Kitsap Caucus

See today’s story in the Kitsap Sun (paper version) for an explanation of Kitsap County’s move to a self-insured health care program. A number of counties and cities around the regional have already made the switch in an effort to curb rising health care costs.

The new program, combined with other cost-saving measures, is expected to reduce the amount the county spends on health care by $12.5. But the “savings” will not mean a decrease in employees’ share of insurance premiums.

Employers nearly everywhere have responded to escalating health care costs by asking employees to shoulder a greater share of the burden through higher premiums and deductibles. So Kitsap County employees were not alone when they saw their premiums jump from two percent of the total cost in 2009 to eight percent in 2010. In 2012, the county pays 86 percent of the tab for premiums; employees pay 14 percent. In 2013, that’s expected to go up to 17 percent, according to Bert Furuta, director of personnel and human services.

Bear in mind that the county isn’t simply shifting the burden, said John Wallen of DiMartino Associates, the county’s health care consultant. The county’s own costs continue to increase, even as it leans harder on employees to foot their portion of the bill.

Nationwide, the proportion of employees’ share of premiums varies widely depending on the industry and region of the county. A recent Mercer survey that divides the county into four regions, showed that, among combined private and public sectors for the “West,” the percentage was 21 percent for single employees, 30 percent for families. At that rate, Kitsap County employees are still ahead of the game.

You may wonder — and I asked — why the county needs a health care consultant, at a current cost of just more than $40,000 per year. According to Furuta, the field of health care is so complex that it requires specialized expertise to navigate. The county tried to go without some years back and found it was not cost-effective, Furuta said.

All the nation that pays attention is paying especial attention to the U.S. Supreme Court this week as it considers health care reform. Chris Henry is working on a story about a local woman who says she has insurance and has received benefits because of the new law. She will be taking a letter to Rob McKenna, Washington attorney general, asking him to drop the lawsuit he is in along with 25 other states. I wouldn’t look for McKenna to reconsider at this point.

When I had a chance to sidle up to the McKenna the governor candidate when he visited the area in January, he joked that the odds were 5-4, a reference to the idea that the decision could be a 5-4 split among the justices.

Calling it “The” decision is actually incorrect. Today the court hears arguments on whether it should be considering the law now, or wait until the mandate actually kicks in, which is 2014.

The mandate decision, whether Congress can write a law forcing you to buy something, is the key question, and those arguments are on Tuesday. On Wednesday is an argument over whether the entire law should be scrapped if the mandate is killed.

Should you like to be informed as the debate goes on, allow me to provide you several links that will prepare for conversations around the watercooler on Facebook.

PolitiFact.com provides the primer Everything you want to know about the health care law* and also gives you a chance to check out the truth or falsehood of several claims about the law. I’m not sure why there is an asterisk in the headline. Maybe it’s an unexplained admission that “everything” probably isn’t accurate.

On NPR’s All Things Considered is a piece about this week’s activities. The package begins with a story about a guy who sells places in line to get into the hearing for $36 an hour. The first customer placed someone in line on Friday, for Tuesday’s arguments. Further on Nina Totenberg responds that she doesn’t know which side will win, but Clarence Thomas is the only one predicted to be solidly against the act. Four justices — Ruth Bader Ginsberg, Elena Kagan, Stephen Breyer and Sonia Sotomayor — are predicted to be locks in favor of the law and the constitutionality of Congress mandating what people have to buy. Antonin Scalia and Samuel Alito are considered in play and Anthony Kennedy is seen as a swing vote. An interesting tidbit: Chief Justice John Roberts could end up voting to uphold the law if there is already a 5-3 vote among the associate justices, because a 5-4 decision “wouldn’t be good for the court as an institution of the country.”

The New York Times and ABC News both have stories on a 1942 Supreme Court decision that serves as the basis for arguments on both sides.

Finally, on Salon, an academic explains some of the motivation behind how judges may rule. Andrew M. Koppelman, John Paul Stevens Professor of Law and Professor of Political Science at Northwestern University, goes into some detail explaining some of the difficulty for the justices in overturning the law. That doesn’t mean they wouldn’t do it, but there are consequences that go beyond the new things the law introduces.

When you read the follow-up news stories on each day’s arguments, you could very well get an inkling of where this will end up in June. Both sides have reason to be optimistic, and to worry.

The city of Port Orchard on Tuesday will hold a public hearing on a moratorium on medical marijuana dispensaries approved by the city council Feb. 22.

The city was allowed to impose the “emergency” moratorium without formal public input, but it is required to follow up with a hearing on the matter.

The owner of Greenthumb Medical referral service and Tacoma Greenthumb, a medical marijuana dispensary, was thwarted by the moratorium in his efforts to establish a medical marijuana facility at 944 Bay Street in Port Orchard. His attorney will be at the hearing tomorrow.

“My position is that I think it’s kind of ridiculous,” said the man, who does not want to be publicly identified due what he describes as recent changes in the industry.

He somewhat understands the moratorium on dispensaries where marijuana is sold, but believes it should not apply to referral centers, where patients obtain medical certification to receive marijuana for treatment of a wide range of ailments. He is not a doctor, but contracts with a doctor to provide referrals.

“A doctor should be able to write a recommendation anywhere in Washington,” he said.

Greenthumb Medical Inc. is registered with Washington State’s Department of Licensing. The owner, who operates in Tacoma, has been denied business licenses in Port Orchard, Bremerton and Gig Harbor.

Meanwhile, he and others with dispensaries in Tacoma are doing so in a state of limbo. Tacoma has temporarily allowed medical marijuana dispensaries, pending the outcome of proposed legislation. A bill to clarify the rules on medical marijuana has passed the state Senate and is under consideration in the House.

Greenthumb was among 19 new dispensaries to receive letters from the city of Tacoma ordering them to stop selling to patients by March 28 or face losing their licenses and possible criminal charges. The Tacoma News Tribune reported Saturday on the latest development in that city’s approach to the budding industry.

Tacoma in October sent similar cease-and-desist letters to eight dispensaries, which caused an immediate uproar. City officials decided to allow the dispensaries to operate, at least until the outcome of the bill became clear, but they were required to file appeals.

The purpose of the latest round of letters, according to the article, was to put all dispensaries on the same legal footing in anticipation of whatever action the city will take when the bill either passes or dies.

According to this business owner, however, the cumulative effect has been chilling, hence his desire to remain anonymous.

The city of Poulsbo also has instituted a moratorium on medical marijuana, although no inquires had been made about such a business when it went into effect.

A poll on the Kitsap Caucus homepage asking, “Do you favor or oppose passage of SB 5073, ‘concerning the medical use of cannabis?’” shows 31 votes for and 12 against the bill, or 72 percent to 28 percent.

The day after an article in the Kitsap Sun reporting that Port Orchard is considering a moratorium on medical marijuana dispensaries, Dave Norton was in a quandary.

Norton, former owner of medical marijuana dispensaries in Key Center and Tacoma, was getting ready to set up shop at the Bayside Plaza in downtown Port Orchard. He’ll take the keys to the leased storefront on Saturday.

Norton asked me what the moratorium could mean to his budding business. Should he move forward with his plans? What are his options? What’s the chance dispensaries will ever be allowed in the city?

Norton said he just wants to help people who have health problems and can find no relief elsewhere. The organization NORML, which seeks to legalize marijuana, lists 19 clinical indications for medical marijuana, from Alzheimer’s, ALS, chronic pain and diabetes, to Rheumatoid arthritis, sleep apnea and Tourette’s syndrome.

The drug is not without side effects and risks, including the possibility of addiction and negative effects on the heart, lungs (if smoked) and impairment of activities of daily living, according to the National Institute on Drug Abuse.

There are implications for mental health as well. According to NIDA, “A number of studies have shown an association between chronic marijuana use and increased rates of anxiety, depression, and schizophrenia.”

No doubt marijuana is powerful medicine, say proponents. But testimony from some who commented on the Kitsap Sun’s story indicate that, at least in some cases, it provides significant relief, where traditional prescription drugs have not, and with fewer side effects.

“Marijuana has replaced the psychotropics, and most of the pain meds and the muscle relaxers. … No more zombies,” wrote robodrill, whose wife has cancer and whose two sons are “wounded warriors.” “I have my wife back, and my sons are no longer the victims they once were, they have some pride back.”

Norton’s intention is to provide a “clean, neat, organized” facility where authorized patients can safely obtain the drug.

“We want people to realize this is going to be very, very professional,” he said.

And discreet. No tacky signs looking like something out of the 1960s. Even the name will be discreet: Bella Oha, meaning “beautiful leaf.”

Norton’s former business was “Green Health.” He shut it down after employees left in change while he recovered from a heart attack engaged in less than professional activities. Norton, with about 1,000 clients and a new partner, wants a fresh start in a new town. But since announcement of the pending moratorium, he’s wondering about the odds he’ll be able to do so.

City officials on Tuesday had plenty of questions of their own. What does the current city code say about dispensaries? Can they deny someone planning one a business license if they apply before the moratorium is formally enacted? Would this open the city up to a lawsuit? And how would the passage of a bill on medical marijuana currently before the state Legislature change the rules?

City code as it stands would allow dispensaries, and other jurisdictions, including Port Angeles, have allowed them. A business license was issued to one dispensary there, and the Port Angeles police won’t intervene unless a violation of the law is called to their attention.

But Port Orchard Police Chief Al Townsend is clear that, in his book, dispensaries are illegal — at least for now — and in his town they’ll be shut down. Townsend on Thursday issued a statement (complete text below), saying, “While the laws clearly need clarification for both those using it and those enforcing it, in my opinion it still is clear that dispensaries are not legal,” he said. “If one of the dispensaries opens in the city, I’m 100% sure we will take enforcement action, unless the law changes in the mean time.”

That could change with the passage of SB 5073, which calls for clarification of the rights of medical marijuana patients, as well as ways to track and regulate legal use of the drug. Hence the discussion of the moratorium. Townsend advised the city council to take a stance that will clearly spell out the city’s policy on dispensaries, at least until they know the fate of the bill.

Until the moratorium formally passes the council, anyone seeking to operate a dispensary could apply for a business license. But City Attorney Greg Jacoby said that the city would be within its rights to deny a license to such a business — even though current code allows it — based on the chief’s interpretation that it is illegal.

In doing so, however, Port Orchard could be opening itself up to the kind of controversy that occurred in Tacoma, when the city tried to revoke the licenses of eight dispensaries. The Tacoma City Council agreed to wait on enforcement until the fate of the bill is clear, after protesters descended on city hall.

The moratorium is not on the council’s agenda for Feb. 22. Norton will be there to state his case.

Take the poll on the Kitsap Caucus homepage: Do you favor or oppose passage of SB 5073, “concerning the medical use of cannabis?”
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Chief Al Townsend’s statement on medical marijuana dispensaries, Feb. 17, 2011:

While the laws clearly need clarification for both those using it and those enforcing it, in my opinion it still is clear that dispensaries are not legal. One patient, one caretaker or grower. That’s how I see it. I believe that’s how the prosecutor feels about it.

If one of the dispensaries opens in the city, I’m 100% sure we will take enforcement action, unless the law changes in the mean time.

If the law does change to legalize dispensaries, my biggest concern was how the city was going to regulate where they would be located. It appears now that the city will create a moratorium on the facilities until such time as they can sufficiently study that issue. I think that’s a really good idea.

What I find most interesting about this is……..if people really want to have options for medical marijuana, why not regulate it and dispense it through the facilities that already exist……..pharmacies. It would seem natural to do so in this way to help ensure compliance with the laws that they already have to follow. The facilities are professional and clean and already located around the community. Seems like the best way to do business. Let Pfizer and the other drug companies market it!

Alan L. Townsend
Chief of Police
City of Port Orchard
546 Bay Street
Port Orchard, WA 98366
(360) 876-1700 FAX: (360) 876-5546
www.cityofportorchard.us