2015 -- S 0475 SUBSTITUTE A

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LC001577/SUB A/3

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2015

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A N   A C T

RELATING TO FOOD AND DRUGS - THE EDWARD O. HAWKINS AND THOMAS C.

SLATER MEDICAL MARIJUANA ACT

     Introduced By: Senators Archambault, Miller, Satchell, Ciccone, and Goldin

     Date Introduced: February 26, 2015

     Referred To: Senate Health & Human Services

     It is enacted by the General Assembly as follows:

     SECTION 1. Sections 21-28.6-3 and 21-28.6-3 of the General Laws in Chapter 21-28.6

entitled "The Edward O. Hawkins and Thomas C. Slater Medical Marijuana Act" are hereby

amended to read as follows:

     21-28.6-3. Definitions. -- For the purposes of this chapter:

      (1) "Cardholder" means a qualifying patient or a primary caregiver who has registered

with the department and has been issued and possesses a valid registry identification card.

      (2) (i) "Compassion center" means a not-for-profit corporation, subject to the provisions

of chapter 6 of title 7, and registered under § 21-28.6-12, that acquires, possesses, cultivates,

manufactures, delivers, transfers, transports, supplies or dispenses marijuana, and/or related

supplies and educational materials, to patient cardholders and/or their registered caregiver

cardholder, who have designated it as one of their primary caregivers.

      (ii) "Compassion center cardholder" means a principal officer, board member, employee,

volunteer, or agent of a compassion center who has registered with the department and has been

issued and possesses a valid registry identification card.

      (3) "Debilitating medical condition" means:

      (i) Cancer, glaucoma, positive status for human immunodeficiency virus, acquired

immune deficiency syndrome, Hepatitis C, post-traumatic stress disorder, or the treatment of

these conditions;

      (ii) A chronic or debilitating disease or medical condition, or its treatment, that produces

one or more of the following: cachexia or wasting syndrome; severe, debilitating, chronic pain;

severe nausea; seizures, including but not limited to, those characteristic of epilepsy; or severe

and persistent muscle spasms, including but not limited to, those characteristic of multiple

sclerosis or Crohn's disease; or agitation of Alzheimer's Disease; or

     (iii) In the case of a qualifying patient seeking treatment for post-traumatic stress disorder

(PTSD), the patient has been diagnosed with PTSD by a licensed psychiatrist, psychologist,

psychiatric and mental health clinical nurse specialist, or independently licensed master's level

mental health professional has received a course of standard pharmacological and mental health

treatment for PTSD with written documentation of inadequate clinical response or intolerable

adverse reactions, received a comprehensive evaluation by a licensed mental health or addiction

professional with a written determination that the patient does not have a current substance use

disorder, and will receive follow-up monitoring and treatment by a licensed health professional in

collaboration with a licensed psychiatrist psychologist, psychiatric and mental health clinical

nurse specialist, or licensed master's level mental health professional at least quarterly for the first

year and semi-annually thereafter to assess clinical response and adverse reactions to medical

marijuana; or

      (iii)(iv) Any other medical condition or its treatment approved by the department, as

provided for in § 21-28.6-5.

      (4) "Department" means the Rhode Island department of health or its successor agency.

      (5) "Marijuana" has the meaning given that term in § 21-28-1.02(26).

      (6) "Mature marijuana plant" means a marijuana plant that has flowers or buds that are

readily observable by an unaided visual examination.

      (7) "Medical use" means the acquisition, possession, cultivation, manufacture, use,

delivery, transfer, or transportation of marijuana or paraphernalia relating to the consumption of

marijuana to alleviate a patient cardholder's debilitating medical condition or symptoms

associated with the medical condition.

      (8) "Practitioner" means a person who is licensed with authority to prescribe drugs

pursuant to chapter 37 of title 5 or a physician licensed with authority to prescribe drugs in

Massachusetts or Connecticut.

      (9) "Primary caregiver" means either a natural person, who is at least twenty-one (21)

years old, or a compassion center. A natural person primary caregiver may assist no more than

five (5) qualifying patients with their medical use of marijuana.

      (10) "Qualifying patient" means a person who has been diagnosed by a practitioner as

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having a debilitating medical condition and is a resident of Rhode Island.

      (11) "Registry identification card" means a document issued by the department that

identifies a person as a registered qualifying patient, a registered primary caregiver, or a

registered principal officer, board member, employee, volunteer, or agent of a compassion center.

      (12) "Seedling" means a marijuana plant with no observable flowers or buds.

      (13) "Unusable marijuana" means marijuana seeds, stalks, seedlings, and unusable roots.

      (14) "Usable marijuana" means the dried leaves and flowers of the marijuana plant, and

any mixture or preparation thereof, but does not include the seeds, stalks, and roots of the plant.

      (15) "Written certification" means the qualifying patient's medical records, and a

statement signed by a practitioner, stating that in the practitioner's professional opinion, the

potential benefits of the medical use of marijuana would likely outweigh the health risks for the

qualifying patient. A written certification shall be made only in the course of a bona fide,

practitioner-patient relationship after the practitioner has completed a full assessment of the

qualifying patient's medical history. The written certification shall specify the qualifying patient's

debilitating medical condition or conditions.

     21-28.6-6. Administration of regulations. -- (a) The department shall issue registry

identification cards to qualifying patients who submit the following, in accordance with the

department's regulations:

      (1) Written certification as defined in § 21-28.6-3(15) of this chapter;

      (2) Application or renewal fee;

      (3) Name, address, and date of birth of the qualifying patient; provided, however, that if

the patient is homeless, no address is required;

      (4) Name, address, and telephone number of the qualifying patient's practitioner; and

      (5) Name, address, and date of birth of each primary caregiver of the qualifying patient,

if any.

      (b) The department shall not issue a registry identification card to a qualifying patient

under the age of eighteen (18) unless:

      (1) The qualifying patient's practitioner has explained the potential risks and benefits of

the medical use of marijuana to the qualifying patient and to a parent, guardian, or person having

legal custody of the qualifying patient; and

      (2) A parent, guardian, or person having legal custody consents in writing to:

      (i) Allow the qualifying patient's medical use of marijuana;

      (ii) Serve as one of the qualifying patient's primary caregivers; and

      (iii) Control the acquisition of the marijuana, the dosage, and the frequency of the

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medical use of marijuana by the qualifying patient.

      (c) The department shall verify the information contained in an application or renewal

submitted pursuant to this section, and shall approve or deny an application or renewal within

fifteen (15) days of receiving it. The department may deny an application or renewal only if the

applicant did not provide the information required pursuant to this section, or if the department

determines that the information provided was falsified. Rejection of an application or renewal is

considered a final department action, subject to judicial review. Jurisdiction and venue for

judicial review are vested in the superior court.

     (d) If the qualifying patient’s practitioner notifies the department in a written statement

that the qualifying patient is eligible for hospice care, the department shall verify the application

information in accordance with subsection (c) of this section and issue a registry identification

card to the qualifying patient and primary caregivers named in the patient’s application within

seventy-two (72) hours of receipt of the completed application. The department shall not charge a

registration fee to the patient or caregivers named in the application.

      (d)(e) The department shall issue a registry identification card to each primary caregiver,

if any, who is named in a qualifying patient's approved application, up to a maximum of two (2)

primary caregivers per qualifying patient.

      (1) The primary caregiver applicant shall apply to the bureau of criminal identification of

the department of attorney general, state police, or local police department for a national criminal

records check that shall include fingerprints submitted to the Federal Bureau of Investigation.

Upon the discovery of any disqualifying information as defined in § 21-28.6-6(d)(4), and in

accordance with the rules promulgated by the director, the bureau of criminal identification of the

department of attorney general, state police, or the local police department shall inform the

applicant, in writing, of the nature of the disqualifying information; and, without disclosing the

nature of the disqualifying information, shall notify the department, in writing, that disqualifying

information has been discovered.

      (2) In those situations in which no disqualifying information has been found, the bureau

of criminal identification of the department of attorney general, state police, or the local police

shall inform the applicant and the department, in writing, of this fact.

      (3) The department shall maintain on file evidence that a criminal records check has

been initiated on all applicants seeking a primary caregiver registry identification card and the

results of the checks. The primary caregiver cardholder shall not be required to apply for a

national criminal records check for each patient he or she is connected to through the

department's registration process, provided that he or she has applied for a national criminal

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records check within the previous two (2) years in accordance with this chapter. The department

shall not require a primary caregiver cardholder to apply for a national criminal records check

more than once every two (2) years.

      (4) Information produced by a national criminal records check pertaining to a conviction

for any felony offense under chapter 28 of title 21 ("Rhode Island Controlled Substances Act"),

murder, manslaughter, rape, first-degree sexual assault, second-degree sexual assault, first-degree

child molestation, second-degree child molestation, kidnapping, first-degree arson, second-degree

arson, mayhem, robbery, burglary, breaking and entering, assault with a dangerous weapon,

assault or battery involving grave bodily injury, and/or assault with intent to commit any offense

punishable as a felony or a similar offense from any other jurisdiction shall result in a letter to the

applicant and the department disqualifying the applicant. If disqualifying information has been

found, the department may use its discretion to issue a primary caregiver registry identification

card if the applicant's connected patient is an immediate family member and the card is restricted

to that patient only.

      (5) The primary caregiver applicant shall be responsible for any expense associated with

the national criminal records check.

      (6) For purposes of this section "conviction" means, in addition to judgments of

conviction entered by a court subsequent to a finding of guilty or a plea of guilty, those instances

where the defendant has entered a plea of nolo contendere and has received a sentence of

probation and those instances where a defendant has entered into a deferred sentence agreement

with the attorney general.

      (e)(f) The department shall issue registry identification cards within five (5) days of

approving an application or renewal that shall expire two (2) years after the date of issuance.

Registry identification cards shall contain:

      (1) The date of issuance and expiration date of the registry identification card;

      (2) A random registry identification number;

      (3) A photograph; and

      (4) Any additional information as required by regulation or the department.

      (f)(g) Persons issued registry identification cards shall be subject to the following:

      (1) A patient cardholder shall notify the department of any change in the patient

cardholder's name, address, or primary caregiver; or if he or she ceases to have his or her

debilitating medical condition, within ten (10) days of such change.

      (2) A patient cardholder who fails to notify the department of any of these changes is

responsible for a civil infraction, punishable by a fine of no more than one hundred fifty dollars

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($150). If the patient cardholder has ceased to suffer from a debilitating medical condition, the

card shall be deemed null and void and the person shall be liable for any other penalties that may

apply to the person's nonmedical use of marijuana.

      (3) A primary caregiver cardholder or compassion center cardholder shall notify the

department of any change in his or her name or address within ten (10) days of such change. A

primary caregiver cardholder or compassion center cardholder who fails to notify the department

of any of these changes is responsible for a civil infraction, punishable by a fine of no more than

one hundred fifty dollars ($150).

      (4) When a patient cardholder or primary caregiver cardholder notifies the department of

any changes listed in this subsection, the department shall issue the patient cardholder and each

primary caregiver cardholder a new registry identification card within ten (10) days of receiving

the updated information and a ten-dollar ($10.00) fee. When a compassion center cardholder

notifies the department of any changes listed in this subsection, the department shall issue the

cardholder a new registry identification card within ten (10) days of receiving the updated

information and a ten-dollar ($10.00) fee.

      (5) When a patient cardholder changes his or her primary caregiver, the department shall

notify the primary caregiver cardholder within ten (10) days. The primary caregiver cardholder's

protections as provided in this chapter as to that patient shall expire ten (10) days after

notification by the department. If the primary caregiver cardholder is connected to no other

patient cardholders in the program, he or she must return his or her registry identification card to

the department.

      (6) If a cardholder loses his or her registry identification card, he or she shall notify the

department and submit a ten dollar ($10.00) fee within ten (10) days of losing the card. Within

five (5) days, the department shall issue a new registry identification card with new random

identification number.

      (7) If a cardholder willfully violates any provision of this chapter as determined by the

department, his or her registry identification card may be revoked.

      (g)(h) Possession of, or application for, a registry identification card shall not constitute

probable cause or reasonable suspicion, nor shall it be used to support the search of the person or

property of the person possessing or applying for the registry identification card, or otherwise

subject the person or property of the person to inspection by any governmental agency.

      (h)(i) (1) Applications and supporting information submitted by qualifying patients,

including information regarding their primary caregivers and practitioners, are confidential and

protected under the federal Health Insurance Portability and Accountability Act of 1996, and shall

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be exempt from the provisions of chapter 2 of title 38 et seq. (Rhode Island access to public

records act) and not subject to disclosure, except to authorized employees of the department as

necessary to perform official duties of the department, and pursuant to subsection (i) of this

section.

      (2) The application for qualifying patient's registry identification card shall include a

question asking whether the patient would like the department to notify him or her of any clinical

studies about marijuana's risk or efficacy. The department shall inform those patients who answer

in the affirmative of any such studies it is notified of, that will be conducted in Rhode Island. The

department may also notify those patients of medical studies conducted outside of Rhode Island.

      (3) The department shall maintain a confidential list of the persons to whom the

department has issued registry identification cards. Individual names and other identifying

information on the list shall be confidential, exempt from the provisions of Rhode Island access to

public information, chapter 2 of title 38, and not subject to disclosure, except to authorized

employees of the department as necessary to perform official duties of the department.

      (i)(j) Notwithstanding subsection (h) of this section, the department shall verify to law

enforcement personnel whether a registry identification card is valid solely by confirming the

random registry identification number or name.

      (j)(k) It shall be a crime, punishable by up to one hundred eighty (180) days in jail and a

one thousand dollar ($1,000) fine, for any person, including an employee or official of the

department or another state agency or local government, to breach the confidentiality of

information obtained pursuant to this chapter. Notwithstanding this provision, the department

employees may notify law enforcement about falsified or fraudulent information submitted to the

department.

      (k)(l) On or before January 1 of each odd numbered year, the department shall report to

the house committee on health, education and welfare and to the senate committee on health and

human services on the use of marijuana for symptom relief. The report shall provide:

      (1) The number of applications for registry identification cards, the number of qualifying

patients and primary caregivers approved, the nature of the debilitating medical conditions of the

qualifying patients, the number of registry identification cards revoked, and the number of

practitioners providing written certification for qualifying patients;

      (2) An evaluation of the costs permitting the use of marijuana for symptom relief,

including any costs to law enforcement agencies and costs of any litigation;

      (3) Statistics regarding the number of marijuana-related prosecutions against registered

patients and caregivers, and an analysis of the facts underlying those prosecutions;

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      (4) Statistics regarding the number of prosecutions against physicians for violations of

this chapter; and

      (5) Whether the United States Food and Drug Administration has altered its position

regarding the use of marijuana for medical purposes or has approved alternative delivery systems

for marijuana.

     SECTION 2. This act shall take effect upon passage.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO FOOD AND DRUGS - THE EDWARD O. HAWKINS AND THOMAS C.

SLATER MEDICAL MARIJUANA ACT

***

     This act would add post-traumatic stress disorder to the definition of "debilitating

medical condition" for purposes of qualifying for medical marijuana. It would also accelerate the

issuance of an approved medical marijuana use application if the patient is eligible for hospice

care.

     This act would take effect upon passage.

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