ENTITLED An Act to modify debilitating medical conditions for medical cannabis use.
Be it enacted by the Legislature of the State of South Dakota:
Section 1. That 34-20G-1 be AMENDED:
34-20G-1. Terms used in this chapter mean:
(1) "Allowable amount of cannabis,":
(a) Three ounces of cannabis or less;
(b) The quantity of cannabis products as established by rules promulgated by the department under 34-20G-72;
(c) If the cardholder has a registry identification card allowing cultivation, two flowering cannabis plants and two cannabis plants that are not flowering; and
(d) If the cardholder has a registry identification card allowing cultivation, the amount of cannabis and cannabis products that were produced from the cardholder's allowable plants, if the cannabis and cannabis products are possessed at the same property where the plants were cultivated;
(2) "Bona fide practitioner-patient relationship," a treatment or consulting relationship between a practitioner and patient, during which:
(a) The practitioner completes, at the initial visit, an assessment of the patient's medical history and current medical condition, including an appropriate in-person physical examination;
(b) The patient is under the practitioner's care for the debilitating medical condition that qualifies the patient for the medical use of cannabis or has been referred by the practitioner caring for the patient's debilitating medical condition that qualifies the patient for the medical use of cannabis to another practitioner;
(c) The patient has a reasonable expectation that the practitioner providing the written certification will continue to provide follow-up care to the patient to monitor the medical use of cannabis; and
(d) The relationship is not for the sole purpose of providing a written certification for the medical use of cannabis unless the patient has been referred by a practitioner providing care for the debilitating medical condition that qualifies the patient for the medical use of cannabis;
(3) "Cannabis products," any concentrated cannabis, cannabis extracts, and products that are infused with cannabis or an extract thereof, and are intended for use or consumption by humans. The term includes edible cannabis products, beverages, topical products, ointments, oils, and tinctures;
(4) "Cannabis product manufacturing facility," an entity registered with the department pursuant to this chapter that acquires, possesses, manufactures, delivers, transfers, transports, supplies, or sells cannabis products to a medical cannabis dispensary;
(5) "Cannabis testing facility" or "testing facility," an independent entity registered with the department pursuant to this chapter to analyze the safety and potency of cannabis;
(6) "Cardholder," a qualifying patient or a designated caregiver who has been issued and possesses a valid registry identification card;
(7) "Cultivation facility," an entity registered with the department pursuant to this chapter that acquires, possesses, cultivates, delivers, transfers, transports, supplies, or sells cannabis and related supplies to a medical cannabis establishment;
(8) "Debilitating medical condition,":
(a) A chronic or debilitating disease or medical condition or its treatment that produces one or more of the following: cachexia or wasting syndrome; severe, debilitating pain; severe nausea; seizures; or severe and persistent muscle spasms;
(b) Acquired immune deficiency syndrome or positive status for human immunodeficiency virus;
(c) Amyotrophic lateral sclerosis;
(d) Multiple sclerosis;
(e) Cancer or its treatment, if associated with severe or chronic pain, nausea or severe vomiting, or cachexia or severe wasting;
(f) Crohn s disease;
(g) Epilepsy and seizures; or
(h) Post-traumatic stress disorder;
(9) "Department," the Department of Health;
(10) "Designated caregiver," an individual who:
(a) Is at least twenty-one years of age;
(b) Has agreed to assist with a qualifying patient's medical use of cannabis;
(c) Has not been convicted of a disqualifying felony offense; and
(d) Assists no more than five qualifying patients with the medical use of cannabis, unless the designated caregiver's qualifying patients each reside in or are admitted to a health care facility, as defined in 34-12-1.1, an accredited prevention or treatment facility, as defined in 34-20A-2, a mental health center, as defined in 27A-1-1, a child welfare agency, as defined in 26-6-1, or a community support provider or community services provider, as defined in 27B-1-17, where the designated caregiver is employed;
(11) "Disqualifying felony offense," a violent crime that was classified as a felony in the jurisdiction where the person was convicted;
(12) "Edible cannabis products," any product that:
(a) Contains or is infused with cannabis or an extract thereof;
(b) Is intended for human consumption by oral ingestion; and
(c) Is presented in the form of foodstuffs, beverages, extracts, oils, tinctures, or other similar products;
(13) "Enclosed, locked facility," any closet, room, greenhouse, building, or other enclosed area that is equipped with locks or other security devices that permit access only by a cardholder or a person allowed to cultivate the plants. Two or more cardholders who reside in the same dwelling may share one enclosed, locked facility for cultivation;
(14) "Flowering cannabis plant," the reproductive state of the cannabis plant in which the plant shows physical signs of flower budding out of the nodes of the stem;
(15) "Medical cannabis" or "cannabis," marijuana as defined in 22-42-1;
(16) "Medical cannabis dispensary" or "dispensary," an entity registered with the department pursuant to this chapter that acquires, possesses, stores, delivers, transfers, transports, sells, supplies, or dispenses cannabis, cannabis products, paraphernalia, or related supplies and educational materials to cardholders;
(17) "Medical cannabis establishment," a cultivation facility, a cannabis testing facility, a cannabis product manufacturing facility, or a dispensary;
(18) "Medical cannabis establishment agent," an owner, officer, board member, employee, or volunteer at a medical cannabis establishment;
(19) "Medical use," includes the acquisition, administration, cultivation, manufacture, delivery, harvest, possession, preparation, transfer, transportation, or use of cannabis or paraphernalia relating to the administration of cannabis to treat or alleviate a registered qualifying patient's debilitating medical condition or symptom associated with the patient's debilitating medical condition. The term does not include:
(a) The cultivation of cannabis by a nonresident cardholder;
(b) The cultivation of cannabis by a cardholder who is not designated as being allowed to cultivate on the cardholder's registry identification card; or
(c) The extraction of resin from cannabis by solvent extraction unless the extraction is done by a cannabis product manufacturing facility;
(20) "Nonresident cardholder," a person who:
(a) 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;
(b) Is not a resident of this state or who has been a resident of this state for fewer than forty-five days;
(c) Was issued a currently valid registry identification card or its equivalent by another state, district, territory, commonwealth, 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
(d) Has submitted any documentation required by the department, and has received confirmation of registration;
(21) "Practitioner," a physician, physician assistant, or advanced practice registered nurse, who is licensed with authority to prescribe drugs to humans. In relation to a nonresident cardholder, the term means a person who is licensed with authority to prescribe drugs to humans in the state of the patient's residence;
(22) "Qualifying patient," a person who has been diagnosed by a practitioner as having a debilitating medical condition;
(23) "Registry identification card," a document issued by the department that identifies a person as a registered qualifying patient or registered designated caregiver, or documentation that is deemed a registry identification card pursuant to 34-20G-29 to 34-20G-42, inclusive;
(24) "Safety-sensitive job," any position with tasks or duties that an employer reasonably believes could:
(a) Cause the illness, injury, or death of an individual; or
(b) Result in serious property damage;
(25) "Under the influence of cannabis," any abnormal mental or physical condition that tends to deprive a person of clearness of intellect and control that the person would otherwise possess, as the result of consuming any degree of cannabis or cannabis products; and
(26) "Written certification," a document dated and signed by a practitioner:
(a) Stating that the patient has a qualifying debilitating medical condition or symptom associated with the debilitating medical condition;
(b) Affirming that the document is made in the course of a bona fide practitioner-patient relationship;
(c) Specifying the qualifying patient's debilitating medical condition; and
(d) Specifying the expiration date of the qualifying patient's written certification, pursuant to 34-20G-43.
Section 2. That 34-20G-26 be REPEALED.
Section 3. That 34-20G-72 be AMENDED:
34-20G-72. The department shall promulgate rules pursuant to chapter 1-26:
(1) Establishing the form and content of registration and renewal applications submitted under this chapter;
(2) Establishing a system to numerically score competing medical cannabis establishment applicants, in cases where more applicants apply than are allowed by the local government, that includes analysis of:
(a) The preference of the local government;
(b) In the case of dispensaries, the suitability of the proposed location and its accessibility for patients;
(c) The character, veracity, background, qualifications, and relevant experience of principal officers and board members; and
(d) The business plan proposed by the applicant, that in the case of a cultivation facility or dispensary shall include the ability to maintain an adequate supply of cannabis, plans to ensure safety and security of patrons and the community, procedures to be used to prevent diversion, and any plan for making cannabis available to low-income registered qualifying patients;
(3) Governing the manner in which the department shall consider applications for and renewals of registry identification cards, that may include creating a standardized written certification form;
(4) Governing medical cannabis establishments to ensure the health and safety of qualifying patients and prevent diversion and theft without imposing an undue burden or compromising the confidentiality of a cardholder, including:
(a) Oversight requirements;
(b) Record-keeping requirements;
(c) Security requirements, including lighting, physical security, and alarm requirements;
(d) Health and safety regulations, including restrictions on the use of pesticides that are injurious to human health;
(e) Standards for the manufacture of cannabis products and both the indoor and outdoor cultivation of cannabis by a cultivation facility;
(f) Requirements for the transportation and storage of cannabis by a medical cannabis establishment;
(g) Employment and training requirements, including requiring that each medical cannabis establishment create an identification badge for each agent;
(h) Standards for the safe manufacture of cannabis products, including extracts and concentrates;
(i) Restrictions on the advertising, signage, and display of medical cannabis, provided that the restrictions may not prevent appropriate signs on the property of a dispensary, listings in business directories including phone books, listings in marijuana-related or medical publications, or the sponsorship of health or not-for-profit charity or advocacy events;
(j) Requirements and procedures for the safe and accurate packaging, labeling, distribution, and tracking of medical cannabis;
(k) Certification standards for testing facilities, including requirements for equipment and qualifications for personnel; and
(l) Requirements for samples of cannabis and cannabis products submitted to testing facilities, including batch sizes to not exceed fifty pounds of cannabis intended for retail sale, batch sizes for homogenous cannabis products intended for retail sale, and procedures to ensure representative sampling;
(5) Establishing procedures for suspending or terminating the registration certificates or registry identification cards of cardholders and medical cannabis establishments that commit multiple or serious violations of this chapter;
(6) Establishing labeling requirements for cannabis and cannabis products, including requiring cannabis product labels to include the following:
(a) The length of time it typically takes for a product to take effect;
(b) Disclosing ingredients and possible allergens;
(c) A nutritional fact panel; and
(d) Requiring that edible cannabis products be clearly identifiable, when practicable, with a standard symbol indicating that it contains cannabis;
(7) Establishing procedures for the registration of nonresident cardholders and the cardholder's designation of no more than two dispensaries, which shall require the submission of:
(a) A practitioner's statement confirming that the patient has a debilitating medical condition; and
(b) Documentation demonstrating that the nonresident cardholder is allowed to possess cannabis or cannabis preparations in the jurisdiction where the nonresident cardholder resides;
(8) Establishing the amount of cannabis products, including the amount of concentrated cannabis, each cardholder and nonresident cardholder may possess; and
(9) Establishing reasonable application and renewal fees for registry identification cards and registration certificates, according to the following:
(a) Application fees for medical cannabis establishments may not exceed five thousand dollars, with this upper limit adjusted annually for inflation;
(b) The total fees collected shall generate revenues sufficient to offset all expenses of implementing and administering this chapter;
(c) A sliding scale of patient application and renewal fees based upon a qualifying patient's household income;
(d) The fees charged to qualifying patients, nonresident cardholders, and caregivers shall be no greater than the costs of processing the application and issuing a registry identification