BILL ANALYSIS                                                                                                                                                                                                    



                                                                  SB 420
                                                                  Page  1

          Date of Hearing:   July 8, 2003

                            ASSEMBLY COMMITTEE ON HEALTH
                                Dario Frommer, Chair
                  SB 420 (Vasconcellos) - As Amended:  May 27, 2003

           SENATE VOTE :   24-12
           
          SUBJECT  :   Medical Marijuana.

           SUMMARY  :   Establishes a voluntary program for the issuance of  
          identification cards to patients qualified to use medical  
          marijuana and makes changes necessary to implement and enforce a  
          system providing medical marijuana to chronically ill patents.   
          Specifically,  this bill  :   

          1)States legislative intent to facilitate the prompt  
            identification of qualified patients and their caregivers in  
            order to avoid unnecessary arrests, to promote a state-wide  
            application, to collect data regarding the extent of serious  
            medical conditions, and to enhance the access to medical  
            marijuana through collective, cooperative cultivation  
            projects. 

          2)Defines "primary caregiver" as someone 18 years or older who  
            is responsible for the housing, health, and safety of a  
            patient.  Allows an operator or staff of residential care  
            facilities to be named as a primary caregiver and allows a  
            person to be to be named by one or more qualified patients if  
            all patients live within the same city or county, but  
            prohibits a person from being a primary caregiver to patients  
            in different cities or counties.

          3)Defines "serious medical condition" as AIDS, anorexia,  
            arthritis, cachexia, cancer, chronic pain, glaucoma, migraine,  
            muscle spasms, seizures, severe nausea, or any illness that  
            substantially limits the ability of a person to conduct one or  
            more major life activities.

          4)Requires DHS to design marijuana identification cards and to  
            establish and maintain a voluntary program to issue  
            identification cards to qualified patients and their  
            designated caregivers. 

          5)Directs county health departments to charge an application  








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            fee, provide applications to individuals seeking to join the  
            identification card program, receive and process applications,  
            maintain records of the program, and issue the identification  
            cards that are valid for one year.  

          6)Requires DHS to develop protocols for use by county health  
            departments to implement the program, including protocols to  
            confirm the accuracy of information, to develop application  
            forms used to request identification cards, and design  
            identification cards to identify a patient and a caregiver.

          7)States that no patient or caregiver in possession of a valid  
            identification card shall be subject to arrest for possession,  
            transportation, delivery, or cultivation of medical marijuana  
            in an amount approved by DHS, unless there is reasonable cause  
            to believe that the information contained in the card is false  
            or falsified.

          8)Provides that it shall not be necessary for a person to obtain  
            an identification card in order to claim protection under the  
            Compassionate Use Act.

          9)Requires persons seeking an identification card to pay a fee  
            and provide the all information required.  Allows a legal  
            representative to apply on behalf of a patient, and designate  
            himself or herself as the primary caregiver, if the patient  
            lacks the capacity to make medical decisions.

          10)Requires county health departments to process applications  
            within 30 days by verifying all information provided,  
            including medical records and physician qualifications, and by  
            approving or denying the application.  

          11)Requires an issued identification card to contain specific  
            information including a unique user identification number,  
            expiration date, photo identification, and a 24-hour toll-free  
            telephone number that will enable state and local law  
            enforcement officers access to information to verify the  
            information on the cards.  

          12)Requires county health departments, upon approval of an  
            application, to transmit the user identification number, date  
            of expiration of the card, and the name of the issuing health  
            department to DHS within 24 hours.









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          13)Allows applications be denied if an applicant does not  
            provide the information required, if the county health  
            department demonstrates the information is false, or if an  
            applicant does not meet the criteria.  

          14)Allows applications to be appealed or resubmitted after six  
            months, unless otherwise authorized by the county health  
            department.

          15) Provides that identification cards be valid for one year and  
            provides for annual renewal, pending verification of new and  
            current information.

          16) Requires DHS to establish application and renewal fees that  
            are sufficient to cover the expenses incurred by DHS and each  
            county health department.  Provides for not less than 50  
            percent of the fees collected are made available to county  
            health departments.

          17)Requires cardholders to notify the county health department  
            of any change in the person's physician or designated primary  
            caregiver within 7 days, and requires a cardholder to annually  
            submit updated medical documentation regarding the patient's  
            serious medical condition, and the name and duties of the  
            patient's designated primary caregiver.  

          18) Deems a card expired, and that of any caregiver, if a person  
            who possesses the card fails to comply with the requirements  
            established in #17 above.

          19)Provides that patients, caregivers and persons providing  
            assistance shall not be subject, on that sole basis, to  
            criminal liability for transporting, processing,  
            administering, delivering or cultivating marijuana.

          20)Requires DHS to issue emergency regulations, after public  
            comment and consultation with interested organizations,  
            including patients, health care professionals, researchers,  
            and law enforcement, to determine the appropriate amounts of  
            marijuana for personal medical use, by July 1, 2003.

          21)Requires DHS, after public comment and consultation with  
            interested organizations, to adopt regulations governing the  
            operation and supervision of cooperatives, by December 31,  
            2004.








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          22)Requires state or local law enforcement agencies to accept an  
            identification card issued by DHS, unless the official has  
            reasonable cause to believe that the information on the card  
            is false, or the card is being use for fraudulent means.

          23) Provides that accommodation for medical marijuana is not  
            required in the workplace or in jails or penal institutions  
            where prisoners reside or persons are detained.

          24)States that penal institutions are not prohibited from  
            allowing the use of medical marijuana under circumstances that  
            will not endanger the health or safety of other prisoners or  
            the security of the facility.

          25)Prohibits the smoking of medical marijuana in any place where  
            smoking is prohibited by law, within 1,000 feet of a school or  
            youth center, on a school bus, or while operating a motor  
            vehicle or boat.

          26) Makes medical marijuana available to some criminal  
            defendants who are eligible for the use of medical marijuana,  
            subject to court approval. 

          27) Creates penalties for persons who fraudulently obtain,  
            steal, or use an identification card.

           EXISTING LAW:  

          1)Provides, under Proposition 215 of 1996, the Compassionate Use  
            Act, the right to obtain and use marijuana for medical  
            purposes where medical use is deemed appropriate and has been  
            recommended by a physician and ensures that patients and their  
            primary caregivers are not subject to criminal prosecution or  
            sanction.  Protects physicians from punishment for  
            recommending marijuana to a patient for medical purposes.

          2)Prohibits the possession, transportation, sale, or cultivation  
            of marijuana, unless otherwise provided by law.

           FISCAL EFFECT  : According to the Senate Appropriations Committee  
          analysis, the cost of the program will be between $1 million and  
          $2 million per year, which would be entirely offset by fees for  
          the identification cards.









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           COMMENTS  :   

           1)PURPOSE OF THIS BILL  .  According to the author, this bill will  
            realize the implementation of the Compassionate Use Act and  
            will provide appropriate access to medical marijuana that was  
            provided under the act.  The author states that patients in  
            California continue to have limited access to medical  
            marijuana due to the lack of appropriate legislation to  
            implement a program to distribute medical marijuana, guide law  
            enforcement officers and protect physicians, caregivers and  
            patients.  

          According to the author, this measure is a result of lengthy  
            negotiations between the author, stakeholders, and a special  
            task force created by the Attorney General.  It defines key  
            terms, specifies the medical conditions that qualify for  
            medical marijuana, clarifies the role of primary caregiver,  
            and makes clear the qualifications and role of attending  
            physicians.  In addition, the bill establishes a legal system  
            to identify patients and caregivers through a statewide  
            system.

           2)BACKGROUND  .  According to a General Accounting Office (GAO)  
            report, four states allow medical use of marijuana, including  
            Oregon, Alaska, Hawaii and California.  Of the four,  
            California is the only state that does not have a state-run  
            registry, leaving local jurisdictions to develop their own  
            guidelines and voluntary registries.  The GAO report further  
            demonstrates that some communities in California have created  
            voluntary local registries to provide medical marijuana users  
            with registry cards to document that the cardholder is  
            eligible for medical use of marijuana.  

          According to Attorney General Bill Lockyer, a task force to  
            address the implementation of the Compassionate Use Act was  
            assembled to discuss the implementation of the act.  This  
            29-member task force is comprised of patients, law  
            enforcement, doctors and local government representatives and  
            met over the six months.  The task force created enforceable  
            recommendations that include the establishment of a registry  
            identification program administered by DHS and recommends that  
            DHS determines the amount of appropriate medical marijuana.   
            This bill is a result of task force recommendations to create  
            a statewide system and that would standardize guidelines for  
            the use of medical marijuana.  








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           3)OPPOSITION  .  The California Conference of Local Health  
            Officers (CCLHO) is concerned about requiring local public  
            health departments to establish and operate a registry system.  
             CCLHO argues public health departments should not be diverted  
            from their primary care public health functions in order to  
            operate this registry.  Furthermore, CCLHO states the  
            regulation of drugs and monitoring of physicians should be the  
            responsibilities of the California Medical Board and DHS, not  
            the county health department.  Finally, CCLHO suggests a  
            registration system should be administered by a state agency,  
            such as DHS or the Department of Justice.

          The Committee on Moral Concerns argues that the bill would  
            create a statewide trafficking network, without providing  
            adequate safeguards to ensure marijuana is used appropriately.  
             The Campaign for California Families states this bill is  
            another step toward legalizing marijuana use and is concerned  
            about identification cards that would be easy to forge.  

           4)PREVIOUS LEGISLATION  .   The author introduced similar  
            legislation in each of the last two sessions.  SB 848 of  
            failed passage on the Assembly floor in 2000 and SB 187 passed  
            off the Assembly floor in 2001 but was not taken up in the  
            Senate for concurrence in Assembly amendments.   

           5)PRIOR ACTION  .  This bill was heard by the Assembly Committee  
            on Public Safety on July 2, 2003 and passed by a vote of 5-2.



           REGISTERED SUPPORT / OPPOSITION  :

           Support 
           
          Americans for Medical Rights
          Being Alive, People with HIV/AIDS Action Coalition
          California Medical Association
          California National Organization for the Reform of Marijuana  
          Laws
          California Nurses Association
          California State Department of Justice
          City and County of San Francisco
          Drug Policy Alliance Network
          Friends Committee on Legislation of California








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          Marijuana Policy Project
          San Francisco AIDS Foundation
          San Mateo County Board of Supervisors
          2 individuals
           
            Opposition 
           
          California Conference of Local Health Officers
          Campaign for California Families
          Committee on Moral Concerns
          Recovery California Coalition

           Analysis Prepared by  :    Clara Craven / HEALTH / (916) 319-2097