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Facts

Amendment Act B18-622 — AKA the "Legalization of Marijuana for Medical Treatment Amendment Act of 2010"

AN ACT Codification District of Columbia Official Code 2001 Edition 2010 Fall Supp. West Group Publisher ENROLLED ORIGINAL IN THE COUNCIL OF THE DISTRICT OF COLUMBIA

To amend the Legalization of Marijuana for Medical Treatment Initiative of 1999 to define key terms, to clarify who is permitted to cultivate, possess, dispense, or use medical marijuana, to require a written recommendation from one’s physician, to restrict the use of medical marijuana, to protect physicians from sanctions for recommending medical marijuana, to establish a medical marijuana program, to establish requirements for dispensaries and cultivation centers, to authorize the Board of Medicine to audit physician recommendations and to discipline physicians who act outside of the law, to set out penalties for violating this act, to prohibit the public use of medical marijuana, to establish a Medical Marijuana Advisory Committee, to require fees collected to be applied toward administering this act, to establish liability provisions, to clarify that this act does not require any public or private insurance to cover medical marijuana, and to authorize the Mayor to issue rules; and to amend the District of Columbia Health Occupations Revision Act of 1985, the Health Clarifications Act of 2001, the District of Columbia Uniform Controlled Substances Act of 1981, and the Drug Paraphernalia Act of 1982 to make conforming amendments.

BE IT ENACTED BY THE COUNCIL OF THE DISTRICT OF COLUMBIA, That this act may be cited as the “Legalization of Marijuana for Medical Treatment Amendment Act of 2010”.

Sec. 2. The Legalization of Marijuana for Medical Treatment Initiative of 1999, effective February 25, 2010 (D.C. Law 13-315; 57 DCR 3360), is amended to read as follows:

“Sec. 2. Definitions.

“For the purposes of this act, the term:

“(1) “Administer” or “administration” means the direct introduction of medical marijuana, whether by inhalation, ingestion, or any other means, into the body of a person.

“(2) “Bona fide physician-patient relationship” means a relationship between a physician and patient in which the physician:

“(A) Has completed a full assessment of the patient's medical history and current medical condition, including a personal physical examination; and

“(B) Has responsibility for the ongoing care and treatment of the patient. “(3) “Caregiver” means a person who:

“(A) Is designated by a qualifying patient as the person authorized, on the qualifying patient’s behalf, to possess, obtain from a dispensary, dispense, and assist in the administration of medical marijuana;

caregiver; patient; and

“(B) Is registered with the Department as the qualifying patient’s

“(C) Is not currently serving as the caregiver for another qualifying

“(D) Is at least 18 years of age.

“(4) “Controlled Substances Act” means the District of Columbia Uniform

Controlled Substances Act of 1981, effective August 5, 1981 (D.C. Law 4-29; D.C. Official Code § 48-901.02 et seq.).

“(5) “Cultivation center” means a facility operated by an organization or business registered with the Mayor pursuant to section 6 from or at which medical marijuana is cultivated, possessed, manufactured, and distributed in the form of medical marijuana, and paraphernalia is possessed and distributed to dispensaries.

“(6) “Department” means the Department of Health.

“(7) “Dispensary” means a facility operated by an organization or business registered with the Mayor pursuant to section 6 from or at which medical marijuana is possessed and dispensed and paraphernalia is possessed and distributed to a qualifying patient or a caregiver.

“(8) “Dispense” means to distribute medical marijuana to a qualifying patient or caregiver pursuant to this act and the rules issued pursuant to section 14.

“(9) “Distribute” means the actual, constructive, or attempted transfer from one person to another.

“(10) “Manufacture” means the production, preparation, propagation, compounding, conversion, or processing of marijuana, either directly or indirectly by extraction from substances of natural origin, or independently by means of chemical synthesis, or by a combination of extraction and chemical synthesis, and includes any packaging or repackaging of the substance or labeling or re-labeling of its container.

“(11) “Marijuana” shall have the same meaning as provided in section 102(3)(A) of the Controlled Substances Act.

“(12) “Medical marijuana” means marijuana cultivated, manufactured, possessed, distributed, dispensed, obtained, or administered in accordance with this act and the rules issued pursuant to section 14.

“(13) “Minor” means any person under 18 years of age, but does not include an emancipated minor.

“(14) “Paraphernalia” means:

“(A) Objects used, intended for use, or designed for use in preparing, storing, ingesting, inhaling, or otherwise introducing medical marijuana into the human body; and

“(B) Kits, objects, devices, or equipment used, intended for use, or designed for use in planting, propagating, manufacturing, cultivating, growing, harvesting, processing, or preparing medical marijuana.

“(15) “Physician” means an individual who is licensed and in good standing to practice medicine or osteopathy under District law.

“(16) “Program” means the medical marijuana program established by section 6. “(17) “Qualifying medical condition” means:

“(A) Human immunodeficiency virus;

“(B) Acquired immune deficiency syndrome;

“(C) Glaucoma;

“(D) Conditions characterized by severe and persistent muscle spasms,

such as multiple sclerosis;

“(E) Cancer; or

“(F) Any other condition, as determined by rulemaking, that is:

“(i) Chronic or long-lasting;

“(ii) Debilitating or interferes with the basic functions of life; and

“(iii) A serious medical condition for which the use of medical

marijuana is beneficial: medical or surgical measure; or

“(I) That cannot be effectively treated by any ordinary

“(II) For which there is scientific evidence that the use of medical marijuana is likely to be significantly less addictive than the ordinary medical treatment for that condition.

“(18) “Qualifying medical treatment” means:

“(A) Chemotherapy;

“(B) The use of azidothymidine or protease inhibitors;

“(C) Radiotherapy; or

“(D) Any other treatment, as determined by rulemaking, whose side effects require treatment through the administration of medical marijuana in the same manner as a qualifying medical condition.

“(19) “Qualifying patient” means a resident of the District who has a qualifying medical condition or is undergoing a qualifying medical treatment.

“(20) “Residence” means a dwelling or dwelling unit in which a person lives in a particular locality with the intent to make it a fixed and permanent home. “Sec. 3. Use of medical marijuana.

“(a) Notwithstanding any other District law, a qualifying patient may possess and administer medical marijuana, and possess and use paraphernalia, in accordance with this act and the rules issued pursuant to section 14.

“(b) Notwithstanding any other District law, a caregiver may possess and dispense medical marijuana to a qualifying patient, and possess and use paraphernalia, for the sole purpose of assisting in the administration of medical marijuana to a qualifying patient in accordance with this act and the rules issued pursuant to section 14.

“(c) A qualifying patient may possess and administer medical marijuana, and possess and use paraphernalia, only for treatment of a qualifying medical condition or the side effects of a qualifying medical treatment and only after having:

“(1) Obtained a signed, written recommendation from a physician in accordance with section 5; and

“(2) Registered with the Mayor pursuant to section 6.

“(d) A qualifying patient or caregiver shall only possess, administer, or dispense medical marijuana, or possess or use paraphernalia, obtained from a dispensary registered with the Mayor pursuant to section 6.

“(e) A qualifying patient who is a minor may possess and administer medical marijuana only if the parent or legal guardian of the minor has signed a written statement affirming that the parent or legal guardian:

“(1) Understands the qualifying medical condition or qualifying medical treatment of the minor;

“(2) Understands the potential benefits and potential adverse effects of the use of medical marijuana, generally, and, specifically, in the case of the minor;

“(3) Consents to the use of medical marijuana for the treatment of the minor's qualifying medical condition or treatment of the side effects of the minor’s qualifying medical treatment; and

“(4) Consents to, or designates another adult to, serve as the caregiver for the qualifying patient and the caregiver controls the acquisition, possession, dosage, and frequency of use of medical marijuana by the qualifying patient.

“Sec. 4. Restrictions on use of medical marijuana.

“(a) The maximum amount of medical marijuana that any qualifying patient or caregiver may possess at any moment is 2 ounces of dried medical marijuana; provided, that the Mayor, through rulemaking, may increase the quantity of dried medical marijuana that may be possessed up to 4 ounces; and shall promulgate through rulemaking limits on medical marijuana of a form, other than dried.

“(b)(1) Medical marijuana shall not be administered by or to a qualifying patient anywhere other than the qualifying patient’s residence, if permitted, or at a medical treatment facility when receiving medical care for a qualifying medical condition, if permitted by the facility.

“(2) A qualifying patient or caregiver shall not administer medical marijuana at a dispensary or cultivation center.

“(3) Notwithstanding paragraph (1) of this subsection, a qualifying patient shall not use medical marijuana if exposure to the medical marijuana or the medical marijuana smoke would adversely affect the health, safety, or welfare of a minor.

“(c) A qualifying patient or caregiver shall transport medical marijuana in a labeled container or sealed package in a manner and method established by rulemaking.

“(d) Nothing in this act permits a person to:

“(1) Undertake any task under the influence of medical marijuana when doing so would constitute negligence or professional malpractice; or

“(2) Operate, navigate, or be in actual physical control of any motor vehicle, aircraft, or motorboat while under the influence of medical marijuana.

“(e) The use of medical marijuana as authorized by this act and the rules issued pursuant to section 14 does not create a defense to any crime and does not negate the mens rea element for any crime except to the extent of the voluntary-intoxication defense recognized in District of Columbia law.

“(f) Notwithstanding any other law, a person or entity may provide information about the existence or operations of a cultivation center or dispensary to another person pursuant to this law.

“(g) A qualified patient, caregiver, or an employee of a cultivation center or a dispensary who is stopped by the police upon reasonable suspicion or probable cause that the stopped individual is in possession of marijuana may not be further detained or arrested on this basis alone if the police determine that he or she is in compliance with this act and the rules issued pursuant to section 14.

“Sec. 5. Recommending physician; protections.

“(a) A physician may recommend the use of medical marijuana to a qualifying patient if the physician:

“(1) Is in a bona fide physician-patient relationship with the qualifying patient; and

“(2) Makes the recommendation based upon the physician's assessment of the qualifying patient's medical history, current medical condition, and a review of other approved medications and treatments that might provide the qualifying patient with relief from a qualifying medical condition or the side effects of a qualifying medical treatment.

“(b)(1) A physician’s recommendation that a qualifying patient may use medical marijuana shall be signed by the physician and include:

“(A) The physician’s medical license number; and

“(B) A statement that the use of medical marijuana is necessary for the treatment of a qualifying medical condition or the side effects of a qualifying medical treatment.

“(2) A physician’s recommendation shall be valid only if it is written on a form prescribed by the Mayor.

“(c) Except as provided in section 8, a physician shall not be subject to any penalty, including arrest, prosecution, or disciplinary proceeding, or denial of any right or privilege, for advising a qualifying patient about the use of medical marijuana or recommending the use of medical marijuana to a qualifying patient pursuant to this act and the rules issued pursuant to section 14.

“(d) A physician recommending the use of medical marijuana by a qualifying patient shall not have a professional office located at a dispensary or cultivation center or receive financial compensation from a dispensary or cultivation center, or a director, officer, member, incorporator, agent, or employee of a dispensary or cultivation center.

"Maryland Medical Cannabis Law" — HOUSE BILL 881

Updated as of September 2015. Section titles are not part of the law. Addendum 1 includes additional provisions enacted in Ch. 403 of 2013,

Ch. 256 of 2014, and Ch. 251 of 2015.

Addendum 2 is the text of Criminal Law section § 5-601 relating to the possession of controlled dangerous substances and affirmative defense of medical necessity, and Criminal Law § 5-620 relating to controlled paraphernalia. Article -- Health – General.

Title 13. Miscellaneous Health Care Programs. SUBTITLE 33. NATALIE M. LAPRADE MEDICAL CANNABIS COMMISSION. § 13-3301. Definitions. (a) In this subtitle the following words have the meanings indicated. (b) "Caregiver" means: (1) A person who has agreed to assist with a qualifying patient's medical use of cannabis; and (2) For a qualifying patient under the age of 18 years, a parent or legal guardian. (c) "Certifying physician" means an individual who: (1) Has an active, unrestricted license to practice medicine that was issued by the State Board of Physicians under Title 14 of the Health Occupations Article; (2) Is in good standing with the State Board of Physicians;

(3) Has a State controlled dangerous substances registration; and

(4) Is registered with the Commission to make cannabis available to patients for medical use in accordance with regulations adopted by the Commission.

(d) "Commission" means the Natalie M. LaPrade Medical Cannabis Commission established under this subtitle.

(e) "Dispensary" means an entity licensed under this subtitle that acquires, possesses, processes, transfers, transports, sells, distributes, dispenses, or administers cannabis, products containing cannabis, related supplies, related products containing cannabis including food, tinctures, aerosols, oils, or ointments, or educational materials for use by a qualifying patient or caregiver.

(f) "Dispensary agent" means an owner, a member, an employee, a volunteer, an officer, or a director of a dispensary.

(g) "Fund" means the Natalie M. LaPrade Medical Cannabis Commission Fund established under § 13-3303 of this subtitle.

(h) "Grower" means an entity licensed under this subtitle that: (1) (i) Cultivates, manufactures, processes, packages, or dispenses medical cannabis; or (ii) Processes medical cannabis products; and (2) Is authorized by the Commission to provide cannabis to a qualifying patient, caregiver, processor, dispensary, or independent testing laboratory.

(i) "Independent testing laboratory" means a facility, an entity, or a site that offers or performs tests related to the inspection and testing of cannabis and products containing cannabis.

(j) "Medical cannabis grower agent" means an owner, an employee, a volunteer, an officer, or a director of a grower.

(k) "Processor" means an entity that: (1) Transforms medical cannabis into another product or extract; and (2) Packages and labels medical cannabis.

(l) "Processor agent" means an owner, a member, an employee, a volunteer, an officer, or a director of a processor.

(m) "Qualifying patient" means an individual who: (1) Has been provided with a written certification by a certifying physician in accordance with a bona fide physician-patient relationship; and (2) If under the age of 18 years, has a caregiver. (n) "Written certification" means a certification that: (1) Is issued by a certifying physician to a qualifying patient with whom the physician has a bona fide physician-patient relationship; and (2) Includes a written statement certifying that, in the physician's professional opinion, after having completed an assessment of the patient's medical history and current medical condition, the patient has a condition: (i) That meets the inclusion criteria and does not meet the exclusion criteria of the certifying physician's application; and (ii) For which the potential benefits of the medical use of cannabis would likely outweigh the health risks for the patient; and (3) May include a written statement certifying that, in the physician's professional opinion, a 30-day supply of medical cannabis would be inadequate to meet the medical needs of the qualifying patient. HISTORY: 2013, ch. 43, § 5; ch. 403; 2014, chs. 44, 240, 256; 2015, ch. 251. § 13-3302. Commission established; purpose and duties, identification cards, Web site. (a) There is a Natalie M. LaPrade Medical Cannabis Commission. (b) The Commission is an independent commission that functions within the Department. (c) The purpose of the Commission is to develop policies, procedures, guidelines, and regulations to implement programs to make medical cannabis available to qualifying patients in a safe and effective manner. (d) (1) The Commission shall develop identification cards for qualifying patients and caregivers. (2) (i) The Department shall adopt regulations that establish the requirements for identification cards provided by the Commission. (ii) The regulations adopted under subparagraph (i) of this paragraph shall include: 1. The information to be included on an identification card; 2. The method through which the Commission will distribute identification cards; and 3. The method through which the Commission will track identification cards. (e) The Commission shall develop and maintain a Web site that: (1) Provides information on how an individual can obtain medical cannabis in the State; and (2) Provides contact information for licensed dispensaries. HISTORY: 2013, ch. 403; 2014, chs. 240, 256; 2015, ch. 251. § 13-3303. Commission membership, staff, fees, fund. (a) The Commission consists of the following 16 members: (1) The Secretary of Health and Mental Hygiene, or the Secretary's designee; and (2) The following 15 members, appointed by the Governor: (i) Two members of the public who support the use of cannabis for medical purposes and who are or were patients who found relief from the use of medical cannabis; (ii) One member of the public designated by the Maryland Chapter of the National Council on Alcoholism and Drug Dependence; (iii) Three physicians licensed in the State; (iv) One nurse licensed in the State who has experience in hospice care, nominated by a State research institution or trade association; (v) One pharmacist licensed in the State, nominated by a State research institution or trade association; (vi) One scientist who has experience in the science of cannabis, nominated by a State research institution; (vii) One representative of the Maryland State's Attorneys' Association; (viii) One representative of law enforcement; (ix) An attorney who is knowledgeable about medical cannabis laws in the United States; (x) An individual with experience in horticulture, recommended by the Department of Agriculture; (xi) One representative of the University of Maryland Extension; and (xii) One representative of the Office of the Comptroller. (b)(1) The term of a member is 4 years. (2) The terms of the members are staggered as required by the terms provided for members on October 1, 2013. (3) At the end of a term, a member continues to serve until a successor is appointed and qualifies. (4) A member may not serve more than three consecutive full terms. (5) A member who is appointed after a term has begun serves only for the rest of the term and until a successor is appointed and qualifies. (c) The Governor shall designate the chair from among the members of the Commission. (d) A majority of the full authorized membership of the Commission is a quorum. (e) A member of the Commission: (1) May not receive compensation as a member of the Commission; but (2) Is entitled to reimbursement for expenses under the Standard State Travel Regulations, as provided in the State budget. (f) The Commission may employ a staff, including contractual staff, in accordance with the State budget. (g) The Commission may set reasonable fees to cover the costs of operating the Commission. (h) (1) There is a Natalie M. LaPrade Medical Cannabis Commission Fund. (2) The Commission shall administer the Fund. (3) The Fund is a special continuing, nonlapsing fund that is not subject to § 7-302 of the State Finance and Procurement Article. (4) The State Treasurer shall hold the Fund separately, and the Comptroller shall account for the Fund. (5) The Fund shall be invested and reinvested in the same manner as other State funds, and any investment earnings shall be retained to the credit of the Fund. (6) The Fund shall be subject to an audit by the Office of Legislative Audits as provided for in § 2-1220 of the State Government Article. (7) The Comptroller shall pay out money from the Fund as directed by the Commission. (8) The Fund consists of: (i) Any money appropriated in the State budget to the Fund; (ii) Any other money from any other source accepted for the benefit of the Fund, in accordance with any conditions adopted by the Commission for the acceptance of donations or gifts to the Fund; and (iii) Any fees collected by the Commission under this subtitle. (9) No part of the Fund may revert or be credited to:(i) The General Fund of the State; or (ii) Any other special fund of the State. (10) Expenditures from the Fund may be made only in accordance with the State budget. HISTORY: 2013, ch. 403; 2014, chs. 240, 256; 2015, ch. 251. § 13-3304. Certifying physician registration, registration requirements, medical conditions, physician compensation, procedures. (a) The Commission shall register as a certifying physician an individual who: (1) Meets the requirements of this subtitle; and (2) Submits application materials that meet the requirements of this subtitle. (b) To be registered as a certifying physician, a physician shall submit a proposal to the Commission that includes: (1) The reasons for including a patient under the care of the physician for the purposes of this subtitle, including the patient's qualifying medical conditions; (2) An attestation that a standard patient evaluation will be completed, including a history, a physical examination, a review of symptoms, and other pertinent medical information; and (3) The physician's plan for the ongoing assessment and follow-up care of a patient and for collecting and analyzing data. (c) The Commission may not require an individual to meet requirements in addition to the requirements listed in subsections (a) and (b) of this section to be registered as a certifying physician. (d) (1) The Commission is encouraged to approve physician applications for the following medical conditions: (i) A chronic or debilitating disease or medical condition that results in a patient being admitted into hospice or receiving palliative care; or (ii) A chronic or debilitating disease or medical condition or the treatment of a chronic or debilitating disease or medical condition that produces: 1. Cachexia, anorexia, or wasting syndrome; 2. Severe or chronic pain; 3. Severe nausea; 4. Seizures; or 5. Severe or persistent muscle spasms. (2) The Commission may not limit treatment of a particular medical condition to one class of physicians. (e) The Commission may approve applications that include any other condition that is severe and for which other medical treatments have been ineffective if the symptoms reasonably can be expected to be relieved by the medical use of cannabis. (f) (1) A certifying physician or the spouse of a certifying physician may not receive any gifts from or have an ownership interest in a medical cannabis grower, a processor, or a dispensary. (2) A certifying physician may receive compensation from a medical cannabis grower, a processor, or dispensary if the certifying physician: (i) Obtains the approval of the Commission before receiving the compensation; and(ii) Discloses the amount of compensation received from the medical cannabis grower, processor, or dispensary to the Commission. (g) (1) A qualifying patient may be a patient of the certifying physician or may be referred to the certifying physician. (2) A certifying physician shall provide each written certification to the Commission. (3) On receipt of a written certification provided under paragraph (2) of this subsection, the Commission shall issue an identification card to each qualifying patient or caregiver named in the written certification. (4) A certifying physician may discuss medical cannabis with a patient. (5) (i) Except as provided in subparagraph (ii) of this paragraph, a qualifying patient or caregiver may obtain medical cannabis only from a medical cannabis grower licensed by the Commission or a dispensary licensed by the Commission. (ii) A qualifying patient under the age of 18 years may obtain medical cannabis only through the qualifying patient's caregiver. (6) (i) A caregiver may serve no more than five qualifying patients at any time. (ii) A qualifying patient may have no more than two caregivers. (h) (1) A certifying physician may register biennially. (2) The Commission shall grant or deny a renewal of a registration for approval based on the physician's performance in complying with regulations adopted by the Commission. HISTORY: 2014, chs. 240, 256; 2015, chs. 22, 251.

California Medical Marijuana Program — BALLOT PROPOSITION 215

This initiative measure was submitted to the people in accordance with the provisions of Article II, Section 8 of the Constitution. Proposition 215 added a section to the Health and Safety Code known as the Compassionate Use Act of 1996.

Text of the Law

SECTION 1. Section 11362.5 was added to the Health and Safety Code, to read:11362.5. (a) This section shall be known and may be cited as the Compassionate Use Act of 1996.

(b)(1) The people of the State of California hereby find and declare that the purposes of the Compassionate Use Act of 1996 are as follows:

(A) To ensure that seriously ill Californians have the right to obtain and use marijuana for medical purposes where that medical use is deemed appropriate and has been recommended by a physician who has determined that the person's health would benefit from the use of marijuana in the treatment of cancer, anorexia, AIDS, chronic pain, spasticity, glaucoma, arthritis, migraine, or any other illness for which marijuana provides relief.

(B) To ensure that patients and their primary caregivers who obtain and use marijuana for medical purposes upon the recommendation of a physician are not subject to criminal prosecution or sanction.

(C) To encourage the federal and state governments to implement a plan to provide for the safe and affordable distribution of marijuana to all patients in medical need of marijuana.

(2) Nothing in this section shall be construed to supersede legislation prohibiting persons from engaging in conduct that endangers others, nor to condone the diversion of marijuana for nonmedical purposes.

(c) Notwithstanding any other provision of law, no physician in this state shall be punished, or denied any right or privilege, for having recommended marijuana to a patient for medical purposes.

(d) Section 11357, relating to the possession of marijuana, and Section 11358, relating to the cultivation of marijuana, shall not apply to a patient, or to a patient's primary caregiver, who possesses or cultivates marijuana for the personal medical purposes of the patient upon the written or oral recommendation or approval of a physician.

(e) For the purposes of this section, ''primary caregiver" means the individual designated by the person exempted under this section who has consistently assumed responsibility for the housing, health, or safety of that person. SEC. 2. If any provision of this measure or the application thereof to any person or circumstance is held invalid, that invalidity shall not affect other provisions or applications of the measure that can be given effect without the invalid provision or application, and to this end the provisions of this measure are severable.