“Thousands of Pennsylvania Medical Professionals May Soon Certify Cannabis Patients”
HARRISBURG — In Pennsylvania, nurse practitioners and podiatrists could soon gain the authority to approve patients for medical marijuana cards, pending decisions from the state’s health secretary. Currently, only licensed medical doctors and doctors of osteopathic medicine are permitted to certify patients for the state’s medical cannabis program, which serves hundreds of thousands of active patients.
Supporters of the proposed changes argue that allowing nurse practitioners and podiatrists to certify patients would increase access to the program and potentially lower the costs associated with obtaining a medical marijuana card. However, some state officials believe that telehealth already provides adequate access to the program.
The recommendations from Pennsylvania’s Medical Marijuana Advisory Board come amid a bipartisan effort in the state legislature to relax restrictions on nurse practitioners and enable them to operate independently from physicians. While these legislative efforts have encountered obstacles, the proposal to allow these professionals to certify patients for medical marijuana has faced minimal public opposition.
Many other states have permitted nurse practitioners to approve patients for medical marijuana for years. According to a guide from the cannabis certification company Leafwell, more than 20 states allow nurse practitioners or advanced practice registered nurses to recommend cannabis to qualifying patients.
“What is Pennsylvania scared of?” asked Judy Jenks, a nurse practitioner who operates a medical cannabis clinic in Virginia, in an interview with Spotlight PA. “Is it the cannabis? Or is it the nurse practitioner?” She added, “If you’re scared of either one of those, then you don’t understand either one of those.”
Nurse Practitioners Left Out of Medical Marijuana Program
Nurse practitioners in Pennsylvania undergo advanced medical education and training, allowing them to provide a range of care. They can prescribe medications, diagnose conditions, and manage treatment plans, but these responsibilities are contingent upon written agreements with physicians.
When lawmakers passed the medical marijuana law in 2016, they did not authorize nurse practitioners to certify patients, opting for several compromises to gain sufficient support for the bill in the Republican-controlled House. However, they did grant the Medical Marijuana Advisory Board and the health secretary the authority to implement changes.
In 2018, the advisory board chose not to expand the list of medical professionals eligible to participate in the program but suggested reconsideration in the future. The proposal for podiatrists would limit their certification to conditions related to severe, chronic, or intractable foot pain, while the nurse practitioner proposal does not impose similar restrictions. It emphasizes that nurse practitioners “treat all disease states” and should have unrestricted certification capabilities.
A spokesperson for the Pennsylvania Department of State noted that state law allows nurse practitioners to diagnose all medical conditions, although they must operate within their clinical specialty area. Both proposals would still require nurse practitioners and podiatrists to complete a four-hour training course and apply for the registry, similar to physicians.
Health Secretary to Make Final Decision
Pennsylvania’s medical marijuana law empowers the state’s health secretary, Debra Bogen, to approve or reject the recommendations concerning nurse practitioners and podiatrists. These changes will not require legislative approval, according to several officials and industry experts.
The state’s Board of Nursing has expressed support for the nurse practitioner recommendation, and the advisory board’s report on podiatry states that the Board of Podiatry agrees with the motion. However, a spokesperson for the Department of State indicated that the podiatry board has not formally taken a position on the matter.
The health secretary is currently reviewing the recommendations, with a decision expected by mid-November for podiatrists and late January for nurse practitioners, as noted by department spokesperson Neil Ruhland.
State Rep. Dan Frankel (D., Allegheny), chair of the House Health Committee, remarked to Spotlight PA that it “makes enormous sense” to include nurse practitioners and podiatrists as certifying practitioners, affirming their expertise in this area.
Addressing Patient Access and Needs
Christine Roussel, a member of the Medical Marijuana Advisory Board who presented the nurse practitioner proposal at a public meeting in January, emphasized that one of the primary reasons for the change is to “improve access to care for patients.” However, Spotlight PA’s request for an interview with Roussel was not granted, and a Department of State spokesperson deemed further comment “inappropriate.”
Last year, Laura Mentch, director of the Bureau of Medical Marijuana, stated that she had not received complaints regarding a shortage of practitioners in the program during her tenure. At the time, she was testifying in support of an individual physician’s return to the program. Mentch noted that telehealth has expanded patient options, making certified practitioners more accessible statewide.
Meredith Buettner Schneider of the Pennsylvania Cannabis Coalition told Spotlight PA that the proposed expansion could provide more options for patients and potentially reduce certification costs. She highlighted that some patients may prefer in-person consultations over telehealth appointments, stating, “I think meeting patients where they are is super important and something that we definitely still need to work on.”
Currently, there are nearly 2,000 approved practitioners in Pennsylvania’s medical marijuana program, a relatively small fraction of the state’s total licensed physicians, which includes more than 53,000 active M.D.s and over 11,000 active D.O.s.
In other states, nurse practitioners have played significant roles in medical marijuana programs. For example, a 2021 report from Maryland indicated that nurse practitioners and certified nurse midwives outnumbered physicians and physician assistants in the state’s medical cannabis program. Similarly, Virginia lawmakers approved adding nurse practitioners and physician assistants to their medical cannabis program in 2019.
At her clinic in Virginia, Jenks collaborates with nurse practitioners to certify patients, offering telehealth appointments and custom in-home visits. She emphasizes that cannabis can help manage various conditions, including panic attacks, social anxiety, and chronic pain.
When nurse practitioners are barred from certifying patients for medical cannabis, Jenks argues, it limits patient access to care. “Ultimately, this is about the patient,” she contends. “This is about the patient having access to a substance that help them.”
