BILL ANALYSIS                                                                                                                                                                                                    



                                                                       


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                              UNFINISHED BUSINESS


          Bill No:  SB 420
          Author:   Vasconcellos (D), et al
          Amended:  9/9/03 
          Vote:     21

           
           SENATE HEALTH & HUMAN SERV. COMMITTEE  :  8-3, 4/9/03
          AYES:  Ortiz, Alarcon, Chesbro, Figueroa, Kuehl, Romero,  
            Vasconcellos, Vincent
          NOES:  Aanestad, Ashburn, Battin
          NO VOTE RECORDED:  Escutia, Florez

           SENATE PUBLIC SAFETY COMMITTEE  :  5-1, 5/6/03
          AYES:  McPherson, Vasconcellos, Burton, Romero, Sher
          NOES:  Margett

           SENATE APPROPRIATIONS COMMITTEE  :  7-5, 5/19/03
          AYES:  Alpert, Bowen, Escutia, Karnette, Machado, Murray,  
            Speier
          NOES:  Battin, Aanestad, Ashburn, Johnson, Poochigian
          NO VOTE RECORDED:  Burton

           SENATE FLOOR  :  24-12, 6/2/03
          AYES:  Alarcon, Alpert, Bowen, Burton, Cedillo, Chesbro,  
            Ducheny, Escutia, Figueroa, Karnette, Kuehl, Machado,  
            McClintock, McPherson, Murray, Ortiz, Perata, Romero,  
            Scott, Sher, Speier, Torlakson, Vasconcellos, Vincent
          NOES:  Aanestad, Ackerman, Ashburn, Battin, Brulte, Denham,  
            Hollingsworth, Knight, Margett, Morrow, Oller, Poochigian
          NO VOTE RECORDED:  Dunn, Florez, Johnson, Soto


           SUBJECT  :    Medical marijuana

                                                           CONTINUED





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           SOURCE  :     Author


          DIGEST  :    This bill establishes a voluntary program for  
          the issuance of identification (ID) 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.

           Assembly Amendments  (1) revise provisions relating to  
          renewal fees, (2) set forth the amount of marijuana that  
          may be possessed by qualified patients or primary  
          caregivers, (3) authorize the State Attorney General (AG)  
          to recommend modifications to the possession or cultivation  
          limits to be made to the Legislature, and (4) require the  
          AG to adopt guidelines to ensure the security and  
          non-diversion of marijuana grown for medical use by  
          qualified persons.

           ANALYSIS  :    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 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 (Act) have impeded the  
             ability of law enforcement to interpret and enforce the  
             law.  It finds lack of enforcement has prevented  
             qualified individuals access to medical marijuana and  
             finds a voluntary ID card program consistent with the  
             purpose of the act.  States intent of Legislature to  
             clarify the scope and application of the Act and to  
             facilitate prompt ID of qualified patients, promote  
             uniform application of the act, and enhance access of  
             patients to marijuana through collective cultivation.








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          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 ID 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 ID cards for patients and primary  
             caregivers.

          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 ID cards from  
             arrest for possession, transportation or cultivation for  
             an approved amount of marijuana.  States possession of  
             an ID card is not a requirement to claim protection  
             under Section 11362.5 of the Act.

          7. Requires payment of a fee and specifies documentation  
             necessary to obtain a valid ID 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  







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             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 her  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 five working  
             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, to be maintained by DHS, 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  







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             on primary caregivers.

          16.Requires DHS to establish application and renewal fees  
             that are sufficient to cover the expenses by DHS,  
             including the start-up cost, the cost of reduced fees  
             for Medi-Cal beneficiaries, the cost of identifying and  
             developing a cost effective Internet Web-based system,  
             and the cost of maintaining the 24-hour toll-free  
             telephone number.  Authorizes each county health  
             department to charge an additional fee for all county  
             department or designee costs incurred for administering  
             the program.  However, upon satisfactory proof of  
             participation and eligibility in the Medi-Cal program,  
             these fees shall be reduced by 50 percent.

          17.Provides that qualified patients or primary caregivers  
             may possess no more than eight ounces of dried  
             marijuana, and, in addition, may also maintain no more  
             than six mature and 12 immature marijuana plants per  
             qualified patient.

          18.States that if a patient or primary caregiver has a  
             doctor's recommendation that this quantity does not meet  
             the patient's medical needs, the patient or primary  
             caregiver may possess an amount of marijuana consistent  
             with the patient's needs.

          19.Provides that cities and counties may retain or enact  
             medical marijuana guidelines allowing patients or their  
             caregivers to exceed the state limits.

          20.Provides that the AG may recommend modifications to the  
             possession or cultivation limits, and that such  
             recommendations shall be made to the Legislature no  
             later than 1/1/05.

          21.States that the AG shall adopt guidelines to ensure the  
             security and non-diversion of marijuana grown for  
             medical use by qualified patients.

          22.Permits cooperative cultivation of marijuana for medical  
             purposes, with specified supervision of DHS. 

          23.Requires a state or local law enforcement officer to  







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             accept an ID card unless the officer has reasonable  
             cause to believe the card is fraudulent.

          24.Restricts the use of medical marijuana in workplaces,  
             correctional facilities, near schools or in other places  
             where smoking tobacco is prohibited.

          25.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.

          26.Contains a severability clause.  Authorizes local  
             enforcement of this article.

           Prior Legislation
           
          SB 535 (Vasconcellos) of 1997 established a study to  
          confirm the value of medical marijuana, and established  
          medical guidelines for appropriate administration and use,  
          including treatments.  SB 1887 (Vasconcellos) of 1998  
          authorized local governments to establish medical marijuana  
          distribution programs.  Both bills were defeated in the  
          Assembly.  SB 847 (Vasconcellos), Chapter 750, Statutes of  
          1999 authorized the University of California to establish a  
          California Marijuana Research Program.  SB 848  
          (Vasconcellos) of 1999 proposed a registry system similar  
          to this bill.  The bill 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.

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes    
          Local:  Yes

          Unknown.

           SUPPORT  :   (Verified  7/8/03, per Assembly Health  
          Committee, unable to re-verify at time of this writing)

          Americans for Medical Rights
          Being Alive Los Angeles, Inc.
          California National Organization for the Reform of  







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          Marijuana Laws
          Drug Policy Alliance Network
          Marijuana Policy Project
          San Mateo County Board of Supervisors
          Friends Committee on Legislation of California
          California Medical Association
          California Nurses Association
          City and County of San Francisco
          San Francisco AIDS Foundation
          State Department of Justice
          2 individuals

           OPPOSITION  :    (Verified  7/8/03, per Assembly Health  
          Committee, unable to re-verify at time of this writing)

          California Conference of Local Health Officers
          Campaign for California Families
          Committee on Moral Concerns
          Recovery California Coalition

           ARGUMENTS IN SUPPORT  :    Proponents support the bill  
          because they believe it addresses the concerns of law  
          enforcement and ultimately will help make medical marijuana  
          available to chronically ill patients.  The author's office  
          argues that uniform guidelines and accurate ID 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."

           ARGUMENTS IN OPPOSITION :    Opponents to this bill  
          primarily believe that the ID card system being proposed  
          would be abused, leading to increased illegal drug use, and  







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          therefore argue that this bill 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.


          CP:mel  9/11/03   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

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