What You Should Know About Illinois' Updated Medical Marijuana Rules

By Green Thumb Industries Inc GTBIF.

The Illinois legislature passed SB 2023, with House Amendments 1 and 2, and it is awaiting Governor Pritzker’s signature. This is a summary of the significant changes that the “Bill” makes to the Program.

Makes the program permanent: The Compassionate Use of Medical Cannabis Pilot Program was a pilot program and was set to expire in 2020. The Bill repeals the current 2020 sunset date, removes its pilot program designation, and makes conforming changes by removing “pilot” from various acts.

Adds debilitating medical conditions: Broadens what qualifies as a “debilitating medical condition”:

  • Autism
  • chronic pain
  • irritable bowel syndrome
  • migraines
  • osteoarthritis
  • anorexia nervosa
  • Ehlers-Danlos Syndrome
  • Neuro-Behcet’s Autoimmune Disease
  • neuropathy
  • polycystic kidney disease
  • superior canal dehiscence syndrome

Broadens who can certify patients: Currently, only physicians can certify a debilitating medical condition for a qualifying patient after a physical examination of the person. The Bill allows advanced practice registered nurses (“APRN”), who must have a controlled substances license, and physician assistants (“PA”) to also qualify as certifying health care professionals.

Patients can now make immediate changes to their designated dispensary: The Bill provides that DPH shall provide for immediate changes of a registered qualifying patient’s designated registered dispensing organization. Currently, the patient’s new dispensary must advise the patient that the designated dispensary on file with IDPH has been changed, then notify the old dispensary that the designation has changed and the patient may no longer purchase there, and then notify IDPH of the change and receive confirmation that IDPH has updated its database.

This process was originally intended to prevent “dispensary shopping” because there was up to a 24-hour delay in reflecting a person’s purchases, but IDPH has updated its technology system so that it tracks a person’s purchase of medical cannabis immediately. The Bill requires that DPH must provide for the patient’s changed dispensary immediately to reflect this.

No flower sales or paraphernalia sales to patients under age 21: DPH requested this change so cannabis rules would match with tobacco restrictions. Currently, DPH may not issue medical cannabis cards to patients under 18 except in limited circumstances, such as when the patient has epilepsy. Patients under 18 who are approved by DPH are prohibited from consuming cannabis except for medical cannabis infused products, and from purchasing any usable cannabis. The Bill changes this so that patients under 21 years of age who are approved by DPH are still prohibited from consuming cannabis except for medical cannabis infused products, from purchasing any usable cannabis or paraphernalia used for smoking or vaping medical cannabis.

Product returns will be allowed: The Bill requires IDFPR to adopt rules permitting the return and potential refunds for damaged or inadequate products.

Cultivation centers can sell cannabis to other cannabis cultivation centers: The Bill allows a cultivation center to sell or distribute cannabis to “another cultivation center”, a dispensing organization, or a testing lab.

Principal Officers and Board members can become patients: The Bill removes the prohibition on Principal Officers and board members becoming patients or caregivers.

Physicians can be compensated for research: The Act currently prohibits physicians from receiving remuneration from patients, primary caregivers, cultivation centers, or dispensing organizations (other than payment from a patient for the fee associated with the required examination). The Bill adds an exception to this prohibition for the limited purpose of performing a medical cannabis-related research study. This is to prevent medical cannabis businesses from paying health care professionals to certify patients, but also allows medical cannabis researchers to be compensated for their research-related work.

The Bill adds a new prohibition against certifying health professionals from: accepting, soliciting, or offering any form of remuneration from or to a medical cannabis cultivation center or dispensary for the purposes of referring a patient to a specific dispensary organization.

Expands the number of caregivers allowed: The Bill allows a patient under age 18 to appoint up to 3 designated caregivers (instead of 2 parents or legal guardians) and it can be whomever the patient designates, so long as they still meet the definition of a designated caregiver and at least one designated caregiver is a biological parent or legal guardian. The Bill also allows patients 18 and over to have 3 caregivers.

Designated caregiver definition remains the same (means a person who: (1) is at least 21 years of age; (2) has agreed to assist with a patient's medical use of cannabis; (3) has not been convicted of an excluded offense; and (4) assists no more than one registered qualifying patient with his or her medical use of cannabis)

No more renewals for people with life-long debilitating medical conditions: DPH can no longer require patients and applicants with life-long debilitating medical conditions to renew their cards.

Expanded access for veterans: The Opioid Alternative Pilot Program (OAPP) was created in PA 100-1114 to provide access to medical cannabis as an alternative for persons eligible for opioid prescriptions. It authorizes licensed dispensaries to sell medical cannabis to persons enrolled in the OPAA. In order to enroll in OPAA a person needs to provide written certification from a licensed physician.

The Bill specifically provides that the Department of Public Health (IDPH) must adopt rules or procedures allowing qualified veterans to participate in the OPAA. Currently, the US Department of Veterans Affairs cannot recommend or assist veterans in obtaining medical cannabis. The Bill seeks to allow IDPH to instead provide certification to veterans so that they may participate in OPAA.

The Bill also makes a change so that IDPH must also allow qualified veterans to participate in their quantity waiver process- which allows IDPH to approve certain patients from receiving more than the allowed 2.5 ounces of cannabis in any 14-day period.

Containers for personal transport of product: Currently, any medicinal cannabis in transit must be in a tamper-evident, sealed container. The Bill 1 removes the requirement that it be tamper- evident and merely requires that it be sealed. This has caused confusion in transferring medical cannabis in situations where the product may have been opened by the person in one location, but used in another (home to hospital transfers).

Conflicts of Law: The Bill adds a conflicts of law provision which states that in the event the medical act conflicts with the adult use act, the provisions of the adult use act shall control.

IDFPR can issue non-disciplinary citations: The Bill allows IDFPR to issue non-disciplinary citations to dispensaries for minor violations, which may be accompanied by up to $10,000 civil penalty for each violation. The penalty shall be a civil penalty or other condition as established by rule. The licensee may choose, in lieu of accepting the citation, to request a hearing, and the licensee has 30 days after service to dispute the matter before it becomes and final and non- appealable. Currently, IDFPR may revoke, suspend, reprimand, etc. as it deems necessary any licensed dispensary for violations of the Act. This includes imposing fines up to $10,000 for each violation. However, IDFPR lacks any ability to issue citations for minor violations, such as improper employee training, faulty camera systems, vault log errors, and other violations that an inspector may notice while performing a routine inspection.

Prohibition on seeing doctors for certification only: The Bill states that nothing prevents certifying health care professionals from referring a patient for health services “except when the referral is limited to certification purposes only.” This means DPH expects that a patient will have a bona-fide relationship with their health care professional, and does not want a patient referred to a doctor for the sole purpose of getting a certification.

The preceding article is from one of our external contributors. It does not represent the opinion of Benzinga and has not been edited.

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