A tide is coming in. The Baby Boomers are retiring. When they can't live on their own, many go into what are called “adult residential facilities,” or ARFs.
ARFs offer seniors their own little space. They don't have to take out the trash, or mow the lawn, or clean and wash, if they don't want to. There's someone to make sure medications are taken.
But that medication better not be cannabis.
Fifteen years after Proposition 215 enshrined in the state constitution a medical right to cannabis for the sick and dying, the sick and dying and just plain old have the hardest time getting it.
Even before the 2010 crackdown, California seniors faced tough odds of access. Those odds become impossible as seniors progress along the typical path from independent living to assisted living.
Seniors in adult residential facilities – and there are 5,000 such facilities in Southern California alone – are often denied their cannabis medication, forced to medicate in back alleys, or even evicted for possessing it, according to several activists.
Which is why Pasadena activist Liz McDuffie is ecstatic to share that the California's Department of Social Services has just licensed her and her five-year-old group called the MCC Directory to teach the class “California’s Medical Marijuana Program Act As It Relates to Adult Residential Care Facility Access.” The class is part of mandatory continuing education curriculum for ARF operators who want to keep their state licenses.
“In order to get their renewal, there's a list of classes and they have to take 40 hours, and we're in there!” McDuffie said. It will help keep senior medical marijuana patients in their homes, she said.
State-licensed ARFs have to respect Prop 215 and SB 420, and either accommodate a senior's medical cannabis use, or refer them to facility that does, her class teaches. It's just another step for McDuffie, who's been a medical cannabis advocate since her youth.
“Knowledge is power,” she says. “I've always been an advocate of cannabis for medical use going back to 1969, having it prescribed by a German doctor in Heidelberg for migraines. It's always been medical for me. It was also always such madness – this whole thing, this whole prohibition thing on cannabis.”
In 2004, McDuffie began a Masters thesis at the USC School of Public Administration – on the conflict between state and federal marijuana law. She studied the Canadian marijuana program and began opening information centers in California. They're impossible to make illegal. They don't sell marijuana. They just give away pamphlets on patients' rights under Prop 215 and SB 420, and growing classes. She began hearing a lot from ARFs.
“The reason we have this course is there's been increasing numbers of calls from these licensees saying 'How does this work? Where does the cannabis come from? Our patients want to participate in this program. What is this?'
“I've been teaching SB 420 at least twice every damn month since 2006,” she says. “In order to qualify as approved vendors [for state courses] we had to be teaching the subject matter at least four years, and we have documented proof, for four years we had been teaching SB 420, so that qualified us.”
“When they approved this we just about fainted,” she said. “I've been out there for two years trying to bring doctors to facilities to talk to patients. This is going to be brand new to licensees. This class is now on their list of approved continuing education courses.”
In addition to Prop 215 and SB 420, the course explains that patients must be enrolled in the state's medical marijuana program and have a state identification card. ARFs must receive cannabis from licensed, non-profit collectives or cooperatives, which means incorporated, by-lawed, business tax-paying dispensaries.
“They don't go fetch pot. They let collectives deliver it. They are entering the premises to drop off medicine and can give it directly to the operator of the facility or be allowed directly into the room.”
She admits she has a lot of ignorance to peel back. At best, there currently is a “don't ask don't tell” policy in place at ARFs, she said.
Valerie Corral of the Wo/Men's Alliance for Medical Marijuana related stories of paralyzed patients forced to light up on the sidewalk, and a total lack of compassion and understanding by the corporations who run these places.
“It's bleak out there,” she said.
“In general, facilities have been pretty closed to doing this,” McDuffie said.
Facilities don't want to lose their state license or violate federal law, said MCC Directory member Susan O'Leary. “They think allowing safe access will somehow jeopardize their state license. They often use this as an excuse with me – saying they will lose their license to operate. Not true.”
Their state license is secure, McDuffie says. “Now set before them in a very clear way is how they go about it. To have the DSS behind us on that is absolutely fantastic!”
The federal government is not interested in prosecuting individual patients, her class explains.
“We have to look to the Justice Department memo from James Cole which states clearly, the resources of the federal government are not best used in pursuing seriously ill patients trying to get this medicine following a state program. What that means is it becomes damn important to understand the true scope and parameters of the state medical marijuana program. Very few people do.”
McDuffie's class is just one solution to the endemic problem of senior access. Cities that ban dispensaries severely limit access for seniors in ARFs. And seniors who progress past ARFs into more intensive forms of elder care like nursing homes, hospitals and hospices face almost zero chance they will be able to use cannabis. Federal funding flows through almost all such facilities and prohibits marijuana use.
“I think one of the greatest disappointments of the last 16 years is that we have not been able to provide sufficient access for folks at the end of life,” says Stephen DeAngelo, founder of Harborside Health Center, a large dispensary in Oakland, CA. “If you take a look at the things cannabis is most effective for, it reads like a laundry list of ailments afflicting seniors: stress, depression, anxiety, pain, insomnia. This is a tremendously under-served population.”
The MCCD teaches “California’s Medical Marijuana Program (MMP) as It Relates to Adult Residential Facility (ARF) Access” for $130 per person in Pasadena February 9, Feb. 23, March 8, and March 22 - 11 a.m. to 3 p.m. Register on their web site, MCCDirectory.org
