Title: Section 1004.3 - Application for registration as a certified patient

Effective Date

01/03/2018

1004.3 Application for registration as a certified patient.

(a) A person applying for issuance or renewal of a registration as a certified patient shall:

(1) be a resident of New York State, or be receiving care and treatment in New York State; and

(2) possess a certification issued by a registered practitioner.

(b) New York State residents. An applicant shall demonstrate his or her New York State residency by submitting to the department a copy of information concerning his or her New York State Driver’s License or New York State Identification Card. If the applicant does not possess or cannot obtain a valid New York State Driver’s License or New York State Identification Card, the applicant shall submit a copy of one or more of the following forms of documentation to establish that he or she is a New York resident:

(1) a copy of a government-issued identification card that contains the applicant’s name and New York State address. If the applicant is under the age of eighteen, the parent or legal guardian applying on behalf of the applicant shall submit a copy of the parent or legal guardian’s state or government issued identification and a copy of the applicant’s birth certificate;

(2) a copy of a utility bill or other document indicating an applicant’s residency issued within the previous two months that contains the applicant’s name and address;

(3) a copy of a current lease or similar document indicating an applicant’s residency within New York State; or

(4) such other documentation as approved by the department containing sufficient information to show proof of residency in New York State.

(c) Non-New York State Residents. An applicant applying for registration who is not a resident of New York State but is receiving care and treatment in this state, may qualify for registration as a certified patient if the applicant otherwise meets the requirements of article thirty-three of the public health law and this part, and is temporarily residing in New York State for the purpose of receiving care and treatment from a practitioner registered with the department.

(1) The applicant shall submit a copy of the following forms of documentation along with the application for registration:

(i) a copy of a state or government issued identification card that contains the applicant’s name and permanent address. If the applicant is under the age of eighteen, the parent or legal guardian applying on behalf of the applicant shall submit a copy of the parent or legal guardian’s state or government issued identification and a copy of the applicant’s birth certificate;

(ii) proof of temporary residence in New York State, including, but not limited to a copy of a lease, utility bill, hospital bill, or such other documentation as approved by the department containing sufficient information to show proof of temporary residency in New York State. If the applicant is under the age of eighteen, the parent or legal guardian applying on behalf of the applicant shall submit a copy of such documentation to show sufficient proof of the applicant’s temporary residency in New York State.

(2) Nothing in this part shall be construed to grant to the applicant authorization to transport approved medical marihuana products outside of New York State.

(d) Application for a registry identification card. To obtain, amend or renew a registry identification card, a certified patient shall file a registry application with the department, on a form or in a manner determined by the department, which shall include:

(1) the documentation required in subdivisions (b) and (c) of this section, as applicable;

(2) the information required in section thirty-three hundred sixty-three of the public health law;

(3) for new applicants, if the applicant does not have a current valid New York State Driver’s license, New York State Identification Card, or government issued identification containing a photograph, the applicant shall provide a recent passport-style color photograph of the applicant’s face, taken against a white background or backdrop. The photograph shall be a true likeness of the applicant’s actual appearance on the date the photograph was taken and shall not be altered to change any aspect of the applicant’s physical appearance. The photograph shall have been taken not more than thirty (30) days prior to the date of the application. The photograph shall be submitted in a form and manner described by the department, including as a digital file (.jpeg) when appropriate, provided, however, the department may waive the requirements of this paragraph upon good cause shown. For amendments and renewal applications, the department may utilize a previously submitted photograph if the applicant attests it is a true likeness of the applicant on the date the amendment or renewal application is submitted;

(4) a nonrefundable application fee of fifty dollars; provided, however, that the department may waive or reduce the fee in cases of financial hardship as determined by the department; and

(5) acknowledgement that a false statement in the application is punishable under section 210.45 of the penal law;

(e) If the applicant for a registry identification card is under the age of eighteen or a person who is otherwise incapable of consenting to medical treatment, the application shall be made by an appropriate person over twenty-one years of age. In preparing the application, the applicant may designate up to two proposed designated caregivers who shall be either: (i) a parent or legal guardian of the certified patient; (ii) a person designated by a parent or legal guardian, or (iii) an appropriate person approved by the department upon a sufficient showing that no parent or legal guardian is appropriate or available.

(1) As a condition of registration of a certified patient who is a minor or is incapable of medical decision-making, the applicant shall consent, in a manner determined by the department, to the certified patient’s use of an approved medical marihuana product, and shall acknowledge that the parent, legal guardian or other appropriate person, as applicable, will control the acquisition and possession of the medical marihuana and any device used for its administration.

(2) Once the certified patient who is a minor or is incapable of medical decision-making is registered, the proposed designated caregiver(s) may apply for and, if approved, receive a designated caregiver registration in accordance with the requirements of section thirty-three hundred sixty-three of the public health law and section 1004.4 of this part.

(f) Prior to issuing or renewing a registry identification card, the department may verify the information submitted by the applicant. The applicant shall provide, at the department’s request, such information and documentation, including any consents or authorizations to contact treating practitioners that may be necessary for the department to verify the information.

(g) The department shall approve, deny, or determine incomplete or inaccurate an application to issue or renew a registry identification card within thirty (30) days of receipt of the application. If the application is approved within the 30 day period, the department shall issue a registry identification card as soon as is reasonably practicable.

(h) The department shall notify the applicant in writing, by email, by telephone, or in another manner as determined appropriate by the department, if an application is incomplete or factually inaccurate, and shall explain what documents or information is necessary for the department to consider the application complete and accurate.

(i) An applicant shall have thirty (30) days from the date of a notification of an incomplete or factually inaccurate application to submit the materials required to complete, revise, or substantiate information in the application. If the applicant fails to submit the required materials within such thirty day time period, the application shall be denied by the department.

(j) Applicants whose applications are denied may submit a new application for an initial or renewal of a registry identification card, together with the applicable fee as set forth herein.

(k) A certified patient may designate up to two designated caregivers either on the application for issuance or renewal of a registry identification card or in another manner determined by the department. A designated caregiver may be either a natural person or a facility. For purposes of this section, a “facility” shall mean: a general hospital or residential health care facility operating pursuant to Article 28 of the Public Health Law; an adult care facility operating pursuant to Title 2 of Article 7 of the Social Services Law; a community mental health residence established pursuant to section 41.44 of the Mental Hygiene Law; a hospital operating pursuant to section 7.17 of the Mental Hygiene Law; a mental hygiene facility operating pursuant to Article 31 of the Mental Hygiene Law; an inpatient or residential treatment program certified pursuant to Article 32 of the Mental Hygiene Law;  a residential facility for the care and treatment of persons with developmental disabilities operating pursuant to Article 16 of the Mental Hygiene Law; a residential treatment facility for children and youth operating pursuant to Article 31 of the Mental Hygiene Law; or a private or public school. Further, within each of the facilities listed above, each division, department, component, floor or other unit of such facility shall be entitled to be considered to be a “facility” for purposes of this section.  The application for issuance or renewal of a registry identification card shall include the following information:

(1) name of the proposed designated caregiver(s);

(2) address of the proposed designated caregiver(s);

(3) date of birth of the proposed designated caregiver(s), unless the proposed designated caregiver is not a natural person;

(4) any other individual identifying information concerning the proposed designated caregiver(s) required by the department.

Statutory Authority

Public Health Law, Section 3369-a

Volume

VOLUME E (Title 10)

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