Medical Marijuana Workgroup Report (2012)
Final Report of the
Medical Marijuana Model Program Workgroup
Dear President Miller, Speaker Busch, Chair Frosh, Chair Vallario and Chair Hammen:
As chair of the medical marijuana model program workgroup, I am respectfully submitting to you the final report of the workgroup required by Senate Bill 308, Chapter 215 of the
2011 legislative session.
Our group met three times, and teams within the workgroup met another five times.
Through multiple meetings and discussions, it became clear that workgroup members held different perspectives on some core issues – including the role of the academic research
institution.
Toll Free 1-877-4MD-DHMI-1 – TTY/Maryland Relay Service l-800-735-2258
Web Site: www.dhinh.state.md.us
Senate Bill 308, Chapter 215 (2011) – Final Report of the Medical Marijuana Model Program Workgroup
Page 2
The group decided to provide two different proposals to the legislature – each to be signed by those members of the workgroup in support. Workgroup members were able to sign on to one or both of the proposals. Workgroup member Michael Young chose not to sign on to either proposal.
Proposal 1 is supported by the following workgroup members:● Major Kevin Anderson ● Dr. Trudy Hall
● Major Sam Billotti ●Dr. Joseph Liberto
● Dario Broccolino ●Dr. Nancy Rosen-Cohen
● Dr. Paul Celano ● Dr. Joshua Sharfstein
● Philip Cogan ● Dr. Ryan Vandrey
● Delegate Kathleen Dumais
Proposal 2 is supported by the following workgroup members:● Lynn Billing ●Deborah Miran
● Senator David Brinkley ●Delegate Dan Morhaim
● Dario Broccolino ●Karen O’Keefe
● Philip Cogan ● Senator Jamie Raskin
● Delegate Kathleen Dumais ●Dr. Ryan Vandrey
I appreciate the work and input of all of the members of the workgroup, and look forward to working with the General Assembly on this issue during the 2012 legislative session. If you have any questions, please contact me or Ms. Marie Grant at 410-767-6480.
Sincerely,
Joshua M. Sharfstein, M.D. Secretary
Enclosure
cc: Medical Marijuana Model Program Workgroup Members
Virginia Geckler, Governor’s Office of Crime Control and Prevention Erin Hopwood, House Health and Government Operations Committee Staff Kristen Mahoney, Governor’s Office of Crime Control and Prevention Shirleen Pilgrim, Senate Judicial Proceedings Committee Staff Claire Rossmark, House Judiciary Committee Staff Marie Grant, Director of Governmental Affairs Sarah Albert, Department of Legislative Services, MSAR# 8946
Medical Marijuana Model Program Workgroup
Proposal 1 Medical Marijuana Model Program Workgroup – Proposal 1
Introduction
Senate Bill 308 of 2011 (Chapter 215) required the Secretary of Health and Mental Hygiene to convene a workgroup to develop and assess the feasibility of a State specific proposal for providing access to marijuana to patients in the State for medical purposes. The legislation requires the workgroup to present draft legislation that outlines the key elements of the model program and includes provisions that:
● Provide for oversight and responsibility by programs located in academic medical research institutions in the State;
● Provide for the licensing of a program by the State;
● Establish a program application and review process that includes consideration of best practices and procedures for obtaining review input that is external to the Department of Health and Mental Hygiene;
● Expand the base of information on the use of marijuana for medical purposes on a scientific and policy implementation basis; and
● Implement a program as soon as feasible, with goals of implementation by January 2013.
Senate Bill 308 also requires the workgroup to provide guidance on the criteria for assessing program applications, including an applying program’s plans for:
● Determining the medical conditions to be treated and the duration of therapy proposed;
● Identifying sources of marijuana;
● Determining patient eligibility and informed consent;
● Conducting any associated research projects;
● Reporting data and outcomes;
● Instituting strict controls against illegal diversion; and
● Securing grants or other sources of funding to facilitate the affordability of the program. Senate Bill 308 requires the Secretary of Health and Mental Hygiene to report on the findings of the workgroup to the Senate Judicial Proceedings Committee, the House Health and Government Operations Committee, and the House Judiciary Committee on the findings of the workgroup. This proposal, Proposal 1, is one of two proposals developed by the workgroup to address the requirements of Senate Bill 308.
Framework
The framework for this approach to marijuana for medical uses is that marijuana is not a conventionally accepted treatment in medicine. It does not have approval from the U.S. Food and Drug Administration and its use is not recommended by major professional associations, such as the American Medical Association or the American College of Physicians. These organizations have called for additional research and recognize that marijuana has both potential benefits and potential risks for patients. The benefits include the alleviation of certain debilitating symptoms, and the risks include psychiatric and behavioral side effects and addiction.
When it is not clear whether the benefits exceed the risks of a therapy, institutions often are able to make this therapy available to patients in an “investigational use” setting. This has also been referred to as “compassionate use.” In its comprehensive review of marijuana for medical uses, the Institute of Medicine endorsed this type of approach, stating: Short term use of smoked marijuana (less than six months) for patients with debilitating symptoms (such as intractable pain or vomiting) must meet the following conditions:
● Failure of all approved medications to provide relief has been documented;
● The symptoms can reasonably be expected to be relieved by rapid onset cannabinoid drugs;
● Such treatment is administered under medical supervision in a manner that allows for assessment of treatment effectiveness, and
● Involves an oversight strategy comparable to an institutional review board process that could provide guidance within 24 hours of a submission by a physician to provide marijuana to a patient for a specified use.
Recommendations
The members of the Workgroup that have signed on to this proposal have made recommendations in four areas: process, science, diversion, and other.
Table 1: Process Recommendations Recommendation Comments
1 Marijuana for medical uses may be made
available through approved investigational
use programs overseen by academic medical
research institutions. The term “academic medical research
institution” refers to hospitals that have
medical residency programs for physicians
and conduct research involving human
subjects overseen by the Department of Health
and Human Services.
2 There should be an oversight entity that
develops a RFP consistent with the other
recommended requirements of this report. This group should either be an advisory group
to the Department of Health and Mental
Hygiene (with final approval by the
Department) or an independent group
established along the lines of a professional
licensing board.
3 The academic medical research institution
should pay an application fee and an annual
license fee to recoup the costs of the
application process and oversight. The
application fee should be set by the entity
reviewing the applications and the annual fee
by the entity responsible for oversight. State funds for new programs are limited, and
the licensing of medical marijuana programs
must be cost neutral to the State.
4 The oversight entity will arrange for expert
review of applications. This review should
include an assessment of risks and benefits
with regards to the medical condition to be
treated, patient inclusion and monitoring,
data collection and reporting, and monitoring
for diversion. Experts will submit application reviews to the
oversight entity for consideration in making a
final decision on the application.
5 The oversight entity should be responsible for
ensuring that the academic medical research
institutions meet their responsibilities under
the application. This should include inspections of approved
programs by the oversight entity.
6 There should be annual renewal of licensure
by academic medical research institution. This review should not be pro forma.
Continued approval should be based on
meeting the goals of the application and
providing all appropriate data.
7 There should be an annual report by each
academic medical research institution
licensed for medical marijuana programs, as
well as a public report. Annual reports should include information on
the number of patients served, the county of
residence of the patients, the conditions
treated, outcome data, and any research
studies conducted under the medical
marijuana program. The oversight entity
Recommendation Comments
should establish standard data collection
procedures for approved investigational use
programs.
Table 2: Recommendations for the Scientific Components of Applications from Academic Medical Research Institutions for a Medical Marijuana Program Recommendation Comments
1 The application should specify the
medical conditions to be treated,
proposed on the basis of medical
evidence. This is a standard part of an investigational use
program.
2 The application should specify the
criteria by which the academic
medical research institution will
include and exclude patients from
participation in the program. This is a standard part of an investigational use
program.
3 The application should specify how
patients will be assessed for addiction
before and during treatment with
marijuana. A history of problematic substance use should not
necessarily exclude a prospective patient from
participating in the program, using appropriate
medical need considerations. However, evaluation of
addiction before enrollment and the emergence of
new drug use problems following enrollment will be
important in assessing the risks and benefits of
participation to the patient.
4 The application should include
scientific details of the type of
marijuana to be used in the program. Characterization of a clinical intervention is a
standard part of an investigational use program.
There could be different types of marijuana used by
approved programs; however, consistency of the
characteristics for each type of marijuana used is
essential.
5 The application should specify the
proposed length of treatment, dosage
permitted under the program, and
plan for ongoing evaluation of patient
response. This is a standard part of an investigational use
program.
6 The application must describe how
medical providers will be eligible to
participate in the program and detail
the training and/or certification
required for participation in the
program. Medical providers do not have to be employees or
affiliates of the academic medical research institution.
However, the institution must provide a list of
providers participating in the program to the
oversight entity. This list does not need to be
provided at the time of application for approval.
7 The application should demonstrate
approval by the institution’s IRB. This is a standard part of an investigational use
program.
Recommendation Comments
8 The application should describe the
plan for defining and monitoring the
success or failure of treatment. This is a standard part of an investigational use
program and is important for clinical care.
9 The application should include a plan
for monitoring aggregate data and
outcomes and publishing results, as
appropriate. This will allow for others to learn about the outcomes
of the program.
10 The application should include the
sources of funding for the initiative,
including any research grants. This allows the oversight entity to understand
whether there is external scientific oversight, such as
through a grant funder.
Table 3: Recommendations for the Diversion Components of Applications from Academic Medical Research Institutions for a Medical Marijuana Program Recommendation Comments
1 The application should describe
the source of the marijuana that
will be used in the program. This will allow the state to know the sources of all
marijuana used under this program in Maryland.
2 The application should describe
required training for medical
providers and patients on
diversion related issues. This training should reduce diversion.
3 The application should describe
how the programs will monitor
for diversion. This will allow the oversight entity to assure compliance
with an anti diversion program.
4 The application should describe
how the program will address
violations of the diversion policy. This will assure that there are consequences within the
program for both medical providers and patients for
diversion.
5 The application should describe
any caregiver structure that will
be used in the program, within
limits set in the legislation. The proposed limits in the draft legislation are that a
caregiver is allowed to serve no more than five individuals,
and that no more than two caregivers may serve any one
patient. Caregivers should have protection from
prosecution for their role in an approved program, and
their participation in a program should be reported to an
electronic database available to state law enforcement.
6 The oversight entity should add
any other specifications for
control of diversion by programs
that it deems appropriate.
Table 4: Other Recommendations Recommendation Comments
1 Marijuana growers will be separately
licensed by the State of Maryland. Academic
medical research institutions can obtain
marijuana from any grower licensed by the
State or from the National Institute on Drug
Abuse’s federal marijuana program. This licensure process should focus on good
manufacturing practices and security, including a
product tracking system. If a grower is not
licensed, then its products may not be used in a
program in the State and are subject to
enforcement of state laws against marijuana
cultivation. Growers must be licensed prior to
beginning marijuana cultivation.
2 Academic medical research institutions
with marijuana programs should provide
updated data each day on enlisted patients
to the Prescription Drug Monitoring
Program, or an equivalent process that
allows for access by law enforcement. The state should make marijuana data available
to the police in real time, with appropriate
privacy protections, to assure both that patients
are not penalized for access to marijuana through
a legitimate program and to limit diversion.
3 There should be additional state penalties
for gross misuse of a marijuana program
for diversion purposes.
4 Patients participating in an approved
marijuana program should not be subject to
arrest, prosecution, or criminal penalty for
possession of medical marijuana obtained
through the program.
5 There should be protections from arrest
and prosecution for academic medical
research institutions, growers, and their
staff for participation in an approved
medical marijuana program.
Workgroup Members Signing on to Proposal 1
The following members of the workgroup signed on to Proposal 1:
● Major Kevin Anderson
● Major Sam Billotti
● Dario Broccolino
● Dr. Paul Celano
● Philip Cogan
● Delegate Kathleen Dumais
● Dr. Trudy Hall
● Dr. Joseph Liberto
● Dr. Nancy Rosen Cohen
● Dr. Joshua Sharfstein
● Dr. Ryan Vandrey
Model Legislation to Implement Proposal 1
Two versions of draft legislation are included here. The first version provides for oversight to be conducted by the Department of Health and Mental Hygiene, with the assistance of an Advisory Committee. The second version provides for oversight to be conducted by an independent commission.
Version 1. DHMH and Advisory Committee Oversight.
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, That the Laws of Maryland read as follows:
Article – Health – General
SUBTITLE 31. MEDICAL MARIJUANA ADVISORY COMMITTEE.
13-3101.
(A) IN THIS SUBTITLE THE FOLLOWING WORDS HAVE THE MEANINGS INDICATED.
(B) “ACADEMIC MEDICAL CENTER” MEANS A HOSPITAL THAT:
(1) OPERATES A MEDICAL RESIDENCY PROGRAM FOR PHYSICIANS; AND
(2) CONDUCTS RESEARCH THAT IS OVERSEEN BY THE
FEDERAL DEPARTMENT OF HEALTH AND HUMAN SERVICES AND INVOLVES HUMAN SUBJECTS.
(C) “ADVISORY COMMITTEE” MEANS THE MEDICAL MARIJUANA ADVISORY COMMITTEE ESTABLISHED UNDER THIS SUBTITLE.
(D) “PROGRAM” MEANS AN INVESTIGATIONAL USE-TYPE PROGRAM
OVERSEEN BY AN ACADEMIC MEDICAL CENTER THROUGH WHICH MARIJUANA IS MADE AVAILABLE FOR MEDICAL USES TO PATIENTS.
13- 3102.
(A) THERE IS A MEDICAL MARIJUANA ADVISORY COMMITTEE IN THE DEPARTMENT.
(B) THE PURPOSE OF THE ADVISORY COMMITTEE IS TO:
(1) DEVELOP REQUESTS FOR APPLICATIONS FOR ACADEMIC MEDICAL CENTERS TO OPERATE PROGRAMS, IN ACCORDANCE WITH THIS SUBTITLE;
(2) MAKE RECOMMENDATIONS ON APPROVAL OR DENIAL OF APPLICATIONS FOR PROGRAMS TO THE SECRETARY;
(3) MAKE RECOMMENDATIONS ON APPROVAL OR DENIAL OF RENEWAL APPLICATIONS FOR APPROVAL OF PROGRAMS; AND
(4) ADVISE ON THE MONITOR AND OVERSIGHT OF PROGRAMS APPROVED FOR OPERATION UNDER THIS SUBTITLE.
13- 3103.
(A) THE ADVISORY COMMITTEE CONSISTS OF THE FOLLOWING MEMBERS:
(1) TWO MEMBERS OF THE MARYLAND SENATE, APPOINTED BY THE PRESIDENT OF THE SENATE;
(2) TWO MEMBERS OF THE MARYLAND HOUSE OF DELEGATES, APPOINTED BY THE SPEAKER OF THE HOUSE OF DELEGATES; AND
(3) THE FOLLOWING MEMBERS, APPOINTED BY THE GOVERNOR:
(I) ONE MEMBER OF THE PUBLIC WHO SUPPORTS THE USE OF MARIJUANA FOR MEDICAL PURPOSES;
(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, WHO SPECIALIZE IN ADDICTION, PAIN, ONCOLOGY, NEUROLOGY, OR CLINICAL RESEARCH;
(IV) ONE NURSE LICENSED IN THE STATE, WITH 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 WITH EXPERIENCE IN THE SCIENCE OF MARIJUANA, NOMINATED BY A STATE RESEARCH INSTITUTION;
(VII) ONE REPRESENTATIVE OF THE MARYLAND STATE’S ATTORNEYS’ ASSOCIATION;
(VIII) ONE REPRESENTATIVE OF THE MARYLAND CHIEFS OF POLICE;
(IX) ONE REPRESENTATIVE OF THE MARYLAND SHERIFFS’ ASSOCIATION;
(X) ONE REPRESENTATIVE OF THE MARYLAND FRATERNAL ORDER OF POLICE; AND
(XI) AN ATTORNEY WHO IS KNOWLEDGEABLE ABOUT MEDICAL MARIJUANA LAWS IN THE UNITED STATES.
(B) (1) THE TERM OF AN APPOINTED MEMBER IS 2 YEARS.
(2) THE TERMS OF THE APPOINTED MEMBERS ARE STAGGERED AS REQUIRED BY THE TERMS PROVIDED FOR MEMBERS ON OCTOBER 1, 2012.
(3) AT THE END OF A TERM, AN APPOINTED MEMBER CONTINUES TO SERVE UNTIL A SUCCESSOR IS APPOINTED AND QUALIFIES.
(4) AN APPOINTED MEMBER MAY NOT SERVE MORE THAN THREE CONSECUTIVE FULL TERMS.
(5)AN APPOINTED 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 A CHAIR FROM AMONG THE APPOINTED MEMBERS OF THE ADVISORY COMMITTEE.
(D) A MAJORITY OF THE FULL AUTHORIZED MEMBERSHIP OF THE ADVISORY COMMITTEE IS A QUORUM.
(E) A MEMBER OF THE ADVISORY COMMITTEE:
(1) MAY NOT RECEIVE COMPENSATION AS A MEMBER OF THE ADVISORY COMMITTEE; BUT
(2) IS ENTITLED TO REIMBURSEMENT FOR EXPENSES UNDER THE STANDARD STATE TRAVEL REGULATIONS, AS PROVIDED IN THE STATE BUDGET.
13- 3104.
(A) THE ADVISORY COMMITTEE, WITH THE CONSENT OF THE SECRETARY, SHALL ISSUE A REQUEST FOR APPLICATIONSFOR ACADEMIC MEDICAL CENTERS TO OPERATE MEDICAL MARIJUANA COMPASSIONATE USE PROGRAMS AT LEAST ANNUALLY.
(B) AN APPLICATION SUBMITTED BY AN ACADEMIC MEDICAL CENTER TO OPERATE A PROGRAM UNDER THIS SUBTITLE SHALL:
(1) SPECIFY THE MEDICAL CONDITIONS TO BE TREATED UNDER THE PROGRAM TO BE OPERATED BY THE ACADEMIC MEDICAL CENTER, PROPOSED ON THE BASIS OF EVIDENCE;
(2)SPECIFY THE CRITERIA BY WHICH THE ACADEMIC MEDICAL
CENTER WILL INCLUDE AND EXCLUDE PATIENTS FROM PARTICIPATION IN THE PROGRAM;
(3) SPECIFY HOW PATIENTS WILL BE ASSESSED FOR ADDICTION BEFORE AND DURING TREATMENT WITH MARIJUANA THROUGH THE PROGRAM;
(4)DESCRIBE THE SOURCE OF MARIJUANA TO BE USED IN A
PROGRAM AND INCLUDE SCIENTIFIC DETAILS OF THE TYPE OF MARIJUANA TO BE USED IN THE PROGRAM;
(5) SPECIFY THE LENGTH OF TREATMENT AND DOSAGE PERMITTED UNDER THE PROGRAM;
(6) DESCRIBE HOW HEALTH CARE PROVIDERS WILL BE ELIGIBLE TO PARTICIPATE IN THE PROGRAM AND WHAT TRAINING THEY WILL RECEIVE;
(7) INCLUDE A DESCRIPTION OF WHETHER AND HOW CAREGIVERS WILL INTERACT WITH PATIENTS PARTICIPATING IN THE PROGRAM;
(8) DEMONSTRATE APPROVAL OF THE PROGRAM BY THE ACADEMIC MEDICAL CENTER’S INSTITUTIONAL REVIEW BOARD;
(9) DESCRIBE THE PLAN FOR DEFINING AND MONITORING THE SUCCESS OR FAILURE OF TREATMENT WITH MARIJUANA THROUGH THE PROGRAM;
(10) INCLUDE A PLAN FOR MONITORING AGGREGATE DATA AND OUTCOMES AND PUBLISHING RESULTS FROM THE PROGRAM, AS APPROPRIATE;
(11) INCLUDE A DESCRIPTION OF THE SOURCES OF FUNDING FOR THE PROGRAM, INCLUDING ANY RESEARCH GRANTS;
(12) DESCRIBE ANY REQUIRED TRAINING FOR HEALTH CARE PROVIDERS AND PATIENTS PARTICIPATING IN THE PROGRAM ON DIVERSIONRELATED ISSUES;
(13) DESCRIBE STEPS THE ACADEMIC MEDICAL CENTER WILL TAKE TO
PREVENT AND MONITOR FOR DIVERSION AND ADDRESS VIOLATIONS OF ITS DIVERSION POLICY;
(14) DESCRIBE HOW THE PROGRAM WILL DISPOSE OF ANY UNUSED MARIJUANA; AND
(15) DESCRIBE HOW THE ACADEMIC MEDICAL CENTER AND THE PROGRAM WILL MEET ANY OTHER CRITERIA ESTABLISHED BY THE ADVISORY COMMITTEE RELATED TO DIVERSION OR OTHER ASPECTS OF PROGRAMS.
(C) THE DEPARTMENT SHALL SET APPLICATION FEES AND RENEWAL FEES
THAT COVERS THE EXPENSES ASSOCIATED WITH REVIEWING AND APPROVING APPLICATIONS AND PROVIDING OVERSIGHT TO PROGRAMS.
13-3105.
(A) THE ADVISORY COMMITTEE SHALL ESTABLISH A REVIEW PROCESS INVOLVING REVIEWERS WITH EXPERTISE IN SCIENTIFIC RESEARCH AND ANALYSIS, MEDICAL TRAINING, AND LAW ENFORCEMENT.
(B) THE REVIEWERS SHALL:
(1) REVIEW, EVALUATE, AND RATE APPLICATIONS FOR MEDICAL
MARIJUANA COMPASSIONATE USE PROGRAMS SUBMITTED BY ACADEMIC MEDICAL CENTERS, BASED ON THE PROCEDURES AND GUIDELINES ESTABLISHED BY THE ADVISORY COMMITTEE; AND
(2) MAKE RECOMMENDATIONS TO THE ADVISORY COMMITTEE, BASED ON THE RATINGS AWARDED TO PROPOSALS BY THE REVIEWERS, FOR
APPROVAL OF APPLICATIONS FROM MEDICAL MARIJUANA COMPASSIONATE USE PROGRAMS.
(C) THE ADVISORY COMMITTEE SHALL MAKE RECOMMENDATIONS ON APPROVAL TO THE SECRETARY.
(D) THE SECRETARY MAY GRANT A ONE-YEAR RENEWABLE LICENSE TO A PROGRAM.
13-3106.
(A) AN ACADEMIC MEDICAL CENTER APPROVED TO OPERATE A PROGRAM UNDER THIS SUBTITLE SHALL PROVIDE UPDATED DATA EACH DAY ON PATIENTS AND
CAREGIVERS PARTICIPATING IN EACH PROGRAM OVERSEEN BY THE ACADEMIC MEDICAL CENTER TO [INSERT STATE ENTITY], WHICH WILL MAKE THE DATA AVAILABLE IN REAL TIME TO LAW ENFORCEMENT, SUBJECT TO APPROPRIATE PRIVACY PROTECTIONS.
(B) AN ACADEMIC MEDICAL CENTER OPERATING A PROGRAM APPROVED UNDER THIS SUBTITLE MAY ONLY USE MARIJUANA OBTAINED FROM:
(1) THE FEDERAL GOVERNMENT; OR
(2) A MEDICAL MARIJUANA GROWER LICENSED UNDER THIS SUBTITLE.
(C) IF THE ACADEMIC MEDICAL CENTER UTILIZES CAREGIVERS AS PART OF A PROGRAM APPROVED UNDER THIS SUBTITLE, THE ACADEMIC MEDICAL CENTER SHALL:
(1) LIMIT THE NUMBER OF PATIENTS A CAREGIVER IS ALLOWED TO SERVE TO NO MORE THAN FIVE; AND
(2) LIMIT THE NUMBER OF CAREGIVERS THAT SERVE A PARTICULAR PATIENT TO NO MORE THAN TWO.
(D) AN ACADEMIC MEDICAL CENTER OPERATING A PROGRAM APPROVED UNDER THIS SUBTITLE SHALL REPORT ANNUALLY TO THE ADVISORY COMMITTEE AND THE DEPARTMENT, IN THE FORM SPECIFIED BY THE DEPARTMENT, ON:
(1)THE NUMBER OF PATIENTS SERVED THROUGH THE PROGRAM;
(2) THE COUNTY OF RESIDENCE OF THE PATIENTS SERVED BY THE PROGRAM;
(3) CONDITIONS TREATED UNDER THE PROGRAM;
(4) ANY OUTCOMES DATA ON THE RESULTS OF TREATMENT THROUGH THE PROGRAM; AND
(5)ANY RESEARCH STUDIES CONDUCTED UNDER THE PROGRAM.
(E) AN ACADEMIC MEDICAL CENTER OPERATING A PROGRAM APPROVED UNDER THIS SUBTITLE SHALL APPLY ANNUALLY TO THE DEPARTMENT FOR RENEWAL OF APPROVAL, IN ACCORDANCE WITH ANY PROCEDURES ESTABLISHED BY THE DEPARTMENT.
(F) AN ACADEMIC MEDICAL CENTER OPERATING A PROGRAM APPROVED UNDER THIS SUBTITLE IS SUBJECT TO INSPECTION BY THE DEPARTMENT TO ENSURE
THAT THE PROGRAM IS OPERATING ACCORDING TO THE CONDITIONS OF APPROVAL ESTABLISHED BY THE DEPARTMENT.
(G) THE DEPARTMENT MAY RESCIND APPROVAL OF A PROGRAM IF THE DEPARTMENT FINDS THAT THE PROGRAM IS NOT IN COMPLIANCE WITH THE CONDITIONS OF APPROVAL ESTABLISHED BY THE DEPARTMENT.
13-3107.
ON OR BEFORE JANUARY 1 OF EACH YEAR, THE DEPARTMENT SHALL REPORT TO THE GOVERNOR AND, IN ACCORDANCE WITH § 2-1246 OF THE STATE GOVERNMENT ARTICLE, THE GENERAL ASSEMBLY, ON PROGRAMS APPROVED TO OPERATE UNDER THIS SUBTITLE.
13-3108.
(A) THE [INSERT STATE ENTITY] SHALL ESTABLISH A PROCESS FOR LICENSURE OF MEDICAL MARIJUANA GROWERS TO OPERATE IN THE STATE TO
PROVIDE MARIJUANA TO PROGRAMS APPROVED FOR OPERATION UNDER THIS SUBTITLE.
(B) MARIJUANA GROWN BY AN ENTITY LICENSED UNDER THIS SECTION MAY
PROVIDE MARIJUANA ONLY TO AN ACADEMIC MEDICAL CENTER APPROVED TO OPERATE A PROGRAM UNDER THIS SUBTITLE.
(C) THE [INSERT STATE ENTITY] SHALL ESTABLISH REQUIREMENTS FOR
SECURITY AND MANUFACTURING PROCESS THAT A GROWER MUST MEET IN ORDER TO OBTAIN LICENSURE UNDER THIS SECTION, INCLUDING A REQUIREMENT FOR A PRODUCT TRACKING SYSTEM.
(D) THE [INSERT STATE ENTITY] MAY INSPECT GROWERS LICENSED UNDER THIS SECTION TO ENSURE COMPLIANCE WITH THIS SECTION.
(E) THE [INSERT STATE ENTITY] MAY IMPOSE PENALTIES OR RESCIND THE
LICENSE OF A GROWER THAT DOES NOT MEET THE STANDARDS FOR LICENSURE SET BY THE [INSERT STATE ENTITY].
13-1309.
(A) ANY OF THE FOLLOWING PERSONS ACTING IN ACCORDANCE WITH THE
PROVISIONS OF THIS SUBTITLE MAY NOT BE SUBJECT TO ARREST, PROSECUTION, OR ANY CIVIL OR ADMINISTRATIVE PENALTY, INCLUDING CIVIL PENALTY OR DISCIPLINARY ACTION BY A PROFESSIONAL LICENSING BOARD, NOR BE DENIED ANY RIGHT OR PRIVILEGE, FOR THE MEDICAL USE OF MARIJUANA:
(1)A PATIENT ENROLLED IN A PROGRAM APPROVED UNDER THIS
SUBTITLE WHO IS IN POSSESSION OF AN AMOUNT OF MARIJUANA AUTHORIZED UNDER THE PROGRAM;
(2)A GROWER LICENSED UNDER § 13-3108 OF THIS SUBTITLE OR AN
EMPLOYEE OF THE LICENSED GROWER WHO IS ACTING IN ACCORDANCE WITH THE TERMS OF THE LICENSE;
(3) AN ACADEMIC MEDICAL CENTER, AN EMPLOYEE OF THE ACADEMIC MEDICAL CENTER, OR ANY OTHER PERSON ASSOCIATED WITH THE
OPERATION OF A PROGRAM APPROVED UNDER THIS SUBTITLE FOR ACTIVITIES CONDUCTED IN ACCORDANCE WITH THE PROGRAM APPROVED UNDER THIS SUBTITLE.
(B) (1) A PERSON MAY NOT DISTRIBUTE, POSSESS, MANUFACTURE, OR USE MARIJUANA THAT HAS BEEN DIVERTED FROM A PROGRAM APPROVED UNDER THIS SUBTITLE OR FROM A PATIENT WHO IS ENROLLED IN A PROGRAM APPROVED UNDER THIS SUBTITLE.
(2) A PERSON WHO VIOLATES THIS SUBSECTION IS GUILTY OF A FELONY AND ON CONVICTION IS SUBJECT TO IMPRISONMENT NOT EXCEEDING 5 YEARS OR A FINE NOT EXCEEDING $10,000 OR BOTH.
(3) THE PENALTY UNDER THIS SUBSECTION IS IN ADDITION TO ANY PENALTIES THAT A PERSON MAY BE SUBJECT TO FOR MANUFACTURE, POSSESSION, OR DISTRIBUTION OF MARIJUANA UNDER THE CRIMINAL LAW ARTICLE.
13-3010.
(A) THIS SUBTITLE MAY NOT BE CONSTRUED TO AUTHORIZE ANY INDIVIDUAL TO ENGAGE IN THE FOLLOWING, AND IT DOES NOT PREVENT THE IMPOSITION OF ANY CIVIL, CRIMINAL, OR OTHER PENALTIES FOR THE FOLLOWING:
(1) UNDERTAKE ANY TASK UNDER THE INFLUENCE OF MARIJUANA, WHEN DOING SO WOULD CONSTITUTE NEGLIGENCE OR PROFESSIONAL MALPRACTICE;
(2) OPERATE, NAVIGATE, OR BE IN ACTUAL PHYSICAL CONTROL OF ANY MOTOR VEHICLE, AIRCRAFT, OR BOAT WHILE UNDER THE INFLUENCE OF MARIJUANA;
(3) SMOKE MARIJUANA IN ANY PUBLIC PLACE;
(4) SMOKE MARIJUANA IN A MOTOR VEHICLE; OR
(5)SMOKE MARIJUANA ON A PRIVATE PROPERTY THAT:
(I) 1. IS RENTED FROM A LANDLORD; AND
2. IS SUBJECT TO A POLICY THAT PROHIBITS THE SMOKING OF MARIJUANA ON THE PROPERTY; OR
(II) IS SUBJECT TO A POLICY THAT PROHIBITS THE SMOKING OF
MARIJUANA ON THE PROPERTY OF AN ATTACHED DWELLING ADOPTED BY ONE OF THE FOLLOWING ENTITIES:
1. THE BOARD OF DIRECTORS OF THE COUNCIL OF UNIT OWNERS OF A CONDOMINIUM REGIME; OR
2. THE GOVERNING BODY OF A HOMEOWNER’S
ASSOCIATION.
(B) THIS SUBTITLE MAY NOT BE CONSTRUED TO PROVIDE IMMUNITY TO A PERSON WHO VIOLATES THE PROVISIONS OF THIS SUBTITLE FROM CRIMINAL PROSECUTION FOR A VIOLATION OF ANY LAW PROHIBITING OR REGULATING THE USE, POSSESSION, DISPENSING, DISTRIBUTION, OR PROMOTION OF CONTROLLED DANGEROUS SUBSTANCES, DANGEROUS DRUGS, DETRIMENTAL DRUGS, OR HARMFUL DRUGS, OR ANY CONSPIRACY OR ATTEMPT TO COMMIT ANY OF THOSE OFFENSES. Version 2. Independent Commission Oversight.
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, That the Laws of Maryland read as follows:
Article – Health – General
SUBTITLE 31. MEDICAL MARIJUANA COMMISSION
13-3101.
(A) IN THIS SUBTITLE THE FOLLOWING WORDS HAVE THE MEANINGS INDICATED.
(B) “ACADEMIC MEDICAL CENTER” MEANS A HOSPITAL THAT:
(1) OPERATES A MEDICAL RESIDENCY PROGRAM FOR PHYSICIANS; AND
(2) CONDUCTS RESEARCH THAT IS OVERSEEN BY THE
FEDERAL DEPARTMENT OF HEALTH AND HUMAN SERVICES AND INVOLVES HUMAN SUBJECTS.
(C) “COMMISSION” MEANS THE MEDICAL MARIJUANA COMMISSION ESTABLISHED UNDER THIS SUBTITLE.
(D) “PROGRAM” MEANS AN INVESTIGATIONAL USE-TYPE PROGRAM
OVERSEEN BY AN ACADEMIC MEDICAL CENTER THROUGH WHICH MARIJUANA IS MADE AVAILABLE FOR MEDICAL USES TO PATIENTS.
13- 3102.
(A) THERE IS A MEDICAL MARIJUANA COMMISSION [IN THE DEPARTMENT].
(B) THE PURPOSE OF THE COMMISSION IS TO:
(1) DEVELOP REQUESTS FOR APPLICATIONS FOR ACADEMIC MEDICAL CENTERS TO OPERATE PROGRAMS, IN ACCORDANCE WITH THIS SUBTITLE;
(2) APPROVE OR DENY APPLICATIONS FOR PROGRAMS;
(3) APPROVE OR DENY RENEWAL APPLICATIONS FOR APPROVAL OF PROGRAMS; AND
(4) MONITOR AND OVERSEE PROGRAMS APPROVED FOR OPERATION UNDER THIS SUBTITLE.
13- 3103.
(A) THE COMMISSION CONSISTS OF THE FOLLOWING MEMBERS:
(1) TWO MEMBERS OF THE MARYLAND SENATE, APPOINTED BY THE PRESIDENT OF THE SENATE;
(2) TWO MEMBERS OF THE MARYLAND HOUSE OF DELEGATES, APPOINTED BY THE SPEAKER OF THE HOUSE OF DELEGATES; AND
(3) THE FOLLOWING MEMBERS, APPOINTED BY THE GOVERNOR:
(I) ONE MEMBER OF THE PUBLIC WHO SUPPORTS THE USE OF MARIJUANA FOR MEDICAL PURPOSES;
(II) ONE MEMBER OF THE PUBLIC DESIGNATED BY THE MARYLAND CHAPTER OF THE NATIONAL COALITION ON ALCOHOL AND OTHER DRUG DEPENDENCIES COUNCIL ON ALCOHOLISM AND DRUG DEPENDENCE;
(III) THREE PHYSICIANS LICENSED IN THE STATE, WHO SPECIALIZE IN ADDICTION, PAIN, ONCOLOGY, NEUROLOGY, OR CLINICAL RESEARCH;
(IV) ONE NURSE LICENSED IN THE STATE, WITH 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 WITH EXPERIENCE IN THE SCIENCE OF MARIJUANA, NOMINATED BY A STATE RESEARCH INSTITUTION;
(VII) ONE REPRESENTATIVE OF THE MARYLAND STATE’S ATTORNEYS’ ASSOCIATION;
(VIII) ONE REPRESENTATIVE OF THE MARYLAND CHIEFS OF POLICE;
(IX) ONE REPRESENTATIVE OF THE MARYLAND SHERIFFS’
ASSOCIATION;
(X) ONE REPRESENTATIVE OF THE MARYLAND FRATERNAL ORDER OF POLICE; AND
(XI) AN ATTORNEY WHO IS KNOWLEDGEABLE ABOUT MEDICAL MARIJUANA LAWS IN THE UNITED STATES.
(B) (1) THE TERM OF AN APPOINTED MEMBER IS 2 YEARS.
(2) THE TERMS OF THE APPOINTED MEMBERS ARE STAGGERED AS REQUIRED BY THE TERMS PROVIDED FOR MEMBERS ON OCTOBER 1, 2012.
(3) AT THE END OF A TERM, AN APPOINTED MEMBER CONTINUES TO SERVE UNTIL A SUCCESSOR IS APPOINTED AND QUALIFIES.
(4) AN APPOINTED MEMBER MAY NOT SERVE MORE THAN THREE CONSECUTIVE FULL TERMS.
(5)AN APPOINTED 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 A CHAIR FROM AMONG THE APPOINTED 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.
13- 3104.
(A) THE COMMISSION SHALL ISSUE A REQUEST FOR APPLICATIONS FOR
ACADEMIC MEDICAL CENTERS TO OPERATE MEDICAL MARIJUANA COMPASSIONATE USE PROGRAMS AT LEAST ANNUALLY.
(B) AN APPLICATION SUBMITTED BY AN ACADEMIC MEDICAL CENTER TO OPERATE A PROGRAM UNDER THIS SUBTITLE SHALL:
(1) SPECIFY THE MEDICAL CONDITIONS TO BE TREATED UNDER THE PROGRAM TO BE OPERATED BY THE ACADEMIC MEDICAL CENTER, PROPOSED ON THE BASIS OF EVIDENCE;
(2)SPECIFY THE CRITERIA BY WHICH THE ACADEMIC MEDICAL
CENTER WILL INCLUDE AND EXCLUDE PATIENTS FROM PARTICIPATION IN THE PROGRAM;
(3) SPECIFY HOW PATIENTS WILL BE ASSESSED FOR ADDICTION BEFORE AND DURING TREATMENT WITH MARIJUANA THROUGH THE PROGRAM;
(4)DESCRIBE THE SOURCE OF MARIJUANA TO BE USED IN A
PROGRAM AND INCLUDE SCIENTIFIC DETAILS OF THE TYPE OF MARIJUANA TO BE USED IN THE PROGRAM;
(5) SPECIFY THE LENGTH OF TREATMENT AND DOSAGE PERMITTED UNDER THE PROGRAM;
(6) DESCRIBE HOW HEALTH CARE PROVIDERS WILL BE ELIGIBLE TO PARTICIPATE IN THE PROGRAM AND WHAT TRAINING THEY WILL RECEIVE;
(7) INCLUDE A DESCRIPTION OF WHETHER AND HOW CAREGIVERS WILL INTERACT WITH PATIENTS PARTICIPATING IN THE PROGRAM;
(8) DEMONSTRATE APPROVAL OF THE PROGRAM BY THE ACADEMIC MEDICAL CENTER’S INSTITUTIONAL REVIEW BOARD;
(9) DESCRIBE THE PLAN FOR DEFINING AND MONITORING THE SUCCESS OR FAILURE OF TREATMENT WITH MARIJUANA THROUGH THE PROGRAM;
(10) INCLUDE A PLAN FOR MONITORING AGGREGATE DATA AND OUTCOMES AND PUBLISHING RESULTS FROM THE PROGRAM, AS APPROPRIATE;
(11) INCLUDE A DESCRIPTION OF THE SOURCES OF FUNDING FOR THE PROGRAM, INCLUDING ANY RESEARCH GRANTS;
(12) DESCRIBE ANY REQUIRED TRAINING FOR HEALTH CARE PROVIDERS AND PATIENTS PARTICIPATING IN THE PROGRAM ON DIVERSIONRELATED ISSUES;
(13) DESCRIBE STEPS THE ACADEMIC MEDICAL CENTER WILL TAKE TO
PREVENT AND MONITOR FOR DIVERSION AND ADDRESS VIOLATIONS OF ITS DIVERSION POLICY;
(14) DESCRIBE HOW THE PROGRAM WILL DISPOSE OF ANY UNUSED MARIJUANA; AND
(15) DESCRIBE HOW THE ACADEMIC MEDICAL CENTER AND
THE PROGRAM WILL MEET ANY OTHER CRITERIA ESTABLISHED BY THE COMMISSION RELATED TO DIVERSION OR OTHER ASPECTS OF PROGRAMS.
(C) THE COMMISSION SHALL SET APPLICATION FEES AND RENEWAL FEES
THAT COVERS ITS EXPENSES IN REVIEWING AND APPROVING APPLICATIONS AND PROVIDING OVERSIGHT TO PROGRAMS.
13-3105.
(A) THE COMMISSION SHALL ESTABLISH A REVIEW PROCESS WITH REVIEWERS WITH EXPERTISE IN SCIENTIFIC RESEARCH AND ANALYSIS, MEDICAL TRAINING, AND LAW ENFORCEMENT.
(B) THE REVIEWERS SHALL:
(1) REVIEW, EVALUATE, AND RATE APPLICATIONS FOR MEDICAL
MARIJUANA COMPASSIONATE USE PROGRAMS SUBMITTED BY ACADEMIC MEDICAL CENTERS, BASED ON THE PROCEDURES AND GUIDELINES ESTABLISHED BY THE COMMISSION; AND
(2) MAKE RECOMMENDATIONS TO THE COMMISSION, BASED ON THE RATINGS AWARDED TO PROPOSALS BY THE REVIEWERS, FOR APPROVAL OF APPLICATIONS FROM MEDICAL MARIJUANA COMPASSIONATE USE PROGRAMS.
(C) THE COMMISSION MAY GRANT A ONE-YEAR RENEWABLE LICENSE TO A PROGRAM.
13-3106.
(A) AN ACADEMIC MEDICAL CENTER APPROVED TO OPERATE A PROGRAM UNDER THIS SUBTITLE SHALL PROVIDE UPDATED DATA EACH DAY ON PATIENTS AND
CAREGIVERS PARTICIPATING IN EACH PROGRAM OVERSEEN BY THE ACADEMIC MEDICAL CENTER TO [INSERT STATE ENTITY], WHICH WILL MAKE THE DATA AVAILABLE IN REAL TIME TO LAW ENFORCEMENT.
(B) AN ACADEMIC MEDICAL CENTER OPERATING A PROGRAM APPROVED UNDER THIS SUBTITLE MAY ONLY USE MARIJUANA OBTAINED FROM:
(1) THE FEDERAL GOVERNMENT; OR
(2) A MEDICAL MARIJUANA GROWER LICENSED UNDER THIS SUBTITLE.
(C) IF THE ACADEMIC MEDICAL CENTER UTILIZES CAREGIVERS AS PART OF A PROGRAM APPROVED UNDER THIS SUBTITLE, THE ACADEMIC MEDICAL CENTER SHALL:
(1) LIMIT THE NUMBER OF PATIENTS A CAREGIVER IS ALLOWED TO SERVE TO NO MORE THAN FIVE; AND
(2) LIMIT THE NUMBER OF CAREGIVERS THAT SERVE A PARTICULAR PATIENT TO NO MORE THAN TWO.
(D) AN ACADEMIC MEDICAL CENTER OPERATING A PROGRAM APPROVED UNDER THIS SUBTITLE SHALL REPORT ANNUALLY TO THE COMMISSION, IN THE FORM SPECIFIED BY THE COMMISSION, ON:
(1)THE NUMBER OF PATIENTS SERVED THROUGH THE PROGRAM;
(2) THE COUNTY OF RESIDENCE OF THE PATIENTS SERVED BY THE PROGRAM;
(3) CONDITIONS TREATED UNDER THE PROGRAM;
(4) ANY OUTCOMES DATA ON THE RESULTS OF TREATMENT THROUGH THE PROGRAM; AND
(5)ANY RESEARCH STUDIES CONDUCTED UNDER THE PROGRAM.
(E) AN ACADEMIC MEDICAL CENTER OPERATING A PROGRAM APPROVED UNDER THIS SUBTITLE SHALL APPLY ANNUALLY TO THE COMMISSION FOR RENEWAL OF APPROVAL OF THE PROGRAM, IN ACCORDANCE WITH ANY PROCEDURES ESTABLISHED BY THE COMMISSION.
(F) AN ACADEMIC MEDICAL CENTER OPERATING A PROGRAM APPROVED UNDER THIS SUBTITLE IS SUBJECT TO INSPECTION BY THE COMMISSION TO ENSURE THAT THE PROGRAM IS OPERATING ACCORDING TO THE CONDITIONS OF APPROVAL ESTABLISHED BY THE COMMISSION.
(G) THE COMMISSION MAY RESCIND APPROVAL OF A PROGRAM IF THE COMMISSION FINDS THAT THE PROGRAM IS NOT IN COMPLIANCE WITH THE CONDITIONS OF APPROVAL ESTABLISHED BY THE COMMISSION.
13-3107.
ON OR BEFORE JANUARY 1 OF EACH YEAR, THE COMMISSION SHALL REPORT TO THE GOVERNOR AND, IN ACCORDANCE WITH § 2-1246 OF THE STATE GOVERNMENT ARTICLE, THE GENERAL ASSEMBLY, ON PROGRAMS APPROVED TO OPERATE UNDER THIS SUBTITLE.
13-3108.
(A) THE [INSERT STATE ENTITY] SHALL LICENSE MEDICAL MARIJUANA GROWERS TO OPERATE IN THE STATE TO PROVIDE MARIJUANA TO PROGRAMS APPROVED FOR OPERATION UNDER THIS SUBTITLE.
(B) MARIJUANA GROWN BY AN ENTITY LICENSED UNDER THIS SECTION MAY
PROVIDE MARIJUANA ONLY TO AN ACADEMIC MEDICAL CENTER APPROVED TO OPERATE A PROGRAM UNDER THIS SUBTITLE.
(C) THE [INSERT STATE ENTITY] SHALL ESTABLISH REQUIREMENTS FOR
SECURITY AND MANUFACTURING PROCESS THAT A GROWER MUST MEET IN ORDER TO OBTAIN LICENSURE UNDER THIS SECTION, INCLUDING A REQUIREMENT FOR A PRODUCT TRACKING SYSTEM.
(D) THE [INSERT STATE ENTITY] MAY INSPECT GROWERS LICENSED UNDER THIS SECTION TO ENSURE COMPLIANCE WITH THIS SECTION.
(E) THE [INSERT STATE ENTITY] MAY IMPOSE PENALTIES OR RESCIND THE
LICENSE OF A GROWER THAT DOES NOT MEET THE STANDARDS FOR LICENSURE SET BY THE [INSERT STATE ENTITY].
13-1309.
(A) ANY OF THE FOLLOWING PERSONS ACTING IN ACCORDANCE WITH THE PROVISIONS OF THIS SUBTITLE MAY NOT BE SUBJECT TO ARREST, PROSECUTION, OR ANY CIVIL OR ADMINISTRATIVE PENALTY, INCLUDING CIVIL PENALTY OR DISCIPLINARY ACTION BY A PROFESSIONAL LICENSING BOARD, NOR BE DENIED ANY RIGHT OR PRIVILEGE, FOR THE MEDICAL USE OF MARIJUANA:
(1)A PATIENT ENROLLED IN A PROGRAM APPROVED UNDER THIS
SUBTITLE WHO IS IN POSSESSION OF AN AMOUNT OF MARIJUANA AUTHORIZED UNDER THE PROGRAM;
(2)A GROWER LICENSED UNDER § 13-3108 OF THIS SUBTITLE OR AN
EMPLOYEE OF THE LICENSED GROWER WHO IS ACTING IN ACCORDANCE WITH THE TERMS OF THE LICENSE;
(3) AN ACADEMIC MEDICAL CENTER, AN EMPLOYEE OF THE ACADEMIC MEDICAL CENTER, OR ANY OTHER PERSON ASSOCIATED WITH THE
OPERATION OF A PROGRAM APPROVED UNDER THIS SUBTITLE FOR ACTIVITIES CONDUCTED IN ACCORDANCE WITH THE PROGRAM APPROVED UNDER THIS SUBTITLE.
(B) (1) A PERSON MAY NOT DISTRIBUTE, POSSESS, MANUFACTURE, OR USE MARIJUANA THAT HAS BEEN DIVERTED FROM A PROGRAM APPROVED UNDER THIS SUBTITLE OR FROM A PATIENT WHO IS ENROLLED IN A PROGRAM APPROVED UNDER THIS SUBTITLE.
(2) A PERSON WHO VIOLATES THIS SUBSECTION IS GUILTY OF A FELONY AND ON CONVICTION IS SUBJECT TO IMPRISONMENT NOT EXCEEDING 5 YEARS OR A FINE NOT EXCEEDING $10,000 OR BOTH.
(3) THE PENALTY UNDER THIS SUBSECTION IS IN ADDITION TO ANY PENALTIES THAT A PERSON MAY BE SUBJECT TO FOR MANUFACTURE, POSSESSION, OR DISTRIBUTION OF MARIJUANA UNDER THE CRIMINAL LAW ARTICLE.
13-3010.
(A) THIS SUBTITLE MAY NOT BE CONSTRUED TO AUTHORIZE ANY INDIVIDUAL TO ENGAGE IN THE FOLLOWING, AND IT DOES NOT PREVENT THE IMPOSITION OF ANY CIVIL, CRIMINAL, OR OTHER PENALTIES FOR THE FOLLOWING:
(1) UNDERTAKE ANY TASK UNDER THE INFLUENCE OF MARIJUANA, WHEN DOING SO WOULD CONSTITUTE NEGLIGENCE OR PROFESSIONAL MALPRACTICE;
(2) OPERATE, NAVIGATE, OR BE IN ACTUAL PHYSICAL CONTROL OF ANY MOTOR VEHICLE, AIRCRAFT, OR BOAT WHILE UNDER THE INFLUENCE OF MARIJUANA;
(3) SMOKE MARIJUANA IN ANY PUBLIC PLACE;
(4) SMOKE MARIJUANA IN A MOTOR VEHICLE; OR
(5)SMOKE MARIJUANA ON A PRIVATE PROPERTY THAT:
(I) 1. IS RENTED FROM A LANDLORD; AND
2. IS SUBJECT TO A POLICY THAT PROHIBITS THE SMOKING OF MARIJUANA ON THE PROPERTY; OR
(II) IS SUBJECT TO A POLICY THAT PROHIBITS THE SMOKING OF
MARIJUANA ON THE PROPERTY OF AN ATTACHED DWELLING ADOPTED BY ONE OF THE FOLLOWING ENTITIES:
1. THE BOARD OF DIRECTORS OF THE COUNCIL OF UNIT OWNERS OF A CONDOMINIUM REGIME; OR
2. THE GOVERNING BODY OF A HOMEOWNER’S
ASSOCIATION.
(B) THIS SUBTITLE MAY NOT BE CONSTRUED TO PROVIDE IMMUNITY TO A PERSON WHO VIOLATES THE PROVISIONS OF THIS SUBTITLE FROM CRIMINAL PROSECUTION FOR A VIOLATION OF ANY LAW PROHIBITING OR REGULATING THE USE, POSSESSION, DISPENSING, DISTRIBUTION, OR PROMOTION OF CONTROLLED DANGEROUS SUBSTANCES, DANGEROUS DRUGS, DETRIMENTAL DRUGS, OR HARMFUL DRUGS, OR ANY CONSPIRACY OR ATTEMPT TO COMMIT ANY OF THOSE OFFENSES.
Medical Marijuana Model Program Workgroup
Proposal 2 Medical Marijuana Model Program Workgroup – Proposal 2
Introduction
Senate Bill 308 of 2011 (Chapter 215) required the Secretary of Health and Mental Hygiene to convene a workgroup to develop and assess the feasibility of a State specific proposal for providing access to marijuana to patients in the State for medical purposes. The legislation requires the workgroup to present draft legislation that outlines the key elements of the model program and includes provisions that:
● Provide for oversight and responsibility by programs located in academic medical research institutions in the State;
● Provide for the licensing of a program by the State;
● Establish a program application and review process that includes consideration of best practices and procedures for obtaining review input that is external to the Department of Health and Mental Hygiene;
● Expand the base of information on the use of marijuana for medical purposes on a scientific and policy implementation basis;
● Implement a program as soon as feasible, with the goal of implementation by January 2013. Senate Bill 308 also requires the workgroup to provide guidance on the criteria for assessing program applications, including an applying program’s plans for:
● Determining the medical conditions to be treated and the duration of therapy proposed;
● Identifying sources of marijuana;
● Determining patient eligibility and informed consent;
● Conducting any associated research projects;
● Reporting data and outcomes;
● Instituting strict controls against illegal diversion; and
● Securing grants or other sources of funding to facilitate the affordability of the program. Senate Bill 308 requires the Secretary of Health and Mental Hygiene to report on the findings of the workgroup to the Senate Judicial Proceedings Committee, the House Health and Government Operations Committee, and the House Judiciary Committee. This proposal, Proposal 2, is one of two proposals developed by the workgroup to address the requirements of Senate Bill 308.
Framework
The framework for this approach to marijuana for medical uses includes a recognition that the Maryland General Assembly has determined that patients who find relief from medical marijuana should not be criminalized for doing so. Maryland has removed criminal penalties for patients who prove they have serious medical conditions and that other medications have not provided relief, or for whom side effects from other medications or treatments are too severe. Currently, these patients have no safe means of obtaining marijuana and must instead obtain it from the illegal market or risk a felony criminal conviction by cultivating it. In addition, patients may still be arrested and face a criminal trial. This workgroup was established to create model legislation that includes a means of access for patients. Because of many regulatory hurdles, including those related to marijuana’s status as a “Schedule I” drug, the type of research that would be needed to make marijuana an FDA approved drug has not taken place. The American College of Physicians noted “research expansion has been hindered by a complicated federal approval process [and] limited availability of research grade marijuana.” The American Medical Association and the American College of Physicians do not recommend the use of marijuana, though they support legal protections for physicians who make such recommendations. They have also called for additional research and recognize that marijuana has both potential benefits and potential risks for patients. Other organizations, including the American Academy of HIV Medicine and the American Public Health Association, have positions supporting allowing the medical use of marijuana. The benefits of the medical use of marijuana include the alleviation of certain debilitating symptoms, and the risks include psychiatric and behavioral side effects and dependence. Marijuana has never caused a medically documented fatal overdose. When sufficient research has not been conducted for a medication to receive FDA approval, institutions are sometimes able to make this therapy available to patients in an “investigational use” setting. This has been referred to as “compassionate use.” In its 1999 comprehensive review of marijuana for medical uses, the Institute of Medicine endorsed this type of approach, stating: Short term use of smoked marijuana 1 (less than six months) for patients with debilitating symptoms (such as intractable pain or vomiting) must meet the following conditions:
● Failure of all approved medications to provide relief has been documented;
● The symptoms can reasonably be expected to be relieved by rapid onset cannabinoid drugs;
● Such treatment is administered under medical supervision in a manner that allows for assessment of treatment effectiveness; and
● Involves an oversight strategy comparable to an institutional review board process that could provide guidance within 24 hours of a submission by a physician to provide marijuana to a patient for a specified use.2
Recommendations
The workgroup members that have signed on to this proposal have made recommendations in four areas: process, science, diversion, and other.
1 The Institute of Medicine called for the creation of rapid onset delivery methods other than smoking. Since the Institute’s report, smokeless vaporizers have been developed, allowing marijuana to be heated just below the point of combustion. Clinical research has shown vaporizers to be a safe method of administration. The Institute of Medicine report found that, “except for the harms associated with smoking, the adverse effects of marijuana use are within the range of effects tolerated for other medications.” 2 Institute of Medicine, “Marijuana and Medicine: Assessing the Science Base,” Washington, D.C.: Institute of Medicine, 1999.
Table 1: Process Recommendations Recommendation Comments
1 Marijuana for medical uses may be dispensed to
patients who have been certified by a physician
who has received training from and been certified
by an independent oversight commission. The
marijuana will be supplied by dispensaries or
pharmacies registered with the independent
commission. This allows patients to go to their own
physicians for clinical care, while
ensuring that physicians have
appropriate training and oversight. It
avoids requiring physicians and
academic medical centers to break
federal law by possessing or distributing
marijuana.
2 Academic medical centers may register with the
state to conduct clinical research involving human
subjects with marijuana.
3 An independent commission should be established
to provide oversight, including developing a
training program for physicians and an application
process for physicians, academic medical centers,
growers, dispensaries, and pharmacies that wish to
participate, consistent with the other
recommended requirements of this report. This independent commission should be
established along the lines of dozens of
existing independent agencies in
Maryland, including the Stadium
Authority, Lottery Agency, Handgun
Roster Board, and Maryland Institute for
Emergency Medical Services Systems.
The commission should have one or
more paid staff, and a member of the
AG’s office should provide legal advice to
the commission. Membership to the
commission could be similar to the
membership of the medical marijuana
workgroup to ensure input from a multi
disciplinary team that includes law
enforcement, medical professionals,
researchers, patients, and relevant state
agencies.
4 The costs of oversight shall be funded by one or
more of the following: grants; registration fees paid
by growers, dispensaries, and participating
pharmacies; fees paid by participating academic
medical centers and physicians; and fees paid by
individual patients. The initial application fee and
annual renewal fees will be regulated by the entity
responsible for oversight of the program. State funds for new programs are
limited, and the regulation of medical
marijuana programs must be cost
neutral to the State.
5 The oversight entity will arrange for expert review
of all applications. If qualified experts are not on
the oversight entity, the application may be sent to
a separate panel of experts convened by the
oversight entity. This will include a risk/benefit
analysis with regards to the medical condition to
be treated, if the symptom or condition is not one
of those specifically enumerated in the legislation, Experts will submit application reviews
to the independent commission for
consideration in making a final decision
on the application.
Recommendation Comments
patient inclusion/monitoring, data collection and
reporting, and diversion monitoring.
6 The independent commission will establish a
program to monitor compliance among physicians
and academic medical centers participating in the
state medical marijuana program. The independent commission will assess
compliance with state regulations
regarding the compassionate use
program in addition to program specific
requirements outlined in the initial
application.
7 There should be an annual review of registrations
issued to physicians, academic medical research
institutions, growers, dispensaries, and approved
pharmacies. This review should not be pro forma.
Continued approval of academic medical
centers should be based on meeting the
goals for the application and providing
all appropriate data. Continued approval
of physicians should include ensuring
that the conditions for which patients
are receiving recommendations are
within their clinical practice areas.
8 There should be an annual report by each
physician and each academic medical research
institution licensed for medical marijuana
programs, as well as a public report. Annual reports should include
information on the number of patients
served, the county of residence of the
patients, the conditions treated,
outcome data, and, for academic
research programs, any research studies
conducted under the medical marijuana
program.
Table 2: Recommendations for the Scientific Components of Applications from Certifying Physicians and Academic Medical Research Institutions for a Medical Marijuana Program Recommendation Comments
1 The applications should specify the medical
conditions to be treated. These conditions should
include:
1) conditions that result in the patient being
admitted into hospice or receiving palliative care;
2) a chronic or debilitating disease or medical
condition or the treatment of a chronic or
debilitating disease or medical condition that
produces one or more of the following: cachexia,
anorexia, or wasting syndrome, severe or chronic
pain, severe nausea, seizures, or severe and
persistent muscle spasms.
Conditions not listed above will be considered if
they are included in the application and
symptoms can reasonably be expected to be
relieved by rapid onset cannabinoid drugs. In
each case, the physician should believe
recognized drugs or treatments would not be
effective, or other treatment options would have
more serious side effects or a greater risk of
addiction.
Physicians should document relevant information
in the medical record. The goal of the program is to
provide qualifying patients with
access. These are the conditions
approved for an affirmative defense
in SB 308 and which the science
workgroup considered appropriate.
2 The application should specify the criteria by
which the certifying physician or academic
medical center will include and exclude patients
from participation in the program. This is a standard part of an
investigational use program.
3 The application should specify how patients
would be assessed for addiction before and after
certification to participate in the program. A history of problematic substance
use should not exclude a
prospective patient from
participating in the program using
appropriate medical need
consideration. Evaluation of
addiction before enrollment and the
emergence of new drug use
problems following enrollment will
be important in assessing
risk/benefits of participation to the
patient.
4 The application should specify the proposed
length of certifications and provide a detailed
plan for ongoing evaluation for each medical
condition approved within an academic medical
center. This is a standard part of an
investigational use program.
Recommendation Comments
5 In the case of applications by academic medical
centers, the applications must list individual
medical providers participating within each
academic medical center and must detail training
and/or certifications required for participation.
6 Any application that includes the conduct of
clinical research must include a letter of approval
from the institutional review board (IRB)
affiliated with the academic medical center or an
accredited independent IRB for each study to be
conducted. This is a standard part of an
investigational use program.
7 The application should describe the plan for
defining and monitoring the success or failure of
treatment. This is a standard part of an
investigational use program and is
important for clinical care.
8 The application should include a plan for
monitoring aggregate data and outcomes and, in
the case of academic medical centers, conducting
clinical research, publishing results, as
appropriate. This will allow for others to learn
about the outcomes of the program.
Recommendation Comments
1 Growers’, dispensaries’, and participating
pharmacies’ applications should describe steps to be
taken to prevent and monitor for drug diversion. This will allow the independent
commission to assure compliance
with an anti diversion program.
2 The application should describe how the program
would address violations of the diversion policy. This will ensure that there are
consequences within the program
for both employees of the growers
and dispensaries and patients for
diversion.
3 Medical providers, pharmacies, and growers
responsible for diversion must be dropped from the
program immediately and reported to law
enforcement for violations of program provisions.
Law enforcement cannot be contacted by providers
who suspect them of diversion due to patient
confidentiality (HIPAA) regulations. Patients who are
arrested or convicted of diversion related activities
while in the program should be dropped from the
program and, if possible, have notation in the Drug
Monitoring Program Database. Providers/patients
can appeal to the oversight institution for re
admission to the program.
4 The maximum amount of marijuana that can be
dispensed to a patient will be determined
legislatively or by the commission. Unlike other medications,
physicians may not recommend
dosage for marijuana. In addition,
there are advantages to allowing
patients to self titrate. The
Canadian government approved
prescribing information for Sativex,
the natural marijuana extract now
sold by prescription in Canada,
gives patients complete freedom to
adjust their dose as needed. The
official pamphlet provided to
patients specifies: “The dose you
require is determined by you. You
can determine the dose that best
suits you according to the pain
relief you experience.”
5 The independent commission would craft regulations
for growers and dispensaries regarding security,
transportation, permissible locations, and labeling
and testing to ensure consistency of the strain(s). All
marijuana should be grown indoors with 24 7
security. Oversight regulations would be crafted in
consultation with state agencies. Consistent and clear statewide
regulations will give a clear
mandate for maintaining safety to
the independent commission.
Table 3: Recommendations for the Diversion Components of Applications from Academic Medical Research Institutions, Physicians, Growers, and Providers for a Medical Marijuana Program
Table 4: Other Recommendations Recommendation Comments
1 Marijuana growers must apply and be
separately registered by the State of Maryland
prior to engaging in the enterprise of
cultivating medical marijuana. The registration process should
focus on good manufacturing
practices and security. If a grower
is not registered, then its products
may not be used in a program in
the state, and they are subject to
enforcement of state laws against
marijuana cultivation.
2 Patients who are participating in the program
should be registered in a central database by
the state or the oversight agency. Patients
enrolled in the program will be provided an
identification card that allows police to verify
their participation in the program, but which
does not compromise the confidentiality of
other patients in the program. Law enforcement should not have
full access to the database
(violation of patient
confidentiality). Law enforcement
can use a unique patient identifier
(provided on ID card) to receive
verification of name, address, and
current program status for the
patient associated with that
specific ID.
3 There should be additional state penalties for
gross misuse of a marijuana program for
diversion purposes.
4 Caregivers would be subject to a criminal
background check and would be allowed to
assist no more than five patients. Caregivers
would be able to pick up the medical marijuana
for patients and to assist patients with the act
of administering marijuana or preparing it for
administration.
5 Any surplus raised by the medical marijuana
oversight program could be apportioned for
studies related to the medical marijuana
program or to clinical trials, with any excess
then going to the state’s general fund. In other states, medical marijuana
programs have generated
substantial surpluses. For example,
Michigan generated $4.4 million
through its ID program in FY 2010
and spent only $740,658 on the
program in FY 2010.
Workgroup Members Signing on to Proposal 2
The following members of the workgroup signed on to Proposal 2:
● Lynn Billing
● Senator David Brinkley
● Dario Broccolino
● Philip Cogan
● Delegate Kathleen Dumais
● Deborah Miran
● Delegate Dan Morhaim
● Karen O’Keefe
● Senator Jamie Raskin
● Dr. Ryan Vandrey
Model Legislation to Implement Proposal 2
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, THAT SECTION(S) 5403(D), (E), AND (F), RESPECTIVELY, OF ARTICLE — CRIMINAL LAW OF THE ANNOTATED CODE OF MARYLAND BE RENUMBERED TO BE SECTION(S) 5-403(E), (F), AND (G), RESPECTIVELY.
SECTION 2. AND BE IT FURTHER ENACTED, THAT THE LAWS OF MARYLAND READ AS FOLLOWS:
ARTICLE — CRIMINAL LAW
SECTION 5-402
(D) (1) A MATERIAL, COMPOUND, MIXTURE, OR PREPARATION THAT CONTAINS ANY OF THE FOLLOWING HALLUCINOGENIC OR HALLUCINOGENIC-LIKE SUBSTANCES IS A SUBSTANCE LISTED IN SCHEDULE I:
(I) BUFOTENINE;
(II) DIETHYLTRYPTAMINE;
(III) DIMETHYLTRYPTAMINE;
(IV) 4-METHYL-2, 5-DIMETHOXYAMPHETAMINE;
(V) IBOGAINE;
(VI) LYSERGIC ACID DIETHYLAMIDE;
[(VII) MARIJUANA;]
[(VIII)] (VII) MESCALINE;
[(IX)] (VIII) PEYOTE;
[(X)] (IX) PSILOCYBIN;
[(XI)] (X) PSILOCYN;
[(XII)] (XI) TETRAHYDROCANNABINOL;
[(XIII)] (XII) THIOPHENE ANALOG OF PHENCYCLIDINE;
[(XIV)] (XIII) 2, 5-DIMETHOXYAMPHETAMINE;
[(XV)] (XIV) 4-BROMO-2, 5-DIMETHOXYAMPHETAMINE;
[(XVI)] (XV) 4-METHOXYAMPHETAMINE;
[(XVII)] (XVI) 3, 4-METHYLENEDIOXYAMPHETAMINE;
[(XVIII)] (XVII) 3, 4-METHYLENEDIOXYMETHAMPHETAMINE (MDMA);
[(XIX)] (XVIII) 5-METHOXY-3, 4-METHYLENEDIOXYAMPHETAMINE;
3, 4, 5-TRIMETHOXYAMPHETAMINE;
[(XX)] (XIX)
N-METHYL-3-PIPERIDYL BENZILATE;
[(XXI)] (XX)
[(XXII)] (XXI) N-ETHYL-3-PIPERIDYL BENZILATE;
[(XXIII)] (XXII) N-ETHYL-1-PHENYLCYCLOHEXYLAMINE;
[(XXIV)] (XXIII) 1-(1-PHENYLCYCLOHEXYL)-PYRROLIDINE;
[(XXV)] (XXIV) 1-(1-(2-THIENYL)-CYCLOHEXYL)-PIPERIDINE;
[(XXVI)] (XXV) 1-METHYL-4-PHENYL-4-PROPIONOXYPIPERIDINE (MPPP); AND [(XXVII)](XXVI) 1-(2-PHENYLETHYL)-4-PHENYL-4-ACETYLOXYPIPERIDINE (PEPAP).
5-403.
(D) A MATERIAL, COMPOUND, MIXTURE, OR PREPARATION THAT CONTAINS MARIJUANA IS A SUBSTANCE LISTED IN SCHEDULE II.
5-611.
(A) A PERSON WHO IS EMPLOYED BY A DISPENSING PHARMACY OR A DISPENSING CENTER REGISTERED WITH THE MEDICAL MARIJUANA OVERSIGHT COMMISSION UNDER TITLE 13, SUBTITLE 30 OF THE HEALTH – GENERAL ARTICLE MAY NOT DISTRIBUTE OR DISPENSE
MARIJUANA EXCEPT TO A REGISTERED QUALIFYING PATIENT OR A REGISTERED PRIMARY CAREGIVER.
(B) A PERSON WHO IS REGISTERED WITH THE COMMISSION AS A QUALIFYING PATIENT OR A PATIENT’S PRIMARY CAREGIVER UNDER TITLE 13, SUBTITLE 30 OF THE HEALTH – GENERAL ARTICLE MAY NOT DISTRIBUTE OR DISPENSE MARIJUANA TO ANOTHER PERSON WHO IS NOT A REGISTERED QUALIFYING PATIENT.
(C) A REGISTERED ACADEMIC MEDICAL CENTER REGISTERED UNDER TITLE 13, SUBTITLE 30 OF THE HEALTH — GENERAL ARTICLE OR A CERTIFYING PHYSICIAN UNDER TITLE 13, SUBTITLE 30 OF THE HEALTH — GENERAL ARTICLE MAY NOT DISTRIBUTE OR DISPENSE
MARIJUANA TO ANOTHER PERSON WHO IS NOT A REGISTERED QUALIFYING PATIENT OR A REGISTERED PRIMARY CAREGIVER.
(D) A PERSON WHO VIOLATES SUBSECTION (A) OR (B) OF THIS SECTION IS GUILTY OF A FELONY AND ON CONVICTION IS SUBJECT TO IMPRISONMENT NOT EXCEEDING SEVEN (7) YEARS OR A FINE NOT EXCEEDING $7,000, OR BOTH.
ARTICLE—HEALTH—GENERAL SUBTITLE30.MEDICALMARIJUANA.
13-3001.
(A)IN THIS SUBTITLE THE FOLLOWING WORDS HAVE THE MEANINGS INDICATED.
(B) “BONA FIDE PHYSICIAN-PATIENT RELATIONSHIP” MEANS A RELATIONSHIP IN WHICH THE PHYSICIAN HAS ONGOING RESPONSIBILITY FOR THE ASSESSMENT, CARE, AND TREATMENT OF A PATIENT’S MEDICAL CONDITION.
(C) “CERTIFYING PHYSICIAN” MEANS AN INDIVIDUAL LICENSED BY THE STATE BOARD OF PHYSICIANS UNDER TITLE 14 OF THE HEALTH OCCUPATIONS ARTICLE TO PRACTICE MEDICINE WHO:
(1) HAS COMPLETED A TRAINING COURSE DESIGNED BY THE MEDICAL MARIJUANA OVERSIGHT COMMISSION AND HAS BEEN APPROVED BY THE COMMISSION; OR
(2) HAS COMPLETED TRAINING WITH A REGISTERED ACADEMIC MEDICAL CENTER AND IS CERTIFYING PATIENTS UNDER THE AUSPICESOF A REGISTERED ACADEMIC MEDICAL CENTER.
(D) “DISPENSING CENTER” MEANS AN ENTITY REGISTERED UNDER THIS SUBTITLE THAT ACQUIRES, POSSESSES, DELIVERS, TRANSFERS, TRANSPORTS, SUPPLIES, SELLS, OR DISPENSES MARIJUANA OR RELATED SUPPLIES AND EDUCATION MATERIALS.
(E) “DISPENSING PHARMACY” MEANS A PHARMACY REGISTERED UNDER THIS SUBTITLE THAT ACQUIRES, POSSESSES, DELIVERS, TRANSFERS, TRANSPORTS, SELLS, SUPPLIES, OR DISPENSES MARIJUANA OR RELATED SUPPLIES AND EDUCATIONAL MATERIALS.
(F) “MARIJUANA” HAS THE MEANING STATED IN § 5-101 OF THE CRIMINAL LAW ARTICLE.
(G) “MEDICAL MARIJUANA OVERSIGHT COMMISSION” OR “COMMISSION” MEANS AN
INDEPENDENT COMMISSION APPOINTED BY THE GOVERNOR TO REGISTER AND REGULATE ACADEMIC MEDICAL CENTERS, CERTIFYING PHYSICIANS, GROWERS, DISPENSING CENTERS, AND DISPENSING PHARMACIES.
(H) “MEDICAL USE” MEANS THE ACQUISITION, POSSESSION, CULTIVATION, MANUFACTURE, USE, DELIVERY, SALE, TRANSFER, OR TRANSPORTATION OF MARIJUANA OR
PARAPHERNALIA RELATING TO THE ADMINISTRATION OF MARIJUANA TO TREAT OR ALLEVIATE A REGISTERED PATIENT’S CONDITION OR SYMPTOMS.
(1) (1) “PRIMARY CAREGIVER” MEANS A RESIDENT OF THE STATE WHO:
(I) IS AT LEAST 18 YEARS OLD;
(II) HAS AGREED TO ASSIST WITH NO MORE THAN FIVE QUALIFYING PATIENTS’ MEDICAL USE OF MARIJUANA;
(III) HAS BEEN DESIGNATED AS PRIMARY CAREGIVER ON THE QUALIFYING PATIENT’S
APPLICATION OR RENEWAL FOR A REGISTRY IDENTIFICATION CARD FOR THE PRIMARY CAREGIVER; AND
(IV)HAS SATISFIED THE CRIMINALHISTORY RECORDS CHECK REQUIRED UNDER §133008 OF THISSUBTITLE.
(2)“PRIMARY CAREGIVER” DOES NOT INCLUDE THE QUALIFYING PATIENT’S CERTIFYING PHYSICIAN.
(J)“QUALIFYING PATIENT”MEANS A RESIDENT OF THE STATE WHO:
(1) IS ATLEAST 18 YEARS OLD, UNLESS THE COMMISSION GRANTS AN EXCEPTION AT THE RECOMMENDATIONOF THE PATIENT’S CERTIFYING PHYSICIAN; AND
(2) HAS BEEN PROVIDED WITH WRITTEN CERTIFICATION BYA CERTIFYING PHYSICIAN PURSUANT TO A BONA FIDE PHYSICIAN-PATIENT RELATIONSHIP; OR
(3) IS ENROLLED IN A RESEARCH PROGRAM WITHA REGISTERED ACADEMIC MEDICAL CENTER.
(K)“REGISTERED GROWER” MEANS AN ENTITY THAT:
(1) IS REGISTERED BY THE COMMISSION UNDER THIS SUBTITLE TO BEEXEMPT FROM STATE AND LOCAL PENALTIES FOR CULTIVATINGMARIJUANA IN ACCORDANCE WITHTHIS ACT;
AND
(2) IS EXEMPT FROM STATE AND LOCAL PENALTIES FORTRANSFERRING MARIJUANA CULTIVATED BY THE ENTITY TO A DISPENSING PHARMACY ORTO A DISPENSING CENTERFOR A FEE.
(L)(1)“REGISTERED ACADEMIC MEDICAL CENTER” MEANS A PROGRAM APPROVEDBY THE COMMISSION TO CONDUCT RESEARCHREGARDING THE MEDICAL USE OF MARIJUANA BY HUMANS.
(2)A REGISTERED ACADEMIC MEDICAL CENTER MUST:
(I)OPERATE A MEDICALRESIDENCY PROGRAM FORPHYSICIANS; AND
(II)CONDUCT RESEARCHTHAT ISOVERSEEN BY THE FEDERAL DEPARTMENT OF HEALTH AND HUMAN SERVICES AND THAT INVOLVES HUMAN SUBJECTS.
(M)“REGISTRY IDENTIFICATION CARD” MEANS A DOCUMENT ISSUED BYTHE COMMISSION THAT IDENTIFIES AN INDIVIDUAL AS A QUALIFYING PATIENT OR PRIMARY CAREGIVER.
(N)(1)“USABLE MARIJUANA”MEANS THEDRIED LEAVES AND FLOWERSOFMARIJUANA AND ANY MIXTURE OR PREPARATION OFTHE DRIED LEAVES AND FLOWERS.
(2)“USABLE MARIJUANA” DOES NOT INCLUDE THE SEEDS, STALKS, OR ROOTS OF THE
PLANT.
(O)“WRITTEN CERTIFICATION” MEANS A CERTIFICATION ISSUED BYA CERTIFYING PHYSICIAN TO A QUALIFYING PATIENT WITH WHOM THE PHYSICIAN HAS A BONA FIDE PHYSICIAN-PATIENT RELATIONSHIPTHATINCLUDES A STATEMENTCERTIFYING THAT:
(1)IN THE PHYSICIAN’S PROFESSIONALOPINION, AFTER HAVING COMPLETED A FULL ASSESSMENT OF THE PATIENT’S MEDICALHISTORY AND CURRENT MEDICAL CONDITION, THE
PATIENTHAS A CONDITION WHICH MEETS THE INCLUSION CRITERIA ANDDOES NOT MEETTHE EXCLUSIONCRITERIA OFTHE CERTIFYING PHYSICIAN’S APPLICATION, AND FOR WHICH:
(I)RECOGNIZED DRUGS OR TREATMENT WOULDNOT BE EFFECTIVE; OR
(II)OTHER TREATMENTOPTIONS HAVEMORESERIOUS SIDE EFFECTSOR A GREATER RISK OFADDICTION; AND
(III)THE POTENTIAL BENEFITS OFTHE MEDICAL USE OF MARIJUANA WOULDLIKELY OUTWEIGH THE HEALTH RISKS FOR THE PATIENT.
13-3002.
(A)THERE IS AMEDICALMARIJUANA OVERSIGHTCOMMISSION.
(B)THE COMMISSION IS AN INDEPENDENT COMMISSION THAT FUNCTIONS WITHIN THE DEPARTMENT OFHEALTH ANDMENTAL HYGIENE.
(C)(1)THE COMMISSION CONSISTSOF15 MEMBERS,WHICH SHALL INCLUDE BROADBASED REPRESENTATIVES OF ALLSTAKEHOLDERS.
(2)THE COMMISSION SHALL INCLUDE:
(I) TWO MEMBERS OF THE SENATE OF MARYLAND,APPOINTEDBY THE PRESIDENT OF THE SENATE;
(II) TWO MEMBERS OF THE HOUSE OFDELEGATES, APPOINTED BY THESPEAKER OF THE HOUSE;
(III) THESECRETARY OFHEALTH AND MENTAL HYGIENE, ORTHESECRETARY’S DESIGNEE, WHO SHALL SERVE EXOFFICIO; AND
(IV)10 MEMBERS, APPOINTED BY THE GOVERNOR, INCLUDING THE FOLLOWING MEMBERS:
(1) ONE MEMBER OFTHE PUBLIC WHO SUPPORTS THE USE OF MARIJUANA FOR MEDICAL PURPOSESAND WHO ISOR WAS APATIENT WHOFOUND RELIEF FROM MEDICAL MARIJUANA;
(2) TWO PHYSICIANSLICENSED IN THESTATE;
(3) ONE NURSE LICENSED IN THE STATE;
(4) ONE PHARMACIST LICENSED INTHE STATE:
(5) ONE SCIENTIST WHO HAS CONDUCTED GRANT-FUNDED RESEARCH;
(6) TWO MEMBERS WITHEXPERIENCE IN LAW ENFORCEMENT; AND
(7) AN ATTORNEY WHO IS KNOWLEDGEABLE ABOUT MEDICAL MARIJUANA LAWS IN THE UNITED STATES.
(D)THE TERM OF A MEMBER ISFOUR YEARS.
(E)THE TERMS OFTHE APPOINTED MEMBERS ARE STAGGERED AS REQUIRED BY THE TERMSPROVIDED FOR MEMBERS ONOCTOBER1,2012.
(F)AMEMBER WHO SERVES TWO CONSECUTIVE FULL FOUR-YEAR TERMS MAY NOT BE REAPPOINTED FOR FOUR YEARS AFTER COMPLETIONOFTHOSE TERMS.
(G)A MEMBER WHO ISAPPOINTED AFTER A TERM HAS BEGUN SERVES ONLY FORTHE REST OF THETERM AND UNTILA SUCCESSOR ISAPPOINTED AND QUALIFIES.
(H)ANNUALLY, FROM AMONG THE MEMBERS OFTHE COMMISSION: (1)THE GOVERNOR SHALL APPOINT A CHAIRMAN; AND (2)THE CHAIRMAN SHALL APPOINT A VICE CHAIRMAN. (I)A MEMBER OFTHE COMMISSION:
(1)MAY NOT RECEIVE COMPENSATION AS A MEMBER OFTHECOMMISSION; BUT
(2)IS ENTITLED TO REIMBURSEMENTFOR EXPENSES UNDER THE STANDARD STATE TRAVEL REGULATIONS, AS PROVIDED IN THESTATE BUDGET.
(J)(1)THE COMMISSION MAY EMPLOY A STAFF, INCLUDING CONTRACTUAL STAFF, IN ACCORDANCE WITH THE STATE BUDGET OR FUNDED DIRECTLY BY APPLICATION AND REGISTRATION FEES AND GRANTS TO THE COMMISSION.
(2)THE COMMISSION, IN CONSULTATION WITHTHE SECRETARY, SHALL DETERMINE THE APPROPRIATE JOB CLASSIFICATIONS AND GRADES FOR ALL STAFF.
(K)THECOMMISSION SHALL CONSULT WITH EXPERTS IN PERFORMING ITS DUTIES.
(L) THE COMMISSION SHALL MEETAT LEAST SIXTIMESAYEAR, AT THETIMESAND PLACESTHAT IT DETERMINES.
13-3003.
(A)IN ADDITION TO THEPOWERS SET FORTH ELSEWHERE IN THIS SUBTITLE, THE COMMISSION MAY:
(1)ADOPT RULES AND REGULATIONS TOCARRY OUT THE PROVISIONSOF THIS SUBTITLE;
(2)CREATE SUBCOMMITTEES FROM AMONG ITS MEMBERS;
(3)APPOINT ADVISORY COMMISSIONS, WHICHMAY INCLUDE INDIVIDUALS AND REPRESENTATIVES OF INTERESTED PUBLIC ORPRIVATE ORGANIZATIONS;
(4)APPLY FOR AND ACCEPTANY FUNDS, PROPERTY, OR SERVICES FROM ANY PERSON OR GOVERNMENT AGENCY;
(5)MAKE AGREEMENTS WITHA GRANTOR OR PAYER OFFUNDS, PROPERTY, OR SERVICES;
(6)PUBLISH AND DISSEMINATE ANY INFORMATION THATRELATES TO THE MEDICAL USE OF MARIJUANA AND RELATED RESEARCH; AND
(7)SUBJECT TO THE LIMITATIONS OF THIS SUBTITLE,EXERCISE ANY OTHER POWER THAT IS REASONABLY NECESSARY TO CARRY OUTTHE PURPOSES OFTHIS SUBTITLE.
(B)IN ADDITION TO THE DUTIES SET FORTH ELSEWHERE INTHIS SUBTITLE, THE COMMISSION SHALL:
(1)ADOPT RULES AND REGULATIONS THAT RELATETO ITS MEETINGS, MINUTES, AND TRANSACTIONS;
(2)KEEP MINUTES OFEACH MEETING;
(3)PREPARE ANNUALLYA BUDGETPROPOSAL THAT INCLUDES THE ESTIMATED INCOME OFTHE COMMISSION AND PROPOSED EXPENSES FOR ITS ADMINISTRATION AND OPERATION; AND
(4)PREPAREFROMTHE INFORMATION FILED WITH THECOMMISSION ANYSUMMARY, COMPILATION, OR OTHERSUPPLEMENTARYREPORT THAT WILL ADVANCETHEPURPOSES OF THIS SUBTITLE.
(C) (1)THE COMMISSION MAY CONTRACT WITHA QUALIFIED, INDEPENDENT THIRD PARTY FOR ANYSERVICE NECESSARY TOCARRY OUT THE POWERS ANDDUTIES OF THE COMMISSION.
(2)UNLESS PERMISSION IS GRANTED SPECIFICALLY BY THECOMMISSION, A THIRD PARTY HIRED BY THE COMMISSIONMAY NOT RELEASE, PUBLISH, OR OTHERWISE USE ANY INFORMATION TO WHICHTHE THIRD PARTY HAS ACCESS UNDER ITS CONTRACT.
(D)(1)ON OR BEFORE SEPTEMBER 1,2012, THECOMMISSION SHALL ADOPT REGULATIONS TOIMPLEMENT THISSUBTITLE.
(2)THE COMMISSION MAY SUSPEND OR REVOKE THE REGISTRATIONS OFACADEMIC MEDICAL CENTERS, DISPENSING CENTERS, DISPENSING PHARMACIES, PHYSICIANS, AND
REGISTERED GROWERSTHAT COMMIT ANY VIOLATIONS OFTHIS ACT ORREGULATIONS ISSUED
PURSUANT TO THE ACT.
(E)DISPENSING CENTERS, REGISTERED GROWERS, AND REGISTERED PHARMACIESARE SUBJECT TO INSPECTION BY THE COMMISSION.
(F)THECOMMISSION SHALL ADVANCE THE DEVELOPMENT OF SCIENTIFIC INFORMATION RELATED TO THE MEDICAL USE OF MARIJUANA.
(G)COMMISSION REGULATIONS SHALL NOT REQUIRE REGISTERED ACADEMIC MEDICAL CENTERS OR PHYSICIANS TO:
(I)DESIGNATE DISPENSING CENTERS OR DISPENSING PHARMACIESFOR PATIENTS; (II)POSSESS, CULTIVATE, OR DISTRIBUTE MARIJUANA; OR
(III)HAVEANY CONTROL OVERTHE POSSESSION, CULTIVATION, OR DISTRIBUTION OF MARIJUANA.
13-3004.
(A) THE COMMISSION SHALL CONSULT WITH EXPERTS, INCLUDING ACADEMICS AND MEDICAL PROFESSIONALS, AND ESTABLISH A TRAINING PROGRAM FOR PHYSICIANS WISHING TO BECOME CERTIFYING PHYSICIANS.
(B) THE COMMISSION SHALL SET A REASONABLE FEE FOR PROCESSING PHYSICIAN APPLICATIONS AND FOR THE TRAINING PROGRAM FOR PHYSICIANS.
(C) (1) THE COMMISSION SHALL APPROVE CERTIFYING PHYSICIANS THAT MEET THE REQUIREMENTS OF THIS SUBTITLE, COMPLETE THE TRAINING PROGRAM, AND SUBMIT SATISFACTORY APPLICATION MATERIALS.
(2) EACH PHYSICIAN CERTIFICATION MUST BE RENEWED ANNUALLY.
(D) A PHYSICIAN’S PROPOSAL MUST INCLUDE:
(1) THE CRITERIA BY WHICH PATIENTS WILL BE INCLUDED IN THE PROGRAM, INCLUDING QUALIFYING MEDICAL CONDITIONS;
(2) THE CRITERIA BY WHICH THE PHYSICIAN WILL EXCLUDE PATIENTS FROM THE PROGRAM;
(3) THE PHYSICIAN’S PLAN FOR SCREENING PATIENTS FOR DEPENDENCE, BOTH BEFORE AND AFTER THE QUALIFYING PATIENT IS ISSUED A WRITTEN CERTIFICATION; AND
(4) THE PHYSICIAN’S PLAN FOR THE ONGOING ASSESSMENT AND FOLLOW-UP CARE FOR PATIENTS AND THE COLLECTION OF DATA.
(E) PROVIDED TREATING A GIVEN MEDICAL CONDITIONS FALLS WITHIN A PHYSICIAN’S CLINICAL PRACTICE AREA, THE COMMISSION IS ENCOURAGED TO APPROVE APPLICATIONS FOR THE FOLLOWING MEDICAL CONDITIONS:
(1)A CHRONIC OR DEBILITATING DISEASE OR MEDICAL CONDITION THAT RESULTEDIN THE PATIENT BEING ADMITTED INTO HOSPICE OR RECEIVING PALLIATIVE CARE; AND
(2)A CHRONIC OR DEBILITATING DISEASE ORMEDICAL CONDITION OR THE TREATMENT OF
A CHRONIC OR DEBILITATING DISEASE OR MEDICALCONDITION THAT PRODUCES ONE OR MORE OF THE FOLLOWING: CACHEXIA, ANOREXIA,OR WASTING SYNDROME, SEVERE OR CHRONIC PAIN, SEVERE NAUSEA, SEIZURES, OR SEVERE AND PERSISTENT MUSCLE SPASMS.
(3)THE COMMISSION MAY APPROVE APPLICATIONSTHAT INCLUDEANY OTHER CONDITION THAT IS SEVERE AND RESISTANTTOCONVENTIONAL MEDICINE PROVIDED THAT:
(I) FAILURE OF APPROVED MEDICATIONS TO PROVIDE RELIEF HAS BEEN DOCUMENTED; AND
(II) THE SYMPTOMS CAN REASONABLY BE EXPECTED TO BE RELIEVED BY THE MEDICAL USE OF MARIJUANA.
(F) CERTIFYING PHYSICIANS SHALL BE PROTECTED FROM CIVIL AND CRIMINAL PENALTIES UNDER STATE AND LOCAL LAWS FOR THE ACTIVITIES ALLOWED BY THIS SUBTITLE, INCLUDING ISSUING WRITTEN CERTIFICATIONS AND COLLECTING AND ANALYZING DATA.
(G) (1) EACH YEAR, NO LATER THAN 60 DAYS BEFORE ITS REGISTRATION EXPIRES, EACH CERTIFYING PHYSICIAN SHALL SUBMIT AN ANNUAL REPORT TO THE COMMISSION.
(2) ANNUAL REPORTS SHOULD INCLUDE INFORMATION ON THE NUMBER OF PATIENTS SERVED, THE COUNTY OR COUNTIES OF RESIDENCE, THE MEDICAL CONDITION(S) FOR WHICH MEDICAL MARIJUANA WAS RECOMMENDED, AND A SUMMARY OF CLINICAL OUTCOMES SHOULD BE PROVIDED, INCLUDING A SUMMARY OF ADVERSE EVENTS AND A SUMMARY OF ANY CASES OF SUSPECTED DIVERSION.
(3) ANNUAL REPORTS MAY NOT INCLUDE ANY PERSONALLY IDENTIFIABLE INFORMATION ABOUT PATIENTS.
(H) CERTIFYING PHYSICIANS MAY APPLY FOR RENEWED REGISTRATIONS ANNUALLY. THE COMMISSION SHALL GRANT OR DENY A REGISTRATION BASED ON THE CERTIFYING PHYSICIAN’S PERFORMANCE, INCLUDING WHETHER HE OR SHE IS PROVIDING CERTIFICATIONS FOR MEDICAL CONDITIONS WITHIN HIS OR HER PRACTICE AREA.
13-3005
(A) THE COMMISSION SHALL SET A REASONABLE FEE FOR PROCESSING ACADEMIC MEDICAL CENTER APPLICATIONS.
(B) (1) THE COMMISSION SHALL APPROVE ACADEMIC MEDICAL CENTERS THAT MEET THE REQUIREMENTS OF THIS SUBTITLE AND SUBMIT SATISFACTORY PROPOSALS.
(2) EACH REGISTERED ACADEMIC MEDICAL CENTER REGISTRATION EXPIRES AFTER ONE YEAR, UNLESS IT IS RENEWED.
(C)AN ACADEMIC MEDICAL CENTER’S PROPOSAL MUST INCLUDE:
(1)A LIST OF MEDICALPROVIDERS WHO INTEND TOPARTICIPATEINTHE PROGRAM, AND THEIR QUALIFICATIONS FOR PARTICIPATION, INCLUDING THEIR PROFESSIONAL CREDENTIALS AND TRAINING SPECIFIC TOTHE MEDICAL USE OF MARIJUANA;
(2)THE CRITERIA BY WHICH THE ACADEMIC MEDICAL CENTERS WILLINCLUDE PATIENTS IN THE PROGRAM, INCLUDING QUALIFYING MEDICAL CONDITIONS;
(3)THE CRITERIA BY WHICH THEACADEMIC MEDICAL CENTERS WILLEXCLUDEPATIENTS FROM THE PROGRAM;
(4)THE ACADEMIC MEDICAL CENTER’S PLAN FOR SCREENING PATIENTSFOR DEPENDENCE, BOTH BEFORE AND AFTER THE QUALIFYING PATIENT IS ISSUED A WRITTEN CERTIFICATION;
(5)THE ACADEMIC MEDICAL CENTER’S PLAN FOR THE ONGOING ASSESSMENT AND FOLLOW-UP CARE FOR PATIENTS AND THE COLLECTION ANDANALYZING OFDATA;
(6)ANY CLINICALTRIALS OR ADDITIONAL RESEARCH RELATED TO MEDICAL MARIJUANA THATTHE ACADEMIC MEDICAL CENTER INTENDS TO ENGAGE IN; AND
(7)A LETTER OF APPROVALFROM AN INSTITUTIONAL REVIEW BOARD FOR ALLPROPOSED RESEARCH ACTIVITIES.
(D)THECOMMISSION IS ENCOURAGED TO APPROVE OTHERWISE SATISFACTORY APPLICATIONS THAT INCLUDE ANY OR ALL OFTHE FOLLOWING MEDICALCONDITIONS:
(1) A CHRONIC OR DEBILITATING DISEASE OR MEDICAL CONDITION THAT RESULTED IN THE PATIENT BEING ADMITTED INTO HOSPICE OR RECEIVING PALLIATIVE CARE; AND
(2) A CHRONIC OR DEBILITATING DISEASE OR MEDICAL CONDITION OR THE TREATMENT
OF A CHRONIC OR DEBILITATING DISEASE OR MEDICAL CONDITION THAT PRODUCES ONE OR MORE OF THE FOLLOWING: CACHEXIA, ANOREXIA, OR WASTING SYNDROME, SEVERE OR CHRONIC PAIN, SEVERE NAUSEA, SEIZURES, OR SEVERE AND PERSISTENT MUSCLE SPASMS.
(E) THE COMMISSION MAY APPROVE APPLICATIONS THAT INCLUDE ANY OTHER CONDITION THAT IS SEVERE AND RESISTANT TO CONVENTIONAL MEDICINE PROVIDED THAT:
(1) FAILURE OF APPROVED MEDICATIONS TO PROVIDE RELIEF HAS BEEN DOCUMENTED; AND
(2) THE SYMPTOMS CAN REASONABLY BE EXPECTED TO BE RELIEVED BY THE MEDICAL USE OF MARIJUANA.
(F) A REGISTERED ACADEMIC MEDICAL CENTER, PHYSICIANS WHO ARE PART OF A REGISTERED ACADEMIC MEDICAL CENTER’S PROGRAM, AND REGISTERED ACADEMIC MEDICAL CENTERS’ STAFF SHALL BE PROTECTED FROM CIVIL AND CRIMINAL PENALTIES UNDER STATE AND LOCAL LAWS FOR THE ACTIVITIES ALLOWED BY THIS SUBTITLE, INCLUDING CONDUCTING
RESEARCH INVOLVING MEDICAL MARIJUANA AND CERTIFYING PATIENTS TO PARTICIPATE IN THE PROGRAM.
(G)(1)EACH YEAR,NO LATER THAN60 DAYS BEFORE ITS REGISTRATION EXPIRES, THE
REGISTERED ACADEMIC MEDICAL CENTER SHALLSUBMIT AN ANNUALREPORT TO THE COMMISSION.
(2)ANNUALREPORTS SHOULD INCLUDE INFORMATION ON THE NUMBER OFPATIENTS SERVED,THE COUNTY OR COUNTIES OFRESIDENCE,THE MEDICAL CONDITION(S) FOR WHICH MEDICAL MARIJUANA WAS RECOMMENDED, AND A SUMMARY OF CLINICAL OUTCOMES SHOULD BE PROVIDED FOR EACH INDIVIDUAL PATIENT, INCLUDING ASUMMARY OFADVERSE EVENTS, A SUMMARY OFANY CASES OF SUSPECTED DIVERSION ATTHE LEVEL OF PATIENT, PROGRAM, OR DISPENSING CENTER,AND PROGRESS REPORTS ON RESEARCH STUDIES CONDUCTED UNDER THE MEDICAL MARIJUANA PROGRAM.
(3)ACADEMIC MEDICAL CENTER REPORTS MAYNOT INCLUDE ANYPERSONALLY IDENTIFIABLE INFORMATIONABOUT PATIENTS.
(4)THE REGISTERED ACADEMIC MEDICAL CENTER SHALL PREPARE A LAY SUMMARY OF THE REPORT THATISPUBLICLY AVAILABLE.
(H)ACADEMIC MEDICAL CENTERSMAY APPLY FOR RENEWED REGISTRATIONSANNUALLY. THE COMMISSION SHALL GRANT ORDENY A REGISTRATION BASEDON THE REGISTERED ACADEMIC MEDICAL CENTER’S PERFORMANCE,INCLUDING WHETHER IT IS PROVIDING
APPROPRIATE TRAINING AND OVERSIGHTFORCERTIFYING PHYSICIANS AND COLLECTINGAND ANALYZING DATA.
13-3006.
(A)THECOMMISSION SHALL ISSUE A REQUESTFOR APPLICATIONSFORREGISTERED GROWERS THAT WILL BE EXEMPTFROM CRIMINAL PENALTIES UNDER STATE LAW.
(B)(1)THE COMMISSION SHALL REQUIRE AN APPLICANT FOR A REGISTRATION TO PROVIDE THE FOLLOWING INFORMATION TO THECOMMISSION:
(I)THE NAME OFTHE INDIVIDUAL WHO ISRESPONSIBLE FOR OPERATING THE CULTIVATION FACILITY;
(II)THELOCATION OFTHE PROPOSED CULTIVATION FACILITY OR CULTIVATION FACILITIES;
(III)THESECURITY MEASURESTHAT WILL BE FOLLOWED BY THE REGISTERED GROWER IN CULTIVATING, STORING, AND TRANSPORTING MARIJUANA;
(IV)THE METHOD BY WHICH THE REGISTEREDGROWER WILL ACCOUNTFOR THE AMOUNT
OF MARIJUANA CULTIVATED AND TRANSFERRED TO DISPENSING CENTERS AND DISPENSING PHARMACIES;
(V)THE TRAINING THAT WILL BE PROVIDEDTO EMPLOYEESTO PREVENT DIVERSION; (VI)HOW THE PROGRAM WILLADDRESS VIOLATIONS OF THE DIVERSION POLICY; AND (VII)ANY OTHER INFORMATION THATTHECOMMISSION CONSIDERS NECESSARY.
(2) THE COMMISSION SHALL SELECT THE FEWEST NUMBER OF REGISTERED GROWERS UNDER THIS SECTION AS IS REASONABLE.
(3) REGISTRATIONS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE. REGISTRATIONS MAY BE RENEWED ANNUALLY.
(C) REGISTERED GROWERS WILL BE EXEMPT FROM STATE AND LOCAL PENALTIES FOR CULTIVATING MARIJUANA FOR MEDICAL USE IN ACCORDANCE WITH THIS ACT. A REGISTERED GROWER SHALL:
(1) BE PROTECTED FROM CIVIL AND CRIMINAL PENALTIES UNDER STATE AND LOCAL LAWS FOR POSSESSING AND CULTIVATING MARIJUANA IN ACCORDANCE WITH THIS SUBTITLE;
(2) BE PROTECTED FROM CIVIL AND CRIMINAL PENALTIES UNDER STATE AND LOCAL LAWS FOR SELLING, TRANSPORTING, OR TRANSFERRING MARIJUANA TO DISPENSING CENTERS, DISPENSING PHARMACIES, AND REGISTERED ACADEMIC MEDICAL CENTERS IN ACCORDANCE WITH THIS SUBTITLE;
(3) MEET CERTAIN SECURITY AND SAFETY STANDARDS THAT MAY BE VERIFIED BY THE COMMISSION;
(4) SUBMIT TO PHARMACOLOGICAL TESTING OF THE MARIJUANA CONDUCTED BY THE REGISTERED GROWER OR A PRIVATE ENTITY TO ENSURE:
(I) THAT THE MARIJUANA CAN BE ACCURATELY LABELED BASED ON ITS POTENCY AND STRAIN; AND
(II) THAT THERE IS NO ADULTERATION OR CONTAMINATION OF THE MARIJUANA.
(5) CONDUCT A CRIMINAL HISTORY RECORDS CHECK ON ANY EMPLOYEE OF THE REGISTERED GROWER AS PROVIDED FOR IN THIS SUBTITLE, UNLESS THE REGISTERED GROWER IS ALSO A REGISTERED ACADEMIC MEDICAL CENTER.
(IV) A REGISTERED GROWER MAY NOT:
(1) HOLD ANY OTHER REGISTRATION ISSUED UNDER THIS SUBTITLE UNLESS THE REGISTERED GROWER IS ALSO A REGISTERED ACADEMIC MEDICAL CENTER; OR
(2) BE A CERTIFYING PHYSICIAN.
(E) (1) UNLESS A REGISTERED GROWER IS ALSO A REGISTERED ACADEMIC MEDICAL CENTER, AN INDIVIDUAL WHO HAS BEEN CONVICTED OF SALE OF A CONTROLLED DANGEROUS SUBSTANCE MAY NOT BE AN EMPLOYEE OF A REGISTERED GROWER, UNLESS THE CONVICTION
WAS FOR A VIOLATION OF FEDERAL LAW RELATING TO SALE OF MARIJUANA FOR CONDUCT THAT IS LEGAL UNDER THIS SUBTITLE.
(2) UNLESS A REGISTERED GROWER IS ALSO A REGISTERED ACADEMIC MEDICAL CENTER, AN INDIVIDUAL WHO HAS BEEN CONVICTED OF A FELONY MAY NOT BE AN EMPLOYEE OF A REGISTERED GROWER.
(F)THE COMMISSION,AFTER CONSULTING WITHTHEDEPARTMENT OFAGRICULTURE AND STATEPOLICE, SHALL ADOPT REGULATIONS TOBEFOLLOWEDBY A REGISTEREDGROWER, INCLUDING:
(1)THE SECURITYFEATURESTO BE REQUIRED ON THE PREMISES, WHICH SHALL INCLUDE A REQUIREMENT FOR SECURITY24HOURS PER DAY, SEVEN (7) DAYS PER WEEK AND A PROHIBITION ON CULTIVATING MARIJUANA OUTDOORS;
(2)THE SECURITYFEATURESTO BE REQUIRED IN TRANSPORT TO ANENTITY THAT OBTAINS A REGISTRATION TO DISPENSE MARIJUANA;
(3)LABELING REQUIREMENTS, WHICH SHALL INCLUDETHE WEIGHT OF MARIJUANA IN EACHPACKAGE AND THE FOLLOWING TEXTOR TEXT SUBSTANTIALLY SIMILAR TOIT: “WARNING:FOR QUALIFYING PATIENTS’ MEDICAL USE ONLY.KEEP AWAY FROM CHILDREN. DO NOT OPERATE MACHINERY OR DRIVE WHILE UNDER THE INFLUENCE OF MARIJUANA.”
(4)THELOCATION OF REGISTEREDGROWERS; AND
(5)REGULATIONS TO ENSURE THATREGISTEREDGROWERS ACCURATELY TRACK THE
AMOUNT OF MARIJUANA PRODUCED AND DISPENSED AND TO WHOM THE MARIJUANA IS DISPENSED.
(G)(1)THE COMMISSION MAY ESTABLISHAFEE FOR RENEWAL APPLICATIONS AND RENEWED REGISTRATIONS FOR REGISTERED GROWERS.
(2)THE COMMISSION SHALL GRANT OR DENYA RENEWAL BASED ON THE REGISTERED GROWER’S PERFORMANCE, INCLUDING WHETHER ITHAS FOLLOWED REGULATIONS, INCLUDING BY IMPLEMENTING APPROPRIATE PROCEDURESFOR SECURITY AND NON-DIVERSION.
13-3007.
(A) (1) (I) THE COMMISSION SHALL ESTABLISH A REGISTRATION PROGRAM TO REGISTER ENTITIES THAT ARE EXEMPT FROM STATE AND LOCAL PENALTIES FOR DISTRIBUTING MARIJUANA FOR MEDICAL PURPOSES.
(II) THE COMMISSION SHALL CHARGE A REASONABLE FEE FOR AN APPLICATION TO BE EXEMPT FROM STATE AND LOCAL PENALTIES FOR DISTRIBUTING MARIJUANA FOR MEDICAL PURPOSES.
(III) THE COMMISSION SHALL CHARGE A REASONABLE FEE FOR THE ISSUANCE OF A REGISTRATION UNDER THIS SECTION.
(2) THE COMMISSION SHALL REQUIRE AN APPLICANT FOR A DISPENSING CENTER OR
DISPENSING PHARMACY REGISTRATION TO PROVIDE THE FOLLOWING INFORMATION TO THE COMMISSION:
(I) AN APPLICATION FEE;
(II) THE NAME OF THE INDIVIDUAL WHO IS RESPONSIBLE FOR OPERATING THE DISPENSING PHARMACY OR DISPENSING CENTER;
(III)THE LOCATION OF THE PHARMACY OR DISPENSING CENTER;
(IV)THE SECURITY MEASURESTHAT WILL BEFOLLOWED BYTHEPHARMACY OR DISPENSING CENTER IN RECEIVING, STORING, AND DISPENSING MARIJUANA;
(V)THE METHOD BY WHICHTHE PHARMACY ORDISPENSING CENTER WILL ACCOUNTFOR THE AMOUNT OFMARIJUANA RECEIVED AND DISPENSED;
(VI)THETRAINING THAT WILL BE PROVIDEDTO EMPLOYEESTO PREVENT DIVERSION; (VII)HOW THE PROGRAM WILLADDRESS VIOLATIONS OF THE DIVERSION POLICY; AND (VIII)ANY OTHER INFORMATION THAT THE COMMISSION CONSIDERS NECESSARY.
(3)THE FOLLOWING ENTITIES MAY REGISTERWITH THE COMMISSION TO BE EXEMPT FROMSTATE AND LOCAL PENALTIES FOR DISTRIBUTING MARIJUANA FOR MEDICAL PURPOSES:
(I)A PHARMACY THAT HOLDSA PHARMACYREGISTRATION ISSUED BY THEBOARD OF PHARMACY; OR
(II)A DISPENSING CENTER AS PROVIDED FOR IN THIS SECTION.
(4)A REGISTERED ACADEMIC MEDICAL CENTER WISHING TO DISPENSETO PATIENTSIS NOTREQUIRED TO ALSO BE REGISTERED AS A DISPENSING CENTER.HOWEVER, IF A REGISTERED ACADEMIC MEDICAL CENTER WISHES TO DISPENSE MARIJUANA TO PATIENTS, ITS APPLICATION TO OPERATE AS A REGISTERED ACADEMIC MEDICAL CENTER MUST INCLUDE:
(I)ASUMMARY OFTHE TRAINING THAT WILL BE PROVIDED TO EMPLOYEES AND TO PATIENTS TOPREVENT DIVERSION;
(II)A DESCRIPTION OFTHE MATERIALS THAT WILL BE PROVIDEDTO PATIENTS TO ENSURE INFORMED CONSENT; AND
(III)ADESCRIPTION OF HOW THE PROGRAM WILL ADDRESS VIOLATIONS OF THE DIVERSION POLICY.
(B)(1)AN ENTITY SEEKING TO OPERATE AS A DISPENSING CENTER SHALL PERFORM A CRIMINALHISTORY RECORDS CHECK ON EACH EMPLOYEE.
(2)THIS REQUIREMENT DOES NOT APPLY TO DISPENSING PHARMACIES OR REGISTERED ACADEMIC MEDICAL CENTERS.
(3)AS PARTOF THE CRIMINAL HISTORY RECORDS CHECK FOR AN EMPLOYEE, THE ENTITY SHALL SUBMIT AN APPLICATION TOTHECENTRAL REPOSITORYWITH:
(I)TWO COMPLETE SETSOF THE EMPLOYEE’S LEGIBLE FINGERPRINTS; AND
(II)ANYFEE REQUIRED UNDER STATELAW FOR ACCESS TOSTATE CRIMINAL HISTORY RECORDS.
(4)THE CENTRALREPOSITORY SHALL FORWARD TO THE EMPLOYEE, THE DISPENSING CENTER, AND THECOMMISSION THE EMPLOYEE’S CRIMINALHISTORY RECORD INFORMATION.
(5)INFORMATIONOBTAINED FROM THE CENTRAL REPOSITORY UNDER THIS SUBSECTION IS CONFIDENTIALAND MAY NOT BE DISSEMINATED.
(6)(I)AN INDIVIDUAL WHO HAS BEEN CONVICTED OFSALE OFA CONTROLLED
DANGEROUS SUBSTANCE MAY NOT BE ISSUEDA REGISTRATION TO OPERATE A DISPENSING CENTER, UNLESS THE CONVICTIONWAS FOR A VIOLATION OFFEDERALLAW RELATING TOSALE OFMARIJUANA FOR CONDUCT THAT IS LEGAL UNDER THIS SUBTITLE.
(II)AN INDIVIDUAL WHO HAS BEENCONVICTEDOFSALE OF A CONTROLLED DANGEROUS SUBSTANCEMAY NOT BE AN EMPLOYEE OFA DISPENSING CENTER, UNLESS THE CONVICTION
WAS FOR A VIOLATION OFFEDERALLAW RELATING TOSALE OF MARIJUANA FOR CONDUCT THAT ISLEGAL UNDER THIS SUBTITLE.
(III)AN INDIVIDUAL WHO HAS BEENCONVICTEDOFA FELONY MAY NOT BE ISSUED A REGISTRATION TO OPERATE A DISPENSING CENTER UNLESS THE CONVICTION WAS FOR A VIOLATION OFFEDERAL LAW RELATING TO THE SALE OF MARIJUANA FOR CONDUCT THAT IS LEGAL UNDERTHIS SUBTITLE.
(IV)AN INDIVIDUAL WHO HAS BEENCONVICTEDOFA FELONY MAY NOT BE AN EMPLOYEE OFA DISPENSING CENTER UNLESS THE CONVICTION WAS FOR A VIOLATION OFFEDERALLAW RELATING TOTHESALE OFMARIJUANA FOR CONDUCT THAT IS LEGALUNDER THISSUBTITLE.
(C)EXCEPTIF THE ENTITY IS A REGISTERED ACADEMIC MEDICAL CENTER, AN ENTITY SEEKING TO BE EXEMPTFROMSTATE AND LOCAL CRIMINALPENALTIES FOR OPERATING A DISPENSING CENTER OR REGISTERED GROWER UNDER THIS SUBTITLE SHALL REQUIRE EACH
EMPLOYEE OF THE ENTITY TO SUBMIT TO PERIODIC DRUG TESTING AS DETERMINED BY THE COMMISSION IN REGULATIONS.
(D)(1)EXCEPT AS PROVIDED IN THIS SUBSECTION, THECOMMISSION SHALL ISSUE A REGISTRATION TO OPERATE A DISPENSING CENTER OR DISPENSING PHARMACY IF:
(I)THEREQUIREMENTS OF THIS SECTION ARE MET;
(II)THECOMMISSION HAS VERIFIED THE INFORMATION CONTAINED IN THE APPLICATION; AND
(III)THEAPPLICATION IS IN COMPLIANCE WITHALL REQUIREMENTS ISSUED BY THE COMMISSION.
(2)THE COMMISSION MAY REASONABLY LIMIT THE NUMBER OF DISPENSING CENTERS STATEWIDE OR BY GEOGRAPHIC AREA.
(3)IF THE COMMISSION LIMITSTHE NUMBER OF DISPENSINGCENTERS, IT MAY DECIDE
WHICH TO ISSUE CERTIFICATES BY CONSIDERING THE STRENGTH OF PROPOSED DISPENSING CENTERS’ PLANS, INCLUDING FOR SECURITY, PREVENTING DIVERSION,AND PROVIDING LOWER COST OR FREE MARIJUANA TO QUALIFYING PATIENTS WITHLITTLE OR NO INCOME.
(4)THE COMMISSION SHALL APPROVE OR DENYAN APPLICATION WITHIN60 DAYS AFTER
RECEIPT OFA COMPLETED APPLICATION.
(5)THE COMMISSION SHALL ASSIGN TO EACH ENTITY THATHAS BEEN ISSUED A REGISTRATION UNDER THIS SECTION A UNIQUE DISPENSING CENTER OR DISPENSING PHARMACY IDENTIFICATION NUMBER.
(6)A DENIAL OFAN APPLICATION SHALL BE CONSIDERED A FINAL AGENCY DECISION FOR PURPOSES OF JUDICIALREVIEW UNDER THE ADMINISTRATIVE PROCEDURE ACT.
(E)AN INDIVIDUAL WHO HAS BEENISSUED A REGISTRATION UNDER THIS SECTION SHALL DISPLAYTHE REGISTRATION AT THE DISPENSING PHARMACY OR DISPENSING CENTERAT ALL TIMES WHEN THE DISPENSING PHARMACY OR DISPENSING CENTER IS IN POSSESSIONOF MARIJUANA.
(F)A REGISTRATION HOLDERSHALL REPORTANY CHANGE IN INFORMATION TO THE COMMISSION NO LATER THAN 10 DAYS AFTER THE CHANGE.
(G)AN INDIVIDUAL WHO HAS BEENISSUED A REGISTRATION UNDER THIS SECTIONMAY NOT:
(1)HOLD ANY OTHER REGISTRATION ISSUED UNDER THIS SUBTITLE, UNLESS THE INDIVIDUAL IS A REGISTERED ACADEMIC MEDICAL CENTER; OR
(2)BE A CERTIFYING PHYSICIAN.
(H)ON OR BEFORE SEPTEMBER1,2012, THEMEDICALMARIJUANAOVERSIGHT COMMISSION, IN CONSULTATION WITH THE BOARD OF PHARMACY, THESTATE POLICE, AND STAKEHOLDERS, SHALL DEVELOP REGULATIONSREGARDING THE PROCEDURES TO BE FOLLOWED BY REGISTERED ACADEMIC MEDICAL CENTERS, DISPENSING PHARMACIES, AND DISPENSING CENTERS IN DISPENSING, STORING, AND TRANSPORTING MARIJUANA UNDER THIS SUBTITLE.
(I)(1)THE COMMISSION MAY ESTABLISHAFEE FOR RENEWAL APPLICATIONS AND RENEWED REGISTRATIONS FOR DISPENSING CENTERS AND DISPENSINGPHARMACIES.
(2)THE COMMISSION SHALL GRANT OR DENYA RENEWAL BASED ON THE DISPENSING CENTER ORDISPENSING PHARMACY’S PERFORMANCE, INCLUDING WHETHER ITHAS FOLLOWED REGULATIONS, INCLUDING BY IMPLEMENTING APPROPRIATE PROCEDURES FOR SECURITYAND NON-DIVERSION.
(J)(1)THE SALE OF MARIJUANA MAY NOT BE ADVERTISED ON BILLBOARDS, TELEVISION, OR RADIO.
(2)THE COMMISSION MAY DEVELOP ADDITIONALRULES RESTRICTING THE TIME, PLACE, AND MANNERTHAT MARIJUANA SALES MAY BE ADVERTISED.
(3)RESTRICTIONS ON ADVERTISING SHALL NOT PREVENT APPROPRIATE SIGNS ON THE PROPERTY OF THE REGISTERED DISPENSING CENTER OR LISTINGS INBUSINESS DIRECTORIES INCLUDING PHONE BOOKS.
13-3008.
(A)(1)THE MEDICALMARIJUANAOVERSIGHT COMMISSION, IN CONSULTATION WITH STATE AND LOCAL LAW ENFORCEMENT, SHALLDEVELOP REGULATIONS PROVIDING FOR THE ISSUANCE OFREGISTRYIDENTIFICATION CARDS TO QUALIFYING PATIENTS WHO:
(I) HAVE RECEIVED A WRITTEN CERTIFICATION FROM A CERTIFYING PHYSICIAN; OR
(II) ARE ENROLLED TOPARTICIPATE IN A REGISTEREDACADEMIC PROGRAM’S RESEARCH PROGRAM.
(2)THE COMMISSION MAY ESTABLISH ANAPPLICATION ORRENEWALFEETHAT MAY BE BASED ON ASLIDING SCALE.
(3)THE COMMISSION SHALL ISSUE A REGISTRY IDENTIFICATION CARD TOA QUALIFYING PATIENT WHO HAS BEENISSUED A VALID WRITTEN CERTIFICATION BY A CERTIFIED PHYSICIAN OR WHO HAS BEEN CERTIFIED TO PARTICIPATE IN A MEDICAL MARIJUANAPROGRAM BYA REGISTERED ACADEMIC MEDICAL CENTER.
(4)EACH QUALIFYING PATIENT SHALL SENDTHECOMMISSION:
(I)THE NAME, ADDRESS, AND DATE OF BIRTH OFTHE QUALIFYING PATIENT;
(II)A WRITTEN CERTIFICATION ISSUED BY THEPATIENT’S CERTIFYING PHYSICIAN OR DOCUMENTATION FROM A REGISTERED ACADEMIC MEDICAL CENTER;
(III)THE NAME, ADDRESS, AND DATE OF BIRTHOFTHE QUALIFYING PATIENT’S PRIMARY CAREGIVER, IFTHE PATIENT WISHES TOHAVE A PRIMARY CAREGIVER;
(IV)AN APPLICATION ORRENEWAL FEE THATMAY BE BASED ON A SLIDING SCALE AS DETERMINED BYTHECOMMISSION.
(V)IF THE QUALIFYING PATIENT WISHES TO HAVE A PRIMARY CAREGIVER, THEREASON THAT THE PATIENT REQUIRES THE ASSISTANCE OF A CAREGIVER TOOBTAINMARIJUANA.
(B)(1)THE COMMISSION SHALL:
(I)APPROVE OR DENYAN APPLICATION ORRENEWAL WITHIN 30 DAYS OFRECEIPT OF THE APPLICATION OR RENEWAL;
(II)ISSUE A REGISTRY IDENTIFICATION CARD WITHINFIVE DAYS OFAPPROVINGTHE APPLICATION OR RENEWAL;
(III)ENSURETHAT A PERSON IS NOT DESIGNATED AS A PRIMARY CAREGIVERFORMORE THAN FIVE (5) QUALIFYING PATIENTS.
(2)THE COMMISSION MAY DENYAN APPLICATION OR RENEWAL ONLY IFTHE APPLICANT FAILS TO PROVIDE THE INFORMATION REQUIRED UNDER THIS SECTION OR IFTHE COMMISSION DETERMINES THAT THE INFORMATIONWASFALSIFIED.
(3)THE COMMISSION SHALL DENYA REQUESTFOR A PRIMARY CAREGIVER IF:
(I)THEAPPLICANT FAILS TOPROVIDE THE INFORMATION REQUIREDUNDER THIS SECTION;
(II)THECOMMISSION DETERMINESTHATTHE INFORMATION WAS FALSIFIED;
(III)THE QUALIFYING PATIENT DID NOTPROVIDE A CONVINCING REASON WHYHE OR SHE NEEDED A PRIMARY CAREGIVER;
(IV)THE PRIMARY CAREGIVER IS ALREADY REGISTERED TO ASSISTFIVE PATIENTS; OR
(V)THE PRIMARY CAREGIVER HAS A CONVICTION THAT PRECLUDES PARTICIPATIONIN THE PROGRAM.
(4)DENIALOFTHEAPPLICATION SHALL BE CONSIDERED A FINAL AGENCY DECISION FOR PURPOSES OF JUDICIALREVIEW UNDER THE ADMINISTRATIVE PROCEDURE ACT.
(C)(1)THE COMMISSION SHALL REQUIRE EACH APPLICANT SEEKING TO SERVE AS A
PRIMARY CAREGIVER TO APPLY TO THE CENTRAL REPOSITORY FOR A CRIMINALHISTORY RECORDS CHECK.
(2)THE COMMISSION SHALL PROVISIONALLY APPROVE ANAPPLICATION TO SERVE AS A PRIMARY CAREGIVER PENDING THERESULTS OF A CRIMINAL HISTORY RECORDS CHECK.
(3)AS PART OF THE APPLICATION FOR THE CRIMINALHISTORYRECORDS CHECK, THE APPLICANT SHALL SUBMIT TO THE CENTRAL REPOSITORY:
(I)TWO COMPLETE SETSOF THE APPLICANT’S LEGIBLE FINGERPRINTS TAKENON FORMS APPROVED BY THE DIRECTOROF THECENTRAL REPOSITORY; AND
(II)ANYFEE REQUIRED UNDER STATELAW FOR ACCESS TOSTATE CRIMINAL HISTORY RECORDS.
(4)THE CENTRALREPOSITORY SHALL FORWARD TO THE APPLICANT ANDTO THE COMMISSION THE POTENTIAL PRIMARY CAREGIVER’S CRIMINAL HISTORY RECORD INFORMATION.
(5)INFORMATIONOBTAINED FROM THE CENTRAL REPOSITORY UNDER THIS SUBSECTION IS CONFIDENTIALAND MAY NOT BE DISSEMINATED.
(6)(I)AN APPLICANT WHO HAS BEEN CONVICTED OFPOSSESSION ORSALE OF A CONTROLLED DANGEROUS SUBSTANCE MAYNOT SERVE AS A PRIMARY CAREGIVER, UNLESS THE CONVICTION OCCURRED ON OR AFTER SEPTEMBER1,2012, AND WAS FOR A VIOLATION OF
FEDERAL LAW RELATING TO POSSESSION OR SALE OF MARIJUANA FOR CONDUCTTHAT IS LEGAL UNDER THIS SUBTITLE.
(II)AN INDIVIDUAL WHO HAS BEENCONVICTEDOFA FELONY MAY NOT BE ISSUED A REGISTRY IDENTIFICATION CARD TO SERVE ASA PRIMARY CAREGIVER.
(7)ON RECEIPT OF THECRIMINALHISTORY RECORDS CHECK FROM THE CENTRAL REPOSITORY,THE SECRETARYSHALL NOTIFY THE APPLICANT INWRITING OFTHE APPLICANT’S QUALIFICATION OR DISQUALIFICATION FOR SERVING ASAPRIMARY CAREGIVER.
(D)THE REGISTRY IDENTIFICATION CARD SHALL CONTAINTHE FOLLOWING INFORMATION:
(I)THE NAME, ADDRESS, AND DATE OF BIRTH OFTHE QUALIFYING PATIENT;
(II)THE NAME, ADDRESS,AND DATE OF BIRTH OFTHE QUALIFYING PATIENT’S PRIMARY CAREGIVER, IF ANY;
(III)THE DATE OF ISSUANCE;
(IV)AN EXPIRATION DATE OF THE REGISTRYIDENTIFICATION, WHICHSHALL BE ONE YEAR AFTER THE DATE OF ISSUANCE, UNLESS A DIFFERENT DATE IS INCLUDED ON THE WRITTEN CERTIFICATION;
(V)PHOTO IDENTIFICATION OFTHECARDHOLDER;
(VI) A RANDOM IDENTIFICATION CARD NUMBER; AND
(VII)ANY OTHER INFORMATION PROVIDED FOR BY THE COMMISSION IN REGULATIONS.
(VIII) A PRIMARY CAREGIVER OR QUALIFYING PATIENT WHO HAS BEEN ISSUED A REGISTRY IDENTIFICATION CARD SHALL NOTIFY THE COMMISSION OF ANY CHANGE IN THE PERSON’S NAME OR ADDRESS WITHIN 10 DAYS OF THE CHANGE OR THE REGISTRY IDENTIFICATION CARD SHALL BE CONSIDERED VOID.
(IX) 1. IF THERE IS A CHANGE IN THE STATUS OF A PATIENT’S QUALIFYING MEDICAL CONDITION THAT REQUIRES A CERTIFYING PHYSICIAN TO WITHDRAW THE PATIENT’S WRITTEN CERTIFICATION OR THE QUALIFYING PATIENT’S REGISTERED ACADEMIC MEDICAL CENTER TO TERMINATE THE QUALIFYING PATIENT’S PARTICIPATION IN ITS PROGRAM, THE CERTIFYING
PHYSICIAN OR REGISTERED ACADEMIC MEDICAL CENTER SHALL PROVIDE WRITTEN NOTICE TO THE PATIENT AND THE COMMISSION WITHIN 10 DAYS OF BECOMING AWARE OF THE CHANGE.
2. ON RECEIPT OF THE NOTICE DESCRIBED IN SUBSECTION(B)(IX)(1.), THE COMMISSION SHALL:
A. REVOKE THE PATIENT’S AND, IF APPLICABLE, THE PATIENT’S PRIMARY CAREGIVER’S REGISTRY IDENTIFICATION CARD; AND
B. SEND THE PATIENT AND, IF APPLICABLE, THE PATIENT’S PRIMARY CAREGIVER A REVOCATION NOTICE REQUIRING THE IMMEDIATE RETURN OF ALL REGISTRY IDENTIFICATION CARDS.
3. ON RECEIPT OF A REVOCATION NOTICE UNDER SUBPARAGRAPH 2 OF THE SUBPARAGRAPH, A PATIENT AND, IF APPLICABLE, A PATIENT’S PRIMARY CAREGIVER SHALL:
A. IMMEDIATELY SEND THE COMMISSION OR OTHER ENTITY ISSUING REGISTRY IDENTIFICATION CARDS THE REGISTRY IDENTIFICATION CARD OF THE PATIENT AND, IF APPLICABLE, THE PATIENT’S PRIMARY CAREGIVER; AND
B.HAVE 15DAYSTO DISPOSE OF ANY MARIJUANA IN THE PATIENT’S POSSESSION, BY TRANSFERRING THE MARIJUANA TO A DISPENSING CENTER OR DISPENSING PHARMACY.
(E)THECOMMISSIONSHALLESTABLISH PROCEDURES FOR EACHREGISTERED
QUALIFYING PATIENT TO DESIGNATE A SINGLE DISPENSING CENTER OR DISPENSING PHARMACY ATA TIME WITH THE COMMISSION.
(F)(1)THE COMMISSION SHALL MAINTAIN A CONFIDENTIAL LIST OF THE INDIVIDUALS TO WHOM IT ISSUED REGISTRY IDENTIFICATION CARDS.
(2)THE NAMES OFINDIVIDUALS AND OTHER IDENTIFYING INFORMATION ON THE LIST: (I)ARE CONFIDENTIAL;
(II)MAY NOT BE CONSIDERED A PUBLIC RECORD; AND (III)MAY NOT BE DISCLOSED EXCEPTTO:
1.AUTHORIZED EMPLOYEES OF THE COMMISSION AS NECESSARYTO PERFORMOFFICIAL DUTIES OFTHE COMMISSION; OR
2.AUTHORIZED EMPLOYEES OF STATE ORLOCAL LAW ENFORCEMENT, TO VERIFY THAT AN INDIVIDUAL WHO IS ENGAGED IN THE SUSPECTED ORALLEGED MEDICAL USE OFMARIJUANA IS LAWFULLY INPOSSESSION OF A REGISTRYIDENTIFICATION CARD.LAW ENFORCEMENT WILL NOT BE ABLETO QUERYRECORDS FOR PERSONS NOT IMMEDIATELY BEING CONSIDERED IN CASES OF SUSPECTED MARIJUANA MISUSEOR WHO PRESENTEDLAW ENFORCEMENT WITH THEIR REGISTRY IDENTIFICATION CARD.AUTHORIZED EMPLOYEES OFSTATEOR LOCAL LAW ENFORCEMENTMAY PROVIDE A REGISTRYIDENTIFICATION NUMBER ASSOCIATEDWITH A REGISTRY IDENTIFICATION CARD AND RECEIVE VERIFICATION OFTHE NAME, ADDRESS, AND CURRENTPROGRAM STATUSFOR THE PATIENT ASSOCIATED THE REGISTRY IDENTIFICATION NUMBER.
13-3009.
(A) ANY OF THE FOLLOWING PERSONS ACTING IN ACCORDANCE WITH THE PROVISIONS OF THIS SUBTITLE MAY NOT BE SUBJECT TO ARREST, PROSECUTION, OR ANY CIVIL OR ADMINISTRATIVE PENALTY, INCLUDING CIVIL PENALTY OR DISCIPLINARY ACTION, BY A PROFESSIONAL LICENSING BOARD, NOR BE DENIED ANY RIGHT OR PRIVILEGE, FOR THE MEDICAL USE OF MARIJUANA:
(1) A QUALIFYING PATIENT OR PATIENT’S PRIMARY CAREGIVER WHO HOLDS A VALID REGISTRY IDENTIFICATION CARD AND IS IN POSSESSION OF AN ALLOWABLE AMOUNT OF USABLE MARIJUANA PURCHASED OR ACQUIRED IN ACCORDANCE WITH THE PROVISIONS OF THIS SUBTITLE;
(2) A REGISTERED GROWER OR A REGISTERED GROWER’S EMPLOYEE;
(3) IF A QUALIFYING PATIENT IS UNABLE TO DISPOSE OF MARIJUANA AND HE OR SHE DOES NOT HAVE A CAREGIVER, A PERSON TRANSPORTING THE QUALIFYING PATIENT’S MARIJUANA TO A DISPENSING CENTER OR DISPENSING PHARMACY;
(4)ADISPENSING PHARMACY THAT HOLDS A REGISTRATIONUNDER THISSUBTITLE OR A DISPENSING CENTER ORAN EMPLOYEE OFA DISPENSING PHARMACY ORDISPENSING CENTER;
(5) A CERTIFYING PHYSICIAN;
(6) A REGISTERED ACADEMIC MEDICAL CENTER AND ITS STAFF; OR
(7) A LABORATORY CONDUCTING TESTING OF MEDICAL MARIJUANA, INCLUDING FOR POTENCY AND CONTAMINANTS, OR AN EMPLOYEE OF A LABORATORY CONDUCTING TESTING OF MEDICAL MARIJUANA.
(B) THE POSSESSION OF, OR THE APPLICATION FOR, A REGISTRY IDENTIFICATION CARD DOES NOT ALONE CONSTITUTE PROBABLE CAUSE TO SEARCH AN INDIVIDUAL OR THE PROPERTY OF AN INDIVIDUAL POSSESSING OR APPLYING FOR THE REGISTRY IDENTIFICATION CARD, OR
OTHERWISE SUBJECT THE INDIVIDUAL OR THE PROPERTY OF THE INDIVIDUAL TO INSPECTION BY A GOVERNMENTAL UNIT.
(C) AN INDIVIDUAL MAY NOT BE SUBJECT TO ARREST OR PROSECUTION FOR CONSTRUCTIVE POSSESSION, CONSPIRACY, OR ANY OTHER OFFENSE FOR BEING IN THE
PRESENCE OR VICINITY OF THE MEDICAL USE OF MARIJUANA AS ALLOWED UNDER THIS SUBTITLE.
13-3010.
(A) (1) AN AGENT OF A DISPENSING PHARMACY OR A DISPENSING CENTER MAY SELL OR
DISPENSE AN AMOUNT OF USABLE MARIJUANA THAT DOES NOT EXCEED THE AMOUNT SET BY THE COMMISSION IN A 30-DAY PERIOD TO A REGISTERED QUALIFYING PATIENT OR THE QUALIFYING PATIENT’S PRIMARY CAREGIVER IF THE INDIVIDUAL:
(I) PRESENTS A VALID REGISTRY IDENTIFICATION CARD;
(II) HAS IDENTIFIED THE DISPENSING CENTER OR DISPENSING PHARMACY AS THE SOLE
DISPENSING CENTER OR DISPENSING PHARMACY THAT THE PATIENT CAN RECEIVE MARIJUANA FROM, IN ACCORDANCE WITH COMMISSION REGULATIONS.
(B) ON RECEIPT OF THE INFORMATION REQUIRED UNDER SUBSECTION (A) OF THIS SECTION, THE APPROVED DISPENSING PHARMACY OR DISPENSING CENTER SHALL VERIFY THE INFORMATION PRESENTED.
(C) (1) EACH APPROVED DISPENSING PHARMACY AND DISPENSING CENTER SHALL MAINTAIN INTERNAL RECORDS OF EACH MARIJUANA DISPENSING TRANSACTION.
(II) THE RECORDS REQUIRED UNDER PARAGRAPH (1) OF THIS SUBSECTION SHALL INCLUDE:
(I) THE AMOUNT OF MARIJUANA DISPENSED;
(II) THE REGISTRY IDENTIFICATION NUMBER OF THE INDIVIDUAL TO WHOM THE MARIJUANA WAS DISPENSED AND WHETHER THAT INDIVIDUAL WAS A QUALIFYING PATIENT OR
THE QUALIFYING PATIENT’S PRIMARY CAREGIVER;
(III)THESTRAIN OF MARIJUANA DISPENSED; AND (IV)THE DATE ANDTIME OFTHE TRANSACTION.
(3)A RECORD MAINTAINED UNDER THIS SUBSECTION: (I)IS CONFIDENTIAL; AND
(II)MAY NOT INCLUDE NAMES OR OTHER PERSONAL IDENTIFYING INFORMATION.
(D)(1)A QUALIFYING PATIENT MAY BE REGISTERED AT ONLY ONE DISPENSING PHARMACY OR DISPENSING CENTER AT ANYTIME.
(2)THE COMMISSION SHALL ESTABLISH PROCEDURES TO ALLOW A QUALIFYING PATIENT TO CHANGEHIS OR HER DESIGNATED DISPENSING PHARMACY OR DISPENSING CENTER FOR A $15 FEE.
(3)THE COMMISSION MAY LIMIT THE NUMBER OFTIMES A QUALIFYINGPATIENT MAY CHANGE A DESIGNATION OF A PHARMACY OR DISPENSING CENTER TO ONE TIME EVERY30 DAYS.
13-3011.
A PERSON WHO KNOWINGLY GIVES FALSE INFORMATION OR MAKESA MATERIAL
MISSTATEMENT IN AN APPLICATION FOR REGISTRATION OR IN AN APPLICATION FOR A RENEWAL OFA REGISTRATION UNDER THISSUBTITLE IS GUILTY OFA MISDEMEANOR AND ON CONVICTION IS SUBJECTTO IMPRISONMENT NOTEXCEEDING ONE YEAR, A FINE NOT EXCEEDING $1,000, OR BOTH.
13-3012.
(A)THISSUBTITLE MAYNOT BE CONSTRUED TOAUTHORIZE ANY INDIVIDUAL TO ENGAGE IN THE FOLLOWING, AND IT DOES NOT PREVENTTHE IMPOSITION OFANY CIVIL, CRIMINAL, OR OTHERPENALTIES FOR THE FOLLOWING:
(1)UNDERTAKE ANY TASK UNDER THE INFLUENCE OF MARIJUANA, WHEN DOING SO WOULD CONSTITUTE NEGLIGENCE OR PROFESSIONAL MALPRACTICE;
(2) OPERATE, NAVIGATE, OR BE IN ACTUAL PHYSICAL CONTROL OF ANY MOTOR VEHICLE, AIRCRAFT, OR BOAT WHILE UNDER THE INFLUENCE OF MARIJUANA;
(3) SMOKE MARIJUANA IN ANY PUBLIC PLACE;
(4) SMOKE MARIJUANA IN A MOTOR VEHICLE; OR
(5) SMOKE MARIJUANA ON A PRIVATE PROPERTY THAT:
(I) 1.IS RENTED FROM A LANDLORD; AND
2.IS SUBJECT TO APOLICY THATPROHIBITS THESMOKING OF MARIJUANA ON THE PROPERTY; OR
(II)IS SUBJECT TO A POLICY THAT PROHIBITS THE SMOKING OF MARIJUANA ON THE PROPERTYOFAN ATTACHED DWELLING ADOPTED BY ONE OFTHE FOLLOWING ENTITIES:
1.THE BOARD OF DIRECTORS OFTHE COUNCIL OF UNIT OWNERS OF A CONDOMINIUM REGIME; OR
2.THE GOVERNING BODY OFA HOMEOWNER’S ASSOCIATION.
(B)THIS SUBTITLE MAYNOT BE CONSTRUED TOPROVIDE IMMUNITYTO A PERSON WHO VIOLATESTHE PROVISIONS OFTHIS SUBTITLE FROM CRIMINAL PROSECUTION FOR A VIOLATION OF ANY LAW PROHIBITING OR REGULATING THE USE, POSSESSION, DISPENSING, DISTRIBUTION, OR PROMOTION OFCONTROLLED DANGEROUS SUBSTANCES, DANGEROUS DRUGS, DETRIMENTAL DRUGS, OR HARMFUL DRUGS, ORANY CONSPIRACY OR ATTEMPT TO COMMIT ANY OF THOSE OFFENSES.
13-3013.
NOTHING IN THIS SUBTITLE SHALL BE CONSTRUED TO REQUIRE A PUBLIC OR PRIVATE HEALTH INSURER TO REIMBURSE AN INDIVIDUAL FOR THE COSTS ASSOCIATED WITH THE MEDICAL USE OF MARIJUANA.
13-3014.
(A) BEGINNING OCTOBER 1, 2013, AND EACH OCTOBER 1 THEREAFTER, THE COMMISSION SHALL REPORT TO THE GOVERNOR AND, IN ACCORDANCE WITH § 2-1246 OF THE STATE GOVERNMENT ARTICLE, THE GENERAL ASSEMBLY ON:
(1) THE NUMBER OF APPLICATIONS FOR REGISTRY IDENTIFICATION CARDS;
(2) THE NUMBER OF QUALIFYING PATIENTS AND PRIMARY CAREGIVERS REGISTERED;
(3) THE NATURE OF THE DEBILITATING MEDICAL CONDITIONS OF THE QUALIFYING PATIENTS;
(4) THE NUMBER OF ACADEMIC MEDICAL CENTERS REGISTERED AND THE SCOPE OF THEIR PROGRAMS;
(5) THE ENTITIES RECEIVING REGISTRATIONS TO GROW MARIJUANA;
(6) THE ENTITIES RECEIVING REGISTRATIONS TO DISPENSE MARIJUANA;
(7) THE NUMBER OF REGISTRY IDENTIFICATION CARDS REVOKED;
(8) THE NUMBER OF REGISTRATIONS TO ENTITIES TO GROW OR DISPENSE MARIJUANA
REVOKED; AND
(9)THE NUMBER OF CERTIFYING PHYSICIANS PROVIDING WRITTEN CERTIFICATIONS FOR PATIENTS.
(B)THE REPORT REQUIRED UNDER SUBSECTION(A) OF THIS SECTIONMAY NOT CONTAIN ANY IDENTIFYING INFORMATION OF QUALIFYING PATIENTS, PRIMARY CAREGIVERS, ENTITIES SELECTED TO GROW ORDISPENSE MARIJUANA,OR CERTIFYING PHYSICIANS.
(C) ON OR BEFORE OCTOBER 1, 2013, AND EVERY TWO YEARS THEREAFTER, THE COMMISSION SHALL REPORT TO THE GOVERNOR AND, IN ACCORDANCE WITH § 2-1246 OF THE STATE GOVERNMENT ARTICLE, THE GENERAL ASSEMBLY ON:
(1) WHETHER THERE ARE SUFFICIENT NUMBERS OF DISPENSING PHARMACIES AND DISPENSING CENTERS TO MEET THE NEEDS OF REGISTERED QUALIFYING PATIENTS THROUGHOUT THE STATE;
(2) WHETHER THE NUMBER AND SCOPE OF ACADEMIC PROGRAMS AND THE NUMBER OF CERTIFYING PHYSICIANS IS SUFFICIENT TO MEET THE NEEDS OF PATIENTS IN THE STATE;
(3) WHETHER ANY DISPENSING PHARMACY OR DISPENSING CENTER HAS CHARGED EXCESSIVE PRICES FOR MARIJUANA THAT THE PHARMACY OR CENTER DISPENSED.
(4) ANY NEW AND EMERGING DOCUMENTED SCIENTIFIC EVIDENCE OF THE EFFICACIOUS MEDICAL USE OF MARIJUANA, INCLUDING SYMPTOMS OR CONDITIONS FOR WHICH MARIJUANA MAY BE AN EFFECTIVE TREATMENT.
13-3015.
(A) THE MEDICAL MARIJUANA OVERSIGHT COMMISSION MAY ACCEPT FROM ANY SOURCE GRANTS OR CONTRIBUTIONS TO BE USED IN CARRYING OUT THIS SUBTITLE.
(B) ANY FEES COLLECTED UNDER THIS SUBTITLE SHALL BE USED TO OFFSET THE COSTS OF THE COMMISSION’S ADMINISTRATION OF THIS SUBTITLE. FEES SHALL BE SET AT AN AMOUNT HIGH ENOUGH TO ENSURE THAT THE TOTAL AMOUNT OF FEES ASSESSED, PLUS CONTRIBUTIONS, AND GRANTS COLLECTED ARE SUFFICIENT TO COVER THE COSTS OF ADMINISTERING THIS SUBTITLE.
(C) (1) THE COMMISSION MAY DISTRIBUTE ANY FUNDS RECEIVED THAT EXCEED THE AMOUNT OF FUNDING NEEDED TO FULFILL ITS DUTIES UNDER THIS SUBTITLE TO ACADEMIC INSTITUTIONS OR REGISTERED ACADEMIC MEDICAL CENTERS IN MARYLAND TO STUDY THE
IMPACT OF THE MEDICAL MARIJUANA PROGRAM OR TO CONDUCT CLINICAL OR OBSERVATIONAL RESEARCH ON THE MEDICAL EFFICACY OF MARIJUANA, INCLUDING BUT NOT LIMITED TO:
(I) CLINICAL TRIALS;
(II) SELF-REPORTED INITIAL AND LONG-TERM EFFECTIVENESS AND SAFETY BY PATIENTS;
(II) PHYSICIAN REPORTS OF INITIAL AND LONG-TERM SAFETY AND EFFECTIVENESS;
(IV) ASSESSMENTOF SAFETY AND ACCEPTABILITY OF MEDICALMARIJUANA USE AMONG THE GENERAL PUBLIC AND FAMILYMEMBERS OF QUALIFYING PATIENTS;
(V) IMPACT ON PATIENT ILLICIT AND PRESCRIPTION DRUG USE BEFORE, DURING, AND AFTER USE OF MEDICAL MARIJUANA;
(VI) IMPACT ON THE QUALITY OFLIFE OF THE PATIENT OR THE PATIENT’S FAMILY;
(VII)IMPACT ON ILLICIT DRUG USE IN THE STATE AND ASSOCIATED CRIME STATISTICS.
(2)THE COMMISSION MAY DELIVER ANY FUNDS RECEIVED THATEXCEED THE AMOUNT OF FUNDING NEEDED TOFULFILL ITS DUTIES UNDER THISSUBTITLE THAT REMAIN AFTER DISBURSEMENTS ARE MADE UNDERSUBSECTION(1) TOTHE GENERAL FUND.
SECTION 3. AND BE IT FURTHER ENACTED, THAT THIS ACT SHALL TAKE EFFECT IMMEDIATELY.
Medical Marijuana Model Program Workgroup
Membership
64
Dr. Joshua M. Sharfstein Secretary of Health and Mental Hygiene and Chair of Workgroup
Delegate Dan Morhaim Representative of the Maryland House of Delegates
Delegate Kathleen Dumais Representative of the Maryland House of Delegates
Senator David Brinkley Representative of the Maryland Senate
Senator Jamie Raskin Representative of the Maryland Senate
Deborah Miran Public Member
Dr. Nancy R. Cohen Maryland Chapter of National Council on Alcoholism and Drug
Dependency
Dr. Paul Celano Physician Oncologist
Dr. Joseph G. Liberto Physician Addiction Psychiatrist
Dr. Trudy Hall Physician Pain Management
Philip H. Cogan Pharmacist
Dr. Ryan Vandrey Scientist
Lynn S. Billing Registered Nurse
Karen O’Keefe Lawyer
Major Kevin M. Anderson Maryland Chiefs of Police
Dario J. Broccolino Maryland State’s Attorneys Office
Major Sam Billotti, IV Maryland Sheriffs’ Association
Michael Young Maryland Fraternal Order of Police
Medical Marijuana Model Program Workgroup – Membership
65
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