Bill Summary – FastDemocracy

Enrolled Copy                                                                        S.B. 137
                             MEDICAL CANNABIS AMENDMENTS
                                     2023 GENERAL SESSION
                                          STATE OF UTAH
                                Chief Sponsor: Luz Escamilla
                              House Sponsor: Raymond P. Ward
 6
 LONG TITLE
 General Description:
        This bill enacts provisions related to medical cannabis.
 Highlighted Provisions:
        This bill:
        < defines terms;
        < requires the testing for terpene profiles for certain cannabis products;
        < requires medical cannabis pharmacies to provide terpene information for certain
 cannabis products;
        < modifies patient caps for qualified medical providers;
        < for the initial issuance of a medical cannabis card, extends the expiration date from
 six months to one year unless the recommending medical provider provides a
 shorter expiration date;
        < allows the Department of Health and Human Services to revoke a medical cannabis
 patient card if the recommending medical provider withdraws the provider's
 recommendation for medical cannabis;
        < allows certain physician assistants to diagnose post-traumatic stress syndrome for
 the purpose of recommending medical cannabis;
        < allows medical cannabis pharmacies to maintain a liquid cash account instead of a
 surety bond;
        < allows the Compassionate Use Board to review the recommendation of a cannabis
 product that must be vaporized under certain circumstances;
        < allows a recommending medical provider to provide an initial recommendation for
      S.B. 137                                                                       Enrolled Copy
 medical cannabis virtually under certain circumstances;
        < modifies continuing education requirements for qualified medical providers;
        < allows an individual residing in certain care facilities to use an expired license to
 obtain medical cannabis;
        < consolidates certain criminal background check requirements for guardians and
 caregivers;
        < for publicly traded medical cannabis pharmacies, changes the ownership percentage
 an individual must have to be:
               C   listed in an application for a license; or
               C   required to submit a background check;
        < repeals provisions related to the state central patient portal medical provider;
        < removes the requirement that before an individual obtains a medical cannabis
 pharmacy agent card that the individual be employed by a medical cannabis
 pharmacy;
        < removes the requirement that before an individual obtains a medical cannabis
 courier agent card that the individual be employed by a medical cannabis courier;
        < authorizes a medical cannabis pharmacy to engage in targeted marketing; and
        < makes technical changes.
 Money Appropriated in this Bill:
        None
 Other Special Clauses:
        None
 Utah Code Sections Affected:
 AMENDS:
        4-41a-701, as last amended by Laws of Utah 2022, Chapter 290
        26-61-202, as last amended by Laws of Utah 2022, Chapter 415
        26-61a-102, as last amended by Laws of Utah 2022, Chapters 290, 452
        26-61a-103, as last amended by Laws of Utah 2022, Chapters 290, 415
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      Enrolled Copy                                                                       S.B. 137
        26-61a-104, as last amended by Laws of Utah 2022, Chapters 277, 452
        26-61a-105, as last amended by Laws of Utah 2022, Chapter 452
        26-61a-106, as last amended by Laws of Utah 2022, Chapters 415, 452
        26-61a-116, as enacted by Laws of Utah 2022, Chapter 452
        26-61a-201, as last amended by Laws of Utah 2022, Chapters 198, 290 and 452
        26-61a-202, as last amended by Laws of Utah 2022, Chapters 290, 452
        26-61a-301, as last amended by Laws of Utah 2022, Chapter 290
        26-61a-302, as last amended by Laws of Utah 2019, First Special Session, Chapter 5
        26-61a-401, as last amended by Laws of Utah 2022, Chapters 290, 415
        26-61a-403, as last amended by Laws of Utah 2022, Chapters 415, 452
        26-61a-501, as last amended by Laws of Utah 2022, Chapters 290, 415
        26-61a-502, as last amended by Laws of Utah 2022, Chapter 290
        26-61a-503, as last amended by Laws of Utah 2022, Chapter 415
        26-61a-505, as last amended by Laws of Utah 2022, Chapter 452 and last amended by
 Coordination Clause, Laws of Utah 2022, Chapter 290
        26-61a-506, as last amended by Laws of Utah 2022, Chapter 415
        26-61a-601, as last amended by Laws of Utah 2021, Chapter 337
        26-61a-604, as last amended by Laws of Utah 2022, Chapters 290, 452
        26-61a-606, as last amended by Laws of Utah 2022, Chapters 290, 415
        26-61a-607, as last amended by Laws of Utah 2022, Chapter 452
        58-17b-502, as last amended by Laws of Utah 2022, Chapter 465
        58-67-502, as last amended by Laws of Utah 2021, Chapter 337
        58-68-502, as last amended by Laws of Utah 2021, Chapter 337
        78A-2-231, as last amended by Laws of Utah 2022, Chapter 256
        80-3-110, as last amended by Laws of Utah 2022, Chapter 256
        80-4-109, as enacted by Laws of Utah 2021, Chapter 261
 ENACTS:
        26-61a-117, Utah Code Annotated 1953
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        S.B. 137                                                                       Enrolled Copy
         26-61a-206, Utah Code Annotated 1953
 REPEALS:
         26-61a-602, as last amended by Laws of Utah 2020, Chapter 354
 89
 Be it enacted by the Legislature of the state of Utah:
         Section 1. Section 4-41a-701 is amended to read:
         4-41a-701. Cannabis and cannabis product testing.
         (1) In accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, the
 department may make rules to:
         (a) determine required adulterant tests for a cannabis plant product, cannabis
 concentrate, or cannabis product;
         (b) determine the amount of any adulterant that is safe for human consumption;
         (c) establish protocols for a recall of cannabis or a cannabis product by a cannabis
 production establishment; or
         (d) allow the propagation of testing results forward to derived product if the processing
 steps the cannabis production establishment uses to produce the product are unlikely to change
 the results of the test.
         (2) The department may require testing for a toxin if:
         (a) the department receives information indicating the potential presence of a toxin; or
         (b) the department's inspector has reason to believe a toxin may be present based on the
 inspection of a facility.
         (3) (a) A cannabis production establishment may not:
         (i) incorporate cannabis concentrate into a cannabis derivative product until an
 independent cannabis testing laboratory tests the cannabis concentrate in accordance with
 department rule; or
         (ii) transfer cannabis or a cannabis product to a medical cannabis pharmacy until an
 independent cannabis testing laboratory tests a representative sample of the cannabis or
 cannabis product in accordance with department rule.
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        Enrolled Copy                                                                              S.B. 137
          (b) A medical cannabis pharmacy may not offer any cannabis or cannabis product for
 sale unless an independent cannabis testing laboratory has tested a representative sample of the
 cannabis or cannabis product in accordance with department rule.
          (4) Before the sale of a cannabis product, an independent cannabis testing laboratory
 shall:
          (a) identify and quantify any cannabinoid known to be present in a cannabis product[.];
 and
          (b) test terpene profiles for the following products:
          (i) raw cannabis; or
          (ii) a cannabis product:
          (A) contained in a vaporizer cartridge; or
          (B) in concentrate form; and
          (c) record the five highest terpene profiles tested under Subsection (4)(b).
          (5) The department shall establish by rule, in accordance with Title 63G, Chapter 3,
 Utah Administrative Rulemaking Act, the standards, methods, practices, and procedures for the
 testing of cannabis and cannabis products by independent cannabis testing laboratories.
          (6) The department may require an independent cannabis testing laboratory to
 participate in a proficiency evaluation that the department conducts or that an organization that
 the department approves conducts.
          Section 2. Section 26-61-202 is amended to read:
          26-61-202. Duties.
          (1) The board shall review any available scientific research related to the human use of
 cannabis, a cannabinoid product, or an expanded cannabinoid product that:
          (a) was conducted under a study approved by an IRB;
          (b) was conducted or approved by the federal government; or
          (c) (i) was conducted in another country; and
          (ii) demonstrates, as determined by the board, a sufficient level of scientific reliability
 and significance to merit the board's review.
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       S.B. 137                                                                          Enrolled Copy
        (2) Based on the research described in Subsection (1), the board shall evaluate the
 safety and efficacy of cannabis, cannabinoid products, and expanded cannabinoid products,
 including:
        (a) medical conditions that respond to cannabis, cannabinoid products, and expanded
 cannabinoid products;
        (b) cannabis and cannabinoid dosage amounts and medical dosage forms;
        (c) interaction of cannabis, cannabinoid products, and expanded cannabinoid products
 with other treatments; and
        (d) contraindications, adverse reactions, and potential side effects from use of cannabis,
 cannabinoid products, and expanded cannabinoid products.
        (3) (a) Based on the board's evaluation under Subsection (2), the board shall develop
 guidelines for treatment with cannabis, a cannabinoid product, and an expanded cannabinoid
 product that include:
        [(a)] (i) a list of medical conditions, if any, that the board determines are appropriate
 for treatment with cannabis, a cannabis product, a cannabinoid product, or an expanded
 cannabinoid product;
        [(b)] (ii) a list of contraindications, side effects, and adverse reactions that are
 associated with use of cannabis, cannabinoid products, or expanded cannabinoid products;
        [(c)] (iii) a list of potential drug-drug interactions between medications that the United
 States Food and Drug Administration has approved and cannabis, cannabinoid products, and
 expanded cannabinoid products; and
        [(d)] (iv) any other guideline the board determines appropriate.
        [(4)] (b) The board shall submit the guidelines described in Subsection (3) to the
 director of the Division of Professional Licensing.
        [(5)] (c) Guidelines that the board develops under this section may not limit the
 availability of cannabis, cannabinoid products, or expanded cannabinoid products permitted
 under Title 4, Chapter 41a, Cannabis Production Establishments, or Title 26, Chapter 61a, Utah
 Medical Cannabis Act.
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       Enrolled Copy                                                                          S.B. 137
        (4) The board shall provide a report to the Health and Human Services Interim
 Committee regarding the board's work before October 1 of each year.
        Section 3. Section 26-61a-102 is amended to read:
        26-61a-102. Definitions.
        As used in this chapter:
        (1) "Active tetrahydrocannabinol" means THC, any THC analog, and
 tetrahydrocannabinolic acid.
        (2) "Advertise" or "advertising" means information provided by a medical cannabis
 pharmacy in any medium:
        (a) to the public; and
        (b) that is not age restricted to an individual who is at least 21 years old.
        [(2)] (3) " Cannabis Research Review Board" means the Cannabis Research Review
 Board created in Section 26-61-201.
        [(3)] (4) "Cannabis" means marijuana.
        [(4)] (5) "Cannabis cultivation facility" means the same as that term is defined in
 Section 4-41a-102.
        [(5)] (6) "Cannabis processing facility" means the same as that term is defined in
 Section 4-41a-102.
        [(6)] (7) "Cannabis product" means a product that:
        (a) is intended for human use; and
        (b) contains cannabis or any tetrahydrocannabinol or THC analog in a total
 concentration of 0.3% or greater on a dry weight basis.
        [(7)] (8) "Cannabis production establishment" means the same as that term is defined
 in Section 4-41a-102.
        [(8)] (9) "Cannabis production establishment agent" means the same as that term is
 defined in Section 4-41a-102.
        [(9)] (10) "Cannabis production establishment agent registration card" means the same
 as that term is defined in Section 4-41a-102.
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        S.B. 137                                                                         Enrolled Copy
        [(10)] (11) "Community location" means a public or private elementary or secondary
 school, a church, a public library, a public playground, or a public park.
        [(11)] (12) "Conditional medical cannabis card" means an electronic medical cannabis
 card that the department issues in accordance with Subsection 26-61a-201(1)(b) to allow an
 applicant for a medical cannabis card to access medical cannabis during the department's
 review of the application.
        [(12)] (13) "Controlled substance database" means the controlled substance database
 created in Section 58-37f-201.
        (14) "Delivery address" means:
        (a) for a medical cannabis cardholder who is not a facility, the medical cannabis
 cardholder's home address; or
        (b) for a medical cannabis cardholder that is a facility, the facility's address.
        [(13)] (15) "Department" means the Department of Health.
        [(14)] (16) "Designated caregiver" means:
        (a) an individual:
        (i) whom an individual with a medical cannabis patient card or a medical cannabis
 guardian card designates as the patient's caregiver; and
        (ii) who registers with the department under Section 26-61a-202; or
        (b) (i) a facility that an individual designates as a designated caregiver in accordance
 with Subsection 26-61a-202(1)(b); or
        (ii) an assigned employee of the facility described in Subsection 26-61a-202(1)(b)(ii).
        [(15)] (17) "Directions of use" means recommended routes of administration for a
 medical cannabis treatment and suggested usage guidelines.
        [(16)] (18) "Dosing guidelines" means a quantity range and frequency of administration
 for a recommended treatment of medical cannabis.
        [(17)] (19) "Financial institution" means a bank, trust company, savings institution, or
 credit union, chartered and supervised under state or federal law.
        (20) "Government issued photo identification" means any of the following forms of
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        Enrolled Copy                                                                           S.B. 137
 identification:
         (a) a valid state-issued driver license or identification card;
         (b) a valid United States federal-issued photo identification, including:
         (i) a United States passport;
         (ii) a United States passport card;
         (iii) a United States military identification card; or
         (iv) a permanent resident card or alien registration receipt card; or
         (c) a foreign passport.
         [(18)] (21) "Home delivery medical cannabis pharmacy" means a medical cannabis
 pharmacy that the department authorizes, as part of the pharmacy's license, to deliver medical
 cannabis shipments to a [medical cannabis cardholder's home address] delivery address to
 fulfill electronic orders that the state central patient portal facilitates.
         [(19)] (22) "Inventory control system" means the system described in Section
 4-41a-103.
         [(20)] (23) "Legal dosage limit" means an amount that:
         (a) is sufficient to provide 30 days of treatment based on the dosing guidelines that the
 relevant recommending medical provider or the state central patient portal or pharmacy
 medical provider, in accordance with Subsection 26-61a-502(4) [or (5)], recommends; and
         (b) may not exceed:
         (i) for unprocessed cannabis in a medicinal dosage form, 113 grams by weight; and
         (ii) for a cannabis product in a medicinal dosage form, a quantity that contains, in total,
 greater than 20 grams of active tetrahydrocannabinol.
         [(21)] (24) "Legal use termina