Policy Issues

Are you looking for additional information on a public policy issue, or trying to locate a copy of a presentation you saw at a Women In Government conference? Click on the links below for information about Women In Government activity as well as related policy resources.

Highlights

Economic Security and Opportunities

Formed in 2003, the Economic Security and Opportunities Policy Resource Center works to ensure that economic issues are presented to women state legislators in diverse ways through producing quality newsletters, holding engaging conferences on pertinent economic issues, and promoting information that allows legislators to make sound policy designed to enhance the financial opportunities and knowledge of their constituents.

Diabetes

Launched in 2011, the Diabetes Policy Resource Center serves as a clearinghouse of information for state policymakers in order to promote the adoption of sound public health policies regarding diabetes and other diabetes health related complications such as obesity, heart disease, and kidney disease.

Childhood Obesity

Launched in 2013, the Childhood Obesity Policy Resource Center serves as a clearinghouse of information for state policymakers in order to promote the adoption of sound public health policies regarding childhood obesity.

Pulmonary Hypertension

Launched in 2014, the Pulmonary Hypertension Policy Resource Center provides materials and information for state legislators to learn more about the disease, raise awareness, and promote treatment and management of Pulmonary Hypertension (PH).

Migraines and Headaches

Tune in to Legislator PSAs airing in your local market!

Did you know that Migraine and Headache disease impacts more than 37 million Americans and women are three times more likely to suffer from migraine than men? In addition to the human toll, migraine disease costs more than 200 million dollars a year in the United States in medical expenses and lost work productivity. 

American Migraine Foundation

The American Migraine Foundation provides education, support, and resources for the millions of men, women, and children living with migraine. Its mission is to advance migraine research, promote patient advocacy and expand access to care for patients worldwide. Migraines and other disabling diseases that cause severe head pain impact more than 37 million people in the United States. By educating caregivers and giving patients the tools to advocate for themselves, the American Migraine Foundation has cultivated a movement that gives a collective voice to the migraine community. 

Association of Migraine Disorders

The Association of Migraine Disorders (AMD) is devoted to expanding the understanding of migraine disease and its true scope. Because migraine is a full body condition with a broad spectrum of symptoms, AMD is focused on including many medical specialties in the management of this disease. The centerpiece of this effort is a comprehensive online course to accelerate the training of more medical professionals. For patients, AMD shares the opinions of experts in its series of short podcasts. AMD also believes that migraine has yet to capture the support of the general public and therefore it hosts Shades for Migraine, a playful, collaborative public awareness campaign. Finally, AMD strives to connect and grow an integrated migraine research community. 

CGRP & Migraine Community

CGRP & Migraine Community is an online community provides a supportive group for people with migraine who are taking or interested in the CGRP medications (Aimovig, Ajovy, Emgality - Eptinezumab, Ubrogepant, Rimegepant, Atogepant) including evidence-based information about these medications, new research, & shared experience.   

Chronic Migraine Awareness, Inc.

Chronic Migraine Awareness, Inc. is committed to being the voice of the chronic migraine community. This is accomplished by supporting, educating, and empowering people in their health journey with online peer to peer global support groups, social media campaigns, and in-person events. 

Cluster Busters

Clusterbusters  is dedicated to raising awareness for cluster headache. This form of Trigeminal Autonomic Cephalalgia is considered more painful than childbirth, kidney stones, and gunshot wounds. Cluster headaches are often nicknamed “suicide headaches,” and respond best to high-flow oxygen. Clusterbusters furthers cluster headache research by partnering with and advising medical professionals and innovators to develop new treatments. It educates medical professionals and the patient community in order to reduce time to diagnosis and increase access to appropriate treatments. Clusterbusters’ online and face-to-face support and education helps patients lead their best lives, and sometimes saves lives. 

Coalition of Headache and Migraine Disorders (CHAMP)

The Coalition of Headache and Migraine Disorders  (CHAMP) brings together the most influential patient advocacy organizations and leaders in the area of migraine, cluster and headache diseases. CHAMP enhances communication, coordination, and collaboration to more effectively fight stigma and help people achieve fair access to treatments. Our greatest strength is our members and it is a reflection of how strong people are who live with headache diseases. 

Cluster Headache Support Group

The Cluster Headache Support Group is dedicated to providing a safe, supportive, community for patients and caregivers affected by cluster headache that offers patient education and access to accurate, relevant information and resources, as well as drive and support scientific research that results in treatment advances for patients with cluster headache and other TACs. It adheres to the highest standard of corporate ethics, including disclosure of any and all competing interests. Cluster Headache Support Group’s compassion for the suffering of those affected by cluster headache drives its operations. It believes in collaborative decision-making within its team, soliciting member input, and are committed to working with other headache organizations to further shared goals. 

Danielle Byron Henry Migraine Foundation

The Danielle Byron Henry Migraine Foundation was established in memory of beloved daughter and sister, Danielle, who battled migraine disease for 10 years until it ultimately led to her death at the age of 17. Its mission is to increase access to care, especially for young adults and children, by educating primary care providers in the treatment of migraine. The Foundation provides support to those living with migraine through free, bi-weekly sessions of Headache School and Mindful Yoga in partnership with the University of Utah. It raises community awareness of migraine and its impact on patients, families, and society through bi-annual “Shine Her Light” events. 

The Headache and Migraine Policy Forum

The mission of the Headache and Migraine Policy Forum (HMPF) is to advance public policies and practices that promote accelerated innovation and improved treatments for persons living with headache and migraine disease. HMPF uses a campaign approach to support the education of patients, healthcare providers, and other stakeholders about policy issues that impact access to new and existing therapies with the goal of furthering access to appropriate prevention and treatment options for all patients. HMPF directly advocates with plans, policymakers, and other decision-makers to expand patient access to approved therapies. 

Healthy Women

HealthyWomen is the nation's leading independent, nonprofit health information source for women. Its mission is to educate women to make informed health choices for themselves and for their families. For 30+ years, millions of women have turned to HealthyWomen for answers to their most personal health care questions. HealthyWomen provides objective, research-based health information reviewed by medical experts to ensure its accuracy. Consumers, health care providers, nonprofit and corporate partners, and the media trust HealthyWomen as a valued and reliable health information source. 

International Headache Society

The International Headache Society (IHS) is the world's leading membership organisation for those with a professional commitment to helping people affected by headache. As a charity, the purpose of IHS is to advance headache science, education, and management, and promote headache awareness worldwide.

Migraine Again

Migraine Again is a purpose-driven health media company focused on empowering patients with education and insights that help them suffer less and live more. Founded by patients, for patients in 2014, Migraine Again’s website articles, newsletter, videos, podcasts, interviews, and resources are produced by people with migraine and medically reviewed by leading headache specialists. By engaging with over 1.5 million patients each month, Migraine Again is the largest privately held independent media company for people with migraine and headache disorders in over 170 countries. Its leaders regularly advocate for patients, conduct research, interview experts and produce the Migraine World Summit, the largest event of its kind. Each year, the Summit brings together over 30 world leading experts to offer patients a breadth and depth of treatment insights that they can’t get from their local doctors. In 2018 Migraine Again added The Daily Migraine to its family of properties and is the largest social media community online. 

Migraine.com

Migraine.com inspires people living with migraine to embrace their whole selves and engage in relationships with others to build community. Migraine.com features daily, original content with shareable, customized artwork, weekly email newsletters, and community-generated content and engagement through stories, Q&A, and forums. Migraine.com can provide a bridge between patient experience and health care providers. 

Migraine Disease.com

MigraineDisease.com is an industry leader as the only patient-owned and operated migraine website to have a medical review of all content. All content is reviewed for accuracy by a team of board-certified Migraine and Headache specialists. Doctors who treat migraine and other headache disorders can feel confident in recommending MigraineDisease.com to their patients. The website covers all aspects of living with migraine disease, including diagnosis, treatment options, lifestyle management, and behavioral health. Research is explained in clear, concise terms that everyone can understand. MigraineDisease.com is a truly comprehensive resource for migraine and headache education. 

Migraine World Summit

The Migraine World Summit is the largest virtual patient event in the world for those with chronic headache and migraine disease. Its mission is to reduce the global burden of migraine through world-class education. Each year the event brings together tens of thousands of people to learn from world-leading doctors, experts, and specialists. It is complimentary for a limited time with registration and available online. 

Miles for Migraine

Miles for Migraine creates live, patient-participatory events that reduce the burden of isolation and stigma for people with migraine and headache diseases and their caregivers. It builds community by bringing people together at fun walk/runs and through educational and support programs. Miles for Migraine also has programs specifically focused on engaging and supporting adolescents. Its programs foster empowerment, increase disease awareness, teach skills to advocate for better access to treatments and raise funds for headache fellowship programs.   

National Headache Foundation

Founded in 1970, the National Headache Foundation is the oldest and largest foundation for patients with headache. Its mission is “To cure headache, and end its pain and suffering.” Its vision is “A World Without Headache.” The Foundation is the premier educational and informational resource for those with headache, health care providers, and the public. The work of the Foundation is through education, raising awareness, advocacy, and research. The Foundation established the Certificate of Added Qualification in Headache Medicine for physicians, nurse practitioners, physician assistants, dentists, and clinical psychologists who treat headache patients. The NHF publishes HeadWise® magazine, and NHF News to Know. 

Patient Advocate Foundation

Patient Advocate Foundation provides real-time help for patients facing critical illness and debilitating disease as they encounter barriers in their healthcare. Utilizing experience from 20+ years working alongside patients, PAF is well-known for its quality educational materials that help patients self-advocate to overcome common challenges. In addition, PAF’s skilled staff deliver tangible assistance through personalized case management services, financial support towards medication copayments and the connection to vital community resources, all at no cost to the patient or their caregiver. PAF is the producer for Migraine Matters, an educational resource for persons with migraine or headache disorders. 

Runnin' For Research

Runnin’ for Research strives to improve the quality of life for people with migraine and other headache disorders through raising funds for much-needed research as well as promoting patient empowerment, public awareness, and local and national advocacy. The long-term goal is that R4R will have a network of nationwide run/walk events, locally organized and run by committed volunteers. The primary focus of R4R is to promote the creation of run/walk events in communities throughout the country and empower local volunteers (physicians, nurses, migraine sufferers, and caregivers) to plan, organize, and execute these events.    

U.S. Pain Foundation 

The U.S. Pain Foundation is the leading advocacy organization for people with pain. Its mission is to empower, educate, connect, and advocate for individuals living with a chronic illness that causes pain, as well as their caregivers and clinicians. Through multiple programs and services, the U.S. Pain Foundation works to enhance the quality of life for people with pain, improve patient outcomes, address access and affordability issues, and increase public awareness and empathy for the issue of pain. The U.S. Pain Foundation is an independent nonprofit 501(c)(3) organization.    

 

Patient Opinion Leaders & Blogs

The Daily Headache

The Daily Headache is a blog that candidly addresses the emotional experience of living with migraine and headache disorders and also explores coping strategies, treatments, and research. Although living with these stigmatized disorders can feel lonely and bewildering, millions of other people face similar struggles. The Daily Headache is a place where people with migraine and headache disorders come together and remind each other that none of us are facing this alone. 

Golden Graine

Golden Graine is a blog/brand created by professional patient, Katie M. Golden, to share how she lives a fulfilled life with chronic migraine and pain. Katie found a purpose in writing openly about her experiences in having to navigate an extremely misunderstood and stigmatized chronic illness.

The Migraine Diva

The mission of The Migraine Diva is to help empower and educate people living with headache, migraine disease, and mental illness through patient advocacy. Seeking valuable relationships with like-minded organizations, its goal is to share ideas, resources, and information on accessible treatments to better the lives of migraine patients and their caregivers. By sharing the realities of living with chronic intractable migraine, major depressive disorder and anxiety, The Migraine Diva hopes to empower, elevate and validate the patient voice and experience. 

Migraine Pal

MigrainePal helps those with migraine get the facts with medically referenced answers. Readers can find practical and evidence-based information to empower themselves. MigrainePal was created by Carl Cincinnato who works with several charities and organizations to help lift the global burden of migraine. These include Headache Australia, the Brain Foundation, the Coalition of Headache and Migraine Patients, and the European Migraine and Headache Alliance.

Inflammatory Bowel Disease - IBD (Crohn's Disease and Colitis)

Thank you to the participants who took a walk #InTheirShoes to get a glimpse into living with IBD

According to the Centers for Disease Control, "Inflammatory Bowel Disease (IBD) is a broad term that describes conditions characterized by chronic inflammation of the gastrointestinal tract. The two most common inflammatory bowel diseases are ulcerative colitis and Crohn’s disease. Inflammation affects the entire digestive tract in Crohn’s disease and only the large intestine (also called the colon) in ulcerative colitis. Both illnesses involved an abnormal response to the body’s immune system."

Women In Government took a walk #InTheirShoes via a mobile-platform simulation to gain an experiential understanding of what people living with this disease encounter daily and featured this topic at our Chicago conference.

Resources

Crohn's & Colitis Foundation - Step Therapy Infographic

Crohn's & Colitis Foundation - State Policy Priorities

Presentation - Unveiling Inflammatory Bowel Disease: What Policymakers Should Know, Jake Johnson, State Advocacy Manager, Chron's & Colitis Foundation

Please visit

www.chronscolitisfoundation.org

Cannabis/Marijuana Legalization Public Policy

Post-Conference Cannabis Consult Teleconference Transcript
When:                  Monday, August 6, 2018 – 3p.m.
Featuring:           Jennifer Flanagan, Massachusetts Cannabis Control Commissioner
Purpose:              Provide an opportunity for policymakers to engage more deeply on the topic of state cannabis legalization following panel segment in San Francisco. Click here to review Commissioner Flanagan’s presentation at WIG’s National Legislative Conference in June. 
Agenda:               1. Introduction – Moderator, Lucy Gettman, WIG Executive Director
     2. Massachusetts Implementation & Lessons Learned – Jennifer Flanagan, Massachusetts Cannabis Control Commission & Former State Senator
     3. Response to Pre-Submitted Questions
     4. Open Q&A
 
Lucy Gettman, Executive Director:  Good afternoon, everyone.  Welcome to Women In Government’s Teleconference and Policy Consult.  I’m Lucy Gettman, Executive Director for Women In Government, and as you may know, Women In Government is observing its 30th anniversary this year.  We are thrilled to offer this teleconference on a timely policy topic.  We think this topic is of immense interest to states and communities, and we encourage folks to consider registering for our upcoming State Directors and Healthcare Summit Conferences in Washington, DC from October 3-6, where we will continue to explore policy solutions to other complex issues impacting our states. 
The inspiration for today’s teleconference came from our National Legislative Conference in June.  The cannabis policy session with Massachusetts Cannabis Control Commission Member Jennifer Flanagan was a standing room only affair, and there were far more questions and comments than could be accommodated in the time available.  We are delighted, therefore, that Commissioner Flanagan has graciously agreed to join us for a follow-up session, and listeners, if you haven’t already, please feel free to refer to Commissioner Flanagan’s presentation in San Francisco, the link for which was in the invitation for this teleconference, in addition to a link to submit questions. You may have heard earlier just a couple of minutes ago that this teleconference is being recorded so that we can produce a transcript later so that this can be accessible in multiple formats.  
 
A word about the format for today’s call – we will begin our session in listen-only mode to receive comments from Commissioner Flanagan, we will then respond to questions that were submitted prior to the call, and when Commissioner Flanagan has had a chance to respond to those questions, we will then open up the phone lines so that participants can ask any questions you may have.  If you are listening on the phone and do not have any questions, we ask that you please mute your phones in order to minimize background noise. 
So without further ado, I am pleased to introduce Massachusetts Cannabis Commission Control Board Member Jennifer Flanagan.  Jennifer Flanagan was appointed to the fledgling commission by Governor Baker in 2017.  This is an excellent bipartisan effort, the Governor being a Republican and Commissioner Flanagan being a Democrat.  Prior to that, Jennifer Flanagan served in the Massachusetts State
 
Legislature from 2004 to 2017, first in the House of Representatives and then in the Senate, where she chaired the Joint Committee on Mental Health, Substance Use and Recovery; the Joint Committee on Children, Families, and Persons with Disabilities; and the Special Senate Committee on Addiction Prevention, Treatment, and Recovery Options.  And of course Women In Government proudly claims Commissioner Flanagan because she is a former member of our Board of Directors, where she led our Mental Health & Substance Use Disorders Task Force in 2016, which guided our development of a toolkit that was released in 2017.  Commissioner Flanagan, thank you so much for being with us this afternoon.  We look forward to hearing from you, and take it away!
 
Commissioner Jennifer Flanagan, Massachusetts Cannabis Control Board: Thank you, Lucy, and I want to thank Women In Government for having this conversation today.  I know there are a lot of states that are grappling with what to do with the legalization of marijuana.  Massachusetts specifically had it come to us by ballot initiative.  I understand that there are some legislatures that are doing it by their own doing, but I really wanted to be able to answer questions from people because I know that when I was appointed almost a year ago, the people I relied on were the people in other states who were going through it.  Having been through it in Massachusetts, we know that there are a lot of things that come up.  There are a lot of unintended consequences, and there seem to be a lot of questions around driving, public health, not to mention legalization potency and things of that nature, so I am more than happy to answer questions. 
As Lucy said, I was appointed by the Governor.  Our Governor here in Massachusetts was responsible for appointing a public health appointee, so a lot of the work that I have been doing in Massachusetts has been surrounding our public awareness campaign, has been working with our prevention people to get them to understand what we are doing, and also to look at regulations.  Many people don’t know that regulations surrounding advertising, labelling, packing – all of that can help with the public health aspect of it because we are certainly concerned with diversions to youth, we are concerned about pets and animals getting this product – we just want be make sure that we are doing it responsibly here in Massachusetts, so I am more than happy to answer any questions you may have.
Lucy Gettman: Commissioner Flanagan, why don’t we start with the questions that were submitted prior to when this teleconference began?  The first cluster of questions appears to relate to the general topic of can we treat marijuana like we treat alcohol?  For example how is law enforcement being trained to accommodate legal marijuana as part of their practice?  Can we reliably ascertain levels of marijuana exposure among drivers or other users?  And now that Massachusetts has decriminalized recreational marijuana use, are there any plans to expunge or seal any past marijuana convictions or marijuana offenses?  In other words, can we marijuana like how we treat alcohol?
Commissioner Flanagan:  You can, and you can’t.  I get that’s a typical legislature answer of yes and no.  So Massachusetts passed criminal justice reform, and part of that has the expungement of records – that is going to be part of the law here, and that is separate from what we do as the regulators here at the Cannabis Control Board.  The expungement can happen.  That’s going to probably have to be a legislative fix through criminal justice reform measures any legislature takes.  When it comes to marijuana, and really the question comes down to driving and impaired driving, the major difference between THC and alcohol is that alcohol gets into your blood, so it’s water soluble.  The more you drink, the more you feel the effects of it.  You’re easily able to blow blood alcohol content on the side of the road if you’re stopped by a police officer.  With marijuana it’s a little different because it gets to your liver and it metabolizes differently, you cannot have technically the same .08 per se that we all have for alcohol. 
 
Having said that, that also leads us to “Well then, how do you deal with someone when you have to maybe stop them on the side of the road or you know that they’re impaired?”  Our police officers are being trained as drug recognition experts.  A lot of what happens with people under the influence of marijuana is that their behaviors change.  They may be a little slower to do things, dilation of their pupils is a major indicator, some of the ways they act in dealing with people – so while there is a big push to regulate marijuana like alcohol, the reality is that it’s not as cut and dry as it is with the alcohol industry right now. 
 
I know that that frustrates people because we would all love to have a per se amount where if you stop someone on the side of the road you can certainly be able to tell the level.  There are some devices out there - and I know that there have been some police departments including the Massachusetts State Police that have done pilots with them – that there is a type of device that can determine if you have use marijuana within the past hour.
 
One of the other things that we have learned is that once you use marijuana, there is a very significant drop after the last hour if you smoke it (if you ingest it by smoking) in the levels of THC that are in your body.  That’s why the big questions becomes – if it stays in your body for 30 days – so if I used this 30 days ago, my levels are not as high as the day in which I used it, but you have traceable levels in your body, and so the conversation then for our public safety personnel becomes “What exactly can we do for them?” 
 
I will tell you that the underlying frustration of any regulator of marijuana is because this is federally illegal, we don’t have the resources given to other industries by the federal government to really deal with the everyday questions and concerns of this product.  Our U.S. Attorney [for Massachusetts] Andrew Lelling – it seems like every week he has something else to say.  This week it’s that states should be able to determine for themselves – well, that’s great, but that’s not what’s happening in Washington.  We’re trying to get through this, and impaired driving is something that we take very seriously.  This week our Executive Office of Public Safety will unveil their Drugs Driving Campaign, and on Thursday the Cannabis Control Board will unveil our Public Health Awareness campaign, so we’ve made a great effort to ensure that this happens before the stores are open. 
 
Lucy Gettman: That’s very helpful, thank you.  We’ve also had some questions related to resources available – questions regarding private sector engagement in the new policy landscape.  How are entrepreneurial efforts leading to marijuana being supported?  Is it strictly folks are on their own, or is there any seed money available, for example, to support the retail aspect of what’s happening in Massachusetts, and do you know of folks who are investing in the industry?
 
Jennifer Flanagan: Well, I know for a fact that in Massachusetts there’s no money to do anything right now because we haven’t opened up our stores yet, and we are just now taking licensing payments
We’re just now starting to license adult use here in Massachusetts.  We do have the medicinal program that has been up and running since I believe 2014, and they come under the Department of Public Health.  By the end of the year, they will be inherited by the Cannabis Control Commission per the statute, and so once they come over we will have a little bit more money to deal with. 
 
When it comes down to entrepreneurship, the really difficult piece of this is the banking available.  Here in Massachusetts Century Bank has said that they will bank medicinally, and they have been banking medicinal businesses, but they have not said that they will bank for adult use of marijuana, and so as of this moment there is no banking available here in Massachusetts, which means that if someone is looking to start a business or if someone is looking to be part of this, then they have to come up with the capital to do so. 
 
This then leads us into the conversation a little down the road about Social Equity, and how are we trying to get people who have been disproportionately impacted by the drug laws as part of this industry here in Massachusetts, but for the most part, I honestly believe that what’s going to get people the most is the cost of security. 
 
We have a very strict security regulation where we want to make sure that this thing is locked up, and we want to make sure that people cannot get to it.  We know that it’s a cash business, and so that’s going to present challenges on its own.  You know, I tend not to believe people when they tell me that there’s been no crime associated with this because as with any cash business you are ripe for people stealing.  We’ve tried to work through that, and we’ve been trying to encourage banks to be part of this.  Obviously banks are federally insured, so they have to be very careful as to what they do.  Credit unions have been looking at it, but I think really what’s been happening is that people are afraid to pull the trigger.  I think once one person says yes, we’ll see sort of an avalanche of people saying yes, but until that happens then we try to move forward. 
 
A lot of people coming to us have been the R & D’s, so they have the people who have been in the business.  In Massachusetts we are very cognizant that we have a smaller population with only 6 million of us, and I wanted to make sure that people who are not the big money investors from say a Colorado or a California or an Alaska were going to come in and take over the market.  I think that’s one of the biggest things as a legislator, you have to think about – who do you want doing business in your communities, in your state?  So we took great effort to ensure that if you were going to get one of our smaller licenses, our craft cooperative licenses, our transport licenses, that you were going to be a resident of Massachusetts, that we were going to make sure that you are the little guy, that we were going to try to give you as much advantage as we possibly can to stake your claim in this industry. 
 
Lucy Gettman: Thank you, Commissioner.  One more question before we open up the lines, and that is what can you tell us about the state of play with regard to research on safety and health concerns regarding cannabis?  Is there an equal playing field?  Again, this gets back to the alcohol being comparable to marijuana question – what is the state of play regarding the state of research and data on the safety and availability of cannabis?
 
Jennifer Flanagan:  Well, we have a Director of Research that works with the Cannabis Control Commission who comes from Johns Hopkins, and Dr. Julie Johnson is an amazing researcher who has done a lot of work in public health.  We are looking for really validated types of research that we are going to rely on. 
 
We understand that there’s a lot of research out there – some of it comes from the industry, none of it comes from the federal government.  Again, we still have that concern that this is all part of industry or from academic institutions, but that may be limited because of the federal funding piece of this.  We’ve been trying to find really validated sources of information to go on when it comes to creating policy. 
 
Our regulations are in place, and a lot of what’s in our regulations was mandated by Chapter 55 of the Acts of 2017, which I provided to Women In Government, so that people could see it. 
 
We have a very robust research agenda mandated to us, and that comes in the form of dealing with Social Equity.  It deals with diversion and youth use and risky behaviors, and we’re going to focus a little bit on pregnant women.  The elderly have been a concern and the veterans have come up as a concern for us because again the veterans are in a tight spot because most of them have TRICARE from the federal government while at the same time some of them are trying to participate in this industry.  So we are trying to ensure that all of the research we have is validated and that it can really be helpful to us as we move forward. 
 
Lucy Gettman: Great.  I’m going to ask Women In Government’s Managing Director, Maura LaGue, to open up the lines.  We definitely want to hear from you and learn what your questions are, and again we ask folks to mute their phones if they are not going to ask a question so that we can all be heard.  Any questions from the field?
 
Question from New Jersey: The question I have is in terms of your Social Equity program and outreach to disadvantaged groups.  What type of outreach activities did you feel were most successful out of any that you have incorporated already?  In addition to that, I saw that you were doing some workforce type of training and entry for minority entrepreneurs, and I wanted to know what types of programs have been most successful for Massachusetts.
 
Jennifer Flanagan: We’re just starting to do all of this. September 1st we’re going to be a year old, and we’ve literally only approved provisional licenses in the past month.  For Massachusetts, Social Equity came out of Chapter 55 of the Acts of 2017, making sure that the Cannabis Control Commission would actively reach out to the 29 disadvantaged, disproportionately impacted communities that were identified in a report that we had done about six months ago. 
 
Once we had identified those 29 communities, and that was done on economic employment, arrest records, and a whole host of other criteria, we then hired a Community Outreach Coordinator.  Shekia Scott has been amazing in setting up the presentations that we will be giving around our state.  While we understand that the 29 communities have been identified, we do realize that there are people in the other 320 communities in Massachusetts that would like to be part of this.  Shekia’s job is to go out into the communities and really meet people where they are at.  So far there’s been a job fair to recruit people, to talk about possibilities in the industry.  We have people go out and speak to the communities.  I think that there are some churches and church groups that are on the agenda, and really she’s going to work with cities and towns to meet people where they’re at. 
 
It’s interesting in Massachusetts.  Boston is really popular, and you know about inner-city Boston and you know about the communities around Boston, but the further west that you go, the more people want to know about cultivation, the more people really want to know not so much about the retail aspect but can they maybe be part of a product manufacturer or a transport license.  So just being very flexible in the way that we go about this and being very open to the communities is really what Shekia’s job is going to be. 
 
Question: Can you talk about Shekia’s role and clarify what it is that she does?
 
Jennifer Flanagan: Shekia is our Community Outreach Coordinator.  She has been hired to actually go out to the communities, and she’s probably going to be the one doing the most traveling out of all of our employees and to really talk about our Social Equity program, talk about the training programs that you had just asked about.   We’ve also made a concerted effort to recruit people who want to be a part of the training part of it.  There are accountants that are willing to give accounting help to a business; there are people willing to help write business plans.  Do we have attorneys who are willing to help those who can’t afford an expensive attorney?  Through the Social Equity program, it really tries to help those who would otherwise not be able to become part of this to become part of the marijuana industry in Massachusetts. 
 
As regulators, our job is to make sure that this is done correctly.  We also have a mandate from our legislature to ensure that all people are able to be a part of this.  When it comes down to training, we had a comment period back in February, and people came to the forums, they wanted to be a part of this, but they didn’t really know where to start.  Since the marijuana industry is so unique to other industries, we felt it was important to ensure that we had a very robust Social Equity program. 
 
The one thing I can add is that people tend to question us about public health aspects, what’s happening.  We all know that in Massachusetts kids are vaping before they are smoking, and the first thing that they are trying to smoke is marijuana, not tobacco, because we’ve had such a robust tobacco program over the years.  We took great effort, as you can see in the regulations I provided to Women In Government, that under our operations we have specific advertising requirements, and we have a lot of prohibited activities in our advertising. 
 
In Massachusetts you’re not going to see the marijuana leaf in anyone’s logo.  The only time you’re going to see the marijuana leaf is in the warning labels that were created by the Marijuana Control Commission.  You’re not able to sponsor anything where presumably 85% of the audience is under the age of 21, so your Little League teams will not be sponsored by Flanagan’s Marijuana Facility, but your adult softball league may be if you can prove that a lot of kids don’t attend the games. 
 
We ensure that you are required to follow all of the local charters, so if you have a sundown provision and you can’t have anything lit up in your window past a certain time, you won’t be able to do this either.  The question earlier about alcohol – we took everything that was included in the alcohol advertising regulations in this, and then we added some that we felt were important for the public health of our communities. 
 
Lucy Gettman: Just to be clear about the materials that Commissioner Flanagan provided, Women In Government has links to the following available:
  • Legislation to Ensure Safe Access to Marijuana
  • Social Equity Program PowerPoint
  • Regulations for Adult Use of Marijuana
  • Massachusetts Cannabis Control Commission Final Regulations
 
Question from New York: Can you address the homelessness issue that I understand has grown in Colorado, and I understand that in Colorado there have been more problems than say in the state of Washington, but is that something that you have set aside money for, or is that something that you have been anticipating, and how might you address that?  I have not looked at the regulations you provided yet, but I will take a look at this call.
 
Jennifer Flanagan: We have not set aside money for anything right now because we don’t have any money.  In Chapter 55, the legislature determined that the revenue collected by the sale of marijuana is going to go to four different places, one of which is substance abuse.  My concern, given my background, is that we are going to have an increase in people searching for addiction services, and we have to be ready for that.  While people who have a heroin addiction have to go inpatient to be detoxed, that’s not the same type of process for someone who is on marijuana. 
 
We are very well aware of the homelessness issue that has gone on in Colorado, specifically what they call the young adult and the emerging adult homeless population.  We were also aware that some of the schools had an uptick in the applicants because people thought it would be interesting to go to Colorado to go to college, and so we are looking at that type of information so that we can collect data as we move forward from the first day of the opening of our stores.  We are very well aware of what’s going on in Colorado and we are trying in our own little pockets around the state to prepare for what could happen, but not the Commission specifically, just by themselves. 
 
The one thing I can add to that, though, is that the Commission has been very proactive – and all five Commissioners have been very proactive – in partnering with the communities. We know that we can’t do this by ourselves.  We realize we can’t do this by ourselves.  We know that we have to work with the Department of Public Health, the Department of Public Safety.  We’re working a lot with the Department of Agriculture, so we know that we have to go where people are and try to extract data as much as we can. 
 
Question: Of the revenue or the revenue that you anticipate from this, is there any that is designated for or carved up in any way for preventing youth use or homeless or any other kind of social ills that there have been some findings on?
 
Jennifer Flanagan: Yes, the revenue is going to go to the General Fund.  It’s been determined that the revenue from the marijuana sales is going to be cut up, and substance abuse is the first thing on that.  Also, I believe, drunk driving and education and things of that nature.  Having been part of the Senate, they’re pretty well aware of what could happen, and I think that they’ve been flexible in listening to what we may need as we go forward. 
 
We’re also going to have what’s known as the Marijuana Trust Fund, which means that we keep some of that revenue, and we keep that revenue so that we can have the community outreach staff member, have a research agenda, possibly get the IRBs (Institutional Review Boards)  involved, making sure that all of the work that we do is validated.  We’ve also committed to doing a yearly conference on marijuana research, and our Research Director will then partner with other people to have a national conference come to Boston.  So we are very proactive in trying to anticipate where the money will absolutely be needed moving forward. 
 
The one thing I will tell you about revenue, though, is that you probably heard just in random new stories because I know we hear about it from other states that we’re projected to make $63 million in our first year.  People expected our doors to open July 1, and we’re almost at September 1, and nothing is open yet because in our law we are required to have an independent testing agency, and no independent testing agency has finished their application for licensure.  Until we award a license to an independent testing lab, no store can be opened because the product can’t be tested.
 
Question from New York: I’m wondering what the reasoning process and the rationale was to create a new commission as opposed to regulating under an existing liquor regulatory body?
 
Jennifer Flanagan: That was determined by the legislature.  I think I mentioned that our initiative was under Question Four – the initiative was called Question Four in 2016 – and under that question they wanted to put in under the Treasurer.  Our Alcohol Commission comes under our State Treasurer, and so that was initially the thought, that that was where it was going to go.  But I think given the work of our Gaming Commission—given the separate Gaming Commission that is bringing casinos to Massachusetts—that the legislature determined that they wanted an independent agency that had five appointees and that could work independently of anyone else.  I did notice in our research that when you call a lot of other states, they did sort of piggyback it with alcohol regulatory agencies. 
 
I have to say, though, in full disclosure, I’m the only one in the state who voted against Question Four for the law, and I’m now regulating it, so sometimes the legislative intent helps given the fact that I voted for this before I got here, not knowing that this was where I was going to end up. 
 
Lucy Gettman: Commissioner Flanagan, we do have another question, and that is we understand that there are some energy efficiency standards that are part of the cannabis regulations in Massachusetts.  Can you tell us about the reasoning behind including that language?
 
Jennifer Flanagan: Sure, the energy efficiency language is because years ago the legislature passed what we call the Global Warming Act of 2050, so by 2050 Massachusetts has to get to a certain point to reduce the carbon footprint.  And no matter what type of industry comes into Massachusetts, they have to conform to what’s already in the law. 
 
Commissioner Doyle has been working extensively on the energy issues and working to inform companies that are coming in that we do have restrictions on how much energy you are allowed to use for your business.  Growing marijuana is a light-intensive, high energy industry, but there are ways that industry members have been able to accommodate for that, and I believe that some are looking at solar, some are looking at different kinds of lightbulbs, the water filtration is a big deal, and a lot of the businesses are filtering the water that comes from the cities and towns because they want nothing in it except for what they put in it, and so they’ve had to make accommodations for that. 
 
On top of that, the other thing that we are very cognizant of is farming.  Farming was not included in Question Four back in 2016, but the legislature chose to highlight the farming industry here in Massachusetts.  We allow for craft cultivation, we allow for outdoor growing; we are going to allow for a whole host of things that are going to hopefully benefit the farmers because we see that industry declining here in Massachusetts.  At the same time, they have restrictions on the types of energy that they can use as well.
 
Question from New York: I’m wondering how you are handling child protection, child removals, birth testing for drugs for marijuana – anything like that, if you’ve got anything in there. Thoughts about it?
 
Jennifer Flanagan: Technically we don’t do that as regulators.  That’s going to come from the legislature.  I know that when I was in the legislature I was Chair of the Children, Families, and Persons with Disabilities Committee, so I dealt a lot with child protective services.  I know the question is being brought up because now there are women who self-report that they are using marijuana while they are in delivery and they’re giving birth and how to handle that.  I think that they’re trying to figure out to what extent the child is at risk.  Certainly if you have a parent who drinks and there is the possibility of Fetal Alcohol Syndrome but we don’t yet know what happens with the children who come from parents who are ingesting marijuana.  Part of that has been difficult for DCF, and they are working with the legislature to determine if anything needs to happen.  That is on top of what we’ve already had to accommodate for in Massachusetts, for the heroin epidemic and the opiate epidemic. 
 
The question becomes do you take the child or do you provide wrap-around services for the family and allow the family to keep the child?  They’re grappling with that as well and they haven’t come to any answers yet.  And the same thing with pregnancy – there’s been no determination.  I know that I’ve gotten a lot of calls from people—nurses in the emergency room—as to should they be filing neglect charges against parents who come in, and the parents are being treated, and they’re obviously under the influence.  I think unofficially they’re taking the stance that if you are under the influence, just as you were with alcohol, if you can’t properly care for your child then they’re going to have to do something about it. But if you self-report that you used it three weeks ago then there’s nothing that they can do. 
 
That’s going to be something that needs to be addressed in our next legislative session.  Our legislators have gone home for the year, so there are no more legislative sessions.  That’s part of the things where I poke my nose around in the legislature and try to figure out if there’s a way that we can do policy instead of legislation because the Secretariats have the ability to set policy where if we’re going to legislate this, then we run the risk that we have advocacy groups coming in and trying to fight both sides of it. 
 
The one thing I will add to that though, too, is that for your teenagers we’ve also … I added a social hosting provision to the law so that if you are someone who is providing marijuana to someone who is under the age of 21, we can get you on social hosting because essentially you are diverting the product to underage kids.  We have the same thing here for alcohol.  If you’re a parent having a party at your house and kids are drinking, the parents can get you on social hosting. 
 
The one thing I will suggest to the staff and the legislators on the call is that under the medicinal program Massachusetts was required to do a baseline study report - and the report came out, and I can get that to Women In Government if you want to see it – just to see where your state stands before adult use starts to get sold, so that you can gauge pre- and post-utilization and see where you need to make additional changes or where you need to focus your dollars on.  What we found is that 35% of people thought that it was ok to drive or have reported driving while under the influence, and that it was safer than alcohol, and that there was a large part of the population who don’t see what the problem is.  For us, that’s something that we addressed in our public awareness campaign. 
 
Lucy Gettman: Commissioner Flanagan, I know that it’s not going live until Thursday, but is there anything that you can share about the components of the public awareness campaign or things that the Commission thought about during its development? 
 
Jennifer Flanagan:  Sure.  Under the law, under Section 51 of that statute, we were required to work with our Department of Public Health to come up with a scientifically based campaign, which means that we couldn’t just come up with all of these statements that weren’t proven. 
 
We had 12 focus groups that we did throughout Massachusetts, we had some parent focus groups, and we had some general user focus groups.  We did not have focus groups of minors.  We didn’t get into that piece of it.  From there we created a campaign that will have an online presence, meaning that we have one minute, 30 second, and 15 second spots.  We will have billboards across Massachusetts.  We have parent rack cards, so we will have things for people to hand out and know that they will be available to all 351 of our cities and towns should they need them.  The Commission will give them out every time we do a presentation with our community outreach staff member.  We have very black-and-white statements.  “People under 21 cannot use this.  It’s illegal.  Make sure that you lock it up.  Make sure that you only have one ounce in your possession at any given time.”  Just the very basics of the law, and once we start to generate revenue, we are then going to go into more precise campaigns. 
 
Personally I would like to talk more about youth aversion, pregnancy, veterans, the elderly – those types of populations.  We were very specific about how the character looks, who the character is.  If you look at Colorado’s, it’s very much Colorado, right?  It’s very much walking trails and all of those types of things.  Well, we’ve incorporated some of the beach colors here from Massachusetts because we have Cape Cod, we dress our person differently, our character differently, we have interactions that are very different.  We think we’ve captured all populations of people as best as we can in the short amount of time that we have for this. 
 
I know there’s a big thing with Facebook.  We’re trying to do Facebook ads, but obviously Facebook has this thing going on right now with the word marijuana, so we’ll make changes as we need to.  You’ll be able to see a very robust type of campaign thus far.  For the rack cards we have a parent rack card so that you can talk to your kids, and we have a general rack card so that you know the dos and don’ts of the law.  The one thing that was glaring to me that we found in our pre-campaign research was that people didn’t know the law.  They know it’s legal, they read a couple of headlines, they know that they can’t ingest outside.  They don’t realize that they can’t have more than an ounce.  It’s really sort of an education tool. 
 
Maura LaGue: I grew up in Massachusetts, and when you and I were talking earlier this year, you were describing to me the challenge of having a state law that may or may not conflict with the sentiments of the towns.  I remember what that was like when smoking was banned where it just became a patchwork of ordinances.  Can you describe that process a little bit for other states that may be in a similar situation where the law may come into conflict with the locals’ feelings?
 
Jennifer Flanagan: Sure.  We have 351 independently operating cities and towns.  We don’t have county government.  We don’t have these big populations of people.  Each city and town has the ability to set their own charter, and the way that I describe the marijuana issue is that we sort of have to grow within all of these cracks in the sidewalk. 
 
For instance, in our regulations, you cannot be closer than 500 feet to a school or a playground.  Well, for a community who’s trying to be very walkable and who’s trying to be very proactive in getting families out in public spaces, that doesn’t work.  We give the cities and towns the ability to accommodate for that.  We say K-12 and we say playgrounds – some towns have expanded it to you can’t be at a college campus.  They’re nervous about the college campuses.  Others don’t want it anywhere near daycares.  So it depends on the city and town. 
The other thing too is when it comes to zoning.  There’s people who have commercial, industrial, retail, overlap, all these types of zoning.  What we say in our regulations is that you cannot ban marijuana sales through zoning, which means that essentially you’ve got to figure it out.  You have to figure out a way that this can be in your town. 
 
Going back a little, because this was about a question, everybody went to the ballot to determine whether they wanted it or not.  From that point, cities became “Yes” cities and “No” cities.  If the majority of your residents voted “yes”, you were considered a “yes” town, and if a majority voted “no”, you were considered a “no” town.  If you’re a “no” town, then your city government can just take a reaffirming vote and ban it so that you don’t have to have it in your town. 
 
If you’re a “yes” town and you don’t like that and you want to ban marijuana sales or ban marijuana at all--even the cultivations--you’ve got to go to the ballot.  You’ve got to go to the next ballot question that you have, and you have to put it to the town for a vote.  It can’t be done by your local government, and so we feel as though giving the cities the power to determine for themselves what they want it to look like while at the same time they have to follow state regulations. 
 
For instance, in the law it states that you can have up to 20% of your liquor store licenses for retail marijuana, meaning that if you’ve got 5 liquor stores, you can have up to 20% licenses go to marijuana.  Now you can’t sell them side by side – you have to get a separate license – but if you’re a town that has one liquor store, we’ll make you round up so that you’re able to have one marijuana store if you’re a “yes” town.  We know that there are some towns that are so small they don’t even have liquor stores, so we make provisions for that.
 
But all in all, we make sure that you have to comply with city charters and city ordinances for advertising.  We make sure that when it comes to transportation, we’re not allowing people to have any type of advertising on their car.  So if you’re driving through towns and one allows you and one doesn’t, we don’t want people getting caught for that.  There are some things we determine for them, but the cities and towns will get to determine what their landscape will look like. 
 
The one thing we do have which I don’t think other states really have is the Host Community Agreement.  If you’re going to site yourself in the city of Fitchburg, you have got to work with the town of Fitchburg to do a Host Community Agreement.  Under the law, the city is allowed to recoup up to 3% of your sales for impact fees, things like if you’re down this road that otherwise wouldn’t be used, and the road now needs to be paved, the money can go towards that because there’s an impact for you being there.  If there’s an uptick in 911 calls and your police and fire are being used more, then you may be able to give them more money for an impact fee.  We don’t allow you, however, to rake the businesses over the coals.  You can’t be asked for roofs of schools or new playgrounds or any of those things.  It has to be an impact from being in that town.  So there are some things that we are pretty heavy-handed on.
 
Question: Do you have any statistics at this time about how many people have applied for licenses or the various kinds of licenses yet?
 
Jennifer Flanagan: There have been a couple hundred people who have opened up applications, but they have not completed applications.  Each entity is allowed up to 3 licenses.  Some want to take that advantage, and some don’t want to take that advantage.  The other day, we approved 3 licenses for this one company – one for cultivation, one for product manufacturing (which means making the edibles and extracting the oils), and one for retail.  So he got 3 licenses but he’s one entity.  Part of the hang-up is – because again, we have a very long, involved process – is that we have third-party background checks.  When we send off for a background check, we have to wait for that to come back, and then when we call the city and town to ask if the Host Agreement is done and if they comply with the zoning, the city and town has up to 60 days to get back to us.  A lot of our hang-up now is waiting for other people to get back to us. 
 
The other thing that I should mention too though--as part of the social equity side with regards to licenses – we allow people with CORIs (Criminal Offender Record Information, see p. 5) to be part of this industry as long as they’re not selling it.  So if you have a drug charge on you, a marijuana possession charge, if you have any type of charge like that then you can be part of this.  If your CORI comes back and there is something on it, you’re not automatically disqualified.  I will point you to the back of the regulations (starts p. 178) that will tell you the number of crimes that if you’ve committed you cannot be part of this industry – and that’s trafficking, distribution, gun charges, there’s a whole host of things that you can’t have.  But we are very well aware of the people who can’t be part of the industry and may have a background, and so we do allow partially for that. 
 
Question: I know that you said the hang-up with the licenses is pretty much with the third-party background check company and the zoning, but do you have an entity that helps applicants to complete their application?  Is there any technical assistance to help them complete their applications?
 
Jennifer Flanagan:  There will be.  There hasn’t been yet.  Everything is online.  The whole application is online.  I’ve had people ask me if I can give them a copy of the application, and I can’t because we don’t have anything on paper.  That’s apparently the way these types of applications are done.  We contract out with a company who writes them up with the criteria for our application. 
 
There will be technical assistance.  I don’t believe it’s happened yet, but again because you’re up and running, it’s sort of like when you’re first in line, you kind of get the bad end of the deal because we don’t have all of these things in place, where I’m sure that two years from now we will. 
 
We do have a licensing division of the Cannabis Control Commission, and they can provide answers for people who have questions.  A lot of it is producing documents, but we’ve also had people open up license applications just to poke around because they’re curious, and we don’t know if they’ll finish the application or if they ever will.  So we don’t reach out to people to ask what they’re doing.  If they don’t finish it, they don’t finish it.  What we do is we take the ones who have completed the four packets – and I think that’s in the PowerPoint that I provided – if you finish the four packets then it gets moved on to licensing, and from there a determination will be made. 
 
Lucy Gettman: If there are no other questions, Commissioner Flanagan, thank you for being so generous with your time, your insight, and your experience to share with other states who might be considering a similar experience.  Also, I want to remind folks that if you are interested in this and other compelling policy topics, please consider registering for our 24th Annual State Directors Conference and our 9th Annual Healthcare Summit October 3-6, 2018 at the Grand Hyatt Hotel here in Washington, DC.  We would love to see you!  Any final comments, Commissioner Flanagan?
 
Jennifer Flanagan: If there’s anything that people need, feel free to contact me.  I think that my contact information is somewhere with Women In Government.  The way we learned was contacting other states, so if you feel as though there is something that you are concerned about, I can go through the regulations, the law, or whatever people would like. 
                Jennifer Flanagan, Commissioner
                Massachusetts Cannabis Control Commission
                Office: (617) 701-8403
                Email: Jennifer.Flanagan@mass.gov
                www.Mass-Cannabis-Control.com
 
Maura LaGue:  Thank you for attending, and I will be following up with anyone who RSVP’d with Commissioner Flanagan’s contact information as well as links to the information that she provided before the call.  As always, please reach out to Women In Government for this topic or any others, and we will try to help you as best as we can.
 
Lucy Gettman: It’s been a pleasure for us to conduct this policy consult, and please let us know what other topics may be of interest to you.  We would love to do this again.  Commissioner Flanagan, thank you so very much!  Take care, everyone.
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