Medical Dispensary Staff & Registered Caregiver Compliance Guide

Authorizing Statutes & Rules

• Primary Statute: Title 22 MRSA Chapter 558-C (Maine Medical Use of Cannabis Act)
• Regulatory Authority: OCP Rules Chapter 4 (18-691 CMR Ch. 4)
• Regulatory Agency: Office of Cannabis Policy (OCP), Maine Department of Administrative and Financial Services
• Key Statutory Sections:
  • §2422: Definitions
  • §2423-A: Authorized conduct for medical use of cannabis
  • §2425-A: Registry identification cards and registration certificates
  • §2429-A: Packaging and labeling requirements
  • §2430-G: Record keeping, inspections, and reporting requirements

Critical Definitions (Title 22 §2422)

Qualifying Patient

A person with a debilitating medical condition who has received a written certification from a physician or APRN, and who possesses a valid registry identification card or written certification. (Title 22 §2422(9))

Registered Primary Caregiver

A person, 21 years or older, who is registered with OCP and provides care to a qualifying patient, including acquiring, possessing, cultivating, manufacturing, delivering, transferring, transporting, supplying, or administering cannabis. Registered caregivers have no patient limit (cultivation limits: 30 mature/60 immature plants OR 500/1000 sq ft canopy). Unregistered family/household caregivers may serve up to 2 patients. (Title 22 §2422(12); §2423-A(2)(B); §2423-A(3)(C-1))

Registered Dispensary

A not-for-profit entity registered with OCP that acquires, possesses, cultivates, manufactures, delivers, transfers, transports, sells, supplies, or dispenses cannabis or related paraphernalia to registered qualifying patients and caregivers. (Title 22 §2422(11))

Prepared Marijuana (Usable Cannabis)

Dried leaves and flowers of the marijuana plant, and any mixture or preparation thereof, but does NOT include seedlings, seeds, stalks, roots, or the weight of any non-marijuana ingredients combined with marijuana. (Title 22 §2422(7))

Registry Identification Card

A document issued by OCP that identifies a person as a qualifying patient, primary caregiver, caregiver's assistant, or dispensary assistant. (Title 22 §2422(13))

Debilitating Medical Condition

Any of the following conditions or treatment thereof: Cancer, glaucoma, positive HIV/AIDS status, Hepatitis C, ALS, Crohn's disease, agitation of Alzheimer's disease, nail-patella syndrome, PTSD, or peripheral neuropathy. (Title 22 §2422(1))

Written Certification vs. Registry Card

Critical distinction: Qualifying patients may use cannabis with either a registry identification card OR a written certification from their physician/APRN. (Title 22 §2423-A(1)(A))

• Registry Identification Card: Pre-verified by OCP. Card alone (plus photo ID) is sufficient for purchase.
• Written Certification Only: Must be an original or copy of the physician's/APRN's written certification stating the patient has a qualifying condition. Dispensaries should verify the certification appears legitimate and includes:
  • Provider's name, license number, and signature
  • Patient's name and date of birth
  • Statement that patient has a qualifying debilitating medical condition
  • Date of certification (must be current - typically 1 year validity)

Best Practice: Keep photocopies of written certifications with your transaction records for compliance verification.

Verification Script for Staff

Cultivation Authorization

Patients and caregivers have extensive cultivation rights under Title 22 §2423-A:

• Patient Cultivation: Qualifying patients may cultivate their own cannabis (up to 6 mature, 12 immature plants) OR designate their primary caregiver to cultivate on their behalf. (§2423-A(1)(D))
• Caregiver Cultivation: A registered caregiver may cultivate cannabis for their qualifying patients (up to 6 mature and 12 immature plants per patient). (§2423-A(2)(D))
• Shared Cultivation: Two or more qualifying patients from the same household may share two cultivation areas and assist each other with cultivation. (§2423-A(1)(E))
• Possession at Cultivation Site: The 8-pound limit does NOT apply at the cultivation location - patients/caregivers may possess the entire harvest. (§2423-A(1)(B))

Dispensary Advice: When patients ask about home cultivation, direct them to these statutory limits and recommend they document their plant counts for compliance.

No Per-Transaction Limits for Maine Patients

Unlike visiting patients (see below), Maine-registered patients have no per-transaction or per-day purchase limits as long as total possession stays within the 8-pound limit. However:

• Dispensaries should use professional judgment to prevent suspicious bulk purchases that could indicate diversion
• Large purchases should be documented with extra detail in transaction records
• Staff should be trained to recognize red flags for potential diversion to illegal markets

Visiting Patient Purchase Limits

Visiting qualifying patients from other states face stricter limits:

• Maximum per 15-day period: 2.5 ounces of prepared marijuana (combination of flower and cannabis products) (OCP Visiting Patient Guidance, 2024)
• Verification Required: Must present their home state's registry card or equivalent documentation
• No Cultivation Rights: Visiting patients may NOT cultivate cannabis in Maine
• Reciprocity: Maine accepts medical cannabis certifications from states that extend reciprocity to Maine patients (see OCP website for current list)

Inventory Tracking System Requirements

Per Title 22 §2430-G and OCP guidance, registered dispensaries must maintain a state-approved seed-to-sale tracking system:

• Track ALL cannabis: From cultivation through testing, manufacturing, and final sale
• Real-time updates: Inventory must be updated within 24 hours of any acquisition, cultivation, manufacturing, testing, sale, or disposal activity
• Manifest System: All transfers between facilities must be documented with transport manifests
• Waste Tracking: Cannabis waste must be rendered unusable and documented per OCP and DEP joint guidance

Current System: Many medical dispensaries use METRC (Marijuana Enforcement Tracking Reporting Compliance) or similar state-approved systems. Check with OCP for currently approved platforms.

Dispensing Workflow - Step by Step

1. Verify Patient/Caregiver: (See Patient Verification section above)
2. Consult with Patient:
   • Ask about intended use, experience level, and preferences
   • Recommend products based on patient needs and available inventory
   • Explain product potency, dosing recommendations, and consumption methods
   • IMPORTANT: Do NOT make medical claims. Frame recommendations as educational information only.
3. Verify Packaging & Labeling: Before dispensing, confirm all products have:
   • Child-resistant, tamper-evident packaging
   • Universal "Contains THC" symbol
   • Complete label with potency, batch number, and warnings
4. Complete Transaction:
   • Ring up sale in POS system
   • Enter all required transaction data into inventory tracking system
   • Provide receipt
5. Patient Education: Remind patient of:
   • Private consumption only (not in public view)
   • No driving under the influence
   • Store cannabis securely away from minors
   • Cannabis remains federally illegal - no crossing state lines

Caregiver Patient Limits

Registered primary caregivers have NO PATIENT LIMIT under current Maine law. (Title 22 §2423-A(2) - statute data extracted 1/07/2025)

• Registered caregivers: No maximum patient count - cultivation limits apply (30 mature/60 immature plants OR 500/1000 sq ft canopy)
• Unregistered family/household caregivers: May serve up to 2 patients maximum (must be family or household members) (Title 22 §2423-A(3)(C-1))
• Note: The former 5-patient limit was removed by legislative amendment PL 2017, c. 452, §4

Caregiver Business Operations

Per Title 22 §2423-A(2), a registered primary caregiver may:

• Hire employees: Caregivers may hire assistants (21+ years old, or 18+ family members) to help with cultivation, processing, and patient services
• Operate a retail location: Caregivers may establish a storefront for patient consultations and cannabis sales
• Cultivate cannabis: Up to 30 mature and 60 immature plants OR 500 sq ft mature/1000 sq ft immature canopy (not per-patient, total limits)
• Manufacture products: Process cannabis into edibles, concentrates, tinctures, and other cannabis products
• Deliver to patients: Transport and deliver cannabis directly to patients' homes

Caregiver Registration Requirements

To operate as a registered primary caregiver, individuals must:

• Be 21 years or older (exception: parent/guardian caregivers for minor patients)
• Submit application to OCP: Including criminal background check (Title 22 §2425-A)
• Obtain registry identification card: Issued by OCP after approval
• Comply with residency requirements: Per OCP guidance, caregivers must meet Maine residency standards
• Renew annually: Registry cards expire and must be renewed each year

Reference Document: See "OCP Letter Residency Requirements for Registered Dispensaries & Caregivers" in guidencedocs folder for current residency rules.

Caregiver vs. Dispensary: Key Differences

Reciprocity Requirements

Maine recognizes medical cannabis certifications from states that extend reciprocity to Maine patients. Per OCP guidance:

• Approved States List: Includes (as of 2024): Alaska, Arizona, California, Colorado, Connecticut, Delaware, Florida, Hawaii, Illinois, Maryland, Massachusetts, Michigan, Montana, Nevada, New Hampshire, New Jersey, New Mexico, New York, Oklahoma, Oregon, Pennsylvania, Rhode Island, Vermont, Washington, and Washington D.C.
• Check OCP Website: The approved states list is updated periodically. Always verify current reciprocity at maine.gov/dafs/ocp/medical-use/visiting-patients

Verification Procedures for Visiting Patients

1. Verify Home State Registry Card: Inspect the out-of-state medical cannabis registry card or certification document. Confirm:
   • Card is from an approved reciprocity state
   • Card is not expired
   • Card appears legitimate (has official state seals, security features)
2. Verify Photo ID: Check government-issued photo ID to confirm identity matches the registry card
3. Check Purchase History: Visiting patients are limited to 2.5 oz per 15-day period. You must track their purchases to enforce this limit:
   • Record visiting patient purchases in your tracking system
   • Before each sale, verify the patient hasn't exceeded 2.5 oz in the past 15 days
   • If near limit, inform patient of remaining allowance
4. Document Transaction: Record the sale with visiting patient's home state and registry number for compliance verification

Visiting Patient Limitations

• Purchase Limit: 2.5 ounces per 15-day period (combined flower and products)
• No Cultivation: Visiting patients may NOT grow cannabis in Maine
• No Caregiver Designation: Visiting patients cannot designate a Maine caregiver
• Consumption Only: Products purchased in Maine must be consumed in Maine - cannot transport across state lines (federal prohibition)
• Product Differences: Maine product formulations may differ from home state. Advise patients to consult with dispensary staff on proper dosing and use.

Script for Serving Visiting Patients

Mandatory Label Requirements

Every product label must include (Title 22 §2429-A; OCP Rules Ch. 4, §8):

1. Universal Symbol: "Contains THC" symbol with specific design and color standards (provided by OCP)
2. Product Identification:
   • Product name
   • Net weight or volume
   • Batch or lot number
   • Harvest date and packaging date
3. Potency Information:
   • Total THC content (mg and percentage)
   • CBD content (if applicable)
   • For edibles: mg THC per serving and per package
4. Testing Information:
   • Testing facility name and license number
   • Test date
   • Results for potency, pesticides, heavy metals, and microbials
5. Dispensary/Caregiver Information:
   • Name of dispensary or caregiver
   • License or registration number
   • Contact information
6. Required Warnings:
   • "For medical use only by qualifying patients"
   • "Keep out of reach of children"
   • "Do not drive or operate machinery while using"
   • "Women should not use marijuana during pregnancy or breastfeeding"
   • "Smoking is hazardous to your health"
   • "There may be health risks associated with consumption of this product"
7. Ingredients List: For manufactured products (edibles, topicals, etc.), list all ingredients including allergens

Labeling Prohibitions

Labels and packaging MUST NOT (Title 22 §2429-A(2)):

• Appeal to minors: No cartoons, toys, animals, or child-friendly imagery
• Depict humans or animals: Strict prohibition on human/animal images
• Resemble food products: Cannot use brand names or logos of non-cannabis food products
• Make medical claims: Cannot claim to diagnose, treat, cure, or prevent any disease
• Obscure required information: All mandatory label elements must be clearly visible
• Include misleading statements: All information must be truthful and not deceptive

Pre-Dispensing Product Verification Checklist

Before handing product to patient, visually verify:

• ☐ Package is child-resistant and sealed/tamper-evident
• ☐ Universal "Contains THC" symbol is present and visible
• ☐ Batch/lot number is legible
• ☐ THC/CBD potency information is clearly stated
• ☐ Testing facility name and date are present
• ☐ All required warnings are printed on label
• ☐ Dispensary/caregiver name and license number are present
• ☐ Package is not damaged or compromised
• ☐ Product is within expiration date (if applicable)

If ANY item fails: Do NOT dispense the product. Quarantine it and notify your manager/compliance officer immediately.

Professional Refusal Script

Incident Documentation Requirements

Every refused sale must be documented in an incident log with:

• Date and time of refusal
• Name of staff member who refused sale
• Reason for refusal (be specific but factual)
• Description of individual (if no ID obtained)
• Registry card number (if applicable)
• Any threats or problematic behavior
• Whether law enforcement was contacted

Retention: Maintain incident logs for minimum 5 years per Title 22 §2430-G record retention requirements.

Registry Identification Card Requirement

Per Title 22 §2425-A and OCP guidance:

• ALL employees/assistants must obtain a registry identification card from OCP before beginning work
• The card identifies them as a "dispensary assistant" or "caregiver assistant"
• Cards are NOT tied to a specific employer - assistants may work for multiple dispensaries/caregivers
• Assistants must carry their registry card AT ALL TIMES while working with cannabis

Criminal Background Check Requirements

Individual caregivers (but NOT assistants) must undergo criminal background checks (Title 22 §2425-A(2)(C)):

• Caregivers: Must submit to criminal history record check through Maine Background Check Center (MBCC)
• Assistants: EXEMPT from criminal background check requirement (per OCP guidance)
• Dispensary Officers/Directors: Must obtain registry cards and may be subject to background checks as part of dispensary licensing

Reference: See "Memo-MMMP Stakeholders RIC Announcement.pdf" in guidencedocs for updated assistant registry card guidance.

Assistant Authorized Conduct

With a valid registry card, assistants may (Title 22 §2423-A):

• Possess cannabis while performing duties for the dispensary/caregiver
• Assist with cultivation, harvesting, processing, and manufacturing
• Assist with transporting cannabis between licensed facilities
• Assist with dispensing cannabis to qualifying patients
• Access cultivation and processing areas
• Handle cash transactions and record-keeping

Critical Limitation: Assistants may ONLY perform these activities while working for a registered caregiver or dispensary. Personal possession outside of work requires their own patient registry card.

Employee Training Requirements

While not explicitly mandated by statute, OCP strongly recommends all dispensary and caregiver staff receive training on:

• Maine Medical Use of Marijuana Act (Title 22 Ch. 558-C)
• OCP Rules Chapter 4
• Patient verification procedures
• Possession and purchase limits
• Product labeling and packaging requirements
• Inventory tracking and record-keeping
• Recognizing diversion and prohibited sales
• Customer service and de-escalation techniques

This Guide: Can serve as a foundational training resource. Print and distribute to all staff.

Age Requirement

All dispensary and caregiver assistants must be 21 years or older. (Title 22 §2423-A)

Exception: Parent or legal guardian caregivers for minor patients may be under 21 if they are the patient's designated primary caregiver.

Per-Transaction Checklist

• ☐ Verify patient/caregiver registry identification card (check expiration)
• ☐ Verify government-issued photo ID (confirm name match)
• ☐ For visiting patients: Check 15-day purchase history and remaining allowance
• ☐ For caregivers: Confirm patient name and registry number they're purchasing for
• ☐ Verify all products have compliant packaging and labeling before dispensing
• ☐ Provide dosing guidance and consumption method education
• ☐ Complete transaction in POS system with all required data fields
• ☐ Update inventory tracking system in real-time (within 24 hours)
• ☐ Provide receipt with transaction details
• ☐ Remind patient of safe use, storage, and transport requirements

Closing Shift Checklist

• ☐ Reconcile cash drawer with transaction records
• ☐ Verify all transactions are entered into inventory tracking system
• ☐ Secure all cannabis inventory in locked storage
• ☐ Review and file any incident reports from the shift
• ☐ Complete shift handoff notes for next shift (highlight any issues or red flags)
• ☐ Verify security system is armed before leaving premises
• ☐ Document any inventory discrepancies for manager review

Weekly Compliance Review

• ☐ Review all incident reports and refused sales for patterns
• ☐ Audit random sample of transaction records for completeness
• ☐ Verify inventory tracking system matches physical inventory count
• ☐ Check that all product on shelves is within expiration dates
• ☐ Review visiting patient purchase logs for compliance
• ☐ Ensure all staff registry cards are current (check expiration dates)
• ☐ Review any OCP guidance updates or rule changes
• ☐ Document staff training completed during the week