A bill

to amend the South Carolina Code of Laws by enacting the "put patients first act"; by adding article 22 to chapter 53, title 44 so as to AUTHORIZE REGISTERED PATIENTS TO USE MARIJUANA FOR MEDICAL PURPOSES, PHYSICIANS TO RECOMMEND THE MEDICAL USE OF MARIJUANA FOR THOSE PATIENTS, AND INDIVIDUALS TO ACT AS REGISTERED CAREGIVERS FOR THOSE PATIENTS, ALL WITH EXCEPTIONS; TO CREATE A CONFIDENTIAL REGISTRY THROUGH WHICH TO ISSUE IDENTIFICATION CARDS TO REGISTERED PATIENTS AND REGISTERED CAREGIVERS; TO PROVIDE CERTAIN DEFENSES AND OTHER PROTECTIONS TO REGISTERED PATIENTS, REGISTERED CAREGIVERS, AND PHYSICIANS FROM CRIMINAL LIABILITY AND PROFESSIONAL DISCIPLINE FOR CONDUCT AUTHORIZED BY THIS ARTICLE; TO AUTHORIZE THE OPERATION OF DISPENSARIES TO CULTIVATE, GROW, AND DISPENSE MARIJUANA FOR MEDICAL USE; TO PROVIDE CERTAIN DEFENSES AND PROTECTIONS TO DISPENSARIES FOR CONDUCT AUTHORIZED BY THIS ARTICLE; TO ALLOW ESTABLISHMENT OF FEES; TO CREATE CRIMINAL PENALTIES; TO PROVIDE FOR THE PROMULGATION OF REGULATIONS AND DEVELOPMENT OF GUIDANCE AND FORMS; AND FOR OTHER PURPOSES; and by repealing article 4 OF chapter 53, title 44 relating to controlled substances therapeutic research.

Be it enacted by the General Assembly of the State of South Carolina:

SECTION 1.   This act may be cited as the "Put Patients First Act".

SECTION 2.   Chapter 53, Title 44 of the S.C. Code is amended by adding:

Article 22

Put Patients First Act

   Section 44-53-2220.   For purposes of this article:

   (1) "Bona fide physician-patient relationship" means:

      (a) a physician and patient treatment or counseling relationship, in the course of which the physician has completed a full assessment of the patient's medical history and current medical condition, including an appropriate personal physical examination;

      (b) physician consultation with a patient with respect to the patient's debilitating medical condition before the patient applies for a registry identification card; and

      (c) physician availability to provide follow-up care and treatment to the patient including, but not limited to, patient examination to determine the efficacy of the use of medical marijuana as a treatment of the patient's debilitating medical condition.

   (2) "Criminal record" means all information documenting an individual's contact with the criminal justice system, including data regarding identification, arrest, citation, arraignment, conviction, judicial disposition, custody, and supervision.

   (3) "Debilitating medical condition" means:

      (a) cancer, glaucoma, positive status for human immunodeficiency virus, and acquired immune deficiency syndrome, or treatment for these conditions;

      (b) a chronic or debilitating disease or medical condition, or treatment of that disease or medical condition, that results in one or more of the following symptoms, and for which, in the professional opinion of that patient's physician, the use of medical marijuana would alleviate one or more of the symptoms:

         (i) cachexia;

         (ii) severe pain;

         (iii) severe nausea;

         (iv) seizures, including those that are characteristic of epilepsy; or

         (v) persistent muscle spasms, including those characteristic of multiple sclerosis; and

      (c) another disease or medical condition, or treatment of that disease or medical condition, determined by the department to be a debilitating medical condition pursuant to department regulation or department approval of a petition submitted by a patient or a patient's physician.

   (4) "Department" means the Department of Health and Environmental Control.

   (5) "Dispensary" means an entity registered pursuant to Section 44-53-2540.

   (6) "Enclosed secured facility" means a closet, room, greenhouse, building, or other enclosed area equipped with locks or other security devices that permit access only by a registered patient, registered caregiver, or an employee or agent of a dispensary, as applicable.

   (7) "Engage in the medical use of marijuana" means the acquisition, possession, production, cultivation, use, transfer, or transportation of marijuana or paraphernalia relating to the administration of marijuana to alleviate the symptoms and side effects of a registered patient's debilitating medical condition, which is in compliance with all the limitations and restrictions of this article.

   (8) "Managing the well-being of a registered patient" means performing tasks to assist a registered patient with activities of daily living, provided the assistance is not limited only to helping a patient to engage in the medical use of marijuana.

   (9)    "Marijuana" has the same meaning as defined in Section 44-53-110.

   (10) "Medical verification" means documentation required by the department provided by a physician to a patient in the course of a bona fide physician-patient relationship for the patient's submission to the department with an application for a registry identification card, which supports the physician's opinion that the patient has a debilitating medical condition with symptoms or side effects that might be alleviated by the medical use of marijuana and that reasonable medical efforts have been made over a reasonable amount of time without success to relieve the symptoms or side-effects.

   (11) "Paraphernalia" has the same meaning as defined in Section 44-53-110.

   (12) "Parent" means:

      (a) a custodial mother or father of a patient under the age of eighteen years; or

      (b) a person with legal custody of a patient under the age of eighteen years; or

      (c) a person who is the legal guardian of a patient under the age of eighteen years.

   (13) "Patient" means a person who qualifies as a person with a debilitating medical condition.

   (14) "Physician" means a physician who is licensed in good standing to practice medicine in this State pursuant to Chapter 47, Title 40.

   (15) "Registered caregiver" means a person, other than a registered patient or a registered patient's physician, who is eighteen years or older and who has been issued a registry identification card by the department, identifying the person as someone who has agreed to undertake responsibility for managing the well-being of a registered patient including, but not limited to, by assisting the registered patient with the medical use of marijuana.

   (16) "Registered patient" means a person who has been issued a registry identification card by the department identifying the person as having a debilitating medical condition who is entitled to engage in the medical use of marijuana.

   (17) "Registry identification card" means the nontransferable confidential registry identification card issued by the department to a patient or caregiver that identifies the patient as authorized to engage in the medical use of marijuana or a caregiver as authorized to help a particular registered patient engage in the medical use of marijuana.

   Section 44-53-2230.   (A) A registered patient may engage in the medical use of marijuana in a quantity that is medically necessary to address a debilitating medical condition, provided the quantity does not exceed the limits provided for in subsection (B).

   (B) A registered patient's medical use of marijuana is lawful within the following limits:

      (1) up to two ounces of a usable form of marijuana; and

      (2) up to six marijuana plants, with three or fewer being mature, flowering plants that are producing a usable form of marijuana.

   (C) Registered patients and registered caregivers may:

      (1) cultivate or otherwise produce marijuana only in an enclosed, locked facility; and

      (2) may acquire marijuana only from registered dispensaries or from one another.

   Section 44-53-2240.   In the case of medical use of marijuana in excess of the amounts allowed pursuant to Section 44-53-2230, a registered patient or registered caregiver may raise as an affirmative defense to charges of violation of this article, or violation of another provision of law relating to the regulation of marijuana, that the quantity of marijuana used in excess of those limitations is medically necessary to alleviate the symptoms or side effects of the patient's debilitating medical condition and may submit a medical verification provided to the patient by the physician pursuant to Section 44-53-2320 as proof that the quantity is medically necessary.

   Section 44-53-2250.   (A) A registered patient or registered caregiver must not:

      (1) engage in the medical use of marijuana in a way that endangers the health or well-being of another person;

      (2) engage in the medical use of marijuana in plain view of the public or in a public place; or

      (3) possess medical marijuana or otherwise engage in the use of medical marijuana in or on the grounds of a public or private school or childcare facility or in a school bus.

   (B) A registered patient must not:

      (1) undertake a task while under the influence of marijuana pursuant to this article when doing so would constitute negligence or professional malpractice; or

      (2) operate, navigate, or otherwise be in actual physical control of a vehicle, aircraft, or motorboat while under the influence of marijuana pursuant to this article.

   Section 44-53-2260.   In addition to other penalties provided in this article and other applicable laws of the State, the department shall revoke for a period of one year the registry identification card of a registered patient or registered caregiver found to have wilfully violated a provision of this article.

   Section 44-53-2270.   A patient under eighteen years of age must not engage in the medical use of marijuana unless:

   (1) two physicians have diagnosed the patient as having a debilitating medical condition with symptoms or side effects that might be alleviated by the medical use of marijuana;

   (2) reasonable medical efforts have been made over a reasonable period of time without success to relieve the symptoms or side effects;

   (3) one of the physicians referred to in this section has explained the possible risks and benefits of medical use of marijuana to the patient and the patient's parents who reside in the State;

   (4) the physician referred to in item (3) has provided the patient and the patient's parents who reside in the State with the medical verification required pursuant to Section 44-53-2320;

   (5) the patient's parents who reside in the State consent in writing to the patient's medical use of marijuana;

   (6) a parent of the patient who resides in the State:

      (a) consents in writing to serve as the patient's registered caregiver; and

      (b) submits to the department:

         (i)    an application for the patient's registry identification card;

         (ii) an application to serve as the registered caregiver of the patient;

         (iii) the written consents required by this section;

         (iv) the medical verification from the patient's physician required by this section; and

         (v) any other information required by the department;

   (7) the department approves the patient's and parent's applications to qualify as a registered patient and registered caregiver, respectively, and provides both registry identification cards to the parent designated as the registered caregiver;

   (8) the registered patient and registered caregiver collectively possess quantities of marijuana no greater than those specified in Section 44-53-2230 or 44-53-2240 at any given time; and

   (9) the registered caregiver controls the acquisition of the marijuana and the dosage and frequency of its use by the registered patient.

   Section 44-53-2280.      The department shall create and maintain a confidential registry of patients who have applied for a registry identification card authorizing the medical use of marijuana pursuant to this article.

   Section 44-53-2290.   (A) No person is permitted to gain access to information about patients or caregivers maintained in the department's confidential registry or received by the department as part of an application for a registry identification card, or information otherwise maintained by the department about applicants, except for authorized department employees in the course of performing official duties related to this article and authorized officials of state or local law enforcement agencies who have detained or arrested a person who claims to be engaged in the medical use of marijuana.

   (B) A state or local law enforcement official's right to access the information contained within the department's confidential registry and other information referenced in subsection (A) is limited to the purpose of verifying that an individual who has presented a registry identification card or documentation serving as the functional equivalent is lawfully in possession of the card or its functional e