Under present law, it is generally a criminal offense for a person to manufacture, deliver, or sell, or possess with the intent to manufacture, deliver, or sell, marijuana. The classification of the offense and authorized penalties depend on the amount of marijuana involved in the offense. Under present law, certain products that are derived from the cannabis plant (such as hemp, FDA-approved prescription medications, and products with limited amounts of THC that are used for clinical research or treatment of specific medical conditions) are excepted from the definition of marijuana and, therefore, not subject to criminal penalties.
Present law also establishes the medical cannabis commission to study and make recommendations related to the medical use of cannabis in Tennessee should cannabis be reclassified or declassified as a controlled substance at the federal level.
Generally, this bill enacts the Tennessee Medical Cannabis Act to exempt persons who have a qualifying medical condition to obtain a card that authorizes the cardholder to use marijuana under certain circumstances without committing a criminal offense. This bill also changes certain duties of the medical cannabis commission.
QUALIFYING PATIENTS
Under this bill, a qualifying patient will be eligible to apply for a registry identification card (discussed below) to permit the use of marijuana, subject to various conditions. For purposes of this bill, a "qualifying patient" means a person who has been diagnosed by a health care practitioner with the authority to prescribe drugs to humans (a "practitioner") as having a debilitating medical condition. This bill identifies the following medical conditions as debilitating medical conditions:
(1) Cancer;
(2) Glaucoma;
(3) Positive status for HIV;
(4) AIDS;
(5) ALS;
(6) Crohn's disease;
(7) Ulcerative colitis;
(8) Alzheimer's disease;
(9) PTSD;
(10) Chronic pain;
(11) Severe acute pain; or
(12) Autism;
(13) A chronic or debilitating disease or medical condition or its treatment that produces: cachexia or wasting syndrome, severe nausea, seizures, or severe and persistent muscle spasms; and
(14) A condition that the individual's practitioner considers debilitating to the individual for which the practitioner is qualified to treat through their medical education and training.
In addition to the debilitating medical conditions listed in (1) – (14), this bill specifies a process by which residents of Tennessee may petition the department of health to designate another serious medical condition or side effect of treatment to the list of debilitating medical conditions.
This bill authorizes the department to establish a sliding scale of patient application and renewal fees based upon a qualifying patient's household income. The fees charged to qualifying patients, nonresident cardholders, and designated caregivers in aggregate must be no greater than the costs of processing applications and issuing registry identification cards.
This bill also generally provides that a nonresident cardholder may obtain, possess, or use medical cannabis in this state. For purposes of this bill, a "nonresident cardholder" means a person who:
(1) Has been diagnosed with a debilitating medical condition, or is the parent, guardian, conservator, or other person with authority to consent to the medical treatment of a person who has been diagnosed with a debilitating medical condition;
(2) Is not a resident of this state or has been a resident of this state for less than 90 days;
(3) Was issued a currently valid registry identification card or its equivalent under the laws of another state, district, territory, commonwealth, or insular possession of the United States, or country recognized by the United States, that allows the person to use cannabis for medical purposes in the jurisdiction of issuance; and
(4) Has completed any documentation required by the department.
DESIGNATED CAREGIVERS
For purposes of this bill, a designated caregiver can be:
(1) A natural person who agrees to assist no more than five qualifying patients with the medical use of cannabis; or
(2) An entity registered in this state to provide healthcare services that agrees to assist with qualifying patients' medical use of cannabis, including an employee or agent acting on behalf of the institution.
REGISTRY IDENTIFICATION CARDS
No later than May 1, 2024, this bill requires the department of health to begin issuing registry identification cards (referred to as a "card" in this Summary) to qualifying patients who submit the following, in accordance with the department's rules:
(1) A written certification issued by a practitioner within 90 days immediately preceding the date of the application. For purposes of this bill, a "written certification" means a document dated and signed by a practitioner, stating that, in the practitioner's professional opinion, the patient is likely to receive therapeutic or palliative benefit from the medical use of cannabis to treat or alleviate the patient's debilitating medical condition or symptoms associated with the debilitating medical condition. A written certification must affirm that it is made in the course of a bona fide practitioner-patient relationship;
(2) The application or renewal fee;
(3) Contact information of the qualifying patient;
(4) Contact information of the qualifying patient's practitioner;
(5) Contact information of the designated caregiver(s) chosen by the qualifying patient;
(6) A signed statement from each designated caregiver who is a natural person, agreeing to assist with a qualifying patient's medical use of cannabis;
(7) The name of no more than two dispensaries that the qualifying patient designates, if any;
(8) Documentation demonstrating that a greater number of designated caregivers is needed due to the patient's age or medical condition if the patient requests more than one designated caregiver at any given time; and
(9) A signed statement that the qualifying patient or a designated caregiver intends to cultivate cannabis plants for the patient's medical use and understands the requirements and restrictions associated with cannabis cultivation and documentation that supports the ability of the patient or caregiver to cultivate cannabis in a suitable enclosed, locked facility.
The full text of this bill specifies various requirements for the form and contents of a card.
Subject to certain exceptions, this bill requires the department to:
(1) Verify the information contained in an application or renewal for a card and approve or deny the application or renewal within 15 days of receiving a completed application or renewal;
(2) Issue cards to a qualifying patient and any designated caregiver within five days of approving the application or renewal; and
(3) Enter a registry identification number of each designated dispensary into the verification system.
This bill prohibits the department from issuing a registry identification card to a qualifying patient who is younger than 18 years of age unless:
(1) The qualifying patient's practitioner has explained the potential risks and benefits of the medical use of cannabis to the custodial parent or legal guardian with responsibility for healthcare decisions for the qualifying patient; and
(2) Such custodial parent or legal guardian consents in writing to allow the qualifying patient's medical use of cannabis, serve as a designated caregiver, and control the acquisition, dosage, and frequency of the medical use of cannabis by the qualifying patient.
The full text of this bill lists the grounds upon which the department may deny an application or renewal for a card, or for designation as a caregiver. If the department denies an application or renewal, the department must provide written notice to the applicant. Judicial review of the department's denial of an application or renewal is vested in the chancery court of Davidson County.
Until a qualifying patient who has submitted an application and the required fee to the department receives a card or a rejection, a copy of the individual's application, written certification, and proof that the application was submitted to the department is deemed a temporary card. This bill contains a similar provision for a designated caregiver whose application is pending.
The full text of this bill specifies documentation that will be deemed a card until 60 days after the date the department makes applications available for qualifying patients and designated caregivers.
ALLOWABLE AMOUNT OF CANNABIS
Generally, this bill limits the amount of cannabis that a cardholder may obtain or possess at one time to an "allowable amount of cannabis", which this bill defines to mean:
(1) Two and one-half ounces of cannabis, not including cannabis products;
(2) Cannabis products containing a total of no more than 2,000 milligrams of THC;
(3) Six cannabis plants if the cardholder has a registry identification card allowing cultivation; and
(4) The amount of cannabis and cannabis products that were produced from the cardholder's allowable plants if the cardholder has a registry identification card allowing cultivation; provided, that the cannabis and cannabis products are possessed at the same property where the plants were cultivated.
If the qualifying patient's practitioner specifies a greater quantity that permitted under (1) – (4) is reasonably necessary to meet the qualifying patient's medical needs every fourteen (14) days, the "allowable amount of cannabis" means the amount specified in the practitioner's written certification.
MEDICAL CANNABIS ESTABLISHMENTS
For purposes of this bill, the following are medical cannabis establishments:
(1) A cultivation facility, which is an entity registered with the department that acquires, possesses, cultivates, delivers, transfers, transports, supplies, or sells cannabis and related supplies to medical cannabis establishments;
(2) A cannabis testing facility, which is an independent entity registered with the department to analyze the safety and potency of cannabis;
(3) A cannabis product manufacturing facility, which is an entity registered with the department that acquires, possesses, manufactures, delivers, transfers, transports, supplies, or sells cannabis products to medical cannabis dispensaries;
(4) A dispensary; and
(5) Another medical cannabis entity registered by the department.
The full text of this bill specifies the application requirements for a medical cannabis establishment. Not later than 90 days after receiving an application for a medical cannabis establishment, this bill requires the department to register the prospective medical cannabis establishment and issue a registration certificate and a random identification number of at least 10 digits if all conditions specified in the full text of this bill are satisfied. Additionally, this bill requires the department to issue a renewal registration certificate within 10 days of receipt of a renewal application and renewal fee from a medical cannabis establishment if its registration certificate is not under suspension and has not been revoked.
This bill specifies various requirements and prohibitions for the operation of a medical cannabis establishment, including:
(1) Criminal history background checks are required for each person seeking to become a principal officer, board member, agent, volunteer, or employee;
(2) A prohibition against employing any person who is under 21 years of age;
(3) Procedures for the oversight of the medical cannabis establishment and procedures to ensure accurate recordkeeping;
(4) Implementation of security measures designed to deter and prevent the theft of cannabis and unauthorized entrance into areas containing cannabis;
(5) Limiting cannabis production-related activities to a secure facility and limiting access to the facility to agents of the medical cannabis establishment, emergency personnel, and adults who are 21 years of age and older and who are accompanied by medical cannabis establishment agents;
(6) Only a cannabis product manufacturer may produce cannabis products;
(7) A prohibition against sharing office space with or referring patients to a practitioner;
(8) Inspection requirements;
(9) Protocols for dispensing cannabis to a cardholder or nonresident cardholder; and
(10) A dispensary is prohibited from dispensing more than the allowable amount of cannabis to a nonresident cardholder or a registered qualifying patient, directly or via a designated caregiver, in any 14-day period.
The application fees for medical cannabis establishments will be set by the department, in an amount that does not exceed $5,000, which, beginning January 1, 2025, must be increased annually to reflect inflation, as measured by the CPI, rounded to the nearest $10.00. The total fees collected must generate revenues sufficient to offset all departmental expenses of implementing and administering this bill.
This bill specifies the procedure by which the department may suspend or revoke the registration of a medical cannabis establishment.
In computing net earnings for medical cannabis establishments, this bill allows as a deduction from state taxes all the ordinary and necessary expenses paid or incurred during the taxable year in carrying on a trade or business as a medical cannabis establishment, including reasonable allowance for salaries or other compensation for personal services actually rendered.
LIMITATIONS
This bill specifies that it does not authorize a person to engage in, and does not prevent the imposition of any civil, criminal, or other penalties for engaging in, the following conduct:
(1) Undertaking any task under the influence of cannabis, when doing so would constitute negligence or professional malpractice;
(2) Possessing cannabis or otherwise engaging in the medical use of cannabis in any correctional facility, unless the correctional facility has elected to allow the cardholder to engage in the medical use of cannabis;
(3) Smoking cannabis on any form of public transportation, on any school grounds, or in a public place or a place that is open to the public;
(4) Operating, navigating, or being in actual physical control of a motor vehicle, aircraft, train, or motorboat while under the influence of cannabis, except that a registered qualifying patient or nonresident cardholder will not be considered to be under the influence of cannabis solely because of the presence of metabolites or components of cannabis that appear in insufficient concentration to cause impairment; or
(5) Cultivating cannabis if not a registered cultivation facility or a cardholder who is a resident of this state and has a registry identification card allowing cultivation.
LOCAL REGULATION
A local government may enact ordinances or regulations not in conflict with this bill governing the time, place, manner, and number of medical cannabis establishment operations in the applicable jurisdiction. A local government may establish penalties for violations of an ordinance or regulations governing the time, place, and manner of a medical cannabis establishment that may operate in the jurisdiction.
This bill prohibits a local government from prohibiting dispensaries or delivery, either expressly or through the enactment of ordinances or regulations that make medical cannabis establishment operations impracticable in the jurisdiction.
This bill authorizes a local government to require a medical cannabis establishment to obtain a local license to operate, and charge a reasonable fee for the local license.
ACTS NOT REQUIRED
This bill specifies that it does not require:
(1) A government medical assistance program or private insurer to reimburse a person for costs associated with the medical use of cannabis;
(2) A person or establishment in lawful possession of property to allow a guest, client, customer, or other visitor to smoke cannabis on or in that property; or
(3) A landlord to allow the cultivation of cannabis on the rental property.
VIOLATIONS AND PENALTIES
This bill establishes the following violations and penalties:
(1) A cardholder or medical cannabis establishment that intentionally fails to notify the department of changed information is subject to a civil penalty imposed by the department in an amount not to exceed $150 per violation;
(2) A medical cannabis establishment or an agent of a medical cannabis establishment who intentionally sells or otherwise transfers cannabis in exchange for anything of value to a person other than a cardholder, a nonresident cardholder, or a medical cannabis establishment or its agent commits a Class E felony. A person convicted under this (2) will be prohibited from owning, operating, being employed by, or otherwise affiliating with a medical cannabis establishment;
(3) A person who intentionally makes a false statement to a law enforcement official about any fact or circumstance relating to the medical use of cannabis to avoid arrest or prosecution commits a Class B misdemeanor, punishable by imprisonment for not more than 90 days or by a fine of not more than $1,000, or both. If a person convicted of violating this (3) is a cardholder, then the person is disqualified from further participation in the medical cannabis program;
(4) A person who knowingly submits false records or documentation required by the department to certify a medical cannabis establishment commits a Class E felony;
(5) A practitioner who knowingly refers patients to a medical cannabis establishment or to a designated caregiver, who advertises in a medical cannabis establishment, or who issues written certifications while holding a financial interest in a medical cannabis establishment commits a violation, subject to a civil penalty imposed by the department in an amount not to exceed $1,000 per violation;
(6) Generally, it is a Class B misdemeanor for a person, except for purposes directly connected with the administration of this bill, to disclose, make use of, or authorize or knowingly permit the use of confidential information obtained pursuant to this bill;
(7) It is a Class D felony for a person, other than a cannabis product manufacturing facility or its agents complying with this bill, to extract compounds from cannabis using solvents other than water, glycerin, propylene glycol, vegetable oil, or food grade ethanol (ethyl alcohol);
(8) It is a Class D felony for a person to extract compounds from cannabis using ethanol in the presence or vicinity of open flame; and
(9) Except where another penalty is specified for a violation, a medical cannabis establishment that violates this bill is subject to a civil penalty imposed by the department in an amount not to exceed $1,000 per violation. This pena