Are California’s medical marijuana patients getting left behind?

Your guide to California policy and politics
Lynn La BY Lynn La August 1, 2023
Presented by Dairy Cares, Climate-Smart Agricultural Partnership, Southern California Gas Company and Earthjustice

Are California’s medical marijuana patients getting left behind?

After California legalized medical marijuana in 1996 and then recreational cannabis two decades later, one might think that for many patients, the state would be a sanctuary for seeking treatment. 

But as CalMatters’ state Capitol reporter Alexei Koseff explains, those who rely on cannabis to treat pain, seizures, glaucoma and other ailments say that despite helping pave the path toward legalization, they are the ones being left behind.

This is the latest extensive story Alexei has done on cannabis in California:

Under Proposition 215, passed in 1996, patients were able to secure cannabis through legal collectives, where they could pool their resources and pay “caregivers” to grow medicine. But after voters approved Proposition 64 in 2016, which green-lit a commercial cannabis market, California transitioned to a new regulatory framework that required collectives to become licensed, similar to commercial dispensaries. Because the process is expensive and complex, many collectives dissolved within the last five years.

  • Bonnie Metcalf, a 61-year-old Sacramento County resident who uses cannabis to treat her sarcoidosis: “The system that exists is bulls–t. These rich people are paying more for packaging and branding than they are worried about medicine for people. They don’t care. It’s not a medicine to them. It’s just another money-making scheme like beer or cigarettes.”

But commercial dispensaries are also scarce — they’re still prohibited in more than 60% of cities and counties in California. And few dispensaries participate in programs that allow them to donate medical marijuana to patients who cannot afford it.

One more thing to keep in mind: Most health insurance plans do not cover medical marijuana because it’s still outlawed federally. And as access to legal medical marijuana becomes more arduous — especially for patients who are older, have low-income or are suffering from chronic conditions and need large amounts for treatment — getting cannabis through illicit means becomes the alternative.

  • Bette Braden, who runs unlicensed cannabis pop-ups in the Sacramento area: “The laws are so hideous. I used to be an activist. Now I’ve gone over to the underground.”

CalMatters’ new leader: After eight years, CalMatters has a new editor in chief — Kristen Go — and she spoke to Capitol Weekly about her vision, nonprofit news and other issues in an interview posted Monday. Read more about her career from our engagement team. 

More CalMatters kudos: We’re a finalist for two national Online Journalism Association awards. Byrhonda Lyons and Jocelyn Wiener (with data analysis by Jeremia Kimelman) are up in the “Excellence in Social Justice Reporting” category for their story on how California’s prison system shuffles around mentally ill inmates. And Julie Cart and former reporter Nadia Lopez (with data analysis by Erica Yee) are up for the “Topical Reporting: Climate Change” category for their “Race to Zero” series on California’s transformation to electric vehicles. Winners will be announced Aug. 17. 


1 Not quite toilet to tap

Luis Canela, Water Quality Technician, injects sodium hypochloride and armonium sulfate to chlorinate the water at the Pure Water Southern California Demonstration Plant in Carson, on July 28, 2023. Photo by Lauren Justice for CalMatters
A water quality technician at the Pure Water Southern California Demonstration Plant in Carson, on July 28, 2023. Photo by Lauren Justice for CalMatters

If the state’s Water Resources Control Board ends up adopting policies it drafted last month, California residents could be drinking highly purified sewage water in the not too-distant future.

But before you do a spit-take, the proposed rules aren’t as dirty as you think, writes CalMatters’ water policy reporter Rachel Becker

The state has already been using recycled water for more than 60 years, though the water must pass through a reservoir or an aquifer before it’s piped to taps. But under the new proposals, which have been in development for over a decade, wastewater can flow to taps or mixed with raw water upstream of a drinking water treatment plant after undergoing extensive treatment.

As we all know, the water that whirls down toilets and sinks, or flows out of industrial facilities and farm fields, is crawling with germs. “Forever chemicals” and drugs excreted in urine also contaminate sewage water.

But before it reaches a water fountain or tap, the wastewater will have been treated to remove its chemicals and pathogens — including additional processes introduced by the new regulation. The water will be digested by bacteria and microbes, filtered through carbon and cleansed with hydrogen peroxide and UV light, among several other steps. After all that, the water will go through all the typical filtering processes at treatment plants.

  • Darrin Polhemus, California’s Division of Drinking Water deputy director: “Quite honestly, it’ll be the cleanest drinking water around.”

Most of the concerns aren’t about the water’s cleanliness, but rather how expensive and labor intensive the process will be. It’s why most treated sewage in California is released into rivers, streams and the deep ocean instead.

There will be a period for public comment and a panel of experts must review the rules before they go before the water board for a vote as early as the end of December. If adopted, they would likely go into effect next April, but it would still take years for the water to reach your taps.

For the record: This item has been updated to clarify when the treated sewage water would reach taps.

California’s water crisis, explained: CalMatters has a detailed look at how California might increase its water supply, and a dashboard tracking the state’s water situation. There’s a lesson-plan-ready version of the water explainer — especially made for teachers, libraries and community groups — as part of the CalMatters for Learning initiative.

2 Election denial leader recruits in CA

Douglas Frank speaks during the Nebraska Election Integrity Forum in Omaha Nebraska on Aug. 27, 2022. Photo by Rebecca S. Gratz. AP Photo
Douglas Frank speaks during the Nebraska Election Integrity Forum in Omaha on Aug. 27, 2022. Photo by Rebecca S. Gratz. AP Photo

While California isn’t a center of election denial, it isn’t off the beaten path, either. Just this year, a new pro-MAGA majority on the Shasta County Board of Supervisors voted to end its contract with Dominion Voting Systems, the target of many election conspiracy theories since former President Donald Trump’s defeat in 2020 and the victor in a defamation suit settlement with Fox News.

And Douglas Frank, a high school teacher turned pied piper of election denial, is trying to make further inroads in California, the Los Angeles Times reported Monday.

Over the last two-and-a-half years, Frank has been touring the country to spread his so far unproven theories about rampant election fraud. He’s made a concerted effort in California — holding training sessions, currying favor with sheriffs and county supervisors and establishing what he describes as “election integrity groups” — to get more Californians to cast doubt on the integrity of the 2024 election.

Frank is hoping to capitalize on the state’s massive population and on conservatives keen to his message. His grassroots campaign in libraries, bars and churches has taken him up and down Shasta County, Orange County and nearly everywhere in between.

His efforts, and those of like-minded supporters, have paid off most clearly in Shasta County. In March, two months after ditching Dominion voting machines, supervisors announced they would consider counting ballots by hand. So far, Shasta County will be the only county in California to attempt this feat, which states “haven’t done on a large scale in at least 50 years,” according to the L.A. Times.

In addition to the overwhelming logistical and financial hurdles to pull off this endeavor, the county also must contend with the fact that theories of systematic fraud “stealing” the 2020 election from Trump have been largely and repeatedly disproven.

In California, while there has been no widespread fraud and experts and state officials say election systems are secure, there have been scattered problems and attempts to cheat, as CalMatters’ Sameea Kamal detailed in a comprehensive explainer for the 2022 election.

The state Legislature is weighing a number of bills that aim to strengthen election integrity, including one that would ban jurisdictions from terminating contracts for a certified voting system without having a replacement plan in place.

3 Child care providers OK contract

Protesters hold signs at the Child Care Providers United Rally at the California State Capitol in Sacramento on June 15, 2023. Photo by Julie A Hotz for CalMatters
Union members hold signs at the Child Care Providers United rally at the state Capitol in Sacramento on June 15, 2023. Photo by Julie A Hotz for CalMatters

It’s still up to the Legislature and Gov. Gavin Newsom to give the final sign-off, but California’s 40,000 child care providers are another big step closer to a historic pay raise.

Monday night, their union, Child Care Providers United, announced that 99.6% of voting members ratified a tentative contract with the state that is funded by $1 billion in the 2023-24 state budget.

The agreement includes $600 million over two years in rate increases, $100 million a year for health care and $80 million a year for a first-in-the-nation retirement fund for providers. Those will take effect immediately once the contract legislation is signed, while another provision changing the requirement for full-time pay from 30 hours to 25 hours will take effect six months later, according to the union.

  • Nancy Harvey, a provider from Oakland and union bargaining committee member, in a statement:The contract we fought for will truly transform our lives and our profession as childcare providers. For years I’ve done the back-breaking work of caring for toddlers and babies, living with the fear that I would never be able to afford to retire.” 

As Jeanne Kuang of CalMatters’ California Divide team has reported, family child care providers — the vast majority of them women of color — have fought for better pay and benefits for two decades. They say they don’t get paid enough by the state to cover their costs. To pressure lawmakers and Newsom this year, they held rallies at the state Capitol and candlelight vigils outside the governor’s mansion,


CalMatters Commentary

CalMatters columnist Dan Walters: While politicians may be tempted to borrow to cover state budget deficits, that would be a misuse of the state’s bonding authority.

Communities near oil refineries and dairies suffer from ongoing emissions, even as most state credits to reduce pollution have gone to biogas and biofuel projects, write María Arévalo, a Pixley resident and member of the Central Valley Defenders for Clean Air and Water, and Katherine Lee, Richmond youth organizer at the Asian Pacific Environmental Network.


Other things worth your time

Some stories may require a subscription to read

Vehicles’ data collection, use are subject of CA privacy probe // The Wall Street Journal

USC, Stanford could get hit as legacy, donor admissions battle heats up // Los Angeles Times 

Homeless camps are being cleared in California, but what next? // The New York Times 

CA’s ambitious climate target faces serious obstacles, says regulator // The Sacramento Bee

Fruit fly outbreak prompts quarantine in Santa Clarita Valley // Los Angeles Times

Anaheim’s own look finds Disneyland businesses improperly steer policy // Voice of OC

SD police are about to enforce controversial camping ban // The San Diego Union-Tribune

Another CalPERS retiree sues over data breach // The Modesto Bee

Is SF Mayor London Breed at risk of losing reelection? // San Francisco Chronicle

Is a private police agency the solution to SF crime woes? // The San Francisco Standard

Housing project on BART land on hold in dispute with agency // San Francisco Chronicle

LA County gave up on mental health program, handing back millions // Los Angeles Times

How Santa Monica decimated a thriving Black community // The Guardian

See you tomorrow


Tips, insight or feedback? Email lynn@calmatters.org.

Subscribe to CalMatters newsletters here.

Follow CalMatters on Facebook and Twitter.

CalMatters is now available in Spanish on Twitter, Facebook and RSS.