The campaign to create a medical marijuana program in New York was an uphill battle, and even when it passed in 2014, advocates criticized its many restrictions.

Gov. Andrew Cuomo, who expressed skepticism about legalizing medical marijuana, agreed to sign legislation granting five licenses to grow marijuana and capping the number of dispensaries in the state at 20. Some diseases or conditions are not covered by the statute, and it remains illegal to smoke marijuana.

But now, more than a year since the program went into effect and in the face of criticism from patient advocates, state officials are taking incremental steps to try to expand access.

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The Cuomo administration made some changes last year, including allowing home delivery of the drug. The administration also added chronic pain to the list of eligible conditions, and began allowing nurse practitioners to prescribe the drug.

“Recent enhancements such as adding chronic pain as a qualifying condition, allowing registered organizations to wholesale their products to other registered organizations, permitting home delivery and empowering nurse practitioners and physician assistants to certify patients have helped to improve access for patients, streamline production and increase choice,” said Jill Montag, a state Department of Health spokeswoman.

Even though the program has certified more than 20,000 patients and registered more than 1,000 practitioners, the Cuomo administration is now seeking to double the number of companies growing and distributing medical marijuana. The five existing companies who won the initial licenses have sued to block the expansion, arguing that it would drive them out of business, but the state is still moving forward with expansion while the matter is in court.

“From day one, we made clear our commitment to the continued growth of this program so that the New Yorkers who qualify for this therapy have access to it,” Montag said. “The court's decision in April not to block this expansion while the lawsuit is pending certainly helps those residents. We will continue to fight any attempts to block patients from the relief they deserve. The department’s reviews are ongoing regarding conditions that could help expand the program further.”

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Those pushing to expand the program are also seeing progress in the state Legislature, including on a bill to add post-traumatic stress disorder to the list of conditions eligible for medical marijuana. The legislation passed in the Assembly last month and has advanced out of committee in the state Senate. Cuomo has indicated he would be open to signing the legislation if it passes both houses.

In the Assembly, another bill has been introduced that would allow the five licensed marijuana operators to subcontract parts of their business to other companies. Assembly Health Committee Chairman Richard Gottfried, who spearheaded the push to create the program, said he supports the pending legislation.

“The bill would authorize us to allow a registered organization to contract out part of its operation to another entity provided that all the laws and regulations would apply to the other entity,” Gottfried said. “The fact that you’re the best retailer in the world doesn’t mean you’re the best producer, and it may make more sense for you to contract out the processing of the product to another company.”

Gottfried added he’s tried to convince the potential new companies to agree only to distribute the treatment instead of also growing it, but they haven’t been interested.

While Gottfried praised Cuomo’s steps to expand the program, he disagreed with the existence of a list of conditions that are covered under the state program.

“We don’t have laws that tell doctors what you can use penicillin for or what you can use fentanyl for, just to look at opposite ends of the drug spectrum,” he said. “I don’t think the law should be telling doctors what conditions they can use medical marijuana for. To me, there should not be a list, we should trust licensed physicians.”

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More bills of health

REPEAL AND REPLACE

It remains unclear whether Congress will be able to follow through on a pledge to repeal and replace the Affordable Care Act. But if the U.S. Senate advances a measure that already passed in the U.S. House of Representatives, drastic cuts to Medicaid would cost New York billions of dollars. Gov. Andrew Cuomo, who had initially sought more sweeping budgetary powers, was able to secure new authority to balance the state budget in the event of major federal cuts if state lawmakers do not act within 90 days.

E-CIGARETTE BAN

A bill that would expand the state’s Clean Indoor Air Act to electronic cigarettes has garnered some support in both houses, although it was dropped out of this year’s state budget. The Assembly has passed the bill in the past, but it has stalled in the state Senate. This year, the bill has moved through the state Senate Health Committee, though it remains uncertain if it will ultimately go to the floor for a vote.

KENDRA’S LAW

The state Senate passed legislation to bolster Kendra’s Law and renew it permanently ahead of its expiration this month. The legislation is aimed at ensuring mentally ill New Yorkers receive adequate care – and the public is protected – by authorizing court-ordered outpatient treatment for those who pose a safety threat. The bill has been stuck in the Assembly Mental Health Committee.

MEDICALLY ASSISTED SUICIDE

Advocates are once again pushing a bill that would allow doctors to prescribe life-ending drugs to terminally ill patients, although the measure is considered unlikely to pass. State Senate Republicans, including Majority Leader John Flanagan, are critical of the legislation, while Assembly Democrats remain hesitant to throw the conference’s weight behind the bill.

WHAT GOT DONE

The state budget included a provision that will cap the growth of prescription drug spending in the Medicaid program. New York became the first state in the nation to do so. The budget also included funding to increase wages for direct care workers at state-funded nonprofits. With the new funding, direct care workers will see a 3.25 percent annual wage increase each year for the next two years.

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