BILL ANALYSIS                                                                                                                                                                                                    







                          SENATE COMMITTEE ON Public Safety
                             Senator Bruce McPherson, Chair     S
                                2002-2003 Regular Session       B

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          SB 420 (Vasconcellos)                                 
          As Introduced February 20, 2003
          Hearing date:  May 6, 2003
          Health & Safety Code and Uncodified Law
          JM:mc

                                  MEDICINAL MARIJUANA  

                                       HISTORY

          Source:  Author

          Prior Legislation: SB 187 (Vasconcellos) - 2001; not brought up for  
                       concurrence in Assm. amends
                       SB 848 (Vasconcellos) - 2000; failed on Assembly  
                       Floor
                       SB 2089 (Johannessen) - 2000; failed in Senate  
                       Health and Human Services
                       SB 550 (Johnston) - Ch. 8, Stats. 2000  
                       (Dronabinol-synthetic THC)
                       SB 847 (Vasconcellos) - Ch. 750, Stats. 1999

          Support:  Attorney General; Americans for Medical Rights; Drug  
                    Policy Alliance; Marijuana Policy Project; Friends  
                    Committee on Legislation of California; California  
                    Medical Association; California Nurses Association;  
                    City and County of San Francisco; San Francisco Aids  
                    Foundation; San Mateo County Board of Supervisors;  
                    California Chapter of National Organization for the  
                    Reform of Marijuana Laws; Being Alive Los Angeles;  
                    Americans for Safe Access; Marijuana Policy Project;  
                    Santa Barbara Patient/Doctor Coalition





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


                                         KEY ISSUE
           
          SHOULD THE LEGISLATURE ENACT A MEASURE TO IMPLEMENT THE  
          COMPASSIONATE USE OF MARIJUANA ACT OF 1996, INCLUDING A VOLUNTARY  
          REGISTRATION CARD PROCEDURE, SO THAT QUALIFIED PATIENTS COULD USE  
          THERAPEUTIC MARIJUANA WITHOUT FEAR OF PROSECUTION?

                                          
                                       PURPOSE
          
          The purpose of this bill is to implement the Compassionate Use  
          of Marijuana Act in a manner that would allow qualified patients  
          to obtain therapeutic marijuana without fear of arrest and  
          prosecution.
          
           Existing federal and state laws  list marijuana in Schedule I of  
          Schedules I through V of "controlled substances."  Schedule I  
          controlled substances are deemed to have no medical use.   
          Generally speaking, the schedules are designed to classify drugs  
          by potential for abuse, with those in Schedule I deemed to be  
          the most subject to abuse and those in Schedule V the least  
          subject to abuse.  The restrictions on use of controlled  
          substances and, to a somewhat lesser degree, the punishment for  
          illegal possession or transfer of them, are reduced from  
          Schedule I through V.  (Health & Saf. Code  11054 et seq.)

          Existing California  law defines the following crimes and  
          penalties for the possession and transfer of marijuana:

          Possession of 28.5 or less grams        Misdemeanor, maximum  
                                        punishment of a $100 fine.

          Possession of more than 28.5 grams      Misdemeanor, maximum  
                                        jail term of 6 months, fine up to  
                                        $500.




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          Possession of concentrated cannabis          Misdemeanor,  
                                        maximum 1-year jail term, fine of  
                                        up to $500.

          Possession for sale                     Felony prison term of 16  
                                        months, 2-years or 3-years, fine  
                                        up to $10,000.

          Cultivation                        Felony, prison term of 16  
                                        months, 2-years or 3-years, fine  
                                        up to $10,000.

          Sale or transfer                   Felony, prison term of 2, 3  
                                        or 4 years, fine up to $10,000.

           Existing California law, the Compassionate Use Act of 1996  ,  
          provides that the possession or cultivation of marijuana by a  
          patient, or a patient's primary caregiver, upon the  
          recommendation or approval of a physician and for the patient's  
          personal medical use, is not unlawful, notwithstanding general  
          criminal laws to the contrary.  The Act further directs the  
          Legislature to establish a legal means of distributing marijuana  
          to patients. 

           Existing federal law  on possession or distribution of marijuana  
          conflicts with the Act, as federal law does not allow medical  
          use of marijuana.

           This bill  establishes a voluntary statewide medical marijuana  
          Registration Identification Card (RIC) Program administered by  
          the Department of Health Services (DHS). 

           This bill  defines "qualified patient (QP)," "person with  
          identification card,"  "attending physician," "primary  
          caregiver," and "serious medical condition" for the purposes of  
          this bill.

           This bill  defines serious medical condition thus:   AIDS.  (2)  
          Anorexia.  (3) Arthritis.  (4) Cachexia.  (5) Cancer.  (6)  




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          Chronic pain.  (7) Glaucoma.  (8) Migraine.  (9) Persistent  
          muscle spasms, such as those attending multiple sclerosis.  (10)  
          Seizures, such as those associated with epilepsy.  (11) Severe  
          nausea.  (12) Any chronic or persistent medical symptom that  
          either:  (A) Substantially limits the ability of the person to  
          conduct one or more major life activities as defined in the  
          Americans with Disabilities Act of 1990. (B) If not alleviated,  
          may cause serious harm to the patient's safety or physical or  
          mental health.

           This bill  defines a "person with an identification card" as a  
          qualified patient who has applied for and received a valid  
          identification card pursuant to this article.

           This bill  defines a "qualified patient" as a person who is  
          entitled to the protections of the Compassionate Use Act, but  
          who does not have an identification card issued pursuant to this  
          article.

           This bill  defines primary caregiver thus:

           Designated by qualified patient or RIC holder, with specified  
            limits and requirements where one person is the caregiver for  
            multiple patients
           Must be at least 18, with limited exceptions for parents and  
            others entitled to make medical decisions
           Operator or designated employees of a specified clinic or  
            hospice, as defined

           This bill  requires DHS to establish and maintain a voluntary  
          program for the issuance of registry identification cards (RIC)  
          to qualified patients and primary caregivers; requires DHS to  
          develop protocols and application forms for use by county health  
          departments; and authorizes DHS to establish an application and  
          renewal fee.

           This bill  requires every county health department to utilize  
          protocols developed by DHS, as specified to do the following:

          ? Provide, receive and process RIC applications




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          ? Maintain records of the RIC Program, as specified
          ? Transmit application information to DHS
          ? Authorizes the county health department to designate another  
            entity to perform functions necessary to implement the Act and  
            this bill.

           This bill  sets requirements of an applicant to acquire and renew  
          an RIC.

           This bill  provides the following with respect to an RIC:

          ? An RIC is not necessary to claim the protections of the Act.
          ? No person or primary caregiver with an RIC shall be subject to  
            arrest for possession, transportation, delivery or cultivation  
            of medical marijuana in an amount approved by DHS.
          ? State and local law enforcement officials shall accept RICs,  
            unless there is reasonable suspicion of fraud.
          ? A patient holding an RIC, a primary caregiver or other person  
            shall not be subject to criminal liability based solely on  
            conforming to this bill.
          ? An individual is not authorized to smoke or consume marijuana  
            unless otherwise authorized by the Act.
          ? A primary caregiver or other person, as specified, who  
            receives reasonable compensation for services or expenses, is  
            not subject to criminal liability based solely on conforming  
            to this bill.
          ? RICs for patients and primary caregivers should be readily  
            distinguishable.

           This bill  provides the following with respect to county and  
          state duties as to RICs

          ? County health departments must verify information in  
            applications, photograph applicants and caregivers, and  
            approve/deny applications within 30 days.

          ? Counties must 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.




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          ? Counties, within 24 hours of approving an application, must  
            electronically transmit to DHS: a unique applicant ID number;  
            expiration date of the card; and identifying information of  
            the entity that approved the application.<1>

          ? Counties shall issue ID cards within 5 working days of  
            approving the application.

          ? The following information must be contained on an ID card:

                 unique ID number
                 identifying information of approving agency
                 photo of cardholder
                 24-hour phone number for law enforcement to immediately  
               verify the validity of the card. 

           This bill  authorizes qualified patients, RIC holders, and  
          designated caregivers to form cooperatives so as to cultivate  
          marijuana for medical purposes in accordance with DHS  
          regulations.

           This bill  prohibits the smoking of medical marijuana in any  
          place where smoking is prohibited by law, and other specified  
          locations, including motor vehicles.

           This bill  does not require any accommodation of medical  
          marijuana on the premises of any place of employment or any  
          correctional facility.

           This bill  does, nevertheless, provide that an incarcerated  
          person may apply for an RIC, and that a correctional facility  
          may permit an incarcerated person to use medical marijuana,  
          where such use would not endanger the health of other prisoners  
          or the security of the institution.

            This bill  provides the following with respect to the conditions  
          ---------------------------
          <1> Discussions with the author's office indicate that San  
          Francisco has established a model for verification or  
          authentication of an RIC that can be applied statewide.



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          of probation, parole or bail:

           A probationer or defendant on bail may request that the court  
            confirm that he or she may use medical marijuana while on  
            probation or release on bail.
           Court must state its ruling - and the underlying reasons - on  
            the record.
           Parolee can request that he or she be allowed to use medical  
            marijuana.
           Written conditions of parole must reflect decision on request.
           Parolee can take an administrative appeal of a denial of the  
            request.
           Decision on the appeal must be in writing and reflect reasons  
            for decision.

           This bill  provides that no governmental, private, or any other  
          health care service plan or insurer shall be liable for any  
          claim for reimbursement for medical marijuana.

           This bill  prohibits a professional licensing board from taking  
          any disciplinary action against a licensee based solely on  
          conformance with the requirements of this bill.

           This bill  provides that records kept in accordance with this  
          bill are confidential and not subject to public disclosure.

           This bill  defines the misdemeanors listed below, punishable upon  
          a first conviction by imprisonment in the county jail for up to  
          6 months and/or a fine of up to $1,000.  The maximum jail time  
          is increased to 1 year upon a subsequent conviction.  Any person  
          convicted of one of these offenses may be prohibited from  
          obtaining or using an RIC for up to six months, in the  
          discretion of the court.

           Fraudulent representation of a medical condition for purposes  
            of obtaining an RIC
           Theft or fraudulent use of another person's RIC
           Counterfeiting an RIC or similar conduct
           Breaching confidentiality provisions of this bill





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           This bill  provides that any provision of this bill may be deemed  
          separate, distinct and independent.

           This bill  requires DHS to issue emergency regulations by July 1,  
          2004, and to adopt regulations no later than December 31, 2004,  
          for the purposes of this bill.

           This bill  makes findings and declarations related to the medical  
          use of marijuana.  Generally, the bill states the intent to  
          clarify the Act and eliminate confusion about its  
          implementation, to provide for consistent implementation, to  
          allow reasonable access to medicinal marijuana and to address  
          issues that were not adequately covered by the Act.


                                      COMMENTS

          1.  Need for This Bill
           
           The author indicates the following:

               SB 420 seeks to implement Proposition 215 passed in  
               1996 by establishing a voluntary registry  
               identification system for persons who are legitimate  
               users of medical marijuana and their primary  
               caregivers. The card immunizes the cardholder from  
               unnecessary arrest and prosecution for possession,  
               transportation and cultivation of marijuana for  
               medicinal purposes.  Additionally, the bill requires  
               the Department of Health Services to issue regulations  
               determining appropriate quantity of marijuana for  
               possession by qualified patients.  

               The lack of clear guidelines for implementation of  
               Proposition 215 has impeded the ability of law  
               enforcement to consistently interpret and enforce the  
               law.  Additionally, it has limited patients' access to  
               their medicine.

           Author's summary of the bill:




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          4  Establishes a registry identification card program for each  
          person in need of medicinal marijuana and for his/her designated  
          primary caregiver(s).  Under the authority of the state  
          Department of Health Services (DHS), the county health  
          department would accept and process applications and decide  
          whether the patient is qualified for a card.

          4 Clarifies existing law that a patient or primary caregiver who  
          is legally in possession of a photo registry card is immune from  
          arrest for possession, transportation, delivery, or cultivation  
          of medicinal marijuana.

          4  Defines a qualified person as one who submits all required  
          identification information plus written documentation by his/her  
          attending physician that s/he has a serious medical condition  
          (defined in the bill) and the medical use of marijuana is  
          appropriate.

          4  Requires the county health department to confirm the  
          attending physician has a license in good standing in California  
          and to verify the accuracy of the medical records submitted by  
          the patient.

          4  Requires the county health department to issue to an approved  
          applicant a registry identification card (renewable annually)  
          that includes a unique identification number and photograph of  
          the cardholder.

          4  Authorizes the county health department to deny a card to any  
          applicant who fails to provide all required information or who  
          falsifies any information.  

          4  Requires the county health department to provide information  
          about the cardholder to DHS, which shall make the information  
          available through a toll-free, 24-hour telephone number so law  
          enforcement can verify validity of registry cards.

          4  Requires DHS to promulgate emergency science-based  
          regulations defining amounts of marijuana that can be legally  




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          possessed for medicinal purposes.

          4  Allows qualified persons to collectively and cooperatively  
          cultivate marijuana and directs DHS to promulgate regulations  
          that ensure the consistency and quality of medicinal marijuana  
          and protect against illegal diversion of the marijuana.

          4  Prohibits the smoking of medicinal marijuana in any place  
          where smoking is prohibited, in or within 1000 feet of a school  
          or youth facility, on a school bus, in a vehicle that is being  
          operated or while operating a boat.

          4  Sentences for up to one year in jail and a $1000 fine any  
          persons who fraudulently applies for a registry card, steals or  
          uses another person's card or counterfeit a card as well as any  
          person who breaches the confidentiality provisions of this  
          program.

           Author's additional background:

          4Attorney General Bill Lockyer convened a task force to find a  
          way to implement Proposition 215.  This bill represents the work  
          product of this task force.

          4  Proposition 215 urges the state to work with the federal  
          government to facilitate the safe and affordable distribution of  
          medicinal marijuana.

          4 Despite the voters' strong support of medicinal marijuana, the  
          only efforts to provide access have been initiated by community  
          organizations and local governments.  The only response from the  
          federal government so far has been to try to shut down the  
          providers.  This was also the response from the state government  
          until Bill Lockyer replaced Dan Lungren as Attorney General.

          4  Local providers have placed themselves at risk of civil and  
          criminal prosecution by courageously pursuing a variety of  
          distribution models.  While the providers fill a vacuum created  
          by local government inactivity, the government continues to  
          avoid dealing with the distribution issue.




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          4  Eight other states have implemented laws similar to  
          Proposition 215, and Alaska, Colorado, Oregon and Hawaii are  
          among those states that have established a registry system for  
          patients and caregivers. 

          4  Several cities and counties including San Francisco, Santa  
          Cruz and Humboldt have established its own registry system and  
          policies for enforcement as a result of the legal chaos in the  
          field.  To date, San Francisco's program has successfully issued  
          several thousand identification cards to patients and  
          caregivers.

          4  City of San Diego has voted to implement a registry modeled  
          after San Francisco's.


          2.  Controlled substance schedules Under Federal Law  

          Section 812 of Title 21 U.S.C., sets out the five controlled  
          substance schedules.  Marijuana is listed in schedule I, as a  
          drug that is deemed to have no accepted medical use, and thus  
          greatest restrictions for use.  The distinguishing  
          characteristics among the five schedules are set out, below:

          ? Schedule I.

                 The drug or other substance has a high potential  
               for abuse.
                 The drug or other substance has no currently  
               accepted medical use.
                 There is a lack of accepted safety for use of the  
               drug or other 
               substance under medical supervision.

          ? Schedule II.

                 The drug or other substance has a high potential  
               for abuse.
                 The drug or other substance has a currently  




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               accepted medical use 
                  in treatment in the United States or a currently  
               accepted medical use 
                  with severe restrictions.
                 Abuse of the drug or other substances may lead to  
               severe psychological or physical dependence.




          ? Schedule III.

                 The drug or other substance has a potential for  
               abuse less than the drugs or other substances in  
               Schedules I and II.
                 The drug or other substance has a currently  
               accepted medical use in treatment in the United  
               States.
                 Abuse of the drug or other substance may lead to  
               moderate or low physical dependence or high  
               psychological dependence.

          ? Schedule IV.

                 The drug or other substance has a low potential for  
               abuse relative to the drugs or other substances in  
               Schedule III.
                 The drug or other substance has a currently  
               accepted medical use in treatment in the United  
               States.
                 Abuse of the drug or other substance may lead to  
               limited physical dependence or psychological dependence  
               relative to the drugs or other substances in Schedule  
               III.

          ? Schedule V.

                 The drug or other substance has a low potential for  
               abuse relative to the drugs or other substances in  
               Schedule IV.




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                 The drug or other substance has a currently  
               accepted medical use in treatment in the United  
               States.
                 Abuse of the drug or other substance may lead to  
               limited physical dependence or psychological dependence  
               relative to the drugs or other substances in Schedule  
               IV.

          3.  Authorization Cards for Medical Cannabis Users  

          This bill establishes a mechanism (RIC wallet card) which  
          provides a county and state-approved presumption that a PRC or  
          primary caregiver is not in violation of existing drug laws.   
          This presumption would potentially be useful in a situation  
          where a person is questioned by a law enforcement officer  
          regarding the use of marijuana.  Arguably, California law  
          enforcement officers will benefit by reducing the time and  
          energy spent dealing with situations involving marijuana usage,  
          possession, transportation and cultivation, as the mechanism  
          established by this bill will provide an almost instantaneous  
          evaluation of whether or not a crime is being committed. 























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          4.  Argument in Support  
           
           The California Medical Association argues in support:

               SB 420 (Vasconcellos) will help clarify the  
               implementation of Proposition 215 of 1996.  SB 420 is  
               an agreement developed by the California Attorney  
               General Task Force comprised of representatives of key  
               stakeholder group including patients, patient  
               advocates, law enforcement, and medical professionals.

               Voter enactment of Proposition 215 has been followed  
               by a degree of confusion and conflict between various  
               stakeholders - resulting in wasted government  
               resources and needles harm to many patients.

               SB 420 takes a considered and rational approach toward  
               ending that confusion and conflict by allowing the  
               Dept. of Health Services to establish guidelines for  
               the appropriate use of medical marijuana as well as  
               voluntary registry program to use identification cards  
               for qualified patients.

                     A voluntary registry program will afford patients  
                 standardized proof of their physician-recommended use of  
                 medical marijuana;
                     Such a system would also enable law enforcement  
                 officials to easily distinguish between legitimate and  
                 illicit users of the drug; and
                     The system would reduce unnecessary criminal  
                 investigation of patients and the seizure of their  
                 medicine.

          5.  Argument in Opposition  

          The California Conference of Local Health Officers argues in  
          opposition

               The Conference has the following concerns with the  




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               bill:

                     Establishing and operating a registry system  
                 for medical marijuana is not a public health  
                 function and public health departments should not be  
                 diverted from their core . . . functions . . . to do  
                 this.  This bill would require the establishment of  
                 58 individual . . . programs, many in very small  
                 county health departments.

                     Regulating drugs and monitoring physician  
                 prescribing is a medical quality issue under the  
                 auspices of the Medical Board of California and the  
                 State Department of Health Services Licensing and  
                 Certification Division.  Control of fraud and use of  
                 illegal drugs is a law enforcement issue [while]  
                 substance abuse is a public health issue.  There is  
                 little reason for 58 county health departments to  
                 perform either of these functions.

                     Responsibility for this program has been  
                 assigned to the wrong level of government and to the  
                 wrong departments.  If a registration program is  
                 necessary, a better organizational structure would  
                 be a simple, single, statewide program, operated by  
                 a state agency such as the Department of Justice or  
                 the Medical Board of California. 


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