John R. Roby

jroby@pressconnects.com | @PSBJRoby

The Watchdog File is a weekly column investigating the data, officials and institutions that shape life in New York State. Follow @watchdog_file on Twitter, and send tips to jroby@gannett.com.

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More than a year after the first New Yorkers started receiving medical marijuana, less than 1 percent of the state's doctors are qualified to steer patients to providers.

And the names of that handful of doctors is a secret, according to the Department of Health, which has thwarted efforts to publicize Compassionate Care Act providers for as long as there has been a Compassionate Care Act.

Since early last year, critics have described widespread problems with how the program has been implemented. Among them are a lack of access to doctors who have undergone the training and certification that allows them to connect patients with medical marijuana providers.

The health department disputed the characterization that registered doctors are "secret," noting that physicians themselves can use a web-based system to refer a patient to another doctor — provided that doctor has agreed to being listed.

"Health care practitioners do have access to a list of practitioners registered with the medical marijuana program who have consented to being listed on the Department’s Health Commerce System," the department said in an emailed statement.

The department maintains it is "prohibited" from publicly posting the identity of a practitioner registered with the medical marijuana program without that practitioner's consent. Yet the Compassionate Care Act itself contains no such rule. It also pointed to concerns about safety of the registered doctors, but physicians do not directly prescribe medical marijuana, nor is it allowed to be kept at a doctor's office or traditional pharmacy.

A review of the data that are publicly available found:

As of this week, 824 doctors had received state certification. That is up from about 600 as of July, but it constitutes less than 1 percent of the state's 90,000 licensed physicians.

Also as of this week, 12,500 patients had registered to receive medical marijuana, up from about 5,000 in July. That is one-half of one percent of the state's population.

More than half of the state's counties — 34 — had fewer than three certified doctors as of July. Nineteen counties had zero.

Despite the hurdles, the state's medical pot pioneers are optimistic.

"You can't possibly be in this industry without a long-term focus," said Ari Hoffnung, CEO of Vireo Health of New York, one of five companies licensed to grow and dispense medical marijuana. "If you don't think tomorrow will be better than today, you can't get through today."

Since last spring, the health department has been delaying an open records request by the USA Today Network's newsrooms in Binghamton, Elmira and Ithaca for the list of doctors who have registered under the Compassionate Care Act to refer patients to a medical marijuana provider. A request for all similar inquiries made to the department since January 2016 has also been put off four times, in apparent contradiction to the state Freedom of Information Law.

New York law allows a public agency five days to respond to an open records request, then up to 20 additional days to fulfill or deny it. There is a formal appeals process in place by which the press or a private citizen may contest a denial.

The state's Committee on Open Government has advised that an agency "cannot engage in one delay after another" and doing so "constitutes a denial of access that may be appealed."

The department has effectively closed the appeals process by refusing to either fulfill or deny the request.

It's the latest example of the department's resistance to providing public information about the medical marijuana program.

Last year, the Rochester Democrat & Chronicle, also part of the USA Today Network, made a similar request, which has also been subject to months of delays.

The newspaper also found the department had rejected 11 other open records requests since January.

All of this is despite the department's own recommendations, made in a "two-year report" it issued last summer. Among them were to increase the number of providers by allowing nurse practitioners to certify patients into the program, and improve outreach to potential providers.

The department "will explore additional ways in which to ensure that patients have access to registered practitioners, including adding a public list of consenting practitioners registered with the program and enhancing the list of registered practitioners currently available," the report stated.

Last summer, the Assembly unanimously passed a bill that would require the department to post a public, searchable database of registered practitioners on its website. The bill's text said the sponsors "believe current law requires disclosure of this information, but [the Health Department] believes this is not correct. This bill would make it clear that the public is entitled to this information."

The bill died in a Senate committee.

Hoffnung, whose company operates a dispensary in Johnson City, Broome County, said a public, searchable listing of physicians would help patients, who are by definition in poor health and may have limited mobility.

"Many have made the analogy of finding a needle in a haystack, and it should not be that way," he said. "Someone suffering with cancer or ALS shouldn't have to call 30 or 40 doctors to find someone who is registered with the program. We have to make the list more accessible."

The Compassionate Care Act allows marijuana products to be prescribed for patients with one of 10 severe illnesses, such as cancer or HIV/AIDS, and one of five associated conditions, such as chronic pain. It can be dispensed as an oil or capsule, not as a smokable nor edible product.

The health department's two-year report found the most common illness, in 34 percent of patients, was neuropathy, and 53 percent had severe or chronic pain as the underlying condition. Almost 14 percent of patients were diagnosed as terminally ill.

Twenty-five percent of patients, or about 1,200, received medical marijuana because of cancer. Yet also according to the health department, the state recorded an average of 108,000 incidences of all cancers per year between 2009 and 2013, and an average of 35,000 deaths.

The department's figures tend to support Hoffnung's contention that there is a great, unmet humanitarian demand for medical marijuana.

There is also an economic argument to be made. Counties that are host to a manufacturing or dispensing operation receive excise tax revenue. Last year, Broome's share was in the low triple digits.

Yet Vireo's Johnson City dispensary has recently doubled its operating hours, expecting more patients, more jobs, and more revenue to Broome.

"We've made a lot of progress, but we have a tremendous amount of work ahead of us in terms of improving patient access, in terms of increasing participation among health care practitioners to make this program truly successful," Hoffnung said. "We're in the first year of a program that has helped thousand of patients in the state, but there's certainly a lot of work ahead of us."

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BY THE NUMBERS

Registered physicians and certified patients by county, as of June 2016

Broome: 3, 41

Tioga: 2, 15

Chemung: 4, 11

Tompkins: 4, 14

Monroe: 24, 99

Dutchess: 12, 133

Westchester: 42, 340

Source: New York State Department of Health, Two-Year Report, "Medical Use of Marijuana Under the Compassionate Care Act."