PUBLIC BENEFITS PLAN A plan demonstrating the exceptional merits of our application, including information regarding ownership, employment policies, community relations, green business practices, discounted medicine, packaging and labeling requirements, as well as a robust community outreach plan to improve the local community and assist those in need. Hunny’s Health Center 2016 300 Poplar St. Mill Valley, CA 94941 AN EXCEPTIONAL ORGANIZATION Hunny’s Health Center and our affiliates are proud of the work we are able to do to benefit the communities we serve. Our organization works hard to ensure that we are making the world a better place in everything that we do. From providing good paying and rewarding union jobs to our staff to contributing much-needed resources to charitable organizations and local causes, our organization has a long history of making an exceptional impact and benefiting our patients, the areas where we operate, and the society in which we all live. Our dispensary will be much more than a store where patients can purchase cannabis. Our program consists of many unique and beneficial projects that improve the quality of lives for the patients we serve and those in need. We are honored to be able to share our plans to benefit the County of Marin and the thousands of patients who will depend on HHC for reliable products services that they can trust are of the highest quality. PUBLIC BENEFITS PLAN OVERVIEW Hunny’s is committed to ensuring that our organization is a benefit to Marin County and the State of California. In order to achieve this objective, we have developed the organization’s plans with consideration for local ownership, providing a Living Wage, community relations, educational awareness, green business practice, reduced pricing programs, and compliant packaging and labeling for all products. In addition, we will also provide information on our plans for community improvement projects, charitable partnerships, and our history of successful community benefits efforts. We appreciate the opportunity to explain more in depth why we will be an incredible asset to the local Marin County community. Local Ownership As a California Non-Profit Entity, Hunny’s Health Center is not subject to ownership and by nature, this type of corporation is not organized for any person’s private gain; however, our democratically elected Board of Directors is 50% controlled by Marin residents Jason and Cassandra Alley. Jason Alley and his wife, Cassandra, are the founders and directors of California Coastal Organics, a small private cannabis collective serving a small patient base with specialized high-quality cannabis medicines in accordance with State law. Their family is local to Marin as residents of the Dillon Beach area for over a decade, and they understand first-hand the needs of this community. Marin is where they have chosen to raise their children because of its vibrant culture and family values, and they are a familiar face in the local community. This connection will enable them to better serve the local population and run the dispensary in a manner consistent with local norms and values. They have been active members of the local cannabis community for many years and are excited about Marin County’s decision to allow for patient access through properly regulated dispensaries. As the parents of two children, they understand firsthand the need for proper control and accountability for medical cannabis businesses, and will work hard to ensure that the family values of the local community are considered in all HHC operations. Jason and Cassandra have long considered opening a local medical cannabis dispensary, exploring options previously to locate in nearby Sebastopol or Sonoma County where dispensing collectives have been actively licensed for several years. Upon hearing about Marin’s plans to allow for dispensaries, the Alleys decided to focus their energy on applying in their local county to operate a small boutique style dispensary focused on a total health and wellness program. Through activism and advocacy experiences in the medical cannabis community, they were able to meet Mark Pelter and David Spradlin of River City Phoenix (RCP) in Sacramento, who operated a successful dispensary, and whose model and operations were in line with the Alleys’ vision of what a dispensary should be. Their partnership with RCP will allow them to realize their objectives and it will provide the infrastructure and resources necessary to ensure that Hunny’s Health Center is successful and a desirable choice for local patients. Living Wage Our organization will adhere to compensation policies that are consistent with the County’s Living Wage Ordinance (Marin County Code Chapter 2.50) for staff and employees. Rates specified for 2016 are a minimum of $11.70 per hour with health benefits or $13.35 per hour if no health benefits are provided. Our current pay rate exceeds these standards, as shown in our wage scale below. We understand that these rates may be adjusted annually to reflect the increase in the Consumer Price Index during the preceding year for all urban consumers in the San FranciscoOakland-San Jose area as published by the U.S. Department of Labor, Bureau of Labor Statistics. We will ensure that new, continued, extended or otherwise amended employment contracts will incorporate the living wage in effect at the time of the contract change. We intend to provide great wages and a robust benefits package to our staff, including healthcare. Management will be salaried and there will be hourly full and part-time employees. When needed, the organization may elect to use independent contractors to best control our costs; analysis of cost benefit to the organization will be an important factor in all human resource decisions. Part-time employees and contractors who do not receive health benefits will be compensated at the required non-coverage living wage rates. We will make every effort to maintain positive relations with our staff and keep them working with us as long as possible. We plan to invest a great deal of time and energy into training staff, so we seek those who are looking for a long-term commitment, and accordingly, we will offer compensation that reflects that training and level of commitment. We believe in promoting from within if that talent is available, but first and foremost want to have the best employee for any given position. This is what makes our organization great, and an exciting and fruitful place to work. Wage Scale Below is our wage scale for collective positions: Position Minimum Level A Level B Maximum Service Staff $14 per hour $15 per hour $17 per hour $20 per hour QIC Staff $15 per hour $17 per hour $20 per hour $25 per hour Administrative $17 per hour $20 per hour $25 per hour $40 per hour Management $50k year $60k year $70k year $90k year $75k per year $90k year $105k year $120k year Directors Our wage scale is approximate, as every human resource case is unique to the person’s performance, needs, education, and abilities and can change due to the collective bargaining agreement we have in place with our Union. Below are basic outlines as to each level of pay: Minimum - This is the entry level for the given position, meaning the person fulfills the minimum requirements for the job. Level A - The employee has the experience and knowledge to master most of the duties related to the job in an independent manner. Employees whose salary falls between the Minimum and Level A are in the development phase because they are still learning their job. As a general rule, the hourly staff is promoted to Level A after their 90-day probation period if their performance is good. Level B - The employee is highly experienced and their level of productivity exceeds the job requirements. Employees whose salary falls between Levels A and B are in the maturity phase because they are mastering their job. Maximum - The employee is continuously producing results that are well above the requirements of the job. Employees whose salary falls between Level B and Maximum are in the leadership phase because they have demonstrated superior leadership skills and a strong commitment to the organization. Union Membership - Card Check Neutral Our organization agrees not to interfere with employees’ decisions to unionize, thereby being a “card check neutral” facility. In fact, we encourage union membership for all of our staff and are proud of our long-term partnership with the United Food and Commercial Workers Union. If RCP is selected to operate in Marin County, we intend to join UFCW Local 648. Our organization’s existing collectives are currently members of UFCW Local 8 (Sacramento) and UFCW Local 5 (Oakland). Our Union membership is important to us, and we are excited about being an example for the rest of the industry. We were the first organization to join Local 8 in the Sacramento area and we look forward to joining the organizations in Marin County who are also members of Local 648. We believe in allowing our staff to band together to achieve common goals and guarantee good working benefits for them. It is an important security that makes our staff proud and makes them feel as if they are part of a universal movement to bring legitimacy and power to those who work in this industry. United Food and Commercial Workers is helping members of our staff team with the negotiation of wages, work rules, complaint procedures, rules governing hiring, firing and promotion of workers, benefits, workplace safety, and policies. These important aspects of the employment experience create a sense of pride and ownership amongst our staff, and in turn, make them more productive in their work. We are currently in the process of negotiation terms for a Collective Bargaining Agreement with UFCW 648 for our operations in Marin. UFCW gives our staff a voice. Their union membership helps them to realize affordable health insurance, prescription drug coverage, living wages, safe working conditions, equal opportunity, a secure retirement, and a voice in the workplace. This symbiotic relationship is positive for our staff and in turn the organization. A Letter from UFCW confirming our current status as a union provider, as well as an executed Neutrality and Card Check Agreement from UFCW, are attached as Exhibit 7-b. Community Relations We definitely plan to implement a community relations program, with staff who are assigned as points of contact to address neighborhood concerns. A Community Liaison will be made available to the Marin Community Development Department and the Sheriff’s Department at all times to address any needs or issues that may arise. We will provide the name, cell phone number, email address, and fax number of the Community Liaison to all interested City Departments, Law Enforcement Officials, neighbors within 1000 feet of the facility, patient members of the dispensary, and the public to ensure all issues are dealt with promptly and professionally. While we do not anticipate there being issues with dispensary operations, we will encourage our community to bring any concerns with our procedures or the behavior of our members to the Community Liaison for appropriate mediation and resolution. In addition, we will hold an open house for the community prior to opening so they can see firsthand the beauty, professionalism, and security features of the facility. We believe this will help people to better understand what we do, and in turn avoid problematic circumstances due to misconceptions. Educational Awareness Program Hunny’s Health Center will implement an educational awareness program that explains the benefits and potential abuses of cannabis; at the request of any patient or caregiver member, we will provide information and/or referrals to substance abuse disorder education, prevention, and treatment programs. Every new patient or caregiver at our dispensary facility will receive a Patient Handbook that includes information about the benefits of using medical cannabis as well as information about safe use and potential abuse. During each new patient/caregiver’s initial orientation, we will provide an overview of the information in the Patient Handbook to ensure comprehension. Both the handbook and the orientation will include information directing patients/caregivers to staff points-of-contact at our facility so that they may ask specific questions about medical cannabis, and if requested, can be directed to additional information about substance abuse disorder education, prevention, and treatment programs. Our Patient Handbook is included as Exhibit 7-a. In addition, we regularly schedule educational opportunities for our members, including seminars and workgroups on a range of topics. Some of the topics we provide regular educational programming for are Responsible Use, Home Cultivation, Methods of Ingestion, Nutrition, and other topics of interest to our patient members and staff. We also provide space for a number of educational support groups that often are condition related or focused on segments of the patient population such as veterans or seniors. Marin County Green Business Our organization intends to seek and maintain certification as a Marin County Green Business. Our organizational best practices reflect the requirements of Green Business Program membership, including continuous compliance with applicable environmental regulations; conservation of energy, water, and other materials; implementation of sound environmental practices that prevent pollution and waste generation; and sharing environmentally responsible practices with other community businesses. As an organization that promotes health and wellness, we believe that adhering to Green Business standards is an important part of our overall mission. Additional information on our Green Business practices can be found in Section 4 - Operating Plan under the heading “Environmental Impact Report.” Reduced Pricing Plan Hunny’s Health Center will offer a reduced pricing plan for qualified low-income patients and military veterans, as well as a program offering complimentary medicine to qualified patients. Discount Programs: We honor our seniors, military veterans, and SSI patients with regular discounts on their fees for medicine and services. We offer a 20% discount on all HHC products to these groups of patients. HHC Cares Program: Some patients will face economic hardships or physical disabilities that limit their ability to purchase medicine. Patients that qualify will receive complimentary medicine every week and have access to all services. We believe in helping our members that are less fortunate and provide a generous and caring program. Our management team will determine qualification for the HHC Cares Program on a case-by-case basis considering factors such as economic hardship and severity of the medical condition. Packaging, Labeling and Warning Requirements Hunny’s Health Center will adhere to all California Medical Marijuana Regulation Safety Act requirements for packaging and labeling the medical cannabis and medical cannabis products we provide to patients. We are highly committed to using packaging and labeling that best promotes safe use, and prevents misuse, of our products. All of our medical cannabis and medical cannabis products will be dispensed in tamper-evident packaging that is clearly labeled “Medical Cannabis,” “Medical Use Only,” and “Schedule I Controlled Substance.” Labeling will also include the source and date of manufacture and cultivation, prominently displayed in a clear and legible font; pharmacologically active content including THC, CBD, and any other cannabinoid content; and warnings about the medicine’s intoxicating effects. Packages containing only dried flower will be clearly labeled with net weight. Labels for packages containing medical cannabis infused products or edible products will include additional ingredients and warnings if nuts or other known allergens are used, and will use generic names for food products. All packaging and labels for all dispensary products will use designs that are not attractive to children. COMMUNITY BENEFITS PROGRAMS In addition to providing 30 jobs to mostly Marin residents and contributing revenues through taxes, Hunny’s Health Center is working to develop projects to improve the County of Marin that address the common needs of the community. We believe with a little love, inspiration, and dedicated resources, that we can vastly improve the beauty of our local landscape. We have developed the most robust and committed programs in the industry at our current locations, and will do the same in Marin should we be chosen to operate. We contribute at least 5% of gross revenues to these programs currently. The following are some projects we are excited to develop to make this a reality: Ongoing Neighborhood Clean-Up and Graffiti Removal: With the support of local volunteers, organizations with similar goals, and with Hunny’s Health Center providing resources for litter transport, dumping, and clean-up supplies, we are organizing community clean-up days and graffiti removal projects aimed at removing blight and adding beauty. We understand the ongoing struggle and burden of cleaning up areas where dumping, graffiti, and neglect have created undesirable and unattractive situations. Our clean-up days help to create a sense of pride for the area in which we live and work. Health Assistance Programs: We are committed to serving the needs of Marin residents by helping underserved and vulnerable populations find solutions to health related issues in the community. We will perform a health needs assessment in the area based on information from relevant County agencies to target our resources to programs that will directly impact the community. Project Hunger: HHC understands the challenges that many in the community face to just put food on the table every day. We also understand that people who are hungry cannot be productive and contributing members of society. Hunger increases crime, as people become more desperate and less caring in their quest to survive. In an effort to realize a community where no one lacks a decent meal and the ability to eat nutritiously, our organization has organized food pantry programs that provide weekly groceries to hundreds of families. In addition, we work with faith-based and socially conscious groups to provide much-needed resources and contribute directly through food drives and funding commitments to these organizations. Community Gardens: Many of our members and people from the local community are passionate about gardening. There are areas of Marin that sit vacant and unused where there could be a lovely community garden for the neighborhood to participate and benefit from. Community gardens can be maintained by neighborhood volunteers in conjunction with regular funding from Hunny’s Health Center, and can generate resources for the community. We look to partner with groups like Dig Deep Farms and City Slicker Farms who have these programs working and add resources to expand urban gardens in Marin. Cultural and Community Gatherings: HHC looks forward to partnering with local events, both large and small, to increase community awareness and outreach. We believe that Marin has a wonderful array of local events that bring resources and education to the vibrant community. By working to promote, develop, and partner with organizations that host community events, we hope to make Marin a more beautiful place to live. Community Contributions We will work to make Marin a better place to live, work and thrive. The collective will use its resources to improve the community through projects and local funding opportunities. We will partner with local charities and non-profit organizations to provide support and funding for worthwhile projects. Causes we value and will focus on helping in the community are homelessness, education, community cleanup, and public services. The following are organizations we plan on working closely with: • • • • • • San Francisco-Marin Community Food Bank Bay Area Green Business Program Boys and Girls Clubs of Marin 10,000 Degrees 2050kids California Police Activities League • • • • • • • City Slicker Farms Dig Deep Farms Beyond Differences Amigos de las Americas, Marin Chapter Bennett Housing Rebuilding Together Marin Ritter Center • • • • Habitat for Humanity Greater SF Community Action Marin ExtraFood.org Meals of Marin • Toys for Tots A Long History of Giving Back Since being founded in 2010, RCP Sacramento and Magnolia Oakland, have generously contributed to many charitable organizations and have developed robust community benefits programs aimed at improving others’ lives, and the communities in which we serve. We pride ourselves on being leaders in the area of community benefits, as our innovative methods of giving and support have become standards in the cannabis industry. Our Board of Directors works with staff and patient members to select organizations to partner with who do amazing work to improve the quality of life of those in need. The non-profit mission of the organization has also led to the development of our own altruistic programs that meet the direct need of the local communities and citizens we serve, including youth outreach programs and programs to combat hunger and poverty. Below are some organizations we have been honored to work with over the years, as well as programs we have developed ourselves: PARTNER ORGANIZATIONS • • • • • • • • • • • • Twin Lakes Food Bank Toys for Tots Blood Source Blood Drives Chamber Gives Back Toy Drives Susan G. Komen Race for the Cure Boy Scouts of America His Well Ministry Step Out Walk for Diabetes AIDS Walk Walk Now for Autism Speaks Walk for ALS Local High Schools Equipment and Facilities • • • • • • • • • • • • Operation Dignity City of Oakland Holiday Meal Programs West Oakland Skate Park Friends of Defremery Park Friends of Faith Alameda County Food Bank Prescott-Joseph Center Local Basketball Camps Reform CA CANORML Parents 4 Pot Wesley’s Fund PROGRAMS DEVELOPED • • Food Assistance Program- Every week we provide hundreds of local families in need with direct food assistance and fresh produce. In addition, they are provided support to locate other local food assistance resources to help them through their difficult times. The families we serve are extremely grateful for this program. Community Cleanup- One weekend a month we organize our staff and volunteers to participate in community cleanup projects. • • We also report dangerous activities and code violations to the City so they may address problem situations. The Village- A non-profit organization we developed to serve underprivileged youth through supportive programs and partnerships with local youth programs and school districts. Full Belly Backpacks- Focuses on low-income areas to bring after-school and weekend • • meals to children in need, providing over 500 meals a month to kids in need. Birthday Magic- Serves children currently residing in local shelters and permanent supportive housing agencies. We provide a complete birthday party for children in highstress situations so they can enjoy the innocent magic of getting to celebrate their birthday. Community Movie Nights- Program is designed to bring safe, family-friendly fun to • low-income areas. Each month we show a free movie on the big screen and provide fresh fruit and snacks to youth in attendance. Shelter Support Program- We partner with local shelters and provide gift bags to kids with toiletries, blankets, entertainment, stuffed toys, age-appropriate books to read, etc., so that kids can have the ability to feel more at home in their displaced situation. Giving Back to Our Patient Members We also do a great job of taking care of our patient members. Our organization provides the most diverse and supportive programs in the industry for our patients to enjoy, learn, and thrive. We provide approximately $20,000 per month in complimentary medicine to lowincome patients and those on fixed incomes and disability who qualify for our compassion programs. The organization provides an array of complimentary health services that our members can take part in to help them realize a complete wellness program. We also provide educational classes and support groups where members can expand their knowledge and find members with similar situations that they can share experiences with. These in-house programs greatly benefit the patients we serve, and they, in turn, can better serve the community as a whole. We provide a monthly newsletter detailing these services. We are excited to continue to expand our unique service offerings. Below are some of the programs we currently offer at our locations: • • • • • • • • • • • Compassion Program- Complimentary medicine to patients in need. Massage Therapy Chiropractic Services Acupuncture Yoga Classes Reiki Traditional Chinese Medicine Ayurveda Support Groups- Veterans, Condition Based, Patient Need, etc. Educational Classes- Cultivation, Responsible Use, Legal, Vaporization, etc. Counseling- Life, Employment, Legal, etc. 2017 PATIENT HANDBOOK Your guide to being a member of Hunny’s Health Center HUNNY’S HEALTH CENTER 300 POPLAR STREET MILL VALLEY, CA 94941 PATIENT HANDBOOK Contents Welcome to Hunny’s Health Center ............................................................. 3 What We Do ................................................................................................ 4 Patient Member Requirements ................................................................... 5 Rules for Membership to Hunny’s Health Center ......................................... 6 Good Neighbor Policy .................................................................................. 7 Patient Conditions for which Cannabis Medicines can be Beneficial ............ 8 Using Medicine Sensibly and Safely ............................................................. 9 Methods of Medicating.............................................................................. 11 Varieties of Medicine ................................................................................. 10 Informational Resources ............................................................................ 11 Patients’ Rights .......................................................................................... 12 Page 1 of 13 PATIENT HANDBOOK Welcome to Hunny’s Health Center Thank you for becoming a member of HHC’s Collective We are honored you decided to join our collective. We believe our patients deserve the best, so we work hard to provide and environment where patients can thrive. Hunny’s Health Center prides itself on providing a diverse program of knowledge, wellness activities, effective medicines, and social responsibility. It is our pleasure to serve your patient needs. We believe that patients benefit greatly by participating in an array of complimentary services and activities. Our knowledgeable staff will assist you in your wellness program and will be happy to answer any questions you may have regarding our medicines, services, or programs. It is important for you to find the best program for wellness and our staff is here to help. From safety, to variety, to cultivation, our staff can help you to have a positive experience with cannabis medicines. Hunny’s Health Center provides for social activities, educational opportunities, and community service projects that we encourage our patients to get involved in. We are a not-for-profit organization, so your fees go directly into improving the collective and the community we serve. This is your collective and we invite you to be an active part of it. Through sharing our resources with those most in need and working to make our immediate world a better place, we can find healing and well-being through goodwill. Just ask what you can do to help build and improve our collective. We welcome you to Hunny’s Health Center. We have developed a great group of patients and providers to share in opportunity and sharing. We offer a wide variety of great medicines at a good value and specialize in quality production methods. If you wish to provide medicine for the collective, please speak to our leadership staff about our production requirements. You will find all of our medicines to be safe, clean, and thoroughly inspected. Please inform us of any areas for improvement, as we are always looking for ways improve our programs to be even greater. We want to humbly welcome you and thank you for choosing Hunny’s Health Center for all of your wellness needs. Kind Regards, Hunny’s Health Center Staff Page 2 of 13 PATIENT HANDBOOK What We Do We are a patient-focused holistic collective serving a private membership base. We provide a convenient, affordable, discreet, and safe service for qualified patients to access cannabis medicines in accordance with the recommendation of their physician. In addition to medicine, we provide our patients with health management services, support, counseling, and educational opportunities. We also offer organic and natural goods. Our Mission The mission of Hunny’s Health Center, a non-profit patient Collective, is to provide comprehensive compassionate care, counseling, support, and education to qualified patients and their caregivers. We focus on providing a complete holistic wellness program to our patient members that will enable them to find health and happiness in a safe, convenient, and caring environment. Our top priority is patient care. Our Vision Hunny’s Health Center provides excellent service and high quality medicines to seriously ill patients in the area. We ensure that all cannabis medicines provided by Hunny’s Health Center meet the standard for quality medical cannabis production in the State of California. We seek to improve patients’ qualities of life by providing an array of safe and effective medicine and distinctive offerings produced by trained professionals. We facilitate positive transactions, and provide a high level of service and information in the dispensing process. In addition to goods, we provide wellness services to our clients. We offer a wide array of educational material, ongoing counseling on cannabis, nutrition, stress management, and more. Hunny’s Health Center also partners with an array of wellness service providers, such as acupressure therapists, to provide our members with complimentary services. These local partners enable us to reach beyond a person’s symptoms and give them affordable resources in which to directly address their health needs. By investing these resources back into the collective, we hope to create a caring relationship and create patient loyalty, which enables us to grow. The core values of Hunny’s Health Center are compassion, understanding, and knowledge. Compassion enables us to empathize with those we serve and treat them with a level of respect and service that all people should enjoy. We strive to understand the condition and situation of every patient we serve, so that we may provide unique and effective solutions to their needs. We look to provide a knowledge-based program that empowers the patient to learn more about cannabis as a medicine, healthy life styles, and what they can do to improve their quality of life. These values are instilled into every staff member, and give our patients a service that is unparalleled in the industry. Our success is measured by our patient members’ satisfaction. Page 3 of 13 PATIENT HANDBOOK Patient Member Requirements Hunny’s Health Center is a non-profit entity that is compliant with CA Health and Safety Code 11362.5 and 11362.7, the statutes governing cannabis medicines in the state. The following is required to be a member of Hunny’s Health Center: Members must be 18 years of age and have a California issued driver’s license or identification card. Members must have a valid doctor’s recommendation for using cannabis medicines or be the documented caregiver of a qualified patient. Members must agree to the membership agreement, rules for membership and sign a HIPPA privacy authorization. A copy of the member’s physician recommendation and identification documents must be made and kept on file. (Renewals will be updated yearly or at expiration, whichever is sooner). We are a closed-loop patient collective in full compliance with California State law, meaning all medicine provided is done so by other patent members in compliance with Hunny’s Health Center standards and practices. We never accept or dispense medicine from outside resources, as it is not legal nor desirable. We never dispense medicine to those not qualified to use medical cannabis under law or those who are not members of the Hunny’s Health Center Collective. Becoming a Hunny’s Health Center Member: To join our collective, just submit your current and valid medical cannabis recommendation, Patient ID Card, or California Medical Marijuana ID Card and a corresponding State issued picture ID or driver’s license. We will verify your patient status with your doctor before you will be allowed to access the dispensary or services. We will make a copy of your patient documents for our records and give you back the originals. We have got to verify that you are a qualified patient before you can begin receiving medicine. If you want, you can submit information for online verification at www.SouthSanFranciscoCareCenter.com prior to your first visit and avoid some delay. Otherwise our friendly staff will do their best to get you verified in a timely manner. Designating a Caregiver: You can designate a primary caregiver to be authorized to obtain medicine on your behalf. Your caregiver can only access medicine for you unless they too are a patient member of Hunny’s Health Center. Caregivers must have valid State issued documentation or must submit the proper information for approval with our membership staff and wait for approval. Page 4 of 13 PATIENT HANDBOOK Rules for Membership to Hunny’s Health Center 1. Patients must be 18 years of age and have proper ID to access dispensing services. 2. Non-Patients and those who are not members of Hunny’s Health Center, including minors, are not permitted to obtain services from the collective. 3. All members are required to submit proper identification and have their physician recommendation to use cannabis medicines verified and membership validated before accessing Hunny’s Health Center services of any kind. 4. No alcohol, illegal drugs, or weapons of any kind in the presence of Hunny’s Health Center Service Staff to ensure safety. 5. Patient members and caregivers are limited to one service visit per day. 6. Patient members will abide by the limits placed on personal cannabis possession in accordance with CA Health and Safety Codes 11362.5 and 11362.7 and the regulations set forth by local law. 7. Patient Members agree to never sell, distribute or divert medicine obtained through Hunny’s Health Center. Membership will be immediately and permanently terminated if diversion is suspected or discovered. 8. Treat all fellow patients, collective staff, and any other person associated with Hunny’s Health Center with the utmost respect. Offensive and abusive behavior will not be tolerated. 9. Be friendly and support our local and associated businesses. 10. Always be safe and never allow your use of medicine to disturb others in the community. Be discreet and respectful when using medical cannabis. 11. Never abuse cannabis medicines. If you think you have an abuse issue our staff has a list of local resources that can help you. Any perceived abuse will be reported to the collective leadership and be further reviewed. If any of the Rules for Membership are violated there will be a Critical Incident Report filled out and the collective directors and management will take appropriate action. If warranted, we will terminate a patient’s membership and ask them not to return to Hunny’s Health Center. Page 5 of 13 PATIENT HANDBOOK Good Neighbor Policy Hunny’s Health Center and its members have a responsibility to be the best neighbors we can. Help us to ensure that Hunny’s Health Center collective is perceived as a good neighbor. Always be nice, friendly and respectful and caring of our neighbors. Never let your actions interfere with other activities or happenings. It is important for us to have a great relationship with those in our community, including our neighbors, the city, and law enforcement. Be mindful that you are representing the collective as a member and that you are expected to be a good neighbor and a good citizen in your travels in the community. We expect our patient members and collective staff to be courteous and respectful in their experiences with those in our neighborhood. It is important that we be considerate of those who live and work nearby. Please respect these relationships and avoid activities that could disturb others. Be mindful of where you park. Always turn down your music and use low voices when entering or leaving the collective area. Never park illegally on the streets surrounding the collective or in spaces not intended for the collective’s use. If you are having trouble finding appropriate parking, please ask our friendly staff for help. We always want you to feel safe at HHC. If you need an escort to your vehicle, just let our staff know. Report any suspicious or illegal activity. Being a good neighbor will help us to have a good relationship with our community and be able to serve your needs for years to come. Page 6 of 13 PATIENT HANDBOOK Patient Conditions for Which Cannabis Medicines May Be Beneficial Cancer and Chemotherapy Treatment- Cannabis is most effective to combat the side effects of the treatments used to fight cancer. Most notably are its extremely effective in curbing nausea and increasing the appetite of patients experiencing the harsh side effects of chemotherapy and radiation. It also can reduce the pain associated with the disease. HIV/AIDS- HIV/AIDS patients often experience wasting syndrome from the disease and the multitudes of medicines used to combat the disease. Cannabis stimulates their appetite allowing them to eat more regularly and avoid the common traits associated with wasting syndrome, as well as helps ease the pains associated with the disease itself. Pain Afflictions- Research shows that cannabis is a safe and effective treatment for a variety of pain related afflictions, including deep tissue pains, muscle and back pain, and neuropathic or shooting pains. Cannabis does not have the dangerous side effects of other opiate-based painkillers and is not known to be toxic at any level of ingestion, making it a much safer medicine for pain. Multiple Sclerosis- Cannabis improves spasticity and improves tremors in MS patients. It helps control involuntary muscle contraction, balance, bladder control, speech, and eyesight in these patients. Cannabis helps with the immune system, which is thought to be the underlying pathogenic process in MS patients. Gastrointestinal Disorders- Cannabis has value as an anti-emetic and analgesic medication. It helps combat the symptoms brought on by disorders such as Crohn’s Disease, Irritable Bowel Syndrome, and Ulcerative Colitis. Cannabis interacts with the endogenous cannabinoid receptors in the digestive tract, which can result in calming spasms, assuaging pain, and improving motility. Cannabis has also been shown to have anti-inflammatory properties and recent research has demonstrated that cannabinoids are immune system modulators, either enhancing or suppressing immune response. Movement Disorders- Cannabis is effective in treating muscular spasticity, a common condition, affecting millions of people. This condition afflicts individuals who have suffered strokes, as well as those with multiple sclerosis, cerebral palsy, paraplegia, quadriplegia, and spinal cord injuries. Conventional medical therapy offers little to address spasticity problems. Because cannabinoids have antispasmodic, analgesic, anticonvulsant, and anti-ataxia properties, cannabis is extremely effective in treating these disorders, and lacks the side effects and dangers of Valium or other prescribed medicines. Aging- Cannabis has been found to help many patients suffering from conditions that afflict older patients, including arthritis, chronic pain, cancer, Alzheimer's disease, diabetes, and spasticity associated with such diseases as Parkinson's. Arthritis- There are two common types of arthritis, rheumatoid arthritis and osteoarthritis, but both affect the joints, causing pain and swelling, and limiting movement. The analgesic properties of cannabis make it useful in treating the pain associated with arthritis, both on its own and as an adjunct therapy that enhances the efficacy of opioid painkillers. Cannabis has also been shown to have powerful immunemodulation and anti-inflammatory properties suggesting that it could play a role in treating arthritis, and not just in symptom management. Page 7 of 13 PATIENT HANDBOOK Using Medicine Sensibly and Safely Medical cannabis should be a positive in your life. Always strive to have a productive and responsible experience. The freedom to use medical cannabis hinges on patients and providers’ ability to maintain and ethical and compassionate environment. Never let your activity as a patient or producer of medicine hinder the progress of the entre movement. Be educated about medical cannabis and what it means for your condition. It is important to be an informed and active part of your own healing experience. Do not let cannabis interfere with your daily activities or your responsibilities at home, work, or in the community. Be a positive cannabis role model and use your knowledge and experience to counsel and educate less informed users. Learn to titrate and regulate your dosage appropriately. Many patients have found better medicinal effects by using less medicine. Begin by taking in just a small amount of medicine and give it time to take effect (15-30 minutes depending on method of ingestion). Then making a calculated assessment on whether you need to increase your dosage based on how well your symptoms are managed. Never use your medicine if you are planning on driving or are in a situation where your impairment could cause harm to another person or property. Always be aware of your surrounding and ensure proper dosage before performing activities requiring a high level of concentration. Never allow non-patients, especially young people, to have access to your medicine for any reason. Medicine should be locked away in a safe place away from common areas if not being directly supervised by the patient or caregiver. It is unacceptable to leave medicine unattended and susceptible to misuse. Do not abuse the privilege of medical cannabis. Be respectful of the norms and laws of the community you live in. Realize there are still many in the community that lack understanding of medical cannabis. Use discretion in the way that you interact with the community and never let your involvement with medical cannabis or Hunny’s Health Center result in people being concerned or upset. Take a low-key approach and never let your use of medical cannabis be a distraction. Always be cautious and never obtain medicine from o provide medicine to people you do not know to be qualified patients under any circumstance. Never ever divert medicine obtained for your personal medical use to other nonpatients. Any diversion of Hunny’s Health Center products will result in immediate revocation of your membership. - Page 8 of 13 PATIENT HANDBOOK Methods of Medicating The information below is from Americans for Safe Access (ww.americansforsafeaccess.org) Smoking Smoking marijuana produces the most immediate effects and permits the most refined control of your dosage. Smoking any material is not good for the lungs, but the amount of marijuana you need to smoke is so small that you need not be overly concerned. It is better to smoke the flowers rather than the leaves as this also reduces the amount you will need to smoke. Vaporizing Cannabis vaporizers are designed to let users inhale active cannabinoids while avoiding harmful smoke toxins. They do so by heating cannabis to a temperature that is just below the point of combustion where smoke is produced. At this point, THC and other medically active cannabinoids are emitted with little or none of the carcinogenic tars and noxious gases found in smoke. Many medical marijuana patients who find smoked marijuana highly irritating report effective relief inhaling through vaporizers. Also, vaporizers are very efficient so they can save money in the long term. Eating Marijuana can be eaten. When consumed this way, it is usually baked in brownies or cookies, and sometimes made into a candy. It takes longer to feel the effects when eaten, and may take longer for you to learn to control your dosage. However, when you do feel the effects, they may be stronger than those felt by smoking. You may also feel certain heaviness in your body. This will not hurt you. Schedule your time so that you can relax when you take it. Tea Like other herbs, marijuana may be made into a tea. Boil the water first and pour it over the marijuana. Let it steep for longer than you would for common black tea; approximately an hour and a half. Add 1 teaspoon of butter. The effects are similar to eating it. Tincture To prepare a tincture, use 5 parts fresh marijuana to 1 part vodka. If you are using dried marijuana, as is usually the case, use 10 parts marijuana to 1 part vodka. An easy way to do this if you don’t have measuring equipment, is to fill whatever container you are using (glass is preferable as you don’t want to leech any residues from metal containers) to thirds full with marijuana, then fill the container with vodka and let stand for a week or more. Afterward, strain the solution. If you use a larger portion of marijuana, the resulting tincture will be more potent. Compress Follow the recipe as for tea. Make as much as you need to thoroughly soak the cloth you intend to use. Apply to pain and leave on ½ hour. Page 9 of 13 PATIENT HANDBOOK Varieties of Medicine Whole Plant Medicines and Flowers: Dried flowering clusters and leafy material of the cannabis plant. Raw plant material is used as the basis for all other cannabis medicines. The flowers can be smoked, vaporized, extracted, or infused into tinctures and foodbased medicines. Extractions: Cannabis can be extracted by a number of different processes resulting in a resinous substance that is more concentrated in nature and requires less consumption by a patient. Commonly referred to as “hash,” these types of medicine can be smoked, vaporized, or infused into other products. Extractions allow patients to regulate dosage more easily. Kief or Dry Sift Resin Glands: By sifting dried plant matter over a screen of some sort or in a tumbling device, the loose resin gland of the cannabis will be detached from the plant, resulting in what is known as kief. The dry, granular substance is effective for patients to use when smoking, or by adding it to other types of preparations. Food-Based Medicines: Some patients must eat their medicine and the healing properties of cannabis are best bonded to fats and glucose preparations. Butters, oils, and simple syrups are used to infuse with the cannabis medicines, and these preparations are normally added to foods, such as baked goods and candies. The food helps mask the taste of the medicine. These functional foods are all prepared by patient kitchens by members who are trained in the safe handling of foods. They are all discreetly packaged and clearly labeled to ensure safety. Tinctures: Tinctures are liquid preparations in which the cannabis plant material is infused into a substance like alcohol or glycerin for a period of time. It is then strained and bottled for patient use, normally in a dropper container to control dosage. These tinctures are great for patients to add to beverages and produce a more rapid onset. Topical Preparations: Cannabis can be infused into a number of ointments and lotions that may help with conditions, such as eczema or dry skin. Topical medicines do not normally create a psychoactive effect, but some patients find applying them to areas of tissue pain to be helpful. Page 10 of 13 PATIENT HANDBOOK Informational Resources Hunny’s Health Center does its best to provide the most complete information for our patients, but there are many other great informational resources that we encourage our members to become familiar with. Below are a list of great medical cannabis information organizations and their online addresses: Americans for Safe Access: www.americansforsafeaccess.org Medical Cannabis Advocacy organization dedicated to expanding access to cannabis medicines and ending the prohibition of safe and effective medicine. ASA has had innumerable successes in moving forward positive legislation to protect patient rights on local, state, and national levels. California NORML: www.canorml.org California NORML is a non-profit, membership organization dedicated to reforming California's marijuana laws. Our mission is to establish the right of adults to use cannabis legally. We maintain a separate membership and financial base from national NORML. Site provides detailed lists of Doctors and Patient Organizations. Marijuana Policy Project: www.mpp.org A national organization working on ending cannabis prohibition. MPP and MPP Foundation envision a nation where marijuana is legally regulated similarly to alcohol, marijuana education is honest and realistic, and treatment for problem marijuana users is non-coercive and geared toward reducing harm Patients Out of Time: www.medicalcannabis.com The organization known as Patients Out of Time is a non-profit 501c4 corporation of the Commonwealth of Virginia that shall lobby and educate all disciplines of health care professionals; their specialty and professional organizations; and the public at large about medical cannabis (marijuana). West Coast Leaf: www.westcoastleaf.com The West Coast Leaf fosters a socio-political community by providing photos, news, directories, features, and regional information for our readers. We invite your submissions and advertising. The Leaf supports tolerance and maintains that cannabis sales and cultivation should and will be legal for adult consumption. Students for Sensible Drug Policy: www.ssdp.org Students for Sensible Drug Policy are an international grassroots network of students who are concerned about the impact drug abuse has on our communities, but who also know that the War on Drugs is failing our generation and our society. SSDP mobilizes and empowers young people to participate in the political process, pushing for sensible policies to achieve a safer and more just future, while fighting back against counterproductive Drug War policies, particularly those that directly harm students and youth. Page 11 of 13 PATIENT HANDBOOK Patients’ Rights Choice of Providers: You have the right to accurate and easily understood information about the laws and local regulations. You have the right to have your medicine provided elsewhere if needed. Accuracy, Quality, and Control: You have the right to accurately labeled and weighed quality medication and accurate information about the medication being provided. Our quality control staff thoroughly inspects all medicines before it is dispensed to you. Safety: You have the right to obtain your medication in a safe and friendly environment. You have the right to safe and effective medicine handled in appropriate and sanitary conditions. Respect and Non-Discrimination: You have the right to considerate, respectful, and non-discriminatory care. Confidentiality of Health Information: You have the right to talk in confidence with your providers and to have your health care information protected under all appropriate safety provisions. Our staff is discreet and will never release information about you to anyone not authorized by you. Page 12 of 13 2017 MEDICAL CANNABIS BEST PRACTICES HUNNY’S HEALTH CENTER 300 POPLAR STREET MILL VALLEY, CA 94941 Best Practices Contents Good Stewards of the Community .................................................................................................. 3 Creating Clean Medicine ................................................................................................................. 4 Food Safety & Proper Handling ....................................................................................................... 6 Medicinal Edible Kitchens................................................................................................................ 7 Packaging ......................................................................................................................................... 8 Labeling ........................................................................................................................................... 9 Child Proofing ................................................................................................................................ 11 Medicinal Cannabis Labeling and Marketing Ethics ...................................................................... 12 Avoid using unprofessional, slang, or “counter-culture” terms. ................................................... 12 Never falsify information to enhance a product. .......................................................................... 13 Avoid using imagery that insinuates non-medical use .................................................................. 13 Be educated about standards and practices of the cannabis community .................................... 14 Patients Helping Patients .............................................................................................................. 14 Best Practices The Best Practices of Hunny’s Health Center are required to be adhered to by all providers of cannabis for dispensing. Those who create medicine for the dispensary agree to adhere closely to all standards set forth. Good Stewards of the Community One of the hallmarks of well-run medical cannabis dispensary is its positive role in the community. Good dispensaries have a “good neighbor policy” to ensure that they contribute to the overall wellbeing of the neighborhood. A good neighbor policy includes the following elements: Restricting membership to legally qualified patients Providing adequate security to protect patients and the neighborhood Maintaining a clean facility in good repair Preventing nuisance activity like loitering or litter Educating members about rules and appropriate behavior in and around the facility Excluding patients who break the rules or divert medication for non-medical use Keeping lines of communication open with neighbors, elected officials, and law enforcement Responding to community concerns A good neighbor policy will help ensure that patients get the medicine they need and that neighborhoods are protected. Communities have an important role to play in the good neighbor policy, as dispensaries need community input to develop policies that reflect the concerns and values of the neighborhood. They need feedback to know how to contribute to a successful and friendly neighborhood atmosphere. Perhaps the most important element of being a good neighbor is participating in an ongoing dialog between dispensary operators and all members of the community. Well-run dispensaries are good for communities. They bring customers to business districts, provide revenue to city government, and create jobs. They also provide the most practical and effective mechanism for getting high quality medication to those who need it to treat serious conditions. The majority of citizens believe that sick people should have safe access to medical cannabis with a doctor’s recommendation. Dispensaries take this compassionate belief and make it a reality for sick and dying people every day. By having a dispensary in your area, you can feel good about the fact that the lives of the sick and dying are being improved, and in some cases saved – and about the fact that you have a role to play in helping make it work in your neighborhood. Safety for patients and the community is a top priority at medical cannabis dispensaries. Well-run dispensaries adopt a security culture to ensure safety. Security culture refers to a set of practices and strategies that work together to maintain community standards. Best Practices Security culture may involve the following elements: Employing professional, trained security personnel Staying alert to detect problems before they occur Educating patients to be sure they know the rules Implementing policies to prevent diversion Restricting access to the facility to authorized persons Using appropriate security technology and equipment to monitor and secure the facility Maintaining communication with local law enforcement Training staff to prevent and respond to emergencies Educating staff and members as to their rights and responsibilities under the law Individually, these elements help make a dispensary safer. Taken together, they provide a comprehensive safety strategy that makes a well-run dispensary one of the best and most secure neighbors in any given community. There is no greater correlation between dispensaries and crime than movie theaters and crime. Rather, dispensaries carry out important work in a discrete and professional manner. In truth, sufficient security and careful membership screening at good dispensaries serves to protect neighborhoods from undesirable elements in general. In order for us as a community to be pro-active and ensure patient safety, it is imperative that we self-regulate the medicinal products that are being dispensed to patients. Cannabis products intended for medical use must meet certain packaging, labeling, and sanitary requirements to guarantee safe consumption by patients. Understanding proper food handling safety, awareness of the medical uses of cannabis, and communicating accurate dosage information are necessary factors in the process of creating cannabis-infused edibles. All producers of medicine should comply with the minimum industry standards for edibles and related products. Creating Clean Medicine Although there are few certification classes for the production of cannabis, producers should be aware of the cleanliness and quality of cannabis used to produce medicinal edibles. The cannabis used for edible production should be handled like any other food ingredient. It should be free from mold, mildew, insects, pesticides, and other impurities that endanger health. Cannabis Handlers should follow the same practices of hand washing, sanitation, and compassionate awareness that food handlers are expected to follow. Below are some simple steps you can take to make gardens and grow rooms safer and more sanitary. Best Practices Make the garden area a clean work environment. Gardens and grow rooms should be kept cleaned and sanitized prior to cultivation. The best defense is prevention. By eliminating unwanted biological agents from the space prior to planting, you will reduce the need for harsh, potentially hazardous, chemical solutions later on. Surfaces should be kept dust free; floors should be swept or vacuumed regularly. Tools should be sanitized between uses. Plants should be inspected frequently for signs of infestations or chemical imbalance. Regular cleaning is a top priority for medical gardens. Wash up before and after working in grow areas. Researchers have discovered that the most common pathogens transmitted in cannabis are choloform and E. Coli bacteria. The transfer of these bacteriological agents can be greatly reduced by washing your hands before and after working in a garden. Use proper safety equipment when handling medicine. Use gloves and facemasks when handling medicine intended for direct consumption. It is good practice to have a change of clothes, including shoes, which are designated for use in the garden. This helps avoid bringing in pests and contaminants from the outside. If you wanted to go a step further, you can wear protective Tyvek suits, hairnets, protective shoe booties, and nitrile gloves. This safety equipment can be purchased relatively cheap at medical supply stores and safety equipment outlets. Keep unnecessary elements out of the medicine areas. Gardens and grow rooms should not be high traffic areas. People not directly working in the garden should stay out, as they may introduce contaminants. Keep children and pets out of garden areas at all times. Grow rooms are not good storage areas and should be kept clear of clutter. Do not eat in the garden area. Do not smoke tobacco products in the garden. The smoke from tobacco (including blunts) contains unnatural toxins which can build up upon the foliage. This can harm plants and possibly patients. Be aware when working around ventilation intakes, as harsh chemicals and cleaners may be drawn in through the system and contaminate the grow. Use filters when needed and seal the room well to control pests Use safe cleaning products and plant maintenance additives. Since harsh chemicals can damage plant vitality and accumulate inside plant tissue, they should be used sparingly when cultivating medicine. There are many safe and effective fertilizers, pesticides & cleaning agents on the market. Using natural cleaning solutions, such as diluted hydrogen peroxide, are often less expensive and more effective than brand name cleansers. Even natural citrus cleaners can contain petroleum bases that can damage both plants and equipment. Isopropyl alcohol works well on surfaces, utensils and equipment. The use of organic pesticides and nutrients are strongly encouraged as they may be easily flushed and come from natural sources. A simple solution of organic soap can usually take care of small infestation problems if caught early enough. This is why it is important that every plant in the garden be inspected regularly to catch any issues that may arise before they become problematic. Be aware of every product used during cultivation, its possible effects upon human health and document how it was applied. Ensuring patient safety should be the most Best Practices important factor when selecting a product to use in medical gardens. If unsure, ask a professional for help. Always flush with plenty of clear water before harvesting. It is important to clean out as much fertilizer and plant additives that may have accumulated in the plant tissue prior to harvest. Properly flush each plant with the appropriate volume of water. Many resources are available for proper flushing techniques. Handle finished medicinal flowers and byproducts (trimmings) with extreme care. Cure medicine in a sanitized, well ventilated drying area. Adjust the temperature, humidity and air-flow to minimize the risk of mold. Whether trimming before or after the drying process, it is important to have clean hands, tools, storage containers and work surfaces. Use gloves, facemasks, and dedicated clothing, as if working in the garden. Handle trimmings intended for concentrates, edibles, or other cannabis based products, with the same care as finished flowers. Waste should be removed immediately. Be proactive. The most dangerous element of growing medical cannabis is human error on part of the cultivator. Pathogens do not magically appear; they were either present in the room before planting, or introduced later through improper practices. Inspect and sanitize the garden frequently. Keep good notes and do not be afraid to ask a professional when situations arise. Most products related to growing have contact numbers on them to reach the company directly. If unsure if a product is appropriate for your needs, call and ask a representative. Food Safety & Proper Handling In order to protect the health and safety of our patients, medicinal edibles should be produced in a safe and sanitary kitchen environment. It is highly recommended that medicinal edible producers have at least one Certified Food Handler (CFH) on staff. Improper food handling puts patients at risk by unnecessarily exposing them to bacteria, viruses, allergens and harmful chemicals. Irresponsibly produced edibles could further weaken patients with chronic ailments, cause severe allergic reactions, or in some cases, cause death. By educating ourselves about proper food handling, we better serve our families, friends and neighbors who rely upon these products for relief. To become certified, one must complete a state approved training course and examination. Certification, once completed, must be renewed every 3 years. Classes are generally affordable, and the exam itself costs about $60. Upon completion, the original certificate must be in your production facility at all times, and available for the Environmental Health inspector upon request. The CFH does not have to be present during production, as long as they assume the responsibility for training other staff on proper handling techniques. These protections can be put in place without necessarily exposing the medicinal nature of your products. Best Practices Topics presented in certification classes include: Employee illness Hand washing & sanitation Food borne disease Allergens & physical contaminants Temperature control & proper storage Proper cooking temperatures Cross contamination Check with your local health department to find a state approved class offered close to you. Medicinal Edible Kitchens Companies that produce medicines have very stringent standards to ensure their products are free from unwanted toxins and contaminants. Restaurants, caterers, and other food preparation professionals must adhere to strict guidelines to ensure that the foods produced for public consumption are of the highest quality and fit for consumption. Medical cannabis and edibles should be treated no differently. The following are simple guidelines to follow to ensure medicinal edibles are produced in accordance with the industry standards for food and medicine. Always follow Certified Food Handler (CFH) Standards and Practices. California health code requires that all facilities that produce food for human consumption have a Certified Food Handler on staff. These certification classes are affordable and are offered several times throughout the year. It is the responsibility of the CFH to enforce proper food handling procedures in the facility and to train other employees. Maintain a clean and sterile working environment. Create a clean, non-toxic environment in which to work. In medical, science, and food preparation facilities it is common practice to clean areas at the beginning of a work period, throughout the work period, and after the work is done. Ensure all surfaces, equipment, sink areas, and materials are clean and in good repair. Using nonporous surfaces, such as stainless steel, ensure that areas for preparation are free from unseen contaminants. Be sure to use safe cleaning products and that all equipment is inspected thoroughly. Always use safe and sound cleaning methods for all equipment and areas that will come in direct contact with the products. Always use proper safety equipment. Use gloves, hats, hairnets, and safety equipment to reduce the risk of contamination. Nobody should find hair or foreign substances in their medicinal edible products. Many patients have strict dietary needs or severe allergies, so taking the proper steps to make sure there is no cross contamination is extremely important. Best Practices Store cannabis products safely and securely. Raw cannabis, cannabis extractions, and products containing cannabis should always be stored properly and securely. Store cured cannabis in a cool, dry area. All medical cannabis food products should be stored independently from non-cannabis food products and should be clearly labeled as medicine. Refrigerators and freezers temperatures should be checked regularly. Perishables should display expiration dates. Be sure medical cannabis is of the highest quality before use. Ensure that the cannabis was cultivated and cured in a clean environment. Be sure to inspect each batch of medicine closely for signs of mildew, contaminants, pests, overheating, and kiefing. No matter how reliable the source is for the medicinal cannabis it is always good practice to inspect products visually, with magnification. Use a standardized extraction testing method if unsure of the source. Taking steps to remove contaminants. Regardless of safeguards taken during extraction processes, small amounts of mold or other biological contaminants may still be present. When making a butter, oil, or syrup base it is always a good idea to heat at a high temperature (350) for at least on half of an hour. This will cook off any molds or biological contaminants that may be residual in the plant material. It is also important to skim off any contaminants that may rise to the top during the infusion process. Always be sure to strain out unwanted plant matter thoroughly before using extractions in cooking. Alcohol extractions are good for killing contaminants, but not always the best tasting or most effective methods for cooking with cannabis. Concentrates added should always be natural (water) based. They can be dissolved in vegetable oil for cooking purposes. Always improve facility. No facility is perfect, but investing in upgrades and buying new equipment as time goes on is a necessary part of being a medical cannabis provider. Be aware of your workspace and how you can make it safer, cleaner & more ergonomic. Packaging Since medical cannabis is available without a formal prescription (relying instead upon a letter of recommendation from a doctor), it makes sense to treat cannabis products like other over-the-counter medication. It should follow the standards for packaging and labeling set forth by the Food and Drug Administration in that area. It is necessary to package medical products in “Tamper Resistant Packaging” (TRP) to ensure that the product the patient receives has not been altered or changed in any way from its original form. It may seem like a daunting concept, but it is simpler than you may think and may even be more cost effective in the long run. Some examples of qualified TRP packaging can be found on the FDA website. Best Practices Labeling Labeling requirements are necessary to provide patients with full disclosure of the contents. Edible medicines should display prominent drug fact labels, which include prominent warnings, medicinal values, ingredients, expiration dating, and lot number identification. Medicines have minimum labeling requirements and medical cannabis products should be no different, as patients depend on accurate information to make informed decisions about what may or may not be adequate for their therapies and practices. Brief descriptions of different labeling parameters and their practical uses are listed below. WARNING LABELS: Providing clear and prominent warning labels declaring that the contents are medicinal, not intended for use by non-patients or children, and that the product is manufactured in compliance with the standards set forth by Health and Safety Codes related to medical cannabis products. It should display “as per CA Health & Safety code sections 11362.5 & 11362.7”. Warning labels should be brightly colored and in a clear text to ensure that consumers are clearly warned about the product’s possible effects. It is necessary to display warnings in prominent locations, preferably near the package opening. It is also wise to display warnings on both sides of a product, if applicable, to ensure that it can be seen from all angles. MEDICINAL FACTS: Whenever using any medication it is important to read the labeling on a product to know what the product is intended to do, who should or should not be taking it, and how to use it. In the Federal Register of March 1999, the Food and Drug Administration published the OTC Drug Facts Label regulation. This regulation set forth a standard of labeling format for the “Drug Facts” label that ensures readability and clear language so consumers can understand and read the package effectively. The following information must be contained on a drug facts panel: The product's active ingredients, including the amount in each dosage unit. The active ingredient in cannabis is tetrahydrocannabinol (THC) and the amount in each “dosage unit” generally varies in edible products. Without the ability to scientifically test for exact amounts and standardize the process of extraction it is best to simply state that it varies, or not include the dosage amount. Do not mislead patients and caregivers by providing labeling information that may not be accurate. The purpose of the product. Although listing all potential uses of a medicinal edible may be cumbersome, patients and caregivers should have some guidance as to what ailments the medicine is intended to treat. Generally, “pain relief/appetite stimulant” are the most common purposes of cannabis as a medicine and will suffice for the general purpose of labeling requirements. The uses (indications) for the product. The uses of cannabis as a medicine in conjunction with Proposition 215 are as follows; cancer, anorexia, AIDS, chronic pain, spasticity, glaucoma, arthritis, migraine or any other illness for which (a physician finds) marijuana provides relief. It is important to include the physician into the text, as doctors are the cornerstones of using medical cannabis safely Best Practices and for the right purpose. Cannabis has many uses, some of which may not be discovered yet, therefore it is important to make sure that patients consult regularly with physicians to approve their intended uses. Specific warnings, including when the product should not be used under any circumstances, and when it is appropriate to consult with a doctor or pharmacist. This section also describes side effects that could occur and substances or activities to avoid. Included in this section should be warnings about drowsiness, operating motor vehicles, using alcohol with product, pregnancy & breastfeeding, keeping it out of reach of children, and consulting a physician if taken with other medications. Also, it is good to state that patients should consult a physician if adverse effects occur while using the product. Directions for Use/Dosage instructions--when, how, and how often to take the product. Pay close attention to this section. With cannabis edibles, like any medication, dosage varies on weight, metabolism, strength, and dietary habit of the patient. Informing a patient on proper usage for consistent dosages helps patients regulate their intake and use the medicine to better suit their specific needs. For example, encourage patients to use ¼ to ½ of a product at first and increase dosage as needed. This will help to avoid over-medication by patients who may have a lower tolerance to ingested forms of cannabis. Also, patients should be made aware that edible medicine typically has a slower onset time than inhaled medicine, but once activated, the effects have a longer duration. The product's inactive ingredients, important information to help consumers avoid ingredients that may cause an allergic reaction. Inactive ingredients are going to be everything but the THC, including cannabis itself, or cannabis infused butter. It is highly recommended to denote what type of cannabis is primarily used (indica or sativa), as this helps patients understand what may be better for their needs. Every ingredient within the edible must be listed. If it is a brownie, for example, it is not sufficient to say “brownie mix.” It must list the actual ingredients within the brownie mix. Even peanut butter has ingredients in it, so it is not accurate to simply list “peanut butter.” For patients to make informed decisions on the products they purchase, there must be full disclosure of what is actually in every product. Many patients have special dietary needs or allergies that could be triggered by inaccurate information on products. It is the producer’s duty to ensure that the proper information is listed on their products. Other information. As most edibles are food-based products this is a good area to include recommended storage practices for the products. Letting a patient know the proper way to store the product (i.e. temperature, refrigerate after opening, cool, dry place, etc.) enables them to properly take care of their medicine after leaving the dispensary. Non-edible medications & body products. Products not meant to be ingested should be clearly labeled FOR EXTERNAL USE ONLY. There should be clear directions on how to apply to product. Best Practices EXPIRATION DATING: Expiration dates help patients understand that edibles have a limited shelf life and should be consumed before they spoil. A common ingredient used in edible products is butter infused with cannabis. In most cases, butter is the product with the shortest shelf life, as it is a dairy product. Even clarifying butter does not ensure all of the milk fats have been removed; therefore, it is important to know that butter has a shelf life of 3 months. Shelf life of a product may be extended if frozen, but generally never over 6 months. The ingredient with the shortest shelf life determines the expiration date for the product. For example, a natural product, that may use fresh berries, will only have a shelf life of 5-10 days as the berries do. Stale or spoiled products hurt your reputation as a provider and endanger patient health. Be conscious of the phrasing of expiration dates; “use by” and “best before” communicate different concerns. The durability of a product will determine the proper phrasing, and hinges upon whether a product simply loses its freshness on that date or if it may cause illness. Be honest when dating your products. Monitor the freshness of your products over time and adjust your dating process where appropriate. LOT NUMBER IDENTIFICATION: A lot number is a simple coded identification number that enables a provider to trace the origin of the product back through the production process. Lot numbers allow producers important advantages. Should a problem arise with impurities or in the case where an edible provides exceptional relief, lot numbers allow the producer to track each batch through its origins to discover why. This allows better protection and more effective recipes. A lot number can be coded in many different ways, as long as the provider is capable of identifying when and where the medicine was produced. The “lot” consists of the batch of butter, tincture, hash, or, any other extraction used to infuse edibles with medicinal properties. For example, if a batch of butter was made on June 1st from plant matter derived from “Garden A” consisting of “Granddaddy Purple” a good lot number identification may be “0601AGDP.” This form of coding allows the manufacturer to simply look back and say this batch was produced on 06.01 from garden “A” using GDP. It is important to log each batch individually in a record book that may be looked back on later for reference. You can use whatever system allows the information on the history of the medicine to be easily accessed should any issues arise. Child Proofing Most of the negative media focused upon medicinal edibles centers around the perceived risk they pose to children. Edibles are potent and should not be given to children in the absence of medical supervision. But the risk to children can be minimized through smart packaging and storage practices. Don’t use packages and labels that may be appealing to young children, such as bright colors, cartoon characters, goofy lettering, etc. Avoid transparent packaging. Even if the label clearly identifies the product as medicine, remember that many children can’t read it. In the eyes of a small child, a brownie is a brownie. If possible, use opaque or child-proof packaging. Best Practices Encourage patients to store it out of reach, and out of sight, of children. Edibles marketed on visual appeal can be photographed and displayed in menus. Any measure you take to protect children from accidental exposure or ingestion will reflect positively upon both your business and the larger medical cannabis community. Medicinal Cannabis Labeling and Marketing Ethics Product names, company names, and labeling practices greatly influence the public perception and acceptance of medicinal cannabis. When developing and producing these medicines, we must use common sense, as our decisions may greatly impact the positive development of this industry and the greater cause of ensuring safe access. Cannabis has a long-standing counter culture reputation, and it is easy for manufacturers to often overlap the recreational terms for cannabis into products intended for medical use. While generally these references cause no direct harm to a patient, they allow for opponents of medical cannabis to doubt the intentions of the community and question the motives of medical cannabis dispensers. To better protect our professional reputations as providers of safe medicine, we must take it upon ourselves to diffuse these concerns and strengthen our relationship with the patients who rely upon us. Proper product packaging and labeling accomplishes both of these goals by safeguarding the quality of the medicine, clearly identifying the products as medicine and by providing important information so that patients can make good choices regarding their overall health. It is up to us, as providers, to make this step forward. Here are some simple guidelines for medical cannabis product labeling and marketing ethics. Avoid using unprofessional, slang, or “counter-culture” terms. Whether it be the company name, the product name, the information on the label, or marketing tools, it is important to avoid using terms that imply recreational and illegal uses of cannabis. As a medical community, products that clearly convey the medical intent of the product better serve the patients they are intended to help. References to recreational use damage the legitimacy of the product and confuse patients seeking reliable medicine. Professionally packaged products that are effective and consistent out sell products that rely upon cuteness and humor. This a direct reaction from both the patients who purchase medicine and dispensers who are unwilling to recommend products that could endanger patient health or safety. Best Practices Never falsify information to enhance a product. Since cannabis is an herbal medicine, it is extremely difficult to quantify the medicinal values of cannabis. Plants vary in many ways in response to breeding (genetics, strain), cultivation processes, growth & storage environments, extraction methods and handling practices. Potency is directly affected by production decisions made. Testing is expensive and often inconclusive, given that if you test the top flowers of a cannabis plant they would differ in potency from the lower flowers of the same plant. This makes claims regarding specific potencies hard to back up. Medicinal cannabis providers should never label their products with false or fraudulent information. This includes unfounded claims of potency. Such claims put the patients at great risk as it takes away their ability to make safe decisions regarding their health. Misleading or enhancing a product through false claims and exaggerated facts are a disservice to the community and pose real dangers to patients and the providers alike. Avoid unreliable or possibly false claims when attempting to define the potency of cannabis products. Do not enhance labels with inconsistent, untrue, or questionable information regarding strength, medical uses, or nutritional values. If there are verifiable tests done that approximate a product’s potency, it is best to use that information in a clear phrase, such as “contains between 20-30mg of THC” or “Up to 30mg of THC per serving/dose”. When describing dosage, use recognized units of measurement (ounces, milligrams, etc), not abstract approximations (‘doses’, ‘X’). It is not an effective practice to simply label a product “3X” or “20X” to insinuate that there were some incredible levels of THC that were somehow related to each “X” given. All claims will be verified by actual lab testing. No information is always better than false information. A good phrase to remember: “When in doubt, leave it out.” But as providers and dispensers we have a responsibility to communicate as much reliable information as possible to our patients regarding their medicine and how it may affect them. This is an essential part of being a compassionate caregiver. Avoid using imagery that insinuates non-medical use Several medical cannabis products are marketed upon the strength of sexual innuendo, cartoons, blatant recreational use, humor and sarcasm. These practices open the door for conflict and bad publicity, exposing the entire medical cannabis community to a higher degree of criticism and confusing patients. Products containing imagery that can be viewed as unsavory, risqué or childish can give the impression that our community lacks seriousness and professionalism. Develop marketing and products with sound, ethical reasoning and avoid issues that may arise from careless practice and unnecessary imagery. Certain images and phrases Best Practices to avoid: seductive or sexually explicit images, cartoons & graphics that imply childish behavior or recreational uses, parodies of other companies’ logos or advertising, images that signify counter-culture, or copyrighted or trademarked images of any sort. Avoid marketing practices that may encourage or mislead the public into thinking medical cannabis is geared towards young people. Children are especially vulnerable, and every effort should be made to discourage accidental ingestion or application of a medicinal product. Medical cannabis is currently unregulated regarding advertising and marketing practices. We must take it upon ourselves to refine our packaging decisions. Be educated about standards and practices of the cannabis community Many regulations regarding medicinal packaging came from public outcry demanding that large drug companies clearly identify and list the ingredients and intended uses of their products. We can learn from these discussions & laws how to better inform and protect our own patient community. Be an active part of the cannabis community and educate yourself and production staff. Participate in the discussion & implementation of operating standards and regulations that may come about as this movement grows. Learn the history of medical cannabis and cannabis products. Products being dispensed as medicine should be crafted with patient safety in mind. Patients Helping Patients Patients and caregivers need accurate information and expect safe handling practices. Many patients have serious illnesses and the improper use of medication can cause adverse effects. It is important that we recognize and act upon the needs for proper labeling and packaging in all products intended for patient use through dispensaries. Being pro-active in this arena will better protect patient health, alleviate concerns, and reinforce public acceptance of medical cannabis as the safe and effective medicine it is.
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