Jonathan Starkey

The News Journal

A medical clinic set to open near Wilmington next month has one clear mission: certify patients to use medical marijuana.

With Delaware doctors hesitant to sign medical pot recommendations, officials at Massachusetts-based Canna Care Docs say they see an unmet need for patients, and a market, in Delaware.

The group has hired one doctor, a cardiologist, and signed a lease at 9 Germay Drive in an industrial park south of the city. The clinic plans a January 17 opening.

Patients will pay a $200 annual fee for service at Canna Care, a price that includes a session with a "cannabis consultant," an appointment with the doctor and a six-month follow-up. Insurance isn't accepted.

Canna Care's building is just steps away from the site of Delaware's first medical marijuana dispensary, which is scheduled to begin sales in April.

"The problem in Delaware right now is they don't have enough doctors writing recommendations for patients who truly need it," said Kevin Kafka, chief operating officer for Canna Care. "We offer an alternative."

Medical marijuana patients and pot advocates have celebrated the planned opening of Canna Care in Wilmington. But doing business in Delaware might be tricky for the company.

Delaware's medical marijuana law requires doctors who certify medical marijuana applications to have a "bona fide" relationship with the patient that "may not be limited to authorization for the patient to use medical marijuana or consultation for that purpose."

State officials acted recently to further tighten those restrictions.

Dr. Karyl Rattay, director of Delaware's Division of Public Health, sent a letter last month to about 100 physicians with patients in the medical marijuana program, saying that public health officials are "concerned about walk-in health clinics certifying patients for the use of medical marijuana where the traditional physician/patient relationship is not firmly established."

Going forward, state officials will have a higher standard for physician certification documents.

Public health officials reviewing medical marijuana applications must ensure that doctors have completed a full assessment of the patient's medical history; that they have created and maintained health records; that they will continue to provide care for the patient and; that they will provide follow-up care to make sure the marijuana is helping with treatment.

"We may be asking for more information from a certifying physician," said Thom May, who directs the state's medical marijuana program.

May said the new rules were not issued in response to Canna Care's planned opening in Wilmington.

Those rules, however, could result in yet more reluctance among Delaware doctors to sign medical marijuana certification forms, a requirement of any application.

Certifying doctors must agree that their patient is "likely to receive therapeutic or palliative benefit" by using the drug.

Some doctors worry "there has not been rigorous scientific research on medical marijuana because it's been illegal," said Mark Meister, executive director of the Medical Society of Delaware. "Physicians are scratching their heads saying, 'how can I certify?"

Qualifying conditions for Delaware medical marijuana patients include cancer, HIV, agitation of Alzheimer's disease, Post Traumatic Stress Disorder, ALS or Lou Gehrig's Disease, or other conditions that cause intractable nausea, seizures or severe debilitating pain.

There are 164 medical marijuana cardholders in Delaware, with another 46 applications under review, the state says. But with no dispensary, patients have no legal way to obtain the drug.

Todd Kitchen, a medical marijuana cardholder who has helped about a dozen others file applications, said Canna Care's entrance into Delaware is good news for patients who have faced reluctance on the part of doctors, and who have already endured a four-year-long delay waiting for the opening of Delaware's first dispensary.

Lawmakers voted to legalize medical marijuana in 2011.

Kitchen said Canna Care "can help patients here finally get an ID card which allows safe access to medical cannabis, which they really need to improve the quality of their life."

Kafka, head of operations for Canna Care, said the company will follow Delaware's rules. The company's Delaware doctor will meet with patients, and provide follow-up care – even sooner than six months, if necessary.

"We've been working very closely with folks in Dover to ensure that we're in full compliance," Kafka said. "We're taking our current business model and altering it to make sure it fits the regulations in Delaware."

Contact Jonathan Starkey at 983-6756, on Twitter @jwstarkey or at jstarkey@delawareonline.com.