BILL ANALYSIS
SENATE HEALTH AND HUMAN SERVICES
COMMITTEE ANALYSIS
Senator Deborah V. Ortiz, Chair
BILL NO: SB 420
S
AUTHOR: Vasconcellos
B
AMENDED: As Introduced
HEARING DATE: April 9, 2003
4
FISCAL: Judiciary/Appropriations
2
0
CONSULTANT:
>
Margolis/ sl
SUBJECT
Medical marijuana
SUMMARY
This bill establishes a voluntary program for the issuance
of identification cards to patients qualified to use
medical marijuana and makes numerous legal definitions,
clarifications, and statutory changes necessary to
implement and enforce a system providing medical marijuana
to chronically ill patients.
ABSTRACT
Existing law: Existing law:
Authorizes, under the Compassionate Use Act, Proposition
215 of 1996, individuals with chronic medical conditions
and their caregivers to cultivate, possess, and use
marijuana upon the recommendation of their physician.
Provides that physicians who recommend marijuana to their
patients shall not be prosecuted. This existing state law
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conflicts with federal law that makes cultivation,
possession, and use of marijuana a crime.
This bill:
1.Finds that certain problems and uncertainties in the
Compassionate Use Act of 1996 have impeded the ability of
law enforcement to interpret and enforce the law. Finds
lack of enforcement has prevented qualified individuals
access to medical marijuana and finds a voluntary
identification card program consistent with the purpose
of the act. States intent of Legislature to clarify the
scope and application of the Compassionate Use Act and to
facilitate prompt identification of qualified patients;
promote uniform application of the act; and enhance
access of patients to marijuana through collective
cultivation.
2.Defines necessary terms. Defines "primary caregiver" as
an individual designated by the patient and responsible
for housing, health and safety of that patient.
Specifies that primary caregiver may include operators
and staff of residential care facilities; may live in a
city/county different from the patient; must be 18 years
of age or entitled to make medical decisions for the
patient under law. Defines "serious medical condition,"
which qualifies a patient to use medical marijuana, as
including specified chronic diseases such as "AIDS,
anorexia, arthritis, cancer, chronic pain, glaucoma,
multiple sclerosis, epilepsy or any chronic condition
which limits a major life activity and is capable of
causing serious harm."
3.Requires the State Department of Health Services (DHS) to
establish and maintain a voluntary program for the
issuance of identification cards to patients who satisfy
the requirements set out in this bill and who voluntarily
apply for the card.
4.Requires DHS to develop: protocols for county health
departments to confirm the accuracy of applications and
to protect confidentiality; application forms;
distinguishable identification cards for patients and
primary caregivers.
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5.Requires county health departments, or another entity
designated by the county health department, to provide
applications for the ID cards; receive and process
applications; maintain records; and issue cards to
applicants and primary caregivers.
6.Exempts patients and caregivers with valid identification
cards from arrest for possession, transportation or
cultivation for an approved amount of marijuana. States
possession of an identification card is not a requirement
to claim protection under Section 11362.5 of the
Compassionate Use Act.
7.Requires payment of a fee and specifies documentation
necessary to obtain a valid identification card to
include: proof of residency of patient; written
documentation by the attending physician on the
qualifying condition and a statement that the medical use
of marijuana is appropriate; name, address phone number
and license number of the physician; and the name,
duties, and photo of primary caregiver.
8.Permits a legal representative to apply for a card for an
individual who lacks the capacity to make medical
decisions, and designate him or herself to serve as a
primary caregiver.
9.Requires county health departments to verify information
in applications, photograph applicants and caregivers,
and approve/deny applications within 30 days. Requires
counties to issue a temporary card, that shall be valid
for 30 days, if an applicant can establish that the card
is needed on an emergency basis. The card may be
extended for a maximum of 30 days.
10.Requires counties, within 24 hours of approving an
application, to electronically transmit to DHS: a unique
applicant ID number; expiration date of the card; and
identifying information of the entity that approved the
application.
11.Requires counties to issue ID cards within 5 working
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days of approving the application.
12.Requires the following information to be contained on an
ID card: unique ID number; identifying information of
approving agency; photo of cardholder; and a 24-hour
phone number for law enforcement to immediately verify
the validity of the card.
13.Specifies circumstances within which the county may deny
issuance of a card, prohibits reapplication for at least
six months, and allows denied applicants to appeal the
decision.
14.Makes registry cards valid for a renewable one-year
period, and requires notice for change in patient
residence or status.
15.Requires patients to annually submit to the county
updates on his or her medical condition and information
on primary caregivers.
16.Requires DHS to establish application and renewal fees
that are sufficient to cover the expenses by both DHS and
the counties. Requires that the fees be waived upon
proof of indigence.
17.Requires DHS to issue emergency regulations by July 1,
2004, after public comment and consultation with
specified interested organizations, determining
appropriate amounts of marijuana for possession and
medical use by qualified patients.
18.Permits cooperative cultivation of marijuana for medical
purposes, with specified supervision of DHS. Requires
DHS to adopt regulations governing the operation of these
cooperatives by December 31, 2004.
19.Requires a state or local law enforcement officer to
accept an identification card unless the officer has
reasonable cause to believe the card is fraudulent.
20.Restricts the use of medical marijuana in workplaces,
correctional facilities, near schools or in other places
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where smoking tobacco is prohibited.
21.Prohibits administrative or licensing actions against
professionals in compliance with this act. Makes
fraudulent use of an ID card punishable by a fine and up
to one-year in jail.
22.Contains a severability clause. Authorizes local
enforcement of this article.
FISCAL IMPACT
According to the Assembly Appropriations Committee analysis
of a nearly identical bill, SB 187 in 2001, it would cost
between $1-2 million to develop and maintain an ID card
system. Some of the costs may be offset by revenues
generated from application and renewal fees for the cards.
The bill requires DHS to establish application and renewal
fees. The Department of Finance estimates a fee of
$100-200 would be needed to cover all program costs for
about 10,000 individuals eligible for the ID card. Fees
would be waived for an estimated 2,000 indigent applicants.
BACKGROUND AND DISCUSSION
This measure seeks to realize implementation of Proposition
215, the medical marijuana initiative. Despite passage of
the Compassionate Use Act in 1996, access to medical
marijuana by California patients has been severely limited.
Failure to implement this law has been due in part to the
act's direct conflict with federal law and the aggressive
opposition of the federal government; and in part by the
incomplete policy structure of the popular initiative
itself. Proposition 215 made a clear policy statement
regarding access to medical marijuana, but left to the
Legislature and courts responsibility for many key legal
definitions, design of a medical marijuana distribution
system, guidance to law enforcement officers, and
protection of physicians, caregivers, and patients.
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This measure addresses a number of the structural questions
in the proposition and is the product of lengthy
negotiations by the author, many stakeholders, and a
special task force created by the Attorney General. The
bill defines many key terms, clarifying the medical
conditions that qualify a patient; specifying "caregiver"
status, and setting out the qualifications and role of
attending physicians. The bill further provides for a
legal system to identify and distinguish state-approved
patients and caregivers. The bill establishes this
identification system through county health departments
making them responsible for issuing and renewing
identification cards, maintaining records, and providing
necessary confirmations for law enforcement. SB 420
requires fees on applicants to cover necessary costs,
prohibits administrative actions against physicians for
conformance with the act, provides for cooperative
cultivation of marijuana under specific oversight, directs
DHS to determine amounts of marijuana that may be held, and
sets out penalties for fraudulent use of an identification
card.
Proposition 215 directs the state to implement a plan for
the safe and affordable distribution of medical marijuana.
The author has made several unsuccessful attempts to
realize this purpose. Additionally, resistance by both
state and federal authorities has prevented public
distribution of medical marijuana. Numerous private, local
distribution organizations have attempted to obtain and
deliver marijuana for medical purposes, but were forced to
close due to police and judicial action. A number of
California cities either encouraged or openly tolerated
marijuana distribution, but no broad distribution has been
realized. Attorney General Bill Lockyer created a special
task force to design a public distribution system and
appointed the author as chair of the effort. This bill
implements the recommendations of the task force. The
Cities of San Francisco and San Diego currently operate
identification systems like the one proposed in this bill.
Proponents support the bill because they believe it
addresses the concerns of law enforcement and ultimately
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will help make medical marijuana available to chronically
ill patients. The author argues that uniform guidelines
and accurate identification of users will avoid the
confusion and frustration police officers face in
determining the validity of medical possession claims.
Americans for Safe Access states that "Patients across
California need SB 420 to help guarantee them the rights
voters extended to them." Being Alive wrote in support
that, "Despite their possession of a doctor's prescription
for their use of medical marijuana, a number of our members
have nonetheless been harassed by police." San Mateo
County supports the bill's proposed fee system to cover
expenses incurred by counties administering the ID program,
and states that "Providing medical marijuana in a cost
effective and uniform manner that promotes the collection
of data for research and future resource allocation is a
critical step in meeting the objectives of the
Compassionate Use Act."
Opponents to this bill primarily believe that the ID card
system being proposed would be abused, leading to increased
illegal drug use, and therefore argue that SB 420 is merely
an attempt to legalize marijuana use. The Committee on
Moral Concerns (CMC) states that "The bill includes as
'caregiver' people who do nothing for patients but grow,
transport, and sell marijuana." The CMC further states
that, "It creates a statewide marijuana trafficking
network, without adequate safeguards, far beyond what the
voters approved." Recovery California Coalition wrote in
opposition that "There is no medical necessity for
exception to the Controlled Substance Act's provision on
manufacturing and distributing marijuana." Finally, the
California Conference of Local Health Officers (CCLHO)
opposes the bill citing an overburdened county health
system. CCLHO argues that although an ID card system might
be a worthwhile approach, the distribution of medical
marijuana is a medical, not a public health function, and
therefore should be managed by an entity other than the
state's public health system.
SB 535 (Vasconcellos) of 1997 would have established a
study to confirm the value of medical marijuana, and
established medical guidelines for appropriate
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administration and use, including treatments. SB 1887
(Vasconcellos) of 1998 would have authorized local
governments to establish medical marijuana distribution
programs. SB 535 and SB 1887 were defeated in the
Assembly. SB 847 (Vasconcellos) of 1999 authorized the
University of California to establish a California
Marijuana Research Program, and SB 848 (Vasconcellos) of
1999 proposed a registry system similar to this bill. SB
847 was chaptered and SB 848 was defeated in the Assembly.
In 2001, the final version of SB 187 (Vasconcellos) was
identical to this bill; it passed both houses of the
Legislature but was held by the Senate and not sent to the
Governor.
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POSITIONS
Support: Attorney General, State of California
Americans for Medical Rights
Americans for Safe Access
Being Alive Los Angeles, Inc.
California National Organization for the
Reform
of Marijuana Laws
County of San Mateo, Board of Supervisors
Drug Policy Alliance Network
Marijuana Policy Project
1 individual
Oppose: California Conference of Local Health Officers
Campaign for California Families
Committee on Moral Concerns
Recovery California Coalition
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