)  The department shall verify the renewal application information in the 
same manner as specified in R 333.109. 

  History: 2009 MR 6, Eff. Apr. 4, 2009.


R 333.119   Changes in status; notifications; requirements.
  Rule 19. (1)  In order to update  registry  information  for  a  qualifying 
patient or primary caregiver, the registered qualifying  patient,  registered 
primary  caregiver,  or  registered  qualifying  patient's  parent  or  legal 
guardian, as applicable, is responsible for notifying  the  department  of  a 
change in any of the following:
  (a)  The registered qualifying patient's name.
  (b)  The registered qualifying patient's address.
  (c)  The registered qualifying patient's primary caregiver.
  (d)  The registered qualifying patient's legal guardian.
  (2)  The department may notify a registered primary caregiver by  certified 
mail at the address of record  within  14  days  of  any  changes  in  status 
including, but not limited to, both of the following: 
  (a)  The registered qualifying patient's termination  of  the  individual's 
status as primary caregiver or  designation  of  another  individual  as  the 
registered primary caregiver.
  (b)  The end of eligibility for the registered qualifying patient to hold a 
registry identification card. 
  (3)  If the department is notified by a registered qualifying patient  that 
the registered primary caregiver for the patient has changed, the  department 
may notify the initial primary caregiver by certified mail at the address  of 
record that the caregiver's registry identification card is null and void and 
of no effect. 
  (4)  If a registered qualifying patient's certifying physician notifies the 
department  in  writing  that  the  patient  has  ceased  to  suffer  from  a 
debilitating medical condition,  the  department  shall  notify  the  patient 
within 14 days of receipt of the  written  notification  that  the  patient's 
registry identification card is null and void and of no effect. 

  History: 2009 MR 6, Eff. Apr. 4, 2009.


Rule 333.121   Confidentiality.
  Rule 21. (1)  Except as provided in subrules (2)  and  (3)  of  this  rule, 
Michigan medical marihuana program information shall be confidential and  not 
subject to disclosure in any form or manner.  Program  information  includes, 
but is not limited to, all of the following: 
  (a)   Applications  and  supporting  information  submitted  by  qualifying 
patients.
  (b)  Information related to a qualifying patient's primary caregiver.
  (c)  Names and other identifying  information  of  registry  identification 
cardholders.
  (d)  Names and other identifying  information  of  pending  applicants  and 
their primary caregivers.
  (2)  Names  and  other  identifying  information  made  confidential  under 
subrule (1) of this rule may only  be  accessed  or  released  to  authorized 
employees of the department as necessary to perform official  duties  of  the 
department pursuant to the act, including the production of  any  reports  of 
non-identifying aggregate data or statistics.
  (3)  The  department  shall  verify  upon  a  request  by  law  enforcement 
personnel whether a registry identification card is valid, without disclosing 
more information than is reasonably necessary to verify the  authenticity  of 
the registry identification card.
  (4)  The department may release information  to  other  persons  only  upon 
receipt  of  a  properly  executed  release  of  information  signed  by  all 
individuals with legal authority  to  waive  confidentiality  regarding  that 
information, whether a registered qualifying patient, a qualifying  patient's 
parent or legal  guardian,  or  a  qualifying  patient's  registered  primary 
caregiver. The release of information  shall  specify  what  information  the 
department is authorized to release and to whom.
  (5)  Violation of these confidentiality rules may subject an individual  to 
the penalties provided for under section 6(h)(4) of the act.

  History: 2009 MR 6, Eff. Apr. 4, 2009.


Rule 333.123   Complaints.
  Rule  23.   The  department  shall  refer  criminal  complaints  against  a 
registered  qualifying  patient  or  registered  primary  caregiver  to   the 
appropriate state or local authorities.

  History: 2009 MR 6, Eff. Apr. 4, 2009.


R 333.125   Revocation; nullification.
  Rule 25.  (1)   A  registered  qualifying  patient  or  registered  primary 
caregiver who has been convicted of selling marihuana to someone who  is  not 
allowed to use marihuana for medical purposes under the act, shall  have  his 
or her registry identification card revoked and may  be  found  guilty  of  a 
felony punishable by imprisonment for not more than 2 years or a fine of  not 
more than $2,000.00, or both, in addition to  any  other  penalties  for  the 
distribution of marihuana.
  (2)  A registry identification card that is later determined to be based on 
fraudulent information is null and void and of no effect.
  (3)  Any person who has been convicted of a felony involving illegal  drugs 
shall not serve as a qualifying patient's primary caregiver under the act.
  (4)  The department shall send  written  notice  by  certified  mail  to  a 
registered qualifying patient or the patient's registered  primary  caregiver 
of any of the following:
  (a)  An intent to revoke or nullify a registry identification card.
  (b)  That a primary caregiver no longer qualifies for  approval  under  the 
act based on a felony drug conviction.
  (5)  The notice referenced in subrule (4) of this rule  shall  include  the 
right to request a contested case hearing. If the request for hearing is  not 
filed with the department within 21 days from the date the notice was  mailed 
by the department, the right to request a contested  case  hearing  shall  be 
waived.

  History: 2009 MR 6, Eff. Apr. 4, 2009.


Rule 333.127   Management of medical marihuana. 
  Rule 27. (1)  A qualifying patient who has  been  issued  and  possesses  a 
registry identification card shall not be subject to arrest, prosecution,  or 
penalty in any manner, or denied any right or privilege,  including  but  not 
limited to civil penalty or disciplinary action by a business or occupational 
or professional licensing board or bureau, for the medical use  of  marihuana 
in accordance with the act, if the qualifying patient possesses an amount  of 
marihuana that does not exceed the following:
  (a)  Two and one-half (2.5) ounces of usable marihuana.
  (b)  If the qualifying patient has not specified that a  primary  caregiver 
will be allowed under state law to cultivate  marihuana  for  the  qualifying 
patient, 12 marihuana plants kept in an enclosed, locked facility.
  (c)  Any incidental amount of seeds, stalks, and roots.
  (2)  A primary caregiver who has  been  issued  and  possesses  a  registry 
identification card shall not be subject to arrest, prosecution,  or  penalty 
in any manner, or denied any right or privilege, including but not limited to 
civil penalty or  disciplinary  action  by  a  business  or  occupational  or 
professional licensing board or bureau, for assisting a qualifying patient to 
whom he or she is connected through  the  department's  registration  process 
with the medical use of marihuana in accordance with the act, if the  primary 
caregiver possesses an amount of marihuana that does not exceed the following:
  (a)  Two and one-half (2.5) ounces of usable marihuana for each  registered 
qualifying patient to whom he or she is connected  through  the  department's 
registration process.
  (b)  For each registered qualifying patient  who  has  specified  that  the 
primary caregiver will be allowed under state law to cultivate marihuana  for 
the qualifying patient, 12 marihuana  plants  kept  in  an  enclosed,  locked 
facility.
  (c)  Any incidental amount of seeds, stalks, and unusable roots.
  (3)  An individual may simultaneously be registered as a qualifying patient 
and as a primary caregiver.

  History: 2009 MR 6, Eff. Apr. 4, 2009.


Rule 333.131   Review panel for reviewing petitions  for  additional  medical 
conditions or treatments.
  Rule 31. (1)  The department shall appoint a panel  of  not  more  than  15 
members to review petitions to add medical conditions or  treatments  to  the 
list of debilitating medical conditions under R 333.101 (5).  A  majority  of 
the panel members shall be licensed physicians, and the panel  shall  provide 
recommendations to the department regarding whether the petitions  should  be 
approved or denied.
  (2)  Members of the review panel shall include, but not be limited to,  the 
Michigan chief medical executive and 7  appointed  members  of  the  advisory 
committee on pain and symptom management as described in MCL 333.16204a.  The 
7 review panel members from  the  advisory  committee  on  pain  and  symptom 
management shall include 4 licensed physicians and 3 non-physicians.
  (3)  The department shall provide staff support  to  the  review  panel  to 
assist with the scheduling of meetings, conference  calls,  dissemination  of 
petition-related  materials,  and  to  perform  other  administrative  duties 
related to the performance of the panel's review.
  (4)  A quorum of the review panel shall concur with the  recommendation  in 
order to be considered an official  recommendation  of  the  panel.  For  the 
purposes of this subrule, a majority of the members appointed and serving  on 
the review panel constitutes a quorum.

  History: 2009 MR 6, Eff. Apr. 4, 2009.


Rule 333.133   Petition to add qualifying  diseases  or  medical  conditions; 
review panel; recommendations.
  Rule 33. (1)  The department shall  accept  a  written  petition  from  any 
person requesting  that  a  particular  medical  condition  or  treatment  be 
included in the list of debilitating medical conditions under R 333.101. 
  (2)  The department shall submit the written petition to the review panel.  
Within  60  days  of  receipt  of  the  petition,  the  panel  shall  make  a 
recommendation to the department regarding approval or denial of the petition.
  (3)  Upon receipt of a recommendation from the review panel, the department 
shall do all of the following:
  (a)  Post the panel's  recommendations  on  the  department's  website  for 
public comment for a period of 60 days.
  (b)  Give notice of a public hearing not less than 10 days before the  date 
of the hearing. 
  (c)  Hold  a  public  hearing  within  the  60-day  time  period  that  the 
recommendation from the panel is posted on the department's website.
  (4)  After a public hearing, the department  shall  forward  comments  made 
during the hearing to the panel for review. If, based  on  a  review  of  the 
comments, the panel determines that substantive changes should be made to its 
initial recommendation, the petition shall be denied,  the  department  shall 
provide the petitioner with a copy  of  the  initial  recommendation  and  an 
explanation of the substantive changes, and the petitioner may  resubmit  the 
petition to the department at any time.   If  no  changes  are  made  to  the 
initial recommendation or the changes are minor and do not affect the general 
content  of  the   recommendation,   the   department   shall   forward   the 
recommendation to the department director for a final  determination  on  the 
petition.
  (5)  Within 180 days of the date the petition is filed with the department, 
the department director shall make a final determination on the petition. The 
approval or denial of the petition shall be  considered  a  final  department 
action subject to judicial review under the act.
  (6)  If the petition is approved, the department shall  create  a  document 
verifying the addition of the new medical condition or treatment to the  list 
of debilitating medical conditions identified under  R  333.101.  Until  such 
time as these rules are amended to officially recognize the medical condition 
as a qualifying debilitating medical condition, the department shall  develop 
a policy that allows the new medical condition to be used as a qualifier  for 
a registry identification card.

  History: 2009 MR 6, Eff. Apr. 4, 2009.