The County of Santa Clara
California

Report
72278
Approved as Amended
Jun 24, 2014 9:00 AM

Consider recommendations relating to medical marijuana dispensaries in unincorporated Santa Clara County. (Office of the County Executive)

Information

Department:Office of the County ExecutiveSponsors:
Category:Report

Multiple Recommendations

Possible action:
a. Accept report relating to marijuana.
b. Direct Department of Planning and Development to prepare amendments to Zoning Ordinance to eliminate "medicinal marijuana dispensary" as a use classification and delete "medicinal marijuana dispensaries" from non-residential use classification tables.
c. Direct Department of Planning and Development to prepare amendments to Division B26 of the County Ordinance Code prohibiting establishment and operation of marijuana dispensaries, collectives, or cooperatives in unincorporated Santa Clara County.
d. Direct Public Health Department and Department of Alcohol and Drug Services to undertake a public education campaign concerning the adverse effects of recreational marijuana.
e. Direct Administration to investigate regulatory gaps that County functions may be able to fill to strengthen the City of San Jose's regulatory structure for medical marijuana dispensaries.
f. Direct Administration to prepare proposed legislative policy positions pertaining to marijuana for incorporation in County Legislative Policies and Priorities.

Body

FISCAL IMPLICATIONS

There is no negative fiscal impact to the County General Fund associated with the approval of the recommended actions.

 

REASONS FOR RECOMMENDATION

At the February 25, 2014 Board meeting, the Board of Supervisors engaged in a discussion concerning the numerous County departments that have functions related to marijuana.  The Board expressed concerns that County departments may have perspectives and roles that work at cross purposes.

 

Marijuana in our community is a timely topic of discussion for two reasons:  One, the City of San Jose recently revised its operational and land use regulations for medical marijuana dispensaries and, two, as widely reported, marijuana advocates will likely organize and finance an initiative to place a measure on the California ballot in 2016 to legalize recreational marijuana for adults.

 

Summary

There has not been an ongoing work group per se dedicated to coordinating our marijuana roles, but department stakeholders do collaborate when appropriate, and the Office of the County Executive has periodically convened departments to coordinate our activities and strategies, the most recent occurrence of which was in 2011 to propose amending Ordinance Code Division B26 pertaining to Medicinal Marijuana Dispensaries.

 

A pillar of the County mission is to promote a healthy, safe, and prosperous community for all, and, to that end, County departments are unanimous and unequivocal with respect to all aspects of marijuana.  The Administration opposes youth access (unless medically necessary), violations of existing state and federal marijuana laws, the inadequate regulatory structure for medical marijuana dispensaries, and supports regulating marijuana so that those with serious illnesses can obtain an uncontaminated product from a pharmacy through a prescription.

 

Further medical marijuana research should be encouraged to establish its effectiveness and safety.  No other drug has been freely available before its potential harms and benefits have been evaluated.  Two THC drugs for those with a serious illness, Marinol and Nabilone, are currently available through pharmacies, and a third, Sativex, is used in Europe and close to FDA approval.  Marijuana should continue to be available for those 1% to 2% of Californians who have a serious illness, such as, glaucoma, HIV, or cancer.

 

Public Safety and Justice Committee

At the May 21, 2014 Public Safety and Justice Committee meeting, the Committee approved the Administration’s recommendations.  In addition, the Committee expressed two additional wishes.  First, the Committee supported the County Marijuana Work Group continuing its work.  The Administration reported that this work group would continue to convene to further investigate possibly filling regulatory gaps to assist the City of San Jose strengthen its regulatory structure for dispensaries in San Jose.

 

Secondly, the Committee requested Public Health and Alcohol and Drug Services Departments lead a public education campaign that would educate the public about the adverse health effects of marijuana use, particularly on youth.

 

For the reasons set forth in this report, the Administration recommends that the Board of Supervisors prohibit the establishment of medical marijuana dispensaries in the unincorporated county (there are currently no dispensaries located in the unincorporated county), direct the Administration to investigate opportunities for County functions to help fill regulatory gaps for medical marijuana dispensaries in San Jose, and prepare proposed legislative positions to be incorporated into the Board’s Legislative Policies and Priorities.

 

The Administration is recommending (in a linked Legislative File #72598) an urgency moratorium ordinance so that Planning and Development can prepare amendments to Division B26 of the Ordinance Code and the Zoning Ordinance. The moratorium ordinance is necessary so that the County has sufficient time to prepare the appropriate ordinances, and in the interim, no dispensaries can be established in the unincorporated county. The Zoning Ordinance amendment will be considered at the Planning Commission meeting in July and both ordinance amendments would be presented to the Board at its meeting on August 5, 2014. The moratorium ordinance would be effective immediately and shall be in effect for 45 days.  The Board may extend the moratorium ordinance for up to two years, following notice and a public hearing.  The adoption of the moratorium ordinance and any extensions to it require a four-fifths vote.

 

The Administration is also recommending that the Board direct the Administration to prepare marijuana policy positions to incorporate into the County’s Legislative Policies and Priorities in order to permit departments to advocate on behalf of the County’s interests.  The County would be in a position to advocate for medical research, participate in forums studying the effects of legalizing marijuana, and address quality of life policies that will affect our residents.  Additionally, the State Legislature’s current consideration of the Correa bill regarding regulation of medical marijuana dispensaries illustrates the need for the County to take an active role in shaping the policies that impact us and our residents.

 

County Marijuana Work Group

To prepare this report, the Administration established a work group comprised of staff from numerous County departments.  If the Board directs the Administration to prepare analysis and program proposals for additional local regulations of dispensaries, some of these staff would be involved in the development of the proposals.

 

·        Sylvia Gallegos, Deputy County Executive

·        Patrick Vanier, Supervising Deputy District Attorney, Narcotics Prosecution Team

·        Carl Neusel, Assistant Sheriff

·        Dan Peddycord, Director, Public Health Department

·        Sara Cody, Public Health Officer

·        Sue Nelson, Division Director, Children, Family, and Community Services, Department of Alcohol and Drug Services

·        Adam Perez, Sr. Management Analyst, Office of the Public Defender

·        Joe Deviney, Agricultural Commissioner and Sealer

·        Jim Blamey, Director, Department of Environmental Health

·        Carolyn Walsh, Principal Planner, Department of Planning and Building

·        Elizabeth Pianca, Deputy County Counsel

·        Michael Rossi, Deputy County Counsel

·        Danielle Christian, Legislative Analyst, Office of Intergovernmental Relations

·        John Myers, Policies and Procedures Administrator

 

Background on Marijuana

The federal Controlled Substances Act (CSA), adopted in 1970, is federal U.S. drug policy under which the manufacture, importation, possession, use and distribution of certain substances, including marijuana, is regulated.  The CSA defines five schedules of narcotics based on medical uses and the likelihood of addiction.  Under this scheme, marijuana is classified as a Schedule I drug.  Schedule I Controlled Substances are those designated as having “no currently accepted medical use in the United States, a lack of accepted safety for use under medical supervision, and a high potential for abuse.”[1]  Drugs in this category are considered the most dangerous class of drugs due to high potential for abuse and potentially severe psychological and/or physical dependence.

 

Medical Marijuana in California

In 1996, California voters passed Proposition 215, making California the first state in the country to allow for the medical use of marijuana.  Voters approved Proposition 215, known as the Compassionate Use Act, with a 55.5% majority.  Proposition 215’s ballot language stated that it was to “ensure that seriously ill Californians have the right to obtain and use marijuana for medical purposes where that medical use is deemed appropriate and has been recommended by a physician who has determined that the person's health would benefit from the use of marijuana in the treatment of cancer, anorexia, AIDS, chronic pain, spasticity, glaucoma, arthritis, migraine, or any other illness for which marijuana provides relief.”  Included in the ballot language was a statement that patients and their primary caregivers who obtain and use marijuana for medical purposes upon the recommendation of a physician would not be subject to criminal prosecution or sanction.

 

On January 1, 2004, SB 420 (Vasconcellos), the Medical Marijuana Program Act, became law.  The bill established a statewide, voluntary registry identification card system for patients authorized to engage in the medical use of marijuana and their primary caregivers.  SB 420 also allows for the formation of patient collectives, or non-profit organizations, to provide marijuana to collective members.

 

As set forth under SB 420, the California Department of Public Health (DPH) administers the Medical Marijuana Identification Card (MMIC) program.  It is mandatory that all counties participate in the program by (a) providing applications upon request to individuals seeking to join the identification card program; (b) processing completed applications; (c) maintaining certain records; (d) following state implementation protocols; and (e) issuing DPH identification cards to approved applicants and designated primary caregivers.

 

California medical marijuana laws provide a defense or qualified immunity for anyone charged with a marijuana violation if that individual is in full compliance with these medical marijuana laws.  If the individual does not comply, such as, by selling medical marijuana, the individual could be subject to criminal prosecution.

 

Twelve other U.S. states subsequently enacted medical marijuana laws: Alaska, Colorado, Hawaii, Maine, Michigan, Montana, Nevada, New Jersey, New Mexico, Oregon, Rhode Island, Vermont, and Washington.

 

Pending and Recently Passed Legislation

At the time of the May 21 PSJC report, there were two bills proposing state regulation of medical marijuana working their way through the California Legislature – SB 1262 (Correa) and AB 1894 (Ammiano).  Since then, AB 1894 has failed to pass the Assembly floor, leaving only SB 1262.

 

SB 1262 (Correa) passed the Senate at the end of May and is now in the AssemblyThe bill requires all medical marijuana dispensaries, processing facilities, cultivation sites, and transportation services to be licensed by the state Department of Consumer Affairs.  No licensee may obtain a license for more than one of these activities.  In order to obtain a license, a dispensary’s owners must submit to a background check conducted by the California Department of Justice, obtain a letter from the local county or city jurisdiction affirming that the dispensary can legally operate within its limits, comply with all local laws, and pay all required fees.  The bill additionally places restrictions on physicians issuing medical marijuana recommendations by prohibiting them from receiving compensation from dispensaries and requiring disclaimers on advertisements.  Counties and cities would retain their ability to further restrict, regulate, and outright ban medical marijuana dispensaries, and counties are explicitly granted the authority to impose taxes on medical marijuana-related activities.

 

The bill also amends sections of the California Health and Safety Code to apply many of the state’s existing food safety restrictions to marijuana-infused edibles.  Edible manufacturing operations would have to follow food safety regulations, such as, requiring employees to be certified in proper food handling.  SB 1262 also imposes packaging restrictions on edible marijuana products, including requiring packaging to be opaque and tamper proof, prohibiting the use of photos or images of food on packaging, and requiring specific medical and allergen warnings.

 

On June 12, 2014, the bill was assigned to two Assembly committees – the Committee on Business, Professions and Consumer Protection, and the Committee on Public Safety.  The Committee on Business, Professions and Consumer Protection is scheduled to hear the bill on June 17.  The bill has not yet been scheduled for a hearing in the Committee on Public Safety. The committees must hear the bill by June 27 in order for it to move forward, and all bills must be sent to the governor before the end of the legislative session on August 31.

 

City of San Jose’s Recent Action

The City of San Jose also recently approved new regulations on medical marijuana dispensaries.  In a 7-3 vote on June 10, 2014, the City Council approved new regulations that:

·        Require buffer zones between dispensaries and sensitive uses, such as, schools, residential neighborhoods, and businesses

·        Limit locations for medical marijuana dispensaries to industrial zones

·        Prohibit individuals under the age of 18 from entering dispensaries

·        Limit hours of operation to 9 a.m. to 9 p.m.

·        Require security cameras and on-site security personnel

·        Require dispensaries to pay all applicable City taxes

·        Establish a “closed-loop system for dispensaries, though not limited to San Jose’s borders

 

The County submitted a letter to the City Council setting forth our support of a “closed-loop” system to reduce illegal outdoor and indoor growing operations by requiring that dispensaries grow their own medical marijuana, limiting dispensaries to a single cultivation site where they can grow their own medical marijuana, and restricting where that single cultivation site may be located. Dispensaries may only have one cultivation site, and that cultivation site must be located either within San Jose’s limits, within Santa Clara County, or within a county adjacent to Santa Clara County.  Additionally, dispensaries must comply with all state and local laws in the jurisdiction where their cultivation site is located.

 

Despite earlier proposals by various City Councilmembers, the City Council did not approve a requirement that medical marijuana dispensary members obtain state-issued Medical Marijuana Program ID cards, which are administered by the County Department of Public Health.  Based on advice from the City Attorney, the City Council referred this provision to staff for study.

 

Medical Marijuana Dispensaries (MMDs)

From the Administration’s analysis, which included marijuana-related crimes, the effects of marijuana, particularly on youth, the possible increase in youth access to marijuana due to the proliferation of dispensaries in San Jose, and the current lax regulatory environment for medical marijuana dispensaries, the Administration’s recommendation is that the Board of Supervisors prohibit the establishment of dispensaries in the unincorporated area of the county.

 

State law explicitly grants local governments, including the County, the authority to regulate the location and establishment of dispensaries.  Until 2013, appellate courts disagreed regarding whether a local ban on dispensaries was preempted under federal or state laws.  The California Supreme Court resolved this split of authority in City of Riverside v. Inland Empire Patients Health and Wellness Center, Inc. et. al. (referred to as City of Riverside).  City of Riverside is binding precedent on which local governments may rely as explicit authority for regulating or banning dispensaries.  The case held that nothing in the Compassionate Use Act or the Medical Marijuana Program Act expressly or impliedly preempts ordinances declaring medical marijuana dispensaries prohibited uses in a local jurisdiction.

 

If the Board does not wish to ban dispensaries from the unincorporated area, the Administration still proposes that the Board adopt an interim ordinance imposing a moratorium on the existing County regulations permitting the establishment of medical marijuana dispensaries so that the County can further develop local regulations for dispensaries to address current regulatory gaps.  Adoption of the moratorium ordinance would suspend the application of the Zoning Ordinance regulations relating to medical marijuana dispensaries for up to 24-months and prohibit the establishment of any medicinal marijuana dispensary during this time period.

 

History of MMDs in the Unincorporated Areas

Since 1997, Medicinal Marijuana Dispensaries have been allowed in certain commercial and industrial zoning districts in the unincorporated area, subject to obtaining a Use Permit and Architecture and Site Approval.  These zoning districts are located along Bascom Avenue, San Carlos Avenue, and near the County Fairgrounds. 

 

From 1997 to 2009, there were occasional inquiries, but no activity associated with Medicinal Marijuana Dispensaries in the unincorporated area.  However, since 2009, six dispensaries opened in the unincorporated area without first filing for and obtaining the required land use approvals.  After being contacted by the Sheriff and Code Enforcement, five of the dispensaries closed within a month and one was annexed to San Jose. 

 

In order to file for a Use Permit, a pre-application meeting is required.  Only one formal pre-application meeting for a medicinal marijuana dispensary was held in 2009 for a property on Bascom Avenue.  That property did not have sufficient parking for the proposed use, and the cost of remodel/conversion of the existing building was too costly for the applicant. 

 

The Planning Office receives approximately 10 inquires per year about establishing a dispensary in the unincorporated area.  The County of Santa Clara is one of only two jurisdictions in the county, along with San Jose, that allows dispensaries.  The other fourteen jurisdictions have either banned dispensaries or do not permit this use in their zoning ordinances.

 

Marijuana’s Effects and Youth Access

One of the principal reasons the Administration recommends prohibiting the establishment of dispensaries in the unincorporated area of the county is due to the work of the Department of Alcohol and Drug Services (DADS) and Office of the Public Defender.

 

The first attachment is a DADS policy paper that sets forth the harmful effects of marijuana use on youth.  Marijuana is unique in its impact on adolescents and young adults because of the effects it has on memory and executive functioning.  Structural brain changes are found in the amygdalas of even recreational users.  Multiple studies have found that adolescent use is higher in states with medical marijuana laws (8.6%) than states without such laws (6.9%).

 

The Office of the Public Defender (PDO) has also conducted analysis that seems to link the proliferation and proximity of dispensaries in San Jose to an increase in substance-related suspensions in the East Side Union High School District (ESUHSD).

 

For the past two school years, the PDO has been working with five schools in the ESUHSD to find alternatives to suspensions through its School Engagement and Suspensions Alternatives Project (SESAP).  One of the problems that is a growing concern is the frequency of substance-related incidents on campus, and at least one school attributed it to the growth and proximity of marijuana dispensaries in San Jose.  Below is a table and a chart relating to the overall rise in suspensions for substance-use-related incidents in the ESUHSD compared to the decrease in overall suspensions in the district:

 

ESUHSD

2007-2008

2008-2009

2009-2010

2010-2011

2011-2012

2012-2013

Substance Suspensions

398

348

362

297

614

563

Substance Suspensions % inc. / dec.

Baseline

-12.56%

-9.05%

-25.38%

54.27%

41.46%

Overall Suspensions

7,900

4,447

4,450

3,008

2,155

1,606

Overall Suspensions % inc. / dec.

Baseline

-43.71%

-43.67%

-61.92%

-72.72%

-79.67%

 

Source: DataQuest, California Department of Education.

 

 

 

The data above pertains to the annual number of substance-related suspensions and overall suspensions from the 2007-2008 school year to the 2012-2013 school year, the most recent period that data is available at the ESUHSD. The substance-related suspensions are for violations of the following education codes:

 

·        48900(c) Possession, Use, Sale, or Furnishing a Controlled Substance, Alcohol, Intoxicant.

·        48900(d) Offering, Arranging, or Negotiating Sale of Controlled Substances, Alcohol, Intoxicants.

·        48900(j) Offering, Arranging, or Negotiating Sale of Drug Paraphernalia

·        48915(a)(3) Possession of Controlled Substance.

·        48915(c)(3) Sale of Controlled Substance.

 

From 2007-2008 to 2010-11 school years, the ESUHSD schools saw small decreases in the number of substance-related suspensions, but not as significant as the overall decrease in suspensions at the schools (25.38% v. 61.92%).  However, in the 2011-12 school year, there was a significant increase in the number of suspensions for substance incidents. While the schools exhibited a 72.72% decrease in the overall number of suspensions compared to the baseline year of 2007-2008, the substance-related suspensions saw an increase of 54.27%.

 

Furthermore, there was an increase of 106% in substance-related suspensions in 2011-2012, compared to the previous school year, while the schools saw a decrease of 28.36% in overall suspensions in 2011-2012, compared to the previous school year.  This is also the same period when dispensaries were proliferating and at their highest number within San Jose, between 90-100.  These violations were not all for marijuana as the education code does not require schools to track the type of substance.

 

However, based on the Public Defender’s work with four of the ESUHSD high schools in the 2012-2013 school year, it was reported anecdotally that the vast majority of these incidents did, in fact, involve marijuana.  Furthermore, associate principals (APs) of discipline reported that students were coming onto campuses with baggies, pill bottles, and, in some cases, medical marijuana cards from the dispensaries.  The APs were reporting that marijuana use among students persisted last school year, which can be seen by the continued high number of substance-related violations in the 2012-2013 school year.  While possession of up to one ounce of marijuana is an infraction, it is a misdemeanor if the possession is on a school campus.  Thus, the impact is not only discipline related to the suspension, but in many cases can result in a referral to the Juvenile Probation Department in the form of a citation/ticket.  Although, the percentage of drug-related offense citations and arrests to the Probation Department has hovered between 18-20% over the last three calendar years.

 

The schools involved in the PDO School Engagement and Suspension Alternatives Project (SESAP) have developed some innovative ways to work with students who are caught on campus under the influence or in possession of marijuana including no-citations policies, in-house suspension programs, and referrals to drug and alcohol treatment services.  Nevertheless, with the easy access to marijuana that the dispensaries appear to be creating, these incidents require resources for dealing with substances on campus and result in cognitive impairments to developing minds, increased addiction, lower school performance, and avoidable injuries.

 

Although the proliferation of dispensaries in San Jose may have led to an increase in substance-related incidents, one study suggests it may not be solely the availability of medical marijuana that affects youth use, but it may be the normative environment and adult attitudes toward use that result in increased youth use.

 

Crimes Related to Dispensaries and local Marijuana Cultivation

The second attachment is an analysis prepared by the Narcotics Prosecution Team in the Office of the District Attorney that depicts the volume of local illegal indoor and outdoor grows and the connection to organized drug cartels.  In the absence of government oversight, it is not possible to corroborate where dispensaries source their marijuana, and law enforcement agencies have evidence that some local dispensaries are selling marijuana harvested by organized drug cartels.

 

Of 118 indoor marijuana grows over the last three years:

·        76 involved converted homes;

·        2 involved converted warehouses; and

·        41 of these locations were identified as rental properties. 

 

Over the last three years, the Office of the Sheriff’s Marijuana Eradication Team (MET) reported the removal of 355,005 marijuana plants and the seizure of 1,838 pounds of processed marijuana bud derived mostly from outdoor grow locations. These outdoor grow sites were typically discovered by detectives in remote areas of unincorporated Santa Clara County.  In 2013, the MET eradicated 24 gardens and destroyed 99,214 marijuana plants.  The team removed garbage, empty and full propane tanks, car batteries, camping supplies, and chemicals, such as, Miracle Gro, Round Up, Malathion, and Furadan. 

 

In 2012, the MET removed approximately 7 tons of debris from illegal marijuana gardens.  The damage to the environment is profound.  The growers divert water from watersheds and create illegal holding ponds complete with concrete dams.  They cut down trees and terrace hillsides.  The persons tending the gardens leave vast amounts of garbage and human waste, and they shoot and or poison wildlife that intrude into their camps attracted to their food supplies.

 

The MET has captured and arrested persons tending these rural gardens, and the Office of the Sheriff has determined that many of these gardens are directly linked to Mexican drug cartels, most notably the Michoacán Drug Cartel.  According to the Federal High Intensity Drug Trafficking Area Task Force, nearly 90% of the persons arrested in marijuana grows were from Michoacán.  The investigations linking illegal marijuana gardens to these cartels are lengthy and complex.

 

Lax Regulatory Environment for Dispensaries

There are numerous regulatory gaps pertaining to medical marijuana, which is another significant reason for prohibiting dispensaries in the unincorporated area.

 

Generally, under the federal Food, Drug, and Cosmetic Act, new drugs must be approved by the Food and Drug Administration (FDA).  An application for a new drug must include all labelling information, including dosage and the strength of each dose.  Generally, it is the drug manufacturer's responsibility to conduct all required tests to ensure that the drug is safe and effective.

 

The FDA reviews the application and all attached trials, studies, and tests, as well as the manufacturer's proposed labeling.  The FDA process of establishing the effectiveness and safety of a prescription medication is not applied to marijuana.  Moreover, neither the state Medical Marijuana Program nor the California Health and Safety Code designate any state or county agency as the authority to regulate dosage or potency.  Thus, no federal, state, or local agency is regulating dosage or potency of the active agents in marijuana.

 

Because the state-issued Medical Marijuana Program ID Card is voluntary and not required to obtain medical marijuana, no government entity verifies that a patient’s physician recommendation is from a licensed physician or that the recommendation complies with the guidelines set forth in the Compassionate Use Act and the Medical Marijuana Program.

 

Since state law does not consider marijuana an agricultural crop, there are no regulations governing the types and amounts of pesticides or fungicides that can be used, which poses a threat to the environment and to the health of the user.  These crops are not inspected for mold, pesticides, pests, or diseases.  Consumers have no assurance that the marijuana they ingest is uncontaminated.

 

Environmental Health does not regulate the “edibles” available at dispensaries including whether edibles requiring refrigeration or hot-holding are stored at proper temperatures nor that proper food-handling is practiced to avoid foodborne disease transmission.  Pre-packaged edibles are not inspected to ensure proper labeling including whether known allergens (e.g., nuts) are used and total weight.  Packaging is not inspected to ensure that the product is not attractive to children or imitates candy.

 

Weights and Measures does not inspect and certify the scales or barcode scanners at the dispensaries. Packages are not inspected to ensure they contain the stated weight, measure, or count.  Scanners are not inspected to ensure accuracy.

 

If the Board of Supervisors approves prohibiting dispensaries in the unincorporated area, there would still be a role for the County of Santa Clara to assist the City of San Jose with regulating medical marijuana dispensaries.  The Administration believes that it would be productive and important to investigate where the County could contribute to establishing a more rigorous regulatory environment of local dispensaries. 

 

If so directed, the Administration would convene work groups to establish proposed local regulatory functions, staffing and resource requirements, and budgets.  In some cases, the cost of proposed services may be recovered through fees and charges.

 

BACKGROUND

At the February 25, 2014 Board meeting, the Board of Supervisors approved marijuana suppression grants.  In the course of the discussion, the Board of Supervisors requested an analysis by the Administration pertaining to our coordination of marijuana roles and functions.

 

 


[1] http://www.deadiversion.usdoj.gov/schedules

Meeting History

Jun 24, 2014 9:00 AM Video Board of Supervisors Regular Meeting

Item considered concurrent with Item No. 18. Four individuals addressed the Board. Supervisor Simitian amended possible action 'd' to read: Direct Public Health Department and Department of Alcohol and Drug Services to undertake a public education campaign.

The Board directed Administration to report on August 5, 2014 relating to current best practices and the appropriate ratio of dispensaries to population to determine if a complete ban is necessary, access issues for patients in the Partners in AIDS Care and Education (PACE) Clinic, and how the County may be able to support the efforts of the City of San Jose in limiting the number of dispensaries.

RESULT:APPROVED AS AMENDED [UNANIMOUS]
MOVER:S. Joseph Simitian, Supervisor
SECONDER:Mike Wasserman, President
AYES:Mike Wasserman, Cindy Chavez, Dave Cortese, Ken Yeager, S. Joseph Simitian

Transcript

Jun 24, 2014 9:00 AMBoard of SupervisorsRegular Meeting

 

10:25 AMThey monitor the providers that we have. Over 700 beds that we are contracting with really in the bay area. And we do keep track of them, but we do not have in place a process that specifically responds to complaints from neighbors. So, I think it's a really good idea. And what I would recommend is that we come back with a directive and that directive would be sent to all providers. Essentially it's a policy and that policy allows us to [speaker not understood] selective action and any other remedial action up and including terminating a contract.
That would be very well appreciated. Thank you. And thank you for your consideration of this. And I would move all four item with Dr. Pena's recommendation.
14, 15, 19, and 54. supervisor simitian?
10:26 AMI have an abstention on the first two which I indicated would be on item with exception. I have an aye vote on the second.
Let's go to 59 and 64, madam clerk. Don't worry about going around. Supervisor chavez, a motion to approve 59 and 64. Do I have a second? I have a second, discussion, all in favor say aye.
Aye.
That passes 5-nothing. that was 59 and 64, lynn. We are now going to item 14 and 15. Supervisor simitian said previously he will be abstaining from those. Supervisor chavez, there is a motion to approve?
So moved.
Thank you. I need a second? Second. Discussion, seeing none, all in favor say aye.
Aye.
Opposed none abstains one. that passes 4 to 1, supervisor simitian being 1. All right, i'm getting there. We now move on, 16 was handled on consent. We now move on to items 17 and 18. And I say that because I think we can deal with those together unless there is objection. We do have some speaker cards. I'm going to ask the speakers to come forward. First i'm going to ask for susan m. Landry, scott lane, gabrielle [speaker not understood]. And john [speaker not understood]. Hello, there.
10:27 AM> somebody dropped their glasses on the floor.
Thank you. anyone missing their glasses? The clerk will have them for you.
The previous speaker.
> hi, my name is susan landry. i'm a resident in campbell in the county of santa clara. I propose item 17 is the medical marijuana moratorium. [speaker not understood]. I think that we need regulations. We need strong, fair, sensible and compassionate regulations for medical marijuana dispensaries and cultivation sites. And I want to emphasize the word compass at because currently as proposed, items a through f action items under number 17 are pretty biased and only would select regulating agencies commission statements. I do not see any patient input in there or any patient comments. I happen to see -- be the only speaker that was at the committee that recommended to bring this item forward. I had not been contacted for any public input for the moratorium. I also think we should add item g and item g would be have a patient and community input process. We need to hear -- you need to hear the patient voices. You need to hear their stories of hardships that have maybe created by the proposed actions of b through f. So, please consider adding item g and including in the timeline that you have for these directives for staff to come back with recommendations. I would like to see item g added. And I would just like to add in the end, I do believe we need strong, fair, sensible but compassionate regulation. I support the current moratorium, but I do not support an outright ban. Work with the city of san jose. They just approved regulations. Please work with the city of san jose.
10:29 AMThank you. [speaker not understood]. Yes, we got them.
> i'm gabrielle [speaker not understood] with voices united. We work to keep you safe from [speaker not understood] to alcohol, marijuana, and other drugs. And I actually applaud all of the pieces that you are voting on today because in the few treatments, we under that the high potency marijuana is highly addicting to teenagers especially because of the vulnerability of the teenage brain. In fact, one in sick teenagers will become addicted if they're using the high-potency marijuana . Seeing that a lot of people don't under is in the field of prevention, we had reach that shows that easy access to marijuana increases the use of youth and that's been the problem for the last ten years . So, we really need strong regulations so that young people do not have easy access to marijuana. And also, because the misinformation that's out there, I really applaud that you are putting your money where your mouth is to do education in the community. Parents need to understand what today's marijuana is. It's a very high potency level. Grandparents especially who hung out in the '60s really need to know and they take care of a lot of the young people today. They need to know it's no longer the ones with ph. D. Level. It's up to 30 or more percent of thc levels. I think what you're doing is fantastic and I hope that the education you propose goes throughout the county and makes a huge difference. Thank you.
10:31 AMThank you. Mr. Lane.
> thank you very much, supervisor wasserman and board of supervisors and executive.
10:32 AMYou can bring the microphone up to you.
> yes. my name is scott lane. Thank you very much. I looked at a report. For some reason I could not access it [speaker not understood] from staff [speaker not understood]. One of the things I think, two separate issues here. One is medicinal marijuana and one is the road growth, 355,000 plants, for example, in the last three years. Obviously I am totally against that. But in the report which I agree is one sided. It doesn't have patients, doesn't have anyone from the state, be nice to have much more to collaborate widespread research in here. It would be interesting to see if there was a causation or correlation. [speaker not understood] thrown against the wall, but it doesn't necessarily -- it's not cohesive. It's not quite ready yet. So, I would suggest that much widespread group can come in and look at the consumer protection. A lot of things in the report were wonderful. We see quality control, controlled access, making sure you got a doctor that can make sure this is someone that's [speaker not understood]. Now, having said that, I do take issue with the 1 to 2% have serious illness. I think it's actually much higher than that that needs it. I know my mom has cancer, but there are other people who have ptsd and other issues that real coy benefit from that. It might be 10%. I do agree with the speaker there needs to be something that's concerned about addiction. I agree, especially kids [speaker not understood] that are into bungee jumping or skiing or whatever, but I think we need to step back a little bit and look at this. I look and see what san jose did. They were very draconian in the regulations and what's going to happen? There is reference trying to speak to 150,000 people to basically stop that. So, I think you have a well earned reputation of being collaborative in the county and I urge you to continue to do that and get all the different stakeholders involved in doing that. And step back and make sure we do the right thing. Let's increase the control and increase the safety for all involved. Thank you very much.
10:34 AMThank you, Mr. Lane. Mr. Lee. and that will conclude the speaker cards I have on this item.
> thank you for letting me speak. My name is jon lee. I'm [speaker not understood]. I'm here just to speak for the first time with your group about some additional community input. I think there is some effort for you to continue some of the discussion here and clearly as you put eureka work group together, representation from our community, others, so [speaker not understood] some of the facts you have about marijuana usage is outdated. Even anecdotal as noted, there is an opportunity for community input here. Ms. Landry mentioned [speaker not understood]. If you limit the opportunity for them to access the medicine, you're going to increase crime. You're going to increase what you're [speaker not understood] in your schools, endanger the community especially with the enforcement levels we have now. I encourage you to step back. I know i'm late to the game. [speaker not understood] we are a community. We are community members. [speaker not understood]. We want to be good partners with the community. We want to expand that and include community involvement. We'd like to open additional discussion. We'd like to halt any [speaker not understood] actionses. We believe there is opportunity for further discussion. Our arms are open to that and we'd like to continue that. Not putting a ban at this time, but more community input. Thank you very much.
10:36 AMThank you. that concludes the public speaking portion on agenda items 17 and 18. We're taking them together. I look for a motion or comment or both from supervisors. Supervisor chavez.
On this matter, I wanted to request that sylvia get at least a chance to outline the staff report and we can have a discussion with my colleague.
Welcome.
If I may, sylvia geiger, deputy county executive. Item numbers 17 and 18 are the culmination of work that staff has done in response to a board referral February 24th board meeting. The question posed to staff is given our multiplicity of roles and assumption related to marijuana, are our departments working at cross purposes. And I can reassure the board that is not the case. We did reconvene a marijuana work group that has met periodically to coordinate our efforts on marijuana. So, when we say convene, we did an environmental [speaker not understood]. One of the first things and many are aware of this, san jose does [speaker not understood] operational land use regulations with respect to dispensary. So, we conducted research. What we concluded is that, as many of you know, marijuana is a scheduled controlled substance. It doesn't have currently accepted medical use. It's not safe to use under doctor's supervision, and it is deemed to be have a high potential for abuse. What that means is at the fed leal%backv ural level, it is in effect illegal to manufacture, distribute, and sell. As a result, there are very limited federal regulations. In addition, there is a state regulation. So, it's been left to local jurisdictions to fill the regulatory gap through primarily land use regulations. So, what we have now is that marijuana is grown as a crop, but it's not regulated as a commercial crop. It is dispensed as a medicine, but it's not regulated by the fda. Weights and measures does not inspect and certify the weighing devices or the bar code standards. Environmental health does not regulate the marijuana being edible with respect to safety regulations nor it does it certify employees that they are engaging in a appropriate food handling processes so we avoid food-borne illnesses. [speaker not understood]. We can't corroborate the source of marijuana that is available at dispensary. And the d. A. [speaker not understood] indicates there are some instances where, indead was first on the growth side affiliated with drug cartels. In addition, with a report by the public defender that embodies the actual staff report, we found the relationship with the union high school district there seems to be a relationship between the proliferation of dispensaries in san jose and the easy access of marijuana on campuses. You'll see on the chart, sudden related incidence [speaker not understood] are decreasing. [speaker not understood] at least four high schools they're being told is it relates to easy access to marijuana. So, given all of this research, it's been the staff's position that you should recommend to you that we ban dispensaries. Now, there is really a two-part impetus for these actionses now. One is I mentioned san jose ha enacted more stringent regulations. One of the concerns is it would problem [speaker not understood] in unincorporated areas of the site. The second more long view about marijuana, we are aware of 2016 there would likely be a state initiative to legalize [speaker not understood] for adults. Those who sponsored compassionate use act, they were a major funder for colorado 64. If we go the way of colorado, the most likely places recreational marijuana would be available retail would be through dispensaries. [speaker not understood] through lack of planning we now have retail in the unincorporated areas. So, for those particular reasons we are recommending this. Now, I want to state for the record and emphatically, administration supports compassionate use. We support additional research being done at the u. C. San diego medicinal cannabis research study created by the late john [speaker not understood]. We do know from current research that there are effective uses of marijuana dealing with neuropathic pain, spasticity -- I think that's the right name -- [speaker not understood]. We do encourage research on the effectiveness of marijuana. We note that with san jose's new regulations, they have about 78 dispensaries in san jose based on city research. We do have city staff here available [speaker not understood] is the lead staff. We do believe there will be a like number of dispensaries available. So, one being issue with lack of access if we ban dispensaries in the unincorporated area, it will be lack of access. Once they have dispensaries and made an interim decision we would recommend we ban dispensaries in the unincorporated areas, one of the first is the pace clinic. I wanted to talk to the medical director about their experience with hiv/aids patients. And I met with Dr. Ted brook who indicated that given the new drug regimens that they're better tolerated, that there are fewer side effects, it was his explanation that 5 in 100 patients May have a medical necessity for marijuana. And that while this doesn't reflect the views of the entire pace clinic, I didn't poll them, it does reflect one doctor who works with these patients. Given that's correct our recommended actions reflect a two-prong strategy. In essence what we're saying is we want to limit dispensaries in san jose and help them have more robust regulation so we can deal with some of the adverse effects that we have identified. I also want to point out that with [speaker not understood] access, the medical research is replete [speaker not understood] specifically on developing minds more vulnerable to environmental insult. When we attach a report by dad that reflects the impairment that result, including impaired short-term memory, no coordination, alter judgment, possible addiction, alter brain development. Given the counsel tip's addition, our youth felt compelled to bring this forward to you. [speaker not understood] dispensaries to san jose and allow us to do traditional research where we can fill the hole. City of berkeley is in the midst of passing new regulations that deal with food -- state food handling regulations through safety, labeling, content, and environmental health would be reviewing that local legislation in addition at the state level through sb 1260, making it close to the legislature to fill the regulatory gap. We'll find out probably in august that they made it to the public safety committee and whether it guess approved [speaker not understood]. There May be at the state level. I don't fill some of these staffs position a they exist. [speaker not understood] if the board approves this recommendation would undertake a public health education campaign. This is at the direction of the public safety objective committee. We will present a proposal that reflects what we can do with existing resources and also offers proposal if the board thought that was inadequate of what we could do with resources. As I said, one of the resources is to [speaker not understood]. Then lastly, if the board approves it, we are asking for direction to develop policy positions so that it can help us speak for the county's interests. And in particular, gavin newsom and the senate governor's blue ribbon panel say it will be developed in 2016. Our sheriff is in that. More of having a department feed information about process. With that, I and staff are available to respond to questions.
10:45 AMThank you for that, sylvia. we have a motion, we have a second. I see supervisor simitian first, then supervisor yeager.
Thank you. [speaker not understood], first, thank you to you and all the other folks who provided background material. I thought was very helpful. I thought it was fascinating reading actually, on the one hand, on the other hand back and forth conversation. I think from a policy standpoint -- let me just make this observation that you asked -- I think the frustration that I feel as a policy maker is it's been 18 years since we passed the compassionate use state law and we're still, frankly, at a loss to reconcile federal and state on this local action. I'm frustrated. I can imagine the frustration of the public. [speaker not understood] 18 years, they haven't figured out how to make this work. I think the expectation in '96 -- I remember the conversation because I was a candidate during 1996 -- the question came up, where do you stand on this issue? Thinking at the time persuaded me there was a place for compassionate use, that there were appropriate medicinal uses, but I don't think anyone thought we would end up with this catch as catch can oversight regulation, the contract all these years later with federal law. So, I think, I think this is more than timely in terms of saying it's time to sort this out and I think this is a helpful effort, sorting it out. The first question I go to, the regulatory gaps that you mentioned, locking at page 14, packet page 6 38, the discussion about environmental health does not regulate the edible. Weights and measures doesn't [speaker not understood]. You made reference to this in your comment. Why not? And what is your thinking about this going forward? I inferred the things you said, that there was a possibility that going forward we might step in. What is the thinking going forward?
10:48 AMWhat I would offer from the research is both state departments like food and ag believe that instituting new regulations would, in fact, promote illegal activity. That is some of the [speaker not understood] we received. I think from the respective association is the reticence to get involved. I've argued to our staff and said better to get involved than to have our head in the sand. It's an effort. All of these respective professional with their associations.
And again, i'm not critical of the fact we haven't weighed in. I'm just trying to understand. It's been 18 years. I mean, and here we are 18 years later after the voters have approved a law that has resulted in the proliferation of the dispensaries. So, I guess my question is why wouldn't we be treating the edibles -- [speaker not understood] had lots of quality time on this subject in another venue. Why wouldn't he we be creating edibles the same way we do in any other environment, [speaker not understood] retail environment?
10:49 AMThe microphone, you need to get closer. Thank you.
It is a difficult decision. the addition of marijuana [speaker not understood] always considered a dull adulteration [speaker not understood].
It's also not regulated as medicine.
That's right. and that's the quandary that we're in. I think what the report is trying to get ahead of what is going to happen. San francisco does regulate them through their food program. And berkeley is currently going through the process of also regulate the edibles in the dispenser. So, there is a moment of sort in the environmental health to regulate that. There has been discussion with san jose to possibly do that within their jurisdiction also.
10:50 AMOn the food front, I mean, your office does, does regulate grocery stores because they sell food.
Yes.
And restaurants because they sell foods, and food trucks because they sell food, and hospital cafeterias because they sell food, yes?
Yes.
Okay. and I just -- I thank -- I want to encourage you -- I don't want to come to a klan cushion you haven't yet have a study actively, but I do think 18 years later it's clear it's not an issue that's going away any time soon. It looks like there is potential for an expanded concern. So, I do think -- and then weights and measures, what's the brief history here and the thinking going forward?
10:51 AMMr. [speaker not understood]?
Good morning. I think the fact that it's a federal offense to use or do anything with it has become a major [speaker not understood]. Don't want to get involved. It's aiding and abeting. 0001-01-01t00:00:00. 0000000 [speaker not understood] dispensary in the office to be tested. There are a couple that go to dispenseries and do it. They don't recommend that sort of thing. They are still waiting for that [speaker not understood], but federal is really being recognized as not being [speaker not understood].
10:52 AMAgain, as I said, I referenced that earlier. I understand that. But tension, if you will, between our state and local activities and the federal law. We, again, we have a law on the books for 18 years. The staff report references senator vasconcelos to be in effect in 2003 and 2004 that essentially acknowledgeedth state law and find some kind of system to deal with the appropriate eligibility through the bart process. So, again, as a board member want to encourage you to start thinking about how we can weigh in. As a practical matter, if the largest city in the county with 60% of the county's population is going to be a venue for medical marijuana dispensaries, then it seems to me, you know, with a million people in that city alone, 1. 8 in our entire county, weights and measures issues have to be addressed. I think it's time to come to grips with that hard fact f. Let me just ask one question. I know there are other supervisors who want to . The next question goes to public health, and hospital staff. Its was interesting to me in looking at the report, particularly from santa clara valley health and hospital systems. This has been an interesting debate over the years. Could the professional staff describe the difference between dependence and addiction as medical terms of art? And then share some observation about why they chose the word addiction?
10:54 AMDr. Cody. either closer or turn your microphone on.
[speaker not understood]. so, dependence and addiction, it is really kind of fine different. The addiction is the inability to control the use of a drug or alcohol. Also defines behaviorses associated with the addiction that are anti-social or against family, get in the way of working. [speaker not understood] is a bit down on the continuum. It's somebody habitually using the drug, May be able to still cope, keep a job, to stay out of the criminal justice system. So, it's really a progression in terms of the use and the effect it has on the day to day living of the individual.
10:55 AMLooking at the staff report, then, at page 40, 64 1, can we then correctly infer that the choice to use the word addiction was a conscious one? And as I read the report, it implied, to my reading, that addiction was the word you chose to use, that you weren't suggesting that addiction was the appropriate use in all cases, that in some cases there could be a dependence, but in some cases there was, in fact, in the medical sense a true addiction. Am I reading the report correctly?
That is correct. over the 40 years of marijuana use, early on it was stated that marijuana does not lead to dependency or addiction. And over the years and the research that has been done and most recently looked at, again, it has much to do with the potency of current marijuana versus 40 years ago. There are individuals that display dependence, habitual use, the inability to stop using, the psychological affectses when they stop using. Similar to opium or [speaker not understood].
10:56 AMCircle back for me, the bottom line, 18 years after we've got a state law on the books, more than a decade now after the state weighed in at least to a minimal degree with public legislation, we're at a point where we can't keep our head in the sand any more. It's time to step up and [speaker not understood] to get the job done. And I think that's what the recommendations from staff would do today and that's why I support it.
10:57 AMThank you. supervisor yeager. Thank you. I guess maybe to start off my feeling about this, I certainly will favor the moratorium that you're recommending, but i'm just not sure and ready to support a ban that would follow after a additional review. I guess i'm trying to get a little bit more information a to the real value of the marijuana dispensary. So much of the report really focused on the use of marijuana, the effectses, trying to keep it away from kid, all of that. The community issue is whether we want to support the discipline dispensary to compassionate use. I felt there was an absence of that discussion in the report. Maybe when you come back you can include it. Dr. Cody, if you could talk just a little bit about why it is that certain patients find value out of medicinal marijuana, aids patients, cancer patients? Why is it that marijuana is able to provide them certain amount of relief that other drugs don't and, so, at least we as a community want to have that available under a doctor's guidance for patients who get value out of the discipline marijuana.
10:58 AMSure, thanks for the question, [speaker not understood]. To put the whole discussion into context, I think we define what our goals are and step back and ask how our actionses are going to further our goals. It lack regulatory environment with gives us tools which is incredibly challenging. But to focus on the few things that we do know regarding medical marijuana, we do have evidence and what I am trying to [speaker not understood] recently published paper in the new england journal of medicine earlier this June 15, [speaker not understood] and the evidence is well documented and I think put into a nice context. So, there are groups of patients that do benefit from medical marijuana and among those are aid patients [speaker not understood] because marijuana is an' an appetite [speaker not understood]. Marijuana acts as an appetite stimulant and is helpful for [speaker not understood] and then there are some other groups I think [speaker not understood], most patients with [speaker not understood] because of multiple sclerosis and there is a small group of patients with epilepsy. So, there are important medical uses for marijuana and that's the reason for [speaker not understood] and whatever the county decides to do, we have to somehow ensure access for those groups. At the same time, we have to recognize what the adverse health effects are, particularly among children, adolescents and young adults where there is evidence of adverse health effects and that's the challenge.
11:01 AMI need you to focus again on the first part of what you were saying, that there are patients who do need from medical marijuana and making sure that they continue to have access. And that's what I -- that's part of the discussion I think we need to have. I don't know, doctor dyedy, you know how many patients at the [speaker not understood] how many patients in our clinics, in our hospital, are being described in the medical marijuana. We provide clinics [speaker not understood], that if our doctors are pre-scribetionv what options are going to be able for them to get it. At this point it seems like it's only the city of san jose and we aren't really sure -- I don't know about access into the future, but i'd hate to be in a situation where all of a sudden patients that we have no longer have municipal marijuana available to them. I don't know, sylvia, if you're going to have that type of discussion. I don't know if there is a possibility of using maybe the pace clinic. There is a place we can dispense medical marijuana. It just seems like what you're proposing is an absolute shutting the door on any possibility. And I want to keep that door open enough there is no other place we can go, at least there is a place in the county that can provide [speaker not understood] for them.
11:02 AMPeople in the health and hospital system, I don't know, we can go and get the data and bring it back to the board.
11:03 AMSome of the speakers were talking about the absence of community input in people who use the discipline marijuana as part of the study group. I think it would be interesting at some level to talk to people who use the pace clinic to understand, again, where they go for their municipal marijuana. Also, the value that it provides them. 0001-01-01t00:00:00. 0000000 I want to make sure our patients who need it have access and not really knowing what might happen as the city of san jose policies that is enacted. I want to make sure it is going to be available for our patients.
11:04 AMWe have heard your message. we will provide additional information on august 1st, and we will do the research to make sure that we can connect our patients to existing rotation and [speaker not understood] because we understand your point about the new compassionate group.
Shareholderv chavez. shad supervisor chavez.
Thank you. I want to thank you for the staff work. We had a board discussion in february, probably the end of February and you're already back with us. I want to say how much I appreciate that because there are different organizationses in the county that had to work together. The second thing I wanted to do is acknowledge the collaboration between the city of san jose and the county. I do think the city of san jose had a challenge. [speaker not understood] from the city of san jose has been very helpful in terms of linking what the city's needs are to what the county services May be. And I think the point that supervisor simitian made about how to link those services together is going to be very very together. Let me go back to the February 5th discussion just for a moment and make this observation. I think the point that Dr. Katy raised about the challenges are so important. Really, Dr. Cody, what you were saying is so right. On the one hand, we want to be respectful of people who have a medical need. Pain or discomfort, any of those, be mindful of that. And what we've seen is the [speaker not understood] are causing challenges in our school. And I think speaking about this from the county perspective, I want to make this point. Part of why the February conversation happened was that in January the city of san jose hosted a very large meeting with the community around the mayor acv task force to ask people what is happening in the community that we needed to be aware of that we could respond to. There are a number of issues that were brought up. Parents, teachers, advocates. Youth advocates was this responsibility to marijuana was causing sick problems in school, [speaker not understood] buying and selling on campus and don't think there is any wrong with it. I think what happened is that we could wait and do even more studies, although I thought the research done in the report was really valuable. The fact of the matter is we know we don't have an access problem when it relates to children. We don't want to have an access problem for people of compassionate use, but young people have figured out how to access it. So, what I think would be really important when you come back to us is outline the very important work that supervisor yeager's office, how do you make sure you have patient access? Second of all, how do you make sure youth that allow us to be as frank and honest with parents. I don't think we're anywhere near. One of the things i'll share with you, at a meeting I raised this issue. Someone from the community said, you know, compassionate use is really critical and you don't understand how much I need this. And I was sort of struck by, one, when I heard this patient I thought that's right. But the thing that frightened me that they said afterward, but the [speaker not understood] and I realized it wasn't, irrespective of where that person got that information, we weren't putting out information that said, here are the uses, here's what's good four. And that's our responsibility. In many responses, [speaker not understood] and I think that supervisor yeager's point, not to moralize whether or not compassionate use is of value or not, but what is the purpose that this is real making use for and what we know it's good for. So, I wanted to say I love what you wrote out. I wanted to make two additions. I want to support very much what supervisor yeager asked for. I think also supervisor simitian's point about how we can better provide support to the city of san jose. As' going to be critical. One last point. I do think we have to figure out a way to engage patients in that discussion, a point about how we do or don't -- people who are in freed, [speaker not understood]. We have to think a little bit about the people who actually need access. One challenge is we haven't had an access problem here for anybody really because the city of san jose has 7 yet are [speaker not understood]. Access is not the biggest problem we have. That being said, we want to make sure it is available for people to use for compassionate use. I want to point out two drugs similar to marijuana. I don't know if this [speaker not understood] or not, but one thing that would be helpful at least for me and maybe some of my colleagues May be interested in understanding marijuana and methadone. But to better understand what their role could be, too. One of the things that occurs to me, I would want to have sure they can have access to the [speaker not understood] today. Is there another way that's effective? We can [speaker not understood]. For people that May be in need of that medicine.
11:10 AMSupervisor cortese.
I just wanted to clarify, we're doing 17 and 18 together. And 18 the agency ordinance for the moratorium. [speaker not understood]. I don't have any questions on that. The need seems to be the issue with regard to are we really educating people on pros and cons. D on 17, i'm sorry, 17 d. I'm just not clear on the motion what we're doing there. I am of the mind that I think you just said it, what hertionv that people should under about useful purposes should be out there. [speaker not understood] some of the failed drug education campaigns in the past have been so skewed to if you do this, everything goes to hell in a hand basket and people don't. . Some of these conditions touch people in just about every family I think at this point, especially [speaker not understood] cancer. So, to have a balanced education campaign -- that's my theory -- makes more sense to me because I think it will be more compelling to people. Some time [speaker not understood], this is what's good, this is what's not good. That gives people an opportunity to do an analysis. I'm not talking about minor sphere. Clearly those of you need to be ended and if you could clarify where we're going on the motion with d, and there are two questions on the ban portion because I know it's going to die.
11:12 AMSupervisor simitian?
Oh, I thought you were asking me the question.
That's included in the motion at this point.
The motion was intended to include item a through f on item 17 as well the moratorium motion from item 18. The paragraph d that supervisor [speaker not understood] asked about is written [speaker not understood]. There is no reason certainly why we couldn't say take and undertake an education campaign period and let start work through the campaign efforts are appropriately directed towards misuse and abuse and to what extent the education campaign is focused on compassionate use as I think many of the board members have indicated [speaker not understood]. If it's helpful, i'm certainly happy to abbreviate paragraph d to just end after take public education campaign and leave it at that.
11:13 AMI would second that point. supervisor mukasey.
Did you that respond to your concern?
Yes
Unders what we're looking for. B and d, instead of sending it l perm mectionv until some purpose he end. I'm prepared to support this motion. D is clarified, what would be interested for me to get back tail fail 2011. There is all kind of speculation about where the city or city's ordinances in this county are going to ultimately lead. You know, zero dispensaries, one, whatever. I understand that it's possible to create or to get best practice type [speaker not understood] or to put it on proper per capita ratios of dispensarieseses or access points in the population. Clearly san jose is way beyond any such [speaker not understood] i've ever heard of. They're just way over the top in terms of the [speaker not understood] amount of dispensary. I'm just wonder if it's -- [speaker not understood] we have some basis for an uncomplete ban is appropriate, and if so, whether or not there would be any re-visitation [speaker not understood] in terms of city actions. I understand there is a phasing process in san jose. That's why i'm saying I don't believe we'll know at the time these items come back to us for final really what ultimately is going to be the lay of the land in terms of access because of the phasing process especially in san jose. So, what i'm asking for is come back and bring us some analysis on that, if unincorporated ban is always going to make total sense, then [speaker not understood]. If we are sure it's going to always make sense, there May be some need to access there, i'd like to hear what the analysis is on that.
11:16 AMWe will endeavor to provide that information.
Request for information. thank you. With that [inaudible].
Supervisor simitian.
I don't mean the sex comment in the flip way. I meant it quite tieriously. It would be one question of the jurisdiction to allow medical marijuana dispensaries of small and/or remote and/or difficult to access. So, i'm going to pick on montesorino, which is ably represented by supervisor wasserman. Los altos somewhat larger metropolis. If it were one of these smaller communities, I would think this would be a conversation headed in a different drib. When it's a city of 1 million, 60% of the county's population, as geographically dispersed as the city is, it's a different kind of analysis taking the points supervisor yeager making sure we don't get in the way of what I think is appropriate. [speaker not understood]. I do think this conversation is helpful because one of the reasons I think the direction you suggested makes sense is it's been helpful to illuminate just how great the range of challenges and issues is in doing this right. So, you know, even if only one or two facilities opened up in the unincorporated county, all of a sudden you've got a sense, if you're going to do it right, then you've got to set of responsibilities that are pretty substantial as colleagues in san jose I think have discovered. So, i'm happy to make the adjustment to d that supervisor cortese asked for, look forward to your further analysis.
11:18 AMThank you. and with that i'll ask all the supervisors to vote on the motion. All votes have been cast and the results are a unanimous 5-0 vote, for both 17 and 18, madam clerk. Thank you. With that we'll move on to 19, which was handled on consent as was 20. 21, we now move on to 22.