 This is Stink Tech, Hawaii. Community matters here. Aloha. I'm Marcia Joyner, Mrs. Cannabis Chronicles, a 10,000-year odyssey. So tell me news of that planet, of many resources, which wonder far and wide the ancient plant of food, fuel, fiber, cultivated for millennia. As we venture through the past 10,000 years, we will explore and discover the plant of which cannabis derives, the many uses of the plant, hemp, cannabis, ashes, cannabis and religion, cannabis and medicine, cannabis and Gerald Uncle Sam. And so our odyssey begins. Today, our odyssey is not long ago and far away. It's current and in progress. It is needless to say Uncle Sam still has a part to play, but we're going to forget about sessions. Today, we are going to visit with my dear friend, and everybody that watches knows I only talk to dear friends, House of Representatives, majority leader from the Hawaii State House of Representatives, Della Albalates. Welcome, Della. Thank you so much. We've been trying to get her for months. Thank you for having me here. Thank you for being persistent. Yes. Thank you for coming. Della was in the lead or spearheaded this whole thing of cannabis dispensaries. Yes. And so needless to say, the day that the first dispensary opened, she was standing there and I said, now I need to talk to you. She says, OK, call me. Well, we have calls. Thank you so much for coming. Tell us about Della, though, first. I represent urban Honolulu, Makiki, Makali, parts of Manoa, Tantless, all of Tantless, Papakulaya, Pavao, and really urban Honolulu. Can you imagine walking that district? I have walked this district. It's certainly, I love my district. It has great disparity and diversity, but it's a wonderful place to live and raise my kids. So I have two kids, both attend public school. I enjoy being in the legislature as well as public service. It is great. How long have you been in the legislature? Since 2006. So I'll be going into my 13th year. Oh my goodness. And you run every two years? Every two years, yes. So now you're up for re-election again? Yes. And for anybody that doesn't know the election, primary election is Saturday, August 11, and there's no excuse not to vote. Absolutely no excuse. No excuse. No. And there's so much at stake. People say, oh, there's nothing to vote for. Well, yes, there is. There always is. There is. And especially in the cannabis industry. So tell us about the cannabis and this medical cannabis. Medical cannabis. So Hawaii was actually one of the leading states. We were the first state to, through legislation, approve the medical use and recognize the medical use of cannabis. I believe California was the first state to do it by initiative. We unfortunately did not have dispensaries until we were able to pass a bill in 2015. So dispensaries are only something new. And what's happened here in Hawaii is that for medical cannabis for a long period of time, it's been solely by personal grow. Or you could designate a patient, a qualified patient could designate a caregiver who could grow and cultivate for them. But now we have both. We have both. People can continue to grow for themselves individually in places where there are no dispensaries. The ability of caregivers to cultivate is continuing for some time, although we do see some point without phasing down with just the cultivation part of it. And then we have dispensaries as an option. What do you mean phasing down the cultivation? How can that be? So, you know, we've preserved and ensured that personal grow will continue because that's something that, you know, people can take care of their medicine. I think the concern about caregiver cultivations continuing is that we now have the medical cannabis dispensaries and we have a cultivation and production system there. So it's just one way to regulate the market. Again, I think, you know, we don't necessarily foresee dispensaries opening up on the more isolated islands like Molokai and Lanai. So, you know, there's concerns that, you know, we're going to have to continue cultivation. But even on Oahu, there are far away places, you know, the North Shore, for instance. Sure. So, you know, I really want to emphasize that we recognize, and I think the state has recognized that personal grow, the individual being able to grow for themselves is something that will be recognized, you know, going forward. But I think, you know, the real concern is that we see the proliferation and we're watching very carefully all of the states that have medical cannabis as well as recreational cannabis. And I think the concern is if the market should be regulated, it needs to be regulated because while it is a safe plan, you know, there's lots of things that when you grow things, there's lots of things that could be introduced. And so we really want to make sure that the product that is getting to our cannabis patients is quality and safe. Well, given what can be in the ground, you know, like the same thing for lettuce and all these other things that we grow and the water, how do you know? Well, except in the control area for the dispensary, but for regular growers at home. That is the real concern. So I think, you know, when we opened up the dispensaries, we acquired lab testing. Right. And now patients can actually go and take their own products because we have authorized the testing of patients' own homegrown cannabis at the labs. And I think what's sometimes stunning is that, you know, the discovery of mold and heavy metals because you can't avoid those things in an environment like Hawaii in your own personal homegrown system. That's not to say that all of the personally grown cannabis has those impurities, but that's been the concern. So I think we now know better because we have lab testing facilities. Do we have them all over the island or do you have to come bring your product to this? Sure. So we have lab testing facilities, I believe, on Oahu and Maui, I believe, has some. So one of the things that we've done is... Just one or some? I think the last I checked, I believe there were either two or three... On Oahu. Yeah, two or three that were operating and I'm not sure... I'm thinking about people away from King Street. Sure. So one of the things that we did was we don't recognize intra-island transport of cannabis by patients yet. We have allowed in the law though a limited exception so that dispensaries can transport via intra-island air travel for testing purposes only. Even though we don't have lab facilities on every island, the dispensaries can transport for limited purposes to other lab facilities if they don't have a lab facility on their island. And so, again, back to the country of the windward side, North Shore, Haleva, Wai'anae, all these people have to come to King Street. So the dispensaries on each island or the dispensary licensees, they have an opportunity to open up two retail locations. So on the island of Oahu, we're talking of... If you have three dispensary license, we're talking up to six dispensary locations. Most of the dispensary locations currently are concentrated in the urban Honolulu area, but I believe that there might be plans to expand to other areas. You know, it's really though they have to find the right site. There's, again, a lot of regulations about where... What are the regulations about where they can be? They have to be a certain distance from schools. They need to have certain security measures. I think one of the things that we found early on, and it might be changing now, you know, there were some landowners who were not comfortable with allowing cannabis to be on their properties. And it's understandable because, you know, at the federal level cannabis is still not recognized. And so people are taking risks. But finding the right places has been, I think, a challenge for the dispensaries, and yet they're still moving forward with their plans. That's great. Tell us about the reciprocity. So this year, this legislative session... What is reciprocity? So reciprocity is really allowing qualified out-of-state patients to be able to purchase in-state. And what we know is that there are people traveling from other states, and they use medical cannabis in their states. And so we want to encourage their ability to also access their medicine here. They technically cannot transport. They're not supposed to be able to transport their cannabis, their medicine with them. So we want to be sure to open up that market for our dispensaries. And I think, you know, it's important because we are a compassionate state, and we want people to come and visit. And if they, you know, like any other medicine, they should have access to their medicine. So we want to make sure that it's safe. It's been a balance, though, because we also know that we want to make sure that there's enough supply for our in-state patients. And so that was some of the conversation this year. But, you know, I believe our dispensaries, they can operate, and they want to be able to serve out-of-state patients. And so we want to be a destination that recognizes wellness, and we want to make it a welcoming state. So we do want to open up this channel. So has that passed? This session in Act 116, recently signed by the governor, we have set forward the requirements for that. It's still going to take some time because the Department of Health has to implement all the regulations. But we've given them the framework to do that. Two years ago, or three years ago, we had authorized them to start doing it. So we really want the Department of Health to get going on this. They've been awfully slow. Yes, they have been, but, you know, we have asked them to bring up an industry that has to be highly regulated. Could they be faster? Yes. Yes, I think this session, another thing we did was we created an office of cannabis, I believe, office of cannabis regulation and control. And so what we did was we combined the registry program for our patients as well as dispensary program into one office that will operate separately. So before it had been kind of dispersed. So we tried to streamline it and give them more flexibility as well as more staffing so that they can execute on the work that they need to do. Yes, they've been slow about everything. So tell me now, once the reciprocity, we have an issue, people coming, I mean, I don't have an issue with tourists, but this payment of cash. So many tourists come with cash. You know, they're used to writing with the debit or credit card. And why is it that everything is in cash? Well, there continues to be challenges with banking. And unfortunately, that's going to require a federal fix and the federal government passing some legislation to allow for the transfer of money because it's interstate, you know, and all that kind of stuff. The solution that we've come up with here, I believe, does allow people to use cash or to some kind of debit card. But there is, you know, unfortunately, we still have to work with that. And so, you know, people do bring cash with them. They can access their ATM machines. You know, it would be great if we could have more credit card transactions, but it's just something that the industry and it's happening in all of the places where they have. Either recreational or medical cannabis. They're struggling with this issue. So couldn't the state open or private open? Not a bank, but like a credit card. You know how the credit card. I mean, not the credit credit union or community, but not call it a bank, but somehow that you could have this so that the owner of the facility wouldn't have all this cash at the end of the day. There have been suggestions that we can do that. So I think there are people creatively looking at those kinds of options. The real fix, though, and I think, you know, again, with every election, I think as more and more states take on medical cannabis, the pressure to find and come up with a federal fix for the banking problems will emerge. So I'm more hopeful for that. We could engage in trying to create a state bank or a state credit union, but those those still face the same challenges of the current banking situation. What now when you know we have this this issue of money. The thought that I would have all of this cash to go in to a facility, the security. I know that facilities are secure, but what about the patient that comes out and walks to their car or gets on the bus? All of those things that especially older people. I think those are real concerns that I would imagine that the dispensaries on their properties, you know, are very concerned about that too. You know, in other states, we haven't seen the kind of crime emerge around the cannabis dispensaries as some thought that would emerge. So, you know, we have to be concerned about that. You know, the state was really concerned about how they were going to take in all that amount of cash in taxes. And so, and I know the dispensaries have also been very concerned about having those kinds of large amounts of cash also on site. So, you know, people have been taking the appropriate measures. And so that again, that's another reason why regulation is so important. You know, we wanted to we want to ensure that this is their safe transactions and people are safe. We can't protect against everything. But I think, you know, people have to be smart about when they're transporting their own and be safe. Now, we put up a big fight against the governor and the opiate bill. Yes. Of which he vetoed. Yes. And I've broken hearted because we did, did all we could. What, why was the veto? Now, I read the bill and it said that it was an amendment to the definition. So why the veto? So, you know, when the law was first enacted, the Department of Health in 2000 was authorized actually to add qualifying conditions and to amend it so that it could be more inclusive of other uses for the medical cannabis and recognizing other medical uses. They didn't start activating that process until we passed the bill in 2015 for medical cannabis in part, because in 2000, it was the Department of Public Safety that really had authority over medical cannabis. I think we've seen a sea change now that the Department of Health has authority. They've actually authorized additional qualifying conditions. And so I think I understand the governor's veto. You know, it would have been he could have easily just taken our legislation and passed it, but I think we now have an administrative process that works. Now, if that process fails in light of all of the findings and research that we now do have that medical cannabis can be a replacement for opioid addiction and opioid therapies that maybe, you know, then that's when the public should come back to the legislature. But I think we should allow that administrative process to occur because really at the legislature we should be looking at the larger policy issues. And at some point in time, really, we have to ensure and defer that the executive has the ability and the staffing and the resources to do what they need to do in accordance with best practices. Well, now the governor of Hawaii is the most quote, most powerful governor in all 50 states with 18 departments under his purview. That's a big job. Yes. And the health department seems somehow to run amok to do whatever they do without anybody from the top saying, hey, wait a minute, slow down. They even got what was it with the health care? I mean, a nursing home that the fed said you aren't doing a good job because they only had nine examiners. Where is it from the top that says, hey, we need to fix this? So what happens in from what it says that he is supposed to do or she or whatever to what actually happens down in the department? Sure. You know, the Department of Health has a lot of responsibility. And I think with the cannabis dispensaries, we expect it a lot from them. Could they have done things faster? Sure. But they wanted to be careful. I think now that we've reorganized and we've given them more flexibility over both the registry program, so the patients as well as the dispensaries, we're going to, I hope to see more efficient use of resources. They were short staffed for a long time. So a lot of it is about staffing. You know, I think the governor is allowing for this to go forward. The new director is supportive, I believe. So I think we really have to keep pushing on all the advances we've made. Okay, now we need to take a break. Okay. And we'll be back in a minute. Yes. This is Think Tech Hawaii, raising public awareness. Do you want to be cool? If so, watch my show on Tuesdays at one called Out of the Comfort Zone. I sang this song to you because I think you either are cool or have the potential to be seriously cool. And I want you to come watch my show where I bring in experts who talk all about easy strategies to be healthier, happier, build better relationships, and make your life a success. So come sit with the cool kids at Out of the Comfort Zone on Tuesdays at one. See you then. Okay. And we're back. I'm Marsha. And today we are visiting with House Majority Leader, Della Albalates. And we are talking about cannabis. So, tell us about, you know, there's so many questions that patients have. Certainly. Once they get the card, then what? What happens? So, every year they have to recertify their card. And one of the things that we did this year was in Act 116, we authorized the extension of the written certification for debilitating conditions for up to three years for chronic conditions. Every year we come back and we look at ways that we can improve the law. And there's numerous patient-friendly, consumer-friendly provisions that we put in. Another thing that we authorized this year was we're allowing for a bona fide patient-physician relationship to occur by telehealth. So, we know that patients on other islands may not have access to doctors who are willing to certify their medical conditions for the use as a qualifying condition. So, again, those are other things that we've done. A third very important kind of pro-patient thing, two actually, is that we authorized working groups for two very important areas. The first area is regarding reimbursement, insurance reimbursement issues around medical cannabis. That was my next question was, okay, now I go to the doctor and I have this forever ailment, lupus, for instance, MS. Those aren't going to go away. So, what about the insurance Medicare? And I guess Medicare is federal, so that's out. But other insurances? So, that's something that we're going to be struggling with. And, you know, we know that there are actually FDA approved cannabis-based medicines coming on board, right? So, the issue of how are we going to reimburse and pay for these is becoming more and more solidified as something that we need to do something about. So, for the longest time, patients are paying out of pocket and that could be very, very, very expensive. So, you know, we're looking at that. But really, there's a lot of complex issues because insurance, you know, depending on is it federal insurance, federal insurance will not cover it, given the prohibitions at the federal level. So, we have to ask, you know, what are the obstacles and barriers at the other, you know, other levels? And what can the state do to require? There are some states moving forward and then individually some insurance companies may already be honoring some of that, because if they know that it's something that's like replacing opioids that could be costly or other medications, it makes sense for them. But we have to figure out what are the policy obstacles and then see if we can do anything. So, that our audience knows when we talk about opiates and cannabis, the cannabis doesn't cure. No. It just alleviates as you are stepping down from your habit. It keeps you sane. It helps you step down to kick that habit. It isn't, what is it? A supplemental. It is not the cure. So, that we want to keep that straight and the audience doesn't think. Sure. Sure. I think it's really something, you know, the use of cannabis should be used in consultation with a physician. That's what's required right now. A healthcare provider needs to help people navigate it. So, that is in the requirement. You know, there's one other area that we are looking at and we created a working group and that's around employment issues. And when patients, qualified patients who we know are functioning and they can function in the workplace, cannabis allows them to function and be productive. They're concerned about being... A dirty pee test. Yes. Yes. So, you know, we're looking at those issues. Again, other jurisdictions are struggling with it. We have had a long history of zero tolerance. So, really, we need to come to grips with that. And so, there's lots of challenges there. But because medical cannabis is recognized and we have more and more patients coming on board, it's going to become more and more of an issue for our employers. I know that the big, what do you call those things, professional ball-playing groups, basketball, football, they recognize that their players get hurt and that they can use this. Yes, they're recognizing it. You know, there's lots of issues and people can function better. They're still safe. Really, it's about, are they operating under the influence and are they dangerous? And certainly, we do not want people who are under the influence of any drugs in situations. So, we have to look at that carefully. Yeah. Because we have to look at alcohol, which is legal, and that's worse, far worse, to your body. And cigarettes are legal. So, we've got to look at, I think that, now, can we do this safely, I guess is my question, because we're not doing it safe with alcohol other than tax it. So, I had one more question for you, and now it's gone, as old age is it. What next? Where do you go from here? You know, I think we have to continue to monitor what's happening. And every year, there is a push to recognize recreational, basically legalize cannabis for all uses. I think we need to look at that. We need to keep having the conversation. I do think, though, that Hawaii is on the right track, because what we see in other jurisdictions when they quickly go to recreational, then sometimes the needs of medical cannabis patients are lost. And really, we need to make sure, because this started, and it really is about getting quality, safe medication to patients who really need this. You know, I know cancer patients who are benefitting from medical cannabis. We know children with epilepsy can be helped by this. We need to make sure that that is honored, and we create the system that protects the medical use of cannabis. Well, thank you so much. And one last thing, Hawaii is the only state that changed from marijuana to cannabis. Was that your idea? You know, I have to say that it was representative Cynthia Thieland who has really pushed us on that. But, you know, I think all of us have just recognized that it's cannabis, and we should use that term. Thank you so much, Della, for coming and spending this time with us. And we will see you next time.