2015 -- S 0475 SUBSTITUTE A AS AMENDED

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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:

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

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

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amended to read as follows:

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

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

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

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

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

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

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

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

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

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

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issued and possesses a valid registry identification card.

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      (3) "Debilitating medical condition" means:

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

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

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these conditions;

 

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

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

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

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

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

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     (iii) In the case of a qualifying adult patient over eighteen (18) years of age seeking

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treatment for post-traumatic stress disorder (PTSD), the patient has been diagnosed with PTSD by

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a licensed psychiatrist, psychologist, psychiatric and mental health clinical nurse specialist, or

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independently licensed master's level mental health professional has received a course of standard

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pharmacological and mental health treatment for PTSD with written documentation of inadequate

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clinical response or intolerable adverse reactions, received a comprehensive evaluation by a

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licensed mental health or addiction professional with a written determination that the patient does

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not have a current substance use disorder, and will receive follow-up monitoring and treatment by

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a licensed health professional in collaboration with a licensed psychiatrist psychologist,

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

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professional at least quarterly for the first year and semi-annually thereafter to assess clinical

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response and adverse reactions to medical marijuana; or

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

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provided for in § 21-28.6-5.

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

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

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

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readily observable by an unaided visual examination.

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

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

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

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associated with the medical condition.

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

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

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Massachusetts or Connecticut.

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

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

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

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      (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.

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

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

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

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

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

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

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

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

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

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

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

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

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

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debilitating medical condition or conditions.

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

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

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department's regulations:

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

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      (2) Application or renewal fee;

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

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the patient is homeless, no address is required;

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

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

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if any.

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

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under the age of eighteen (18) unless:

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

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

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legal custody of the qualifying patient; and

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

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

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

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      (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.

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

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

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

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

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

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

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judicial review are vested in the superior court.

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

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

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

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

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

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

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

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

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primary caregivers per qualifying patient.

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

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

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

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

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

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

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

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

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information has been discovered.

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

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

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

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

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

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

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

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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

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

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more than once every two (2) years.

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

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

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

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

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

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

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

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

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

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

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to that patient only.

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

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the national criminal records check.

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

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

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

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

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with the attorney general.

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

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

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Registry identification cards shall contain:

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

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      (2) A random registry identification number;

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      (3) A photograph; and

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

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

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

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

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

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

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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

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

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apply to the person's nonmedical use of marijuana.

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

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

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

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

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one hundred fifty dollars ($150).

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

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

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

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

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

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

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

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

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

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

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

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

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the department.

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

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

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

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identification number.

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

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

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

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

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

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

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

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

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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

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

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

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section.

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

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

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

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

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

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

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

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

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

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

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

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

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random registry identification number or name.

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

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

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

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

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

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department.

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

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

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

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

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

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

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practitioners providing written certification for qualifying patients;

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

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

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

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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

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this chapter; and

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

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

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for marijuana.

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     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

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

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

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

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care.

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     This act would take effect upon passage.

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