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Tuesday, Apr 24, 2018
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Patients face delays, bureaucratic headaches after marijuana clinics close

Thousands of patients who received medical marijuana access from physicians at a half-dozen recently closed clinics in Tampa Bay may be forced to find another doctor soon, which is no easy task due to state restrictions.

Tetra Health Care, a California-based chain that hires licensed doctors to write medical marijuana recommendations at six clinics in Florida, shut down all but one of them last month to focus on working with state lawmakers to make access easier for patients, a company spokeswoman said. But a former doctor with the chain said Tetra ran into financial trouble and stopped paying its physicians and staff in October.

Those in the industry say Tetraís downsizing is just one sign of many growing pains doctors and companies will face as Florida heads into its second year offering medical marijuana products to registered residents.

PREVIOUS COVERAGE: Are Florida doctors prepared to treat patients with medical marijuana?

"When they stopped paying us is when I left," said Dr. Kelly King, who worked for Tetra Health Care since the company began opening clinics in Tampa Bay last summer. She said Tetra was still using the passwords of departed physicians to access the state registry that tracks which patients were assigned to them.

"I noticed after I left, they were still putting new patients into my registry," she said. "People I had never seen or treated before."

King, who said she treated hundreds of patients during her time with Tetra, also said the company grew too big too fast. Tetra Health Care had one clinic in Sacramento, Calif., before expanding into Florida.

"They never really opened a lot of offices at one time before," King said.

Tetra had five locations in the Tampa Bay area: two in Tampa and one each in St. Petersburg, Clearwater and Brandon. A sixth was in the Orlando area. Patients are being directed to one remaining center in Tampa, at 2814 W Dr. Martin Luther King Jr. Blvd., for appointments and doctor recommendations.

"The roadblocks from the state and delays in patient access have resulted in higher operational costs than originally projected for the industry statewide, including for Tetra Health Care. Tetra expects to make full restitution shortly," said Tanya Cielo, a spokeswoman for Tetra.

"Tetra has merged locations to our MLK facility, which is our largest clinic and can see the most patients per day," she said. "We are explaining the situation to our patients and offering them a choice to either go with the registered doctor on file or to be deactivated to transfer to a new Tetra physician. The majority of patients have chosen to stay with Tetra. Our overall goal is to make this transition as smooth as possible. We need to be financially strong to be able to go back to Tallahassee to fight for the rights of our patients under Amendment 2."

Cielo said recent changes to qualifying conditions as well as delays in issuing medical marijuana cards to patients are the reasons behind the clinic closures. But others in the industry say that explanation doesnít make a lot of sense.

"The process has actually improved," said Alex Adams, president of Compassionate Care Clinics, a medical marijuana doctorís office in St. Petersburg. "Weíve seen patients get their medical cards within 30 days, sometimes in 21 days. So thatís not really the case."

But itís the patients who will likely suffer the most headaches in the wake of the Tetra closures, King and Adams agreed.

PREVIOUS COVERAGE: It may be legal now, but opening a medical marijuana store in Florida is harder than you think

Patients who visit Tetra in search of medical marijuana need to bring a valid Florida ID and proof of residency in the state for either a walk-in visit or appointment. Staffers walk potential patients through the criteria required by the Florida Department of Health to help them register as patients. Once applicants pay the $75 state fee and receive registration cards in the mail, they can go to a dispensary with the recommendation they receive from a Tetra physician to fill an order. Tetra charges $198 for the service.

"Itís a lose-lose on both sides of the fence. Thereís no real recourse for patients whose doctors left the business," King said. "At Tetra, patients pay a fee for treatment for the entire year. So if patients are forced to switch to a new doctor, theyíll have to pay to get set up somewhere else all over again."

But the added fees are just one part of the problem. By law, a patient can have only one doctor at a time certifying them for medical marijuana use, said Mara Gambineri, a spokeswoman with the Florida Department of Health, which oversees cannabis use in the state. That means a physician must manually "deactivate" a patient in the registry if they are no longer treating them to release them to see another physician.

If a physician refuses to do this or if a patient cannot reach the physician directly, the health departmentís Office of Medical Marijuana Use can step in, Gambineri said.

Adams said the ordeal is "super frustrating" for patients. Some Tetra patients have had trouble getting answers from office staff or reaching doctors by phone after the clinic closures.

Adams said his office has attempted to help patients start over with a new doctor before and said the process can be difficult and tedious.

"It can take weeks," Adams said. "We can guide them, but because of (patient privacy laws), we have no way of acting on their behalf. Most of our patients are seniors, and many donít use a computer regularly. So this is a big cause of concern, especially with the larger clinics that have hundreds or thousands of patients and donít have a local phone number to call."

Another chain of clinics called Marijuana Doctor, which has five locations in the Tampa Bay area, hired two of the former Tetra physicians and is seeing Tetra patients without charging them until the state required seven-month re-visit, a company spokesperson said.

Nearly 64,000 Floridians have signed up through the Department of Health to receive medical marijuana as a form of treatment for a list of qualifying illnesses since the registry opened in 2016. And 883 physicians have taken the state-mandated course that officially qualifies them to examine those patients and recommend products that might help. Dispensaries began opening across the state in 2017.

But clinic closures and backlogs for medical cards at the department of health arenít the only issues that have arose this year.

"Due to the rush of cards that were issued, it seems that some dispensaries are having a difficult time keeping the more popular products on the shelf," Adams said, like low THC- and CBD-based cannabis products, which are usually oils or vaporizer cartridges.

And in another development, a community bank in Central Florida, First Green Bank, announced in December that it would no longer continue to work with medical marijuana companies, even though it was the first in the state to handle cannabis clients and held accounts for six of the seven licensed producers of medical marijuana. Most banks in Florida have steered clear of working with the stateís licensed growers and distributors of cannabis because itís still illegal to possess or distribute the substance under federal law.

When Tetra began opening clinics in locally last year, they did so with advertisements on local radio stations and on high-profile billboards along major highways.

"What Tetra did was great in terms of raising awareness that people in Tampa Bay could get medical marijuana now. A lot of their messaging was just that itís legal now and itís here," said Pete Sessa, chief operating officer of the Florida Cannabis Coalition, which is based in Tampa.

"There have been some growing pains this year," he said. "But I think next year, as some more items get ironed out, weíll start to see more marketing and more clinics opening up again. Itís all about weeding out the Ďfly by nightí people. And the ones who are in it for the long haul and really care about the patients will rise to the top."

Contact Justine Griffin at [email protected] or (727) 893-8467. Follow @SunBizGriffin.

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