Help Me With Sign Hawaii Banking Medical History

Help me with industry sign banking hawaii medical history

I okay we're back we're live we're here on I guess you could say it's Hawaii the state of health which is organized by the State Department of Health and we have with us today Keith really the program manager of the office of health care insurance at my far left and Peter Wittek our branch chief of the STD AIDS prevention branches of the State Department of Health and today we're going to talk about medical marijuana and there are programs in the state department of health we want to discuss since the the bill just passed has it been signed and yet okay all right so but there is every indication it will be as he as he came up with a veto list yet you know is that there's a requirement that he come up with a VTOL to say what he's inclined to veto I'm not sure he has yet I'm sure is required yet but that'll be that would be an indicator whether he's inclined to sign or not sign or in beads over not veto okay anyway so I guess the first first I want to say hi to you guys thanks for coming down thank you for welcome it's great to have this program shout out to Miley sakamoto who puts these shows together thank you Miley okay and and the second thing I want to do is set the stage so let's do that with you Peter you know we've had we've had talked about marijuana for the last several years we've had some bills passed before this year we had what appears to be a really significant bill passed this year that's the dispensary program bill but can it give us the continuum of how this legislation came about and how it's working on on a continuum yeah thanks Jay that's I think that's a good way to start because there just is so much discussion about marijuana not just here in Hawaii but on the mainland Shore and folks had reading the media they they're not sure what's about Hawaii what's about the mainland so starting in Hawaii we were one of the first states in the country to have medical marijuana and the thing that was interesting about Hawaii it was passed by the legislature it was not through a public initiative process so often people that are consuming media see that there are big changes in medical marijuana or marijuana programs those are often driven by popular initiatives for the population is voting in Hawaii Colorado they Colorado Oregon todavia Alaska in Hawaii it was passed by the legislature and that was a new year 2000 so since the year 2000 Hawaii has had a legal medical marijuana program and we can talk a little bit later about what the requirements are but the interesting thing about that law was that there is no provision for dispensaries patients or caregivers were allowed to grow their own marijuana a very limited number of plants and possess a limited amount of marijuana for their own use but if they couldn't grow or they couldn't get it through a caregiver that meant that they need to purchase their marijuana their marijuana medicine on the black market and thus that's not part of being part of an illegal activity yes so the law that contemplates an illegal activity is what it is well it's a rule unless you get to yeah it's a law that provided a great help for many people because they could grow their own but for those that couldn't or people that were too sick or too old or really had no gardening experience or place to grow have they been doing they were pretty suck many have many have take a risk well in terms of growing you mean in terms of yes yes no many many of them have been growing and what we're finding is the course that many more are growing say on the Big Island where there's more possibility more land more agricultural space than say an urban area of Honolulu where it's pretty difficult to grow your own to grow that's appropriate there's the Big Island who's been growing pot for a long time there was some experience growers there perhaps but for years there was pressure from the an activist community from the medical marijuana community to allow for a dispensary so people could legally purchase marijuana and not only legally purchase it but know what they were purchasing so what's the quality what are the characteristics of the Maryland as part of that continuum you start out with the dispensary program it will start off with a registry registration fronts right up so people are legally registered to for healthier news that's right for medical purposes and then you work toward the dispensary dispensaries are the next step and that's the bill which has been recently passed and then but this is not to be confused with legalization or recreational use that's now in this now in four states so Alaska most recently Oregon me before that Washington State and also of course colorado that everybody knows about so and even in those states where there is legal recreational use they still have medical marijuana yeah that's really the 3s call them stages and large scenario all the time right it it doesn't always start this way in fact many states when they started their medical marijuana program started right away with the dispensary system especially the more recent ones they realize that if you are going to be a patient of a medical marijuana program you need safe controlled access well what I mean is the recreation usually you you start with the medical aspect of it medical use of it when one system are another and then you go to recreation all night none of these states we've mentioned went directly to recreation no that's that's absolutely correct although I think it's really fair to say that it's not necessary if you get to the stage of medical marijuana that the next step is necessarily recreational and of course that's the debate for politicians legislators in our community as it has it in any state that we are aware of has it gone to you know the registry program and the dispensary program but not to recreational use yes there's there's many states because there's 23 states that have some form of legal medical marijuana but there are only four states that have recreational marijuana some of those states have just fairly recently started medical marijuana you're hearing about them all the time in the news every year there's a few or and most of those have dispensaries was certainly not all of them have gone to recreational marijuana okay well let's take a moment and talk about the let's see what we should start with so everybody can understand the registry program under the existing the existing law before the dispensary program that just got it enacted what does it call for well that's for the medical marijuana program that started in the year 2000 and a little little known by perhaps many people in Hawaii there are thirteen thousand patients and to be part of that program you have to have one of a few relatively few debilitating conditions cancer is one HIV is another one glycome severe chronic pain is another one you have to find a physician that will diagnose that and is willing to certify that you are a patient that has that diagnosis submit your application to it was to public safety the program was run for 14 years by the Department of Public Safety only came over to the Department of Health in public safety the department that runs the prisons that that's correct and some patients i would say many patients and many in the community felt that this was not the appropriate placement for a program that's facilitating access to legal medical marijuana in a department whose mission is really to i would say to suppress the use of short of drugs show that's why there was such a push to move it over to the Department of Health where would have maybe more of a public health focus okay and and when it came over it came over to to to you it's right as the bread sheaf of the STD AIDS prevention branch but you mentioned before the show began that you're going to change the name of that we are regularly in view of this changing yeah because we want a name that really allows patients that are signing up for the program to feel that they're not really stigmatized in any way by being part of under an STD or aids program because there isn't a very strong connection I think the reason that we got it is because we're used to dealing with law enforcement we're used to dealing with physicians we're used to dealing with patients particularly in HIV and often somewhat unconventional somewhat stigmatized and somewhat at least initially difficult to to introduce pro your problem solvers down there the Gorillaz pigment eyes public elevation so what I've been doing under the existing registry at all well the first thing we had to do was make provision for the 13,000 existing patients and then be able to bring in new patients and we had really limited staff and resources so one of the things that we've developed is an online application system that's not fully complete but should be complete in the next six months and that will eliminate the paper application so this should make it much easier for patients and physicians should make it quicker for the cards to get out to the patients so they can legally use their use their medicine I think one of the things we're happiest about is we've really increased the amount of information that's available to the public so we've set up I think a very successful website that has a lot of question and answers so that people in the public that aren't too sure about it whether their physicians patients or even law enforcement they can have a look at that website in and really have many of their questions answered I guess the last thing that we've done is we work really collaboratively with law enforcement because you know whenever you're talking about marijuana whether its medical or recreational there's a very necessary and important role for law enforcement because marijuana use is prescribed by law and it certainly remains against federal law so we've developed a system where law enforcement if they run into a patient the patient doesn't have their card they can verify very easily whether the is is part of the Department of Health Program so the thing about the registry where you you know they apply they go online whatever they they're in a database now you have the database and it means they have a medical permission doctor's permission to do this or a doctor's certificate certification to do this and that plugs directly into the dispensary program doesn't it the dungeon program we're sort of wraps around the existing law but I think that's what we're looking at maybe Keith will talk a bit of a little later but it is only those patients who are registered in the medical marijuana program in the registry program that are going to be able to access the registry program so you're right it really is one of the foundation steps so to the extent that you've you know been registering people for the past 15 years I guess it's in the state and unrest in the last six months Yeah Yeah right now I suppose you can have a lot more registrations because of the change the adoption of the dispensary program that's a very good question and we believe so so we're expecting that will actually be more applicants now that it's in the department of health rather than public safety and perhaps as we do a better job at education of physicians they will start to feel more comfortable in certifying their patients as well and then of course once the physicians and the patients realize that they can potentially purchase their medication legally in a dispensary that's really going to potentially increase the demand as well we're going to go to a break in a minute you know Peter but I just I get the sense that for not only from you guys but from everybody I know that this is big and it's it's a burden or a challenge to government to be able to deal with a change in social Morris a change in you know even though we've had a registration system this is still going to change things how do you feel about that this is you know sort of a major undertaking it has been a really major under painting but you know I think we want to be responsive to the laws of our state and I think we want to be responsive to the spirit of the laws and I think when the legislators make these made these laws they heard from a very very diverse group of stakeholders they heard from people that do not want marijuana to people that really they think it's saving their lives so I think they really need to trust in the legislative process and then in public health dual our job or do the best we can to make sure we're we're doing the best for patients and with a public health approach we really do focus on our patients they are our key stakeholders in this process it's almost like the Department of house has been waiting for what a hundred years for a challenge of these dimensions and that you're ready I was going to say in my job with HIV we were presented with a very significant challenge 28 years ago with HIV like I think many of my colleagues would think they've had significant significant challenges to it but you're right this is one that involves a lot of uncertainty because there's so little research around medical marijuana and typically in the Department of Health we like to make decisions based on solid strong scientific data and that's really one of the foundations of public health we like to use data that's how we're informed and with medical marijuana because there's been so little research permitted by the federal government we don't have that strong foundation so we have to really depend on our legislators to to chart our course and be assigned to because you can in the surface and hopefully use the opportunity in the coming years as marijuana becomes more available for medical purposes to really engage researchers and make it more legitimate and i would say really talk more straightforwardly to the federal government about the importance of rescheduling medical marijuana so that research is easier to carry out more funds will be available universities will be able 22 jump in and even NIH should be doing research at Maryland happening in the other states which which are you know advancing on marijuana some states are really trying to build research in from the start and that is it is difficult it remains difficult because of a range of federal prohibitions even getting the marijuana for the use of the research right now I think many of us are relying on research been done in other countries Israel particularly has done a lot of research and and small studies that that have been done but if we really want to get to the under a deeper level of understanding for medical marijuana we need to have broader very well established longer term studies that can look at not just the short term effects but really the longer term if that's a great opportunity actually yeah it really is not only to understand fully what you know the way this is going to work in Hawaii but to have research and data and you know scientific conclusions that can be useful elsewhere in the world absolutely and I think the many patients are really looking for this research people want to know what's going to help them and many people turn to medical marijuana I would say particularly people with chronic pain as a way of finding relief without using prescription painkillers particularly opiates which they find is if almost as debilitating as the pain in the first place and as we know causes such levels of addiction so I think it's really important we get a better handle on what what works what's dangerous and if marijuana is to be used as a medication how is it to be consumed through what method how much of it which strains of it whether it's to be eaten or smoked or whatever process it's a great opportunity really scientifically exciting let's take a tuna t4 break to let me take a short break and we're gonna come back and we talked to a Keith about the dispensary program and how he's going to be able to implement it just almost almost signed we're we're about to start on the first yard line okay I'll be right back after this short break this is alex kay hagan host of think tech hawaii business education spotlight my show here at thing tech hawaii is every thursday from three to four in the afternoon i bring an interesting guests from hawaii the mainland and hopefully international guests in the fut re do join us on thursday from three to four p.m. think tech hawaii business education spotlight Aloha Aloha my name is Josh green I'm senator from the Big Island that work in the ER there but on Tuesday afternoons I get to come and spend 45 minutes to an hour with j phi del and the think tech staff they're terrific professionals they help us to bring some of the leading cutting-edge topics here across our state to you so you can join us at our show on health care in Hawaii to talk with leaders from across all the spectrum of Health in our state or you can join us for any other show where we talk about economic development or tourism or some really eclectic programs too so really we'd love to see you here on our show thanks for joining us and thank you okay we're back for live we're talking about medical marijuana in a white and programs in the Department of house which are which are going to implement the legislation that is about to be signed we believe by the governor so far we've talked about the registry program with a Peter winter car and now with keith's really been talked about the dispensary program the registry program has existed for a decade or well 15 years anyway only recently passed over to the Department of Health and now we talk about you know the brand new statute the brand new approach to the dispensary system creating it out of whole cloth right absolutely we are expecting the Builder beside it hasn't been signed yet and with the short time frames that are included in the in the bill we know that we have to start ramping up you can before outside but certainly on the expectations of it being signed by the governor we're already beginning to make plans for how to stand up the dispensary licensure program exciting so in a general sense what is the law called for the law allows for 8 licenses to be provided statewide depending on the island there's three on Oahu two on the Big Island to on Maui and one on Kauai so those are the eight in this island specific relevant County so that for example two on Maui or maui island does include lanai the wicked e1 and when I or mullica is correct that's correct and so these 8 licenses would also then be further defined in the in the law as allowing for two production centers and to dispensaries per license so we talked about 8 licenses we're really talking about 16 production centers and 16 dispensaries 32 potentially separate locations that are spread out throughout the state production Center is a place where you grow marijuana production center would include where it's being grown or where it may be manufactured and changed into a product so the and all of these are defined by law in terms of what the production center is and what the actual products that would eventually be used for retail sale in the dispensaries and the license also contemplates that there would be a location to sell that retail correct and that's the dispensaries yeah okay this is pretty exciting because you have no idea how it's going to play out who's good well maybe no was going to do it any other people already linson like the Oklahoma land rush you know I'm right they at the starting line ready to fire applications well we're hearing that and a lot of it is anecdotal we have gotten some calls from interested interested individuals nothing is submitted on paper yet again the bill hasn't yet been signed and there will be a period of time for us as a department of help to come up with the rules or the regulations on what's going to be required as part of the application process what information will an applicant has to provide to us and as well as what what would qualify someone to hold a license it might not necessarily be the same as the process or the requirements for submitting an application yeah well it's just so interesting so I get it from you that this this bill is is pretty detailed you know right down to how many how many dispensaries and licenses on what island and all that but it also leaves a fair amount of discretion into the State Department of Health as to exactly how to implement that for example the kinds of things that you would include on the application the kind of information you'd want to get that's up to you right and necessarily there is a lot of information that's in the bill 70 some odd pages of bills all right and so the legislature did go into some amount of detail but you're right in that one the department has to come up with what these processes are and what the final requirements will be there's a little bit of latitude but it's really using the structure of the bill as the framework or what else might be provided within the regulations sure I've you know and I've you know as you guys were talking about it is it's a lot of people are participated in this legislative process and so those people presumably are going to be around it in one way or another icicles forward have already given you a lot of their expertise so to speak on how to how to do things and it's in the bill but how do you see ramping up for it I mean what do you got to do well the key thing is we want to what we need to do is to ensure quality and safety of the products yeah that's what we're doing as a department of health and the program that I'm responsible for does licensing inspections or surveys we call them of health care facilities throughout the state so we have a history of doing these kinds of surveys make sure that agencies and facilities and institutions and other organizations comply with state law what is it require of someone to be a skilled nursing facility or a hospital or an ambulatory surgery center so we're going to have the similar kind of thing with medical marijuana licensing where there's production centers or dispensers are actually all of the differences in this case you know for the medical facilities in generally talking about the safety of medical facilities as rendering medical services were you talking about the marijuana bill you talking about regulating the actual production of the marijuana that's different well not quite this it's not quite that ever I want you to tell me in terms of in terms of what we do or health care facilities for example our main mission is to ensure the safety of the patient that goes to the facility okay so similarly we want to ensure the safety of the medical marijuana patient who goes to the dispensary to pick up short a medical marijuana but in doing that you're going to you're going to have to look at the agricultural side and the processing side we will look at the products that result there are requirements in terms of the amount of marijuana that can be grown and can be produced and how that can then be turned into products I would then end up for sale in the dispensary both in terms of quantity and in terms of quality and safety okay we come back to the quality and safety aspects of it we want to make sure that the products that are being sold to medical marijuana patients don't have contaminants I don't have mold and these sorts of things that might otherwise be found in green leafy vegetables that you might buy at a market and we see those kinds of advisories to be sure to wash your lettuce and wash your tomatoes those sorts of things this is not unlike your your your pass/fail system in the restaurants you want it to be wholesome clean sure contaminants safe for the public and send you that's there for you go and you inspect you have a plan for inspection that's right and so in order to achieve that goal of quality and safe products for the patients we have to ramp up this entire process before hand and look at what is it going to require in order to achieve that end result and some of the things are do we have staff will be doing those inspections do we have staff will be managing the program do we have regulations so we've got to write regulations and the bill calls for interim regulations to be written by the end of this calendar year and that's a lot of work that's a lot of work in a short period of time as well as coming up with a process and criteria for selecting applicants who will or to apply and then the selection process on who will actually get a license that's are the same period of time pretty much we want to be sure that any potential medical marijuana dispensary license applicant knows what they're going to get into the standpoint of what they have to submit to us in application and what they're gonna have to comply with once hopefully for them they make us every time by the Department of Health not yet give me maybe pushing on that helmet this is fall I'm again both of these happening at the same time it's so many details so many new ideas or a new issues and new new concepts at play wow so we've got a lot of resources that we've got a marshal together for this we've got you know our Human Resources office working with us on helping to prepare position descriptions on brand new positions that are going to be created we have our attorney general's office and the Deputy Attorney General is working with us on beginning to come up with interim rules and interim requirements and processes for submit all of a of the application and the selection process we've got we've got to find space for the people that were going I so we better our physical plant people looking at where can we where do we have office space available and if don't have office space available work and we get it so there's a lot to do in a very very short period of time and on the expectation that the bill is signed this program starts July one is that the affected so that's the effective date of the bill the effective date of the dispensary being able to dispense marijuana is until next year what time shall I at next while I 15 so that gives you a year to settle things down she's not a whole lot of time well it gives us really less than six months or about six months to have all the interim stuff done which means we got to have staff hired before then which means we've got to have you know drafts that are going to go back and forth to to the attorneys for review done well before then as well so although the dispensary program starts July 15 we're really looking at a program that for all intents and purposes starts in December of this year because that's when we start notifying the public and we notify potential license applicants on what the criteria is going to be if you honored or overwhelmed a lot of both so have you ever been thinking about this I know it hasn't been signed we've been thinking about the kinds of things you would require the kinds of positions you would establish yes go ahead yeah we've been thinking about it for a long time actually again in anticipation and as the bill is going through the legislature and all the permutations that it was going through during the course of all the other key rings etc wondering okay now if it goes this direction what we're going to goes in this direction we're going to need so we've been giving this a lot of thought throughout the course of the legislative session now one of the one of the things of course that you'll also have to do both of you I think will be to educate the public like the right now is an awful lot of speculation about exactly what this is going to do how it's going to be rolled out how it's going to be implemented and how the individual can use it or maybe not use it how it's going to affect the community in general I mean I would say just as an ordinary fellow that this is going to have an effect on the community and people are going to have to go about it or they will be confusion and confusion you know leads to failed programs actually so to make it work you have to get out there and educate people so this is such a big question we want to take another break and then we come back we'll see if we can't address it a little okay okay it's a Keith Ridley program manager the office of health care insurance also my left Peter Widow card branch chief of the STD / aids prevention branch of the State Department of Health talked about medical marijuana today and we'll be right back after this short break Aloha I'm hunter Heflin host of sustainable Hawaii here at think tech away you can tune in every week on thursday at two p.m. to see interviews with sustainability professionals from around the state and even further abroad learning about activities with water management food security waste management a whole host of other fascinating opportunities to get engaged with making a greener islands so if you're interested in making the transition from consuming individuals to communities of producers check us out every Thursday Aloha my name is Paul Jackson better known as PJ and my local interest is in sports I have my own sports radio show at kwa I am 1080 that you can stream live I also have my own website PJ sports radio com we have live guest in studio and we talk about discussions and topics that everyone wants to know locally here on the islands we cover everything from surfing to basketball to whatever's going locally sports-wise we try to do our best and cover the topics and in depth as much as we can once again thank you for joining pj here on hawaii sports update okay we're back for live we're here with Keith really program manager of the office of health care insurance and Peter Whitaker branch chief of the STD AIDS prevention branch at the State Department of Health I'm talking about medical marijuana and indeed there is a bill for the dispensary program America marijuana sitting it on the governor's desk right now and it would take effect watch alive first as the effective date and the actual dispensary you know infrastructure would go into operation a year away from July first correct okay so let's talk about how much the public knows and how much they need to know and how much engagement you've got to have both of you have got to have with them to make this work how you going to do that well the department already has a QA type of information on the website so anyone can go whether they're a medical marijuana patient or just curious about the program can go on the Department of Health website and look at the frequently asked questions that is posted that are posted there and in the very short term we're going to be using that as our primary vehicle for providing information to public but one of the things that we certainly do recognize we need to do is to create a more robust communications program around this whole roll out of medical marijuana dispensaries and to the to the extent that we need to certainly engage or include the registry program in that and what the kinds of diagnosis that qualifies someone to be on the registry will need to include that as well so we really want to take both programs the current program with the registry and the expected future program with the dispensaries and really kind of package them together so the public is aware of what all is necessary as a potential marijuana medical marijuana patient from standpoint of being certified with those diagnoses all the way to the end stage of going into a dispensary and purchasing a medical marijuana so it's a one-stop shopping thing we're both of your officers will be on the State Department of Health website and I can look you both up from that website yeah we're hoping to really work very closely together for because from the perception of the of the public medical marijuana is really one unit internally we're sprit split in how we're administering it but we're really trying to look at it from the perspective of the public you know one of the things we're doing is not only educating it but I think we're trying to overcome a lot of Miss education that's out there if you speak to anybody they all know a lot about medical marijuana and the probably the defense ready what's right or wrong is really a lot of conjecture and the place to start for people that are interested right now and many of your listeners are interested right now would be to start with the bill and the bill is available on this a West 70 pages long 70s 71 pages long summary would be helpful devil is in the details alright you know if you're going to be applying it's important to know that and that's really what we're starting from so it's important that eve ybody in the public and especially those that are interested in applying to run dispensaries feel that the system is working very fairly openly and transparently so when we do make information available it needs to be made available to all people at the same time I think we're very conscious of that and that's part of why we're using a website at this point for getting all no you know what one thing that that he said which was struck me as interesting in fact you both talked about that the bill has a list of medical conditions that qualify for registration the bill has a list and yet and there was an addition to add PTSD to that list in this in this year's bill but you know there's other things right medicine changes there's all kinds of new things come up all the time research research will find that marijuana if it helps this category of condition it could also help this so do you guys have the power to add conditions to that list let's go back to the legislature that's an ex that's an excellent question so with the original legislation of the year 2000 e that original list of conditions was established and since then there have been there's been no consideration of additional conditions however with our new administrative rules for the registry program which will very soon be going to the governor for his signature there's a provision in there to allow petition to the Department of Health every year by physicians patients and the public to provide us with scientific with their own experiential information on what has worked for them what worked for other people in other places to try and give us a scientific basis as much as possible with the limited situation to make a decision whether to add a condition you would make that use a department would make a question yes you know we would do it on the basis of recommendations from whoever really is knowledgeable ultimately would be the director of health that would make that decision how about the other side of it suppose there's a condition that's not really appropriate for marijuana it's just you know we made the list we were being luxurious in some ways so we find now that it really doesn't qualify could you take it off the list there is a provision for removing from the list or certainly putting an advisory out to physicians that it's not appropriate I mean our worst fear of course is that medical marijuana would make conditions actually worse they would exasperate exacerbate the situation so we definitely do not want that to happen the other thing that's potentially negative if people are using marijuana where it may have little or no positive effect it means they may not be looking at other more traditional medications and if you have a serious health condition you want to be using the optimal medication whether it's marijuana or something else so you don't want to be falsely assured that your marijuana is doing something for you if it's really not so that's our the flipside of marijuana as a medicine that's and that's a challenge for the doctors it is a nanny to give up but you know the full advice on these things I can't just go to marijuana and say there's your panacea well and that's why it's very important both and it's established in this law and in our administrative rules that there be a bona fide relationship between the physician and the patient so it's really important that the physician is looking at his patient's condition diagnosing that condition making them aware of the pros and cons of medical marijuana use making them aware of other medications that may be more suitable for their conditions so the bill is really founded on a strong patient-physician relationship not just a physician that's going to certify them and say go off and good luck with your medication yeah I mean in the way of humanity that that is something you do want to avoid so going back to you know what you were talking about before Keith namely the process of taking the applications and you know what he was talking about in terms of the political aspects of going forward on this I can see a lot of people in this state would like to create companies to get those licenses be funded offshore with lots of money in order to build the necessary growing and processing units and it's at least theoretically big business theoretically profitable to the point where money would come in from offshore and people would have expectations of learning a lot of money and that means lots of competition when they come around and file these applications I can guarantee you here today at this table there'll be more than eight applications and guaranteeing that what are you going to do when it gets hot in the kitchen well that's where the selection process is going to be very important and we've got to announce that selection process even before we receive applications we want to be sure to be fair to everyone and this process is very important and critical to be implemented well before we start to receive these applications so we have to identify what's going to be required as part of the application process we've got to identify the criteria for selection of licensees and that's all part of what we've got to come up with within the next few months before we make the announcements for the public and so I'm imagining for example that worthy where the bill lists different kinds of criteria for the documentation that has to be provided as part of the application process I'm envisioning a process where we start adding to that because if everybody submits the same thing and they have the same qualifications and there are these more than eight applications there would be no legitimate fair to some people way for us to identify into license which eight of the hundred applications to license it won't be easy and it won't easy so we've got to come up with a process and as part of what we're working on a process of identifying what that criteria is going to be so that if a hundred of them come in with the exact same thing what differentiates the eighth from among the remaining 92 gonna put this in front of a panel of board Commission some group no just do the committee house it would be existing decision-making process will do it within or within our own decision-making process that's something that the bill allows us to do and these are part of the interim rules that we are required to come up come up with by the end of this calendar year one more thing before we deeply close really of a few minutes left and that is going back to the continuum if you get right so we are on the way at least if you follow other states to recreational marijuana what has to happen before we get there and how is your experience under this bill just about to be adopted they're on the likelihood of recreational marijuana in our future sorry is well you know I think we can learn a little bit from the states that have gone through the process so there are four states in the field the one that has the most experience of course everybody knows his Colorado and my colleagues in Colorado started with a medical marijuana program and then they had a voter initiative would which is instituted the recreational program and they said if they had to do one thing over again they would set up a very well regulated medical marijuana program first where they would get a solid basis in medical marijuana where they would have a good registration system they would have a good tracking system legal infrastructure administrative right after so it's solid and that they also recognize that there's a real public health role that's beyond just the regulation so that's issues about should you be smoking marijuana if you're a pregnant mother when should you be smoking or not smoking if you're driving what jobs can you be doing safely if you're making marijuana if you are taking marijuana at a med as a medication is that safe and in the workplace so there's a whole range of issues that are traditional public health issues that they need to develop the capacity to look at two and one of the things that they wish they'd done was collected a lot more data so are there more car accidents where substance use is an issue are are there materials in forming women not necessarily but the risk is we don't know there's so little research that's the problem we often don't know but that there's a potential risk and we just know that smoking for pregnant women is not a good idea so probably smoking or consuming marijuana may not be a good idea as well so it's a whole undeveloped Public Health role and hopefully through this program we will develop a solid foundation even if it just stays with medical marijuana we need that solid foundation but if it does progress or the politicians decide we are going to our legislators decide we're going to move forward it will have a solid base you'd be much better off than a solid foundation in fact if you don't have a solid foundation that really stands in the way of the next step whatever it does and it really jeopardizes the program in a way to because law enforcement feels uneasy school parents feel uneasy there's just not it feels like it's getting out of control well let me you know let me go to you Keith for the final statement here what would you like to leave with the public about this is it you know it's a difficult moment a challenging moment but you know it's it's a it's a turning point of some sort in our in our social structure here in a way to have this it will change things what is your advice to the public as your camera right the advice is advice is for them to really pay attention to the advisories that we put out in the information that we put out keep informed there is a lot that the Department of Health has yet to develop so we don't have all the answers right now anyway but it's important that the public know that we're doing our best in order to ensure the safety and quality of the products in order for the medical marijuana patient to then be safe as well information will be forthcoming it will be on our website and will be communicated hopefully in a variety of other ways as well so stay tuned to the website continue to go to the website and and see what new information we post thank you gentlemen Keith's relieved at Peter Carr of the Department of Health American Medical Marijuana thank you so much every welcome thank you do this again you