Politics
Top Pennsylvania Health Official Blocks Proposals To Allow Medical Marijuana Recommendations By Nurse Practitioners And Podiatrists
Pennsylvania’s secretary of health has rejected a pair of proposals that would have expanded the types of medical professionals who could recommend cannabis to patients.
The suggested expansions came from the Pennsylvania Medical Marijuana Advisory Board’s Regulatory Subcommittee. One would have allowed nurse practitioners to recommend medical cannabis, while another would have extended that authorization to podiatrists.
Last week, however, Secretary of Health Debra L. Bogen—an appointee of Gov. Josh Shapiro (D)—denied the proposed changes.
In a notice published in the Pennsylvania Bulletin, Bogen said she “does not disagree with the reasoning underlying the Board’s recommendation” to authorize certified registered nurse practitioners (CRNPs) to certify patients for medical marijuana. But she further explained that the proposal would have run up against state law, which limits medical marijuana authorization to doctors.
“The Secretary is guided by the narrow definition assigned to ‘practitioner’ in section 103 of the act,” the filing says, referring to the state’s medical cannabis law. “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.”
Nurse practitioners could have certified patients for any serious medical condition under the board’s recommended changes, while podiatrists would have been able to recommend marijuana only for foot-related pain. In denying the podiatry recommendation in a separate Pennsylvania Bulletin notice, Bogen took issue with that limit.
“The recommendation would only allow for Doctors of Podiatric Medicine to certify for one specific serious medical condition,” her office said. “This limitation does not appear to be consistent with the act, which does not reflect such a restriction for practitioners.”
Bogen “factored this inconsistency into her decision not to effectuate the Board’s recommendation,” it added.
The state’s Board of Nursing had expressed support for the proposal related to nurse practitioners, according to a report last month from Spotlight PA, while the Board of Podiatry similarly backed the recommendation regarding podiatrists.
In the filings denying the two recommendations, Bogen said that she “recognizes that there may be changes to the law or other considerations that may warrant reconsideration of this issue in the future.”
Separately this month, the majority leader of Pennsylvania’s House of Representatives said there’s a “will in the House to move forward” on marijuana legalization in the next session, though he noted that the push could run into opposition in the GOP-controlled Senate.
The comments, from Majority Leader Matt Bradford (D), came on the heels of Democrats clinching control of the House following a race being called for Rep. Frank Burns (D), who beat Republican challenger Amy Bradley.
Polling suggests bipartisan support among voters for marijuana legalization in Pennsylvania, including in at least two jurisdictions where races were tight between House candidates of opposite parties. In House District 44, for example, 67 percent of voters said they support adult-use cannabis legalization, while in House District 18, 68 percent of voters said they were in favor of the reform.
The pro-legalization group Responsible PA commissioned a separate poll published in September that similarly found that a majority of voters in five other key tossup districts supported ending prohibition.
There’s already been at least some movement suggesting another legalization push in the session ahead.
In September, bipartisan Reps. Aaron Kaufer (R) and Emily Kinkead (D) formally introduced a bipartisan marijuana legalization bill, alongside 15 other cosponsors.
And in July, Gov. Josh Shapiro (D) said his administration and lawmakers would “come back and continue to fight” for marijuana legalization and other policy priorities that were omitted from budget legislation he signed into law that month.
Meanwhile, a top GOP Pennsylvania senator who has long expressed concerns about marijuana legalization told advocates recently that she’s against arresting people over cannabis, noting that the policy change could protect her son and disclosing that if it weren’t for marijuana, she might not have met her husband, according to an activist who spoke with her.
As Pennsylvania’s legislature reconvenes amid rising pressure to enact legalization, advocates view the comments from Senate President Pro Tempore Kim Ward (R) as a positive sign that the dam on cannabis reform measures might be weakening in the commonwealth.
As for medical marijuana, the governor last month signed a bill to correct an omission in a law that unintentionally excluded dispensaries from state-level tax relief for the medical marijuana industry.
About three months after the legislature approved the underlying budget bill that Shapiro signed containing tax reform provisions as a partial workaround to a federal ban on tax deductions for cannabis businesses, the Pennsylvania legislature passed corrective legislation last month.
Separately, at a Black Cannabis Week event hosted recently by the Diasporic Alliance for Cannabis Opportunities (DACO), Sen. Sharif Street (D) and Reps. Chris Rabb (D), Amen Brown (D), Darisha Parker (D) and Napoleon Nelson (D) joined activists to discuss their legislative priorities and motivations behind advancing legalization in the Keystone State.
At a press briefing in July, the chair of the Pennsylvania Legislative Black Caucus seemed to temper expectations about the potential timeline of passing legalization legislation, pointing out that the rest of the session will likely be too politically charged heading into the November election to get the job done this year. Then late last month, Shapiro gave it final approval.
Other lawmakers have emphasized the urgency of legalizing as soon as possible given regional dynamics, while signaling that legislators are close to aligning House and Senate proposals.
New data has also underscored the urgency of enacting cannabis reform, revealing that more than 12,000 people were arrested for cannabis possession in the Keystone state last year.
Meanwhile, a report commissioned by activists projected that Pennsylvania would see up to $2.8 billion in adult-use marijuana sales in the first year of implementing legalization, generate as much as $720 million in tax revenue and create upwards of 45,000 jobs.
Street and Dan Laughlin (R) also participated in an X Spaces event in June where they said the votes are there to pass a marijuana legalization bill as soon as this year, though they stressed that the governor needs to work across the aisle to get the job done—and argued that it would be helpful if the federal government implemented its proposed cannabis rescheduling rule sooner rather than later.
Street was also among advocates and lawmakers who participated in a cannabis rally at the Pennsylvania State Capitol in June, where there was a significant emphasis on the need to incorporate social equity provisions as they move to advance legalization.
Laughlin, for his part, also said an event in May that the state is “getting close” to legalizing marijuana, but the job will only get done if House and Senate leaders sit down with the governor and “work it out.”
Warren County, Pennsylvania District Attorney Robert Greene, a registered medical cannabis patient in the state, filed a lawsuit in federal court in January seeking to overturn a ban preventing medical marijuana patients from buying and possessing firearms.
Two Pennsylvania House panels held a joint hearing to discuss marijuana legalization in April, with multiple lawmakers asking the state’s top liquor regulator about the prospect of having that agency run cannabis shops.
Also in April, members of the House Health Committee had a conversation centered on social justice and equity considerations for reform.
At a prior meeting in March, members focused on criminal justice implications of prohibition and the potential benefits of reform.
At another hearing in February, members looked at the industry perspective, with multiple stakeholders from cannabis growing, dispensing and testing businesses, as well as clinical registrants, testifying.
At the subcommittee’s previous cannabis meeting in December, members heard testimony and asked questions about various elements of marijuana oversight, including promoting social equity and business opportunities, laboratory testing and public versus private operation of a state-legal cannabis industry.
And during the panel’s first meeting late last year, Frankel said that state-run stores are “certainly an option” he’s considering for Pennsylvania, similar to what New Hampshire Gov. Chris Sununu (R) recommended for that state last year, though a state commission later shied away from that plan.
Last year, Shapiro signed a bill to allow all licensed medical marijuana grower-processors in the state to sell their cannabis products directly to patients.
Shapiro also recently signed legislation to provide a state-level partial workaround to the federal 280E tax penalty on cannabis businesses.
Separately, Pennsylvania’s prior governor separately signed a bill into law in July 2022 that included provisions to protect banks and insurers in the state that work with licensed medical marijuana businesses.
