Section 691-2-11 - INPATIENT HOSPICE AND NURSING FACILITIESA.Voluntary participation of facility. Inpatient hospice providers and nursing facilities may voluntarily participate in the Maine Medical Use of Marijuana Program, in accordance with this rule and the statute to assist qualifying patients who use marijuana for medical purposes. Nothing in this rule compels an inpatient hospice program or nursing facility to permit marijuana for medical use at the facility by a qualifying patient. Only the inpatient hospice program or nursing facility assisting the patient with the administration of marijuana for medical use is required to be designated by the patient and register as a cardholder.1.Home hospice programs. Home hospice programs are not subject to this rule and the statute. Only inpatient hospice programs are permitted to be a designated MMMP primary caregiver. However, in accordance with this rule and the statute, a qualifying patient may designate the individual home hospice employee who provides hospice care to the patient to also be his or her MMMP-designated primary caregiver, if the employer's policies allow.2.MMMP participation provisions are separate from licensing provisions. The requirements for MMMP participation are subject to the Maine Medical Use of Marijuana Act and this rule, not facility licensing laws. a.MMMP and licensing documentation kept separate. MMMP documentation shall not be included in the medical record, chart or medication administration record (MAR) that is required under facility licensing laws. A qualifying patient's MMMP record must be maintained at the facility as a separate record and shall include, but is not limited to, the inventory record, and documentation of marijuana administration.3.Facility registration required Prior to assisting a patient residing in the facility, inpatient hospice providers and nursing facilities must submit a Department-approved Primary Caregiver Application form to become a registered primary caregiver in the Maine Medical Use of Marijuana Program. There is no application or renewal fee.B.A qualifying patient in a hospice or nursing facility. A qualifying patient while in an inpatient hospice program or a nursing facility may participate in the Maine Medical Use of Marijuana Program in accordance with this rule and the statute. The facility's policy may require the patient to disclose possession when the patient is using or storing marijuana for medical use.C.Designated primary caregiver is the facility. It is the inpatient hospice provider or the nursing facility, not their staff, that is designated a registered primary caregiver and must comply with applicable provisions of these rule and statute. 1.Not required to accept designation as caregiver. An inpatient hospice provider or nursing facility is not required to accept a qualifying patient's designation as the patient's primary caregiver. A facility may not assist the patient with the medical use of marijuana unless designated by the qualifying patient.D.Registry identification cards for staff members. Designated inpatient hospice providers and nursing facilities must apply for registry identification cards for each individual staff member assigned to assist qualifying patients. A registry identification card is issued only to a staff person who is at least 21 years of age and not convicted of a disqualifying drug offense. The application process for a registry identification card is set out in this rule and the statute.E.Criminal history record check. The designated facility must include the copy of a criminal history record check on each staff member for whom the facility submits a registry identification card application or renewal. The criminal history record check submitted by the facility must have been secured within the past 12 months. If the facility does not have the required criminal history record for an individual staff member, the facility must pay for and secure a criminal history record check to submit with the application for a registry identification card.F.Facility registration and staff cards required prior to assisting patients. Prior to assisting qualifying patients, the designated hospice provider or nursing facility must be registered as a primary caregiver and MMMP registry identification cards issued to facility staff who will assist with the patient's medical use of marijuana. No staff member should remove a registry identification card from the facility, except when the authorized staff member is transporting marijuana outside the facility to deliver to the patient or to legally dispose of the marijuana.G.Qualifying patients in facility may not cultivate. Qualifying patients in a hospice inpatient program or a nursing facility may not cultivate their own marijuana.H.Designate a second primary caregiver or dispensary to cultivate. The qualifying patient may either designate an individual, who is not a facility staff member, as a second primary caregiver to cultivate marijuana for the patient's use or the patient may designate a dispensary to cultivate marijuana for medical use.I.Marijuana acquisition: from dispensary or cultivating caregiver. A qualifying patient who is in an inpatient hospice program or a nursing facility may acquire marijuana for medical use in accordance with this rule and the statute. The facility shall document acquisition in the patient's MMMP record. 1.Dispensary. A designated facility acquires marijuana from a dispensary by either sending a facility staff member with a registry identification card to the dispensary to pick up the marijuana or the dispensary delivers the marijuana to the facility.2.Cultivating caregiver. When the qualifying patient has not designated a dispensary to cultivate, the patient may designate a cultivating primary caregiver to cultivate the marijuana for the patient's use.3.Products containing marijuana must be purchased. A facility may not possess, administer or furnish any other types of marijuana except prepared marijuana in an amount of two and a half ounces or less per qualifying patient that has designated the facility. A facility may not make marijuana into products to be ingested. Such products must be acquired or purchased from the designated dispensary or primary caregiver.4.Trip tickets. The facility must retain the marijuana trip ticket from the dispensary or the cultivating caregiver with the marijuana during transport.5.Storage of marijuana for medical use. Special storage consideration is required for marijuana and foods containing marijuana such that access is limited to only the patient and those authorized to assist the patient with the medical use of marijuana.J.Inventory control. When the designated facility stores and maintains the inventory of medical use marijuana for a qualifying patient, the facility shall have a policy that addresses how inventory is recorded and access monitored. 1.Access to inventory. When marijuana is removed from the facility's inventory, the cardholder must document this in the patient's MMMP record.2.Daily inventory. Prepared marijuana must be stored in accordance with the provisions for storing controlled substances and inventoried daily by two staff persons who have MMMP registry identification cards.K.Assisting administration of marijuana. A facility assisting a qualifying patient with the medical use of marijuana shall have protocols in place that are consistent with this rule and the statute to address the storage, inventory monitoring and patient access and use. When the designated facility administers medical use marijuana for a qualifying patient, the facility is subject to the following provisions. 1.Facility staff. A medication technician or a nurse may administer marijuana as long as he or she has been issued a registry identification card for the designated facility. Designated facilities should limit the number of individual staff members who can assist the qualifying patient with marijuana for medical use.2.Administration of marijuana in a facility. Only an authorized cardholder may assist a qualifying patient residing in a facility with the medical use of marijuana.3.Disposal of unused marijuana. The designated facility must comply with this rule and the statute regarding the disposal of unused medical use marijuana.4.Facility smoking policy. The designated facility shall establish and maintain a policy for the administration of marijuana for medical use that includes smoking, vaporizing and using non-smokable forms of medical marijuana.L.Confidentiality. The fact that a patient is participating in the Maine Medical Use of Marijuana Program is confidential and each facility serving MMMP patients must develop "need to know" protocols.M.Discharge from facility. A resident may not be discharged solely because the patient is a qualifying patient in the Maine Medical Use of Marijuana Program.N.Protected conduct: hospice providers, nursing facilities, and staff. The protections and requirements of this rule and the statute are for conduct that is expressly authorized for hospice providers, nursing facilities and their staff that provide care for a qualifying patient in accordance with this rule and the statute.O.Reimbursement. This rule and statute do not affect whether the facility may be reimbursed by other than private money for assisting a qualifying patient with the medical use of marijuana.18-691 C.M.R. ch. 2, § 11