FILED SENATE
Jan 25, 2023
GENERAL ASSEMBLY OF NORTH CAROLINA
S.B. 3
SESSION 2023 PRINCIPAL CLERK
S D
SENATE BILL DRS15007-MGfa-29
Short Title: NC Compassionate Care Act. (Public)
Sponsors: Senators Rabon, Lee, and Lowe (Primary Sponsors).
Referred to:
1 A BILL TO BE ENTITLED
2 AN ACT ENACTING THE NORTH CAROLINA COMPASSIONATE CARE ACT.
3 The General Assembly of North Carolina enacts:
4 SECTION 1. Chapter 90 of the General Statutes is amended by adding a new Article
5 to read:
6 "Article 5H.
7 "North Carolina Compassionate Care Act.
8 "§ 90-113.110. Short title.
9 This Article shall be known and may be cited as the "North Carolina Compassionate Care
10 Act."
11 "§ 90-113.111. Legislative findings and purpose.
12 The General Assembly makes the following findings:
13 (1) Modern medical research has found that cannabis and cannabinoid
14 compounds are effective at alleviating pain, nausea, and other symptoms
15 associated with several debilitating medical conditions.
16 (2) As of January 2023, more than a majority of states, four out of five
17 permanently inhabited United States territories, and the District of Columbia
18 have removed state-level criminal penalties for the medical use, cultivation,
19 and distribution of cannabis, and in enacting this Article, North Carolina now
20 takes similar action to preserve and enhance the health and welfare of its
21 citizens.
22 (3) This Article is intended to make only those changes to existing North Carolina
23 laws that are necessary to protect patients and their doctors from criminal and
24 civil penalties and is not intended to change current civil and criminal laws
25 governing the use of cannabis for nonmedical purposes.
26 (4) The General Assembly enacts this Article pursuant to its police power to enact
27 legislation for the protection of the health of its citizens, as reserved to the
28 State in the Tenth Amendment of the United States Constitution.
29 (5) It is the intent of the General Assembly to prioritize the protection of public
30 health and safety in the creation of a system for the cultivation, processing,
31 and selling of medical cannabis.
32 (6) It is the intent of the General Assembly that the regulatory system created by
33 this Article be nimble and able to respond quickly to changes in the
34 rapidly-evolving cannabis industry.
35 "§ 90-113.112. Definitions.
36 The following definitions apply in this Article:
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1 (1) Adequate supply. – An amount of usable cannabis derived solely from an
2 intrastate source that is possessed by a qualified patient, or collectively
3 possessed by a qualified patient and the qualified patient's designated
4 caregiver, in an amount that does not exceed what is reasonably necessary to
5 assure the uninterrupted availability of cannabis for a period of 30 days, in any
6 form recommended by the qualified patient's physician for the purpose of
7 alleviating the symptoms or effects of the qualified patient's debilitating
8 medical condition.
9 (2) Advisory Board. – The Compassionate Use Advisory Board established in
10 G.S. 90-113.113.
11 (3) Bona fide physician-patient relationship. – A treatment relationship between
12 a physician and a patient in which the physician has completed a full
13 assessment of the patient's medical history, including checking the patient's
14 prescription history in the Controlled Substances Reporting System, and
15 current medical condition, including an in-person physical examination, and
16 the physician is available or offers to provide follow-up care and treatment to
17 the patient, including patient examinations, to determine the efficacy of the
18 use of cannabis as a treatment for the patient's medical condition.
19 (4) Cannabis. – Marijuana as defined in G.S. 90-87(16).
20 (5) Cannabis-infused product. – A product infused with cannabis that is intended
21 for use or consumption other than by inhalation, smoking, or vaping. The term
22 includes a tablet, a capsule, a concentrated liquid or viscous oil, a liquid
23 suspension, a topical preparation, a transdermal preparation, a sublingual
24 preparation, a gelatinous cube, a gelatinous rectangular cuboid, a lozenge in a
25 cube or rectangular cuboid shape, a resin, or a wax.
26 (6) Commission. – The Medical Cannabis Production Commission established in
27 G.S. 90-113.118.
28 (7) Debilitating medical condition. – A diagnosis of one or more of the following
29 for which a physician provides a written certification:
30 a. Cancer.
31 b. Epilepsy.
32 c. Positive status for human immunodeficiency virus (HIV).
33 d. Acquired immune deficiency syndrome (AIDS).
34 e. Amyotrophic lateral sclerosis (ALS).
35 f. Crohn's disease.
36 g. Sickle cell anemia.
37 h. Parkinson's disease.
38 i. Post-traumatic stress disorder, subject to evidence that an applicant
39 experienced one or more traumatic events. Acceptable evidence shall
40 include, but is not limited to, proof of military service in an active
41 combat zone, that the person was the victim of a violent or sexual
42 crime, or that the person was a first responder. Details of the trauma
43 shall not be required.
44 j. Multiple sclerosis.
45 k. Cachexia or wasting syndrome.
46 l. Severe or persistent nausea in a person who is not pregnant that is
47 related to end-of-life or hospice care, or who is bedridden or
48 homebound because of a condition.
49 m. A terminal illness when the patient's remaining life expectancy is less
50 than six months.
51 n. A condition resulting in the individual receiving hospice care.
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1 o. Any other serious medical condition or its treatment added by the
2 Compassionate Use Advisory Board, as provided for in
3 G.S. 90-113.113.
4 (8) Department. – The North Carolina Department of Health and Human
5 Services.
6 (9) Designated caregiver. – A person who possesses a valid registry identification
7 card issued by the Department authorizing the person to assist a qualifying
8 patient with the medical use of cannabis. A designated caregiver shall be at
9 least 21 years of age unless the person is the parent or legal guardian of each
10 qualifying patient the person assists.
11 (10) Medical cannabis center. – A facility owned and operated by a supplier that
12 possesses and dispenses cannabis and cannabis-infused products to registry
13 identification cardholders for human consumption.
14 (11) Medical use of cannabis or medical use. – The acquisition, administration,
15 possession, preparation, transportation, or use of cannabis and
16 cannabis-infused products, or paraphernalia used to administer cannabis
17 products, to treat or alleviate a qualifying patient's debilitating medical
18 condition or symptoms associated with the qualifying patient's debilitating
19 medical condition and includes the transfer of cannabis products from a
20 designated caregiver to a qualifying patient whom the designated caregiver is
21 authorized to assist. "Medical use" does not include the extraction of resin
22 from cannabis by solvent extraction other than water, glycerin, propylene
23 glycol, vegetable oil, or food grade ethanol (ethyl alcohol), unless the
24 extraction is done by a processing facility.
25 (12) Physician. – A person licensed under Article 1 of Chapter 90 of the General
26 Statutes who is in good standing to practice medicine in the State, who has a
27 valid DEA registration, and who has completed continuing medical education
28 courses as required pursuant to G.S. 90-113.114.
29 (13) Production facility. – A facility owned and operated by a supplier that
30 cultivates, possesses, and produces cannabis and cannabis-infused products.
31 (14) Qualified patient. – A person who has been diagnosed by a physician as
32 having a debilitating medical condition and has received a written
33 certification.
34 (15) Registry identification card. – A document issued by the North Carolina
35 Department of Health and Human Services pursuant to G.S. 90-113.115 that
36 identifies a person as a qualified patient or a designated caregiver.
37 (16) Registry identification cardholder. – A qualified patient or a designated
38 caregiver who holds a valid registry identification card issued by the North
39 Carolina Department of Health and Human Services pursuant to
40 G.S. 90-113.115.
41 (17) Regulated medical cannabis supply system or system. – A system established
42 by the North Carolina Department of Health and Human Services pursuant to
43 G.S. 90-113.119 to provide a safe method for producing and distributing
44 cannabis and cannabis-infused products to registry identification cardholders.
45 (18) Smoking. – The use or possession of a lighted cannabis product.
46 (19) Supplier. – A person licensed pursuant to G.S. 90-113.119 to supply cannabis
47 and cannabis-infused products as authorized by this Article. A supplier
48 cultivates cannabis, owns and operates one or more medical cannabis centers,
49 and owns and operates one or more production facilities as set forth in
50 G.S. 90-113.119.
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1 (20) Usable cannabis. – The dried buds and mature female flowers of the plant of
2 the genus Cannabis, and any mixture or preparation thereof, that are
3 appropriate for medical use as provided in this Article.
4 (21) Vaping. – The use of a product which heats a liquid or other form of cannabis
5 in a manner so as to release an aerosol.
6 (22) Written certification. – A statement signed by a physician with whom the
7 patient has a bona fide physician-patient relationship indicating the following:
8 a. In the physician's professional opinion, the patient has a debilitating
9 medical condition.
10 b. The patient's debilitating medical condition.
11 c. In the physician's professional opinion, the potential health benefits of
12 the medical use of cannabis would likely outweigh the health risk for
13 the patient.
14 d. The delivery method of the cannabis.
15 e. The amount and dosage of the cannabis or cannabis-infused product,
16 not to exceed an adequate supply.
17 f. The period of time for which the written certification is valid, not to
18 exceed one year.
19 g. The physician's DEA number.
20 h. The physician's national provider identification number, if the
21 physician has a national provider identification number.
22 i. Any other information required by the Commission.
23 "§ 90-113.113. Compassionate Use Advisory Board; membership; terms; meetings;
24 quorum; expenses.
25 (a) Advisory Board Established. – The Compassionate Use Advisory Board is established
26 and shall consist of 11 members as follows:
27 (1) The Governor shall appoint members to the Advisory Board as follows:
28 a. A medical doctor or doctor of osteopathy licensed in the State.
29 b. A medical doctor or doctor of osteopathy licensed in the State
30 specializing in primary care.
31 c. A medical doctor or doctor of osteopathy who is board-certified to
32 practice addiction medicine in the State.
33 d. A research scientist with expertise in the field of cannabinoid
34 medicine.
35 e. A pharmacist licensed in the State.
36 f. A registry identification cardholder or, for an appointment made
37 before registry identification cards are issued, one person with a
38 debilitating medical condition who intends to use cannabis.
39 g. A parent of a minor qualified patient or, for an appointment made
40 before registry identification cards are issued, one parent of a minor
41 with a debilitating medical condition who intends to use cannabis.
42 (2) Two members appointed by the General Assembly upon recommendation of
43 the Speaker of the House of Representatives in accordance with G.S. 120-121.
44 (3) Two members appointed by the General Assembly upon recommendation of
45 the President Pro Tempore of the Senate in accordance with G.S. 120-121.
46 (b) Terms. – Members of the Advisory Board shall serve a four-year term, beginning
47 effective July 1 of the year of appointment, and may be reappointed to a second four-year term.
48 (c) Chair. – The members of the Advisory Board shall elect a chair. The chair shall serve
49 a two-year term and may be reelected.
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1 (d) Vacancies. – Any appointment to fill a vacancy on the Advisory Board created by the
2 resignation, dismissal, death, or disability of a member shall be made by the original appointing
3 authority and shall be for the balance of the unexpired term.
4 (e) Meetings. – The Advisory Board shall meet at least two times per year for the purpose
5 of reviewing petitions to add debilitating medical conditions.
6 (f) Power. – The Advisory Board shall have the power to approve adding a debilitating
7 medical condition by a majority vote of the members present and voting.
8 (g) Quorum. – Seven members of the Advisory Board shall constitute a quorum for the
9 transaction of business.
10 (h) Administration Support. – All administrative support and other services required by
11 the Advisory Board shall be provided by the Department.
12 (i) Expenses. – The members of the Advisory Board shall receive per diem and necessary
13 travel and subsistence expenses in accordance with the provisions of G.S. 138-5.
14 "§ 90-113.114. Physician requirements.
15 (a) Continuing Medical Education. – Before providing a written certification to a
16 qualified patient, a physician shall complete a 10-hour continuing medical education course on
17 the prescribing of medical cannabis. A physician shall complete a three-hour supplemental
18 continuing medical education course thereafter in any year in which the physician issues a written
19 certification. Records documenting compliance with continuing medical education requirements
20 must be maintained for six consecutive years and may be inspected by the Department or by the
21 NC Medical Board or its agents.
22 (b) R