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‘The state threw them to the wolves’: Health department struggles to manage massive medical marijuana program

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‘The state threw them to the wolves’: Health department struggles to manage massive medical marijuana program

Behind closed doors, Mississippi’s eight-person medical office is struggling against its workload.

The Health Department office charged by the with running Mississippi’s new program is steeped in disorganization: agents rarely visit cultivation sites, application backlogs reach hundreds deep, and lags in communication with licensees often stretch on for weeks, a Mississippi Today investigation found.

Business owners feel frustrated, unheard and worried that the millions of dollars they invested — and the tens of thousands they paid in fees to the — could go up in smoke.

“The state threw them to the wolves,” cultivator Joel Harper said of the fledgling marijuana office. “They should have paid the money to bring in professionals, even a third-party consultant. Instead, they’re sending people out into the cannabis world who have no idea about anything cannabis.”

At the center is a handful of workers, tasked with unrolling a massive program without enough staffing to operate efficiently. Cultivators say when they do hear back from the office, the messages are incomplete or inconsistent – especially when it comes to how they construct their farming facilities.

And that’s if they hear back at all. The office already has mountains of unprocessed paperwork.

As of the second week of January, 277 work permit applications sat in a queue waiting to be processed, according to copies of the office’s records obtained by Mississippi Today. Could-be cannabis workers can’t start their jobs without permits. Another 995 patients had yet to to be told whether or not they’ve been approved for their dispensary cards.

Three dozen businesses had their own applications stuck, along with almost 40 other medical practitioners, the records show.

In a statement to Mississippi Today, department of health spokesperson Liz Sharlot acknowledged the backlogs.

“We are working with the MMCP (Mississippi Medical Cannabis Program) Licensing Director and the team on how to put more efficient processes in place,” she said.

Even when the office hired new workers – growing from four to eight in recent months – little was done to train them on the law and the industry, an employee of the health department told Mississippi Today. The employee spoke on the condition of anonymity out of fear of repercussions.

The health department said in October, when Mississippi Today first reported the backlogs, it was working to fill 25 more positions. That has yet to happen.

The health department worker said much of the disorganization stems from the office’s former director Kris Jones Adcock.

The Department of Health did not answer questions related to plans to increase staffing levels or what medical marijuana-related training their current staffers received.

“The people of Mississippi deserve better,” the worker said.

A Mockingbird Cannabis employee sorts through medical marijuana at the facility in Raymond, Miss., January 20, 2023.

During one five-week period, Adcock held three jobs simultaneously within the health department: the cannabis role, the head of a domestic violence office, and a promotion to a department-wide role as assistant senior deputy.

The health department didn’t respond to questions about the effects managing three positions may have had on her ability to the cannabis office. Adcock now holds only one department-wide role: Assistant Senior Deputy to the Senior Deputy.

Adcock announced two weeks ago that the office’s attorney, Laura Goodson, would be the acting director.

The health department employee also said Adcock set a tone of rushed processes and absentee leadership that has left the marijuana office in clean-up mode.

“There was no due diligence on some of the applications,” the worker said. “Some of it was her knee-jerk reaction to get stuff out the door after it (the backlog) built up. Instead of an orderly process, it was just rushed.”

Emails obtained by Mississippi Today show that it wasn’t just cultivators struggling to hear back. The head of a lab testing facility also expressed frustration.

“The complete lack of communication is just not feasible any longer,” Rapid Analytics director Jeff Keller wrote to Adcock on Dec. 16. “I am begging you to please just name the time on Monday and I will make it work.”

A month later, one of Keller’s employees sent his own desperate plea to the office.

“I’m trying to find out when I’ll be able to start working there,” he wrote about his job at the lab. “My background check was cleared on December 15th … I’ve left multiple messages but have not received a response.”

The CEO of test facility Steep Hill, Cliff Osbon, sent his own email on Jan. 13 on behalf of four employees who still needed their work permits so they could begin work and the lab could start testing marijuana.

Neither testing lab responded to Mississippi Today’s request for a comment.

Zack Wilson, a micro-grower in Potts Camp, said he had a worker waiting more than two weeks on a work permit.

“You send an email. Wait two weeks. Email again,” Wilson said. “You just sit and wait. I know they’re short staffed, but come on guys.”

Joel Harper, owner and founder of Pharm Grown, inspects marijuana plants at his facility in Como, Miss., Monday, January 23, 2023.

Cultivators say unanswered questions have led to a murky-at-best understanding of how some of the regulations are being interpreted and enforced.

That’s bubbled up with the use of so-called “adapted greenhouses,” putting already competitive cultivators more at odds. The regulations call for no outdoor growing, a solid roof, permanent walls and slab foundations.

In the early days after the law was passed, Harper, the head of Como-based Pharm Grown Canna Company, said officials made it clear to industry hopefuls that greenhouses would not be approved as growing facilities. So he, like many others, invested money in renovating a large warehouse that would rely on artificial lights.

In the last few months, he’s noticed much cheaper greenhouse-style structures popping up with the health department’s approval.

Harper and others who followed the bill’s creation closely say greenhouses go against the spirit of what legislators intended.

The debate comes down to word definitions that aren’t spelled out in the law itself. If the bill doesn’t allow any “outdoor” growing, that should mean the structure can’t utilize the sun, some argue. The greenhouses have clear-plastic roofs to use a mix of sun and artificial light. If the facility needs to have a solid and secure roof, clear plastic shouldn’t be permitted, according to some interpretations.

Cultivators like Wilson don’t see it that way.

“The roof certainly isn’t made of liquid or gas,” he said. “Plastic is a solid.”

Wilson said his site plan, including the materials he was using, were all approved by the health department when he handed in his application. He was given his cultivation license in August, according to public records.

Another cultivator, Jason McDonald, is building his own greenhouse under the company name SADUJA. He received his license on Dec. 22. He said his roof is two layers of clear plastic. He has screened-in shutter windows, a cement foundation and plumbing. McDonald runs a tea farm. He’s used to meeting regulations and dealing with bureaucracy and hopes to start growing marijuana by the end of the month.

Mississippi Today also obtained documents Adcock signed off on the site plan, including a hand-drawing where the facility was labeled “greenhouse.”

“I emailed them and asked: ‘Will this greenhouse we’re planning to build meet regs?” McDonald recalled. “They came back and said: ‘you need to read the regulations’ so, I quoted the regulations and said ‘what’s the ruling on this?’ and they said ‘you need to read the regulations.’ I added the specific subsection, and then never got an answer back.”

The word greenhouse, he said, can summon something different depending on the cultivator. He, like others, agrees Mockingbird Cannabis should have been cited for its greenhouse that was under scrutiny in the fall because it had roll-up sides, not permanent walls.

Mockingbird also built a massive state-of-the-art warehouse as its main cultivation site.

“I will tell you we haven’t done anything we didn’t disclose to the Department of Health and in our application,” Mockingbird CEO Clint Patterson told Mississippi Today in October.

Harper and other warehouse operators don’t blame the small businesses for building greenhouses — they’re cheaper to construct and run, leading to significantly higher profit margins. They blame the state for approving them.

“We want them to succeed,” Harper said of greenhouse growers. “We just want them to do it in the way everybody else had to.”

The leading authors behind the bill that created the medical marijuana program could not be reached by Mississippi Today after repeated requests for comment. Rep. Lee Yancey said in the fall that it was the health department’s job to interpret the rules, and if the statutes were not clear enough, it would be addressed in the Legislature.

Sharlot, the health department spokesperson, said it did not approve a model for greenhouses and pointed to the “regulations that specify the physical requirements for a cultivation facility.”

“The MSDH met and continues to meet its statutory requirements as it did with the aggressive timelines in creating the MMCP,” she said.

A Mockingbird Cannabis tends to the “mother” medical marijuana plants at Mockingbird Cannabis in Raymond, Miss., January 20, 2023. These plants are used for create clones, which are cut from the “mother” plant and grow into plants themselves.

On Jan. 11, Adcock brought her recommended changes to cannabis regulations before the board of health hoping for the members’ swift approval.

Public commenting regarding updates to the regulations were open for less than a week, ending the day before Christmas Eve. It got about 150 comments, Adcock told the board.

The end result was a thick stack of paper delivered to each board member fewer than two days before the meeting.

“To get 1,000 pages, less than 48 hours before our meeting, it’s almost impossible to review to know what we’re really doing,” said Jim Perry, the head of the board’s cannabis committee.

Adcock’s proposed changes covered everything from batch sizes for testing to whether a cultivation license could cover more than one growing space under a single license.

During the meeting, Perry said he wasn’t comfortable with passing changes without time to review them and ask questions. State Health Officer Dr. Daniel Edney apologized to the board for the ream of paper and the lack of notice. He promised it wouldn’t happen again.

“Cannabis is special and unique and needs to be heavily vetted,” Edney said at the meeting.

Adcock went over some of the regulation changes she said were the most “emergent,” but ultimately the board chose not to act.

Following the meeting, Perry told a Mississippi Today reporter the committee process was created so “we can hear from people and be able to make well-informed and not rushed decisions.”

A committee meeting about the regulations has been for Jan. 26 at 3 p.m.

Marijuana plants are in place at Pharm Grown in Como, Miss., Monday, January 23, 2023.

With the constant flood of applicants, strapped-for-time staffers aren’t making regular site visits, according to cultivators and those with inside knowledge of the office. That means growers can get their provisional four-month licenses extended, begin growing, finish batches and have them tested and sent to market without having ever met an agent in person.

Onsite visits are required for a renewal of a license, but not for moving a provisional license to a permanent one, according to the health department. When asked about the frequency of agent visits, Sharlot emphasized that the office is remotely monitoring all cultivators with the seed-to-sale tracking program.

Meanwhile, the 163 licensed dispensaries are eying the number of patients – Sharlot said 1,732 as of Monday – who have licenses to purchase medical cannabis. They’re worried it won’t be enough to sustain a business after months paying rent without revenue.

The department of health worker who spoke to Mississippi Today said whenever they make a dent in the patient queue, it doesn’t take long to climb back over 1,000.

The health department says it has licensed a total of 73 cultivators; 12 processors; four waste disposal companies; nine transportation companies; three testing labs; 151 medical practitioners; and 975 workers with permits.

It’s a constant battle to keep up.

This article first on Mississippi Today and is republished here under a Creative Commons license.

State health department braces for impending hospital crisis

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State health department braces for impending hospital crisis

As the Mississippi crisis worsens and threatens to imminently shutter hospitals in the Mississippi Delta, the Department of Health is taking steps to prepare for the impending disaster.

The , an agency that has been gutted by budget cuts and weakened services over the past decade, was not staffed nor funded to take on the full burden of replacing health care services lost if hospitals close.

But State Health Officer Dr. Daniel Edney recently told lawmakers the department, in anticipation of an increase of health care deserts in the Delta, has begun assessing how it can help.

“We’re studying where health care deserts are emerging or we think they’re going to be,” Edney told members of the Senate Public Health Committee on Nov. 21, adding that the Health Department increasing services is “usually not a good thing.”

“We’re the provider of last resort,” he continued. “We’re there for public health. When you see us in perinatal care, hypertension, diabetes management – that means these communities aren’t being served.”

While more than 38 hospitals across the state are at risk of closing, the Mississippi Delta — the poorest region of the state with already dismal health outcomes — is most susceptible to the crisis. In August, the Delta’s only neonatal intensive care unit in Greenville closed. Greenwood Leflore Hospital has eliminated labor and delivery and other major services over the last several months. Today, the Greenwood hospital’s future is uncertain after negotiations with the to enter into a lease agreement abruptly fell through last month.

Additionally, Sharkey Issaquena Hospital and several other Delta hospitals are in dire financial straits.

A recent report from the Center for Quality and Reform shows that over half of rural hospitals in Mississippi – or 38 – are at risk of closing. The state has the highest percentage of rural hospitals at immediate risk of closing in the nation, and hospitals as a whole are in a deficit of more than $200 million in 2022, according to the Mississippi Hospital Association.

A 2019 report from the consulting firm Navigant revealed a similar statistic as the one from 2022: half of rural hospitals were at risk of closure then, too. But the difference now is the severity of the situation, said Ryan Moore, executive director of the Mississippi Rural Hospital Association.

“Hospitals that were bleeding slowly are now bleeding quicker,” said Moore. “But the underlying problem is still the same.”

A 2019 report from the consulting firm Navigant revealed a similar statistic as the one from 2022: Half of rural hospitals were at risk of closure then, too. But the difference now is the severity of the situation, said Ryan Moore, executive director of the Mississippi Rural Hospital Association.

“Hospitals that were bleeding slowly are now bleeding quicker,” said Moore. “But the underlying problem is still the same.”

With no clear solutions in sight, Edney said the Health Department will do what it can to strengthen the “safety net” in these underserved areas.

“We’ve already got an action plan in place,” Edney told lawmakers.

But when Mississippi Today followed up with the state Health Department and submitted a records request for that plan, department officials responded “… as of now we have no plan on paper.”

Mississippi Today then asked for clarification and details of the plan Edney referenced. A Health Department spokesperson emailed a statement from Jim Craig, senior deputy and director of health protection.

“Our next steps in plan development will be to meet with Delta Community Health Center leaders and coordinate needs and efforts with our Field Services office that coordinates care in county health departments around the state,” the statement read.

Mississippi Today then asked for an interview with Craig or someone else with the department, and the reporter was told she could email questions.

The department said it is “currently evaluating” what services might be needed when responding to a question about whether the focus would first be on the Delta and maternity and infant care.

“Maternal and infant services are one of the service areas we are evaluating,” said Craig in the email.

The state Health Department has closed 10 county health departments in the past decade, nine of which were closed in 2016. It also reduced hours in “several” county health departments around the state, though department officials declined to provide a specific number.

In 2016, it announced it would no longer be providing maternity services at the county health departments.

The Health Department’s mission is to promote and protect the health of . The agency does surveillance for diseases such as West Nile virus, flu and sexually transmitted infections, offers disease and injury prevention programming and information and other public health efforts. It also oversees drinking water testing, restaurant permits and inspections, on-site wastewater and sewage system regulation. It is responsible for licensing and regulating child care facilities, nursing homes, and other health care facilities.

There is no timeline for the implementation of the safety net Edney referred to, the department said.

This article first on Mississippi Today and is republished here under a Creative Commons license.

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