1     
UTAH MEDICAL CANNABIS ACT AMENDMENTS

2     
2019 GENERAL SESSION

3     
STATE OF UTAH

4     
Chief Sponsor: Jennifer Dailey-Provost

5     
Senate Sponsor: ____________

6     

7     LONG TITLE
8     General Description:
9          This bill amends provisions regarding the Utah Medical Cannabis Act.
10     Highlighted Provisions:
11          This bill:
12          ▸     removes a requirement that unprocessed cannabis flower be in a blister pack;
13          ▸     increases limit on the number of patients for whom a qualified medical provider
14     may recommend cannabis;
15          ▸     removes a distinction between qualified medical providers and specialists regarding
16     the limit on the number of patients for whom a qualified medical provider may
17     recommend cannabis;
18          ▸     regarding the qualifications for a medical cannabis patient card:
19               •     reduces the age requirement; and
20               •     removes a requirement that certain adults receive approval of the compassionate
21     use board;
22          ▸     repeals elements required for protection from criminal conviction for the use or
23     possession of medical cannabis;
24          ▸     clarifies quantity limits for possession during the decriminalization period; and
25          ▸     makes technical changes.
26     Money Appropriated in this Bill:
27          None
28     Other Special Clauses:
29          None
30     Utah Code Sections Affected:
31     AMENDS:
32          4-41a-602, as renumbered and amended by Laws of Utah 2018, Third Special Session,
33     Chapter 1
34          26-61a-102, as renumbered and amended by Laws of Utah 2018, Third Special Session,
35     Chapter 1
36          26-61a-106, as renumbered and amended by Laws of Utah 2018, Third Special Session,
37     Chapter 1
38          26-61a-201, as renumbered and amended by Laws of Utah 2018, Third Special Session,
39     Chapter 1
40          26-61a-502, as renumbered and amended by Laws of Utah 2018, Third Special Session,
41     Chapter 1
42          26-61a-604, as enacted by Laws of Utah 2018, Third Special Session, Chapter 1
43          58-37-3.7, as last amended by Laws of Utah 2018, Third Special Session, Chapter 1
44     

45     Be it enacted by the Legislature of the state of Utah:
46          Section 1. Section 4-41a-602 is amended to read:
47          4-41a-602. Cannabis product -- Labeling and child-resistant packaging.
48          (1) For any cannabis product that a cannabis processing facility processes or produces,
49     the facility shall:
50          (a) label the cannabis product with a label that:
51          (i) clearly and unambiguously states that the cannabis product contains cannabis;
52          (ii) clearly displays the amount of total composite tetrahydrocannabinol and
53     cannabidiol in the labeled container;
54          (iii) has a unique identification number that:
55          (A) is connected to the inventory control system; and
56          (B) identifies the unique cannabis product manufacturing process the cannabis
57     processing facility used to manufacture the cannabis product;
58          (iv) identifies the cannabinoid extraction process that the cannabis processing facility
59     used to create the cannabis product;
60          (v) does not display an image, word, or phrase that the facility knows or should know
61     appeals to children; and
62          (vi) discloses each active or potentially active ingredient, in order of prominence, and
63     possible allergen; and
64          (b) package the cannabis product in a medicinal dosage form in a container that:
65          (i) [except for a blister pack,] is tamper evident and tamper resistant;
66          (ii) does not appeal to children;
67          (iii) does not mimic a candy container;
68          (iv) [except for a blister pack,] is opaque;
69          (v) complies with child-resistant effectiveness standards that the United States
70     Consumer Product Safety Commission establishes; and
71          (vi) includes a warning label that states: "WARNING: Cannabis has intoxicating
72     effects and may be addictive. Do not operate a vehicle or machinery under its influence. KEEP
73     OUT OF REACH OF CHILDREN. This product is for medical use only. Use only as directed
74     by a qualified medical provider."
75          (2) For any cannabis or cannabis product that the cannabis processing facility processes
76     into a gelatinous cube, gelatinous rectangular cuboid, or lozenge in a cube or rectangular
77     cuboid shape, the facility shall:
78          (a) ensure that the label described in Subsection (1)(a) does not contain a photograph or
79     other image of the content of the container; and
80          (b) include on the label described in Subsection (1)(a) a warning about the risks of
81     over-consumption.
82          (3) The department shall make rules in accordance with Title 63G, Chapter 3, Utah
83     Administrative Rulemaking Act, establishing a standard labeling format that:
84          (a) complies with the requirements of this section; and
85          (b) ensures inclusion of a pharmacy label.
86          Section 2. Section 26-61a-102 is amended to read:
87          26-61a-102. Definitions.
88          As used in this chapter:
89          [(1) "Blister" means a plastic cavity or pocket used to contain no more than a single
90     dose of cannabis or a cannabis product in a blister pack.]
91          [(2) "Blister pack" means a plastic, paper, or foil package with multiple blisters each
92     containing no more than a single dose of cannabis or a cannabis product.]
93          [(3)] (1) "Cannabis" means marijuana.
94          [(4)] (2) "Cannabis cultivation facility" means the same as that term is defined in
95     Section 4-41a-102.
96          [(5)] (3) "Cannabis processing facility" means the same as that term is defined in
97     Section 4-41a-102.
98          [(6)] (4) "Cannabis product" means a product that:
99          (a) is intended for human use; and
100          (b) contains cannabis or tetrahydrocannabinol.
101          [(7)] (5) "Cannabis production establishment agent" means the same as that term is
102     defined in Section 4-41a-102.
103          [(8)] (6) "Cannabis production establishment agent registration card" means the same
104     as that term is defined in Section 4-41a-102.
105          [(9)] (7) "Community location" means a public or private school, a church, a public
106     library, a public playground, or a public park.
107          [(10)] (8) "Department" means the Department of Health.
108          [(11)] (9) "Designated caregiver" means an individual:
109          (a) whom an individual with a medical cannabis patient card or a medical cannabis
110     guardian card designates as the patient's caregiver; and
111          (b) who registers with the department under Section 26-61a-202.
112          [(12)] (10) "Dosing parameters" means quantity, routes, and frequency of
113     administration for a recommended treatment of cannabis in a medicinal dosage form or a
114     cannabis product in a medicinal dosage form.
115          [(13)] (11) "Independent cannabis testing laboratory" means the same as that term is
116     defined in Section 4-41a-102.
117          [(14)] (12) "Inventory control system" means the system described in Section
118     4-41a-103.
119          [(15)] (13) "Local health department" means the same as that term is defined in Section
120     26A-1-102.
121          [(16)] (14) "Local health department distribution agent" means an agent designated and
122     registered to distribute state central fill shipments under Sections 26-61a-606 and 26-61a-607.
123          [(17)] (15) "Marijuana" means the same as that term is defined in Section 58-37-2.
124          [(18)] (16) "Medical cannabis" means cannabis in a medicinal dosage form or a
125     cannabis product in a medicinal dosage form.
126          [(19)] (17) "Medical cannabis card" means a medical cannabis patient card, a medical
127     cannabis guardian card, or a medical cannabis caregiver card.
128          [(20)] (18) "Medical cannabis cardholder" means a holder of a medical cannabis card.
129          [(21)] (19) "Medical cannabis caregiver card" means an official card that:
130          (a) the department issues to an individual whom a medical cannabis patient cardholder
131     or a medical cannabis guardian cardholder designates as a designated caregiver; and
132          (b) is connected to the electronic verification system.
133          [(22)] (20) (a) "Medical cannabis device" means a device that an individual uses to
134     ingest cannabis in a medicinal dosage form or a cannabis product in a medicinal dosage form.
135          (b) "Medical cannabis device" does not include a device that:
136          (i) facilitates cannabis combustion; or
137          (ii) an individual uses to ingest substances other than cannabis.
138          [(23)] (21) "Medical cannabis guardian card" means an official card that:
139          (a) the department issues to the parent or legal guardian of a minor with a qualifying
140     condition; and
141          (b) is connected to the electronic verification system.
142          [(24)] (22) "Medical cannabis patient card" means an official card that:
143          (a) the department issues to an individual with a qualifying condition; and
144          (b) is connected to the electronic verification system.
145          [(25)] (23) "Medical cannabis pharmacy" means a person that:
146          (a) (i) acquires or intends to acquire:
147          (A) cannabis in a medicinal dosage form or a cannabis product in a medicinal dosage
148     form from a cannabis processing facility; or
149          (B) a medical cannabis device; or
150          (ii) possesses cannabis in a medicinal dosage form, a cannabis product in a medicinal
151     dosage form, or a medical cannabis device; and
152          (b) sells or intends to sell cannabis in a medicinal dosage form, a cannabis product in a
153     medicinal dosage form, or a medical cannabis device to a medical cannabis cardholder.
154          [(26)] (24) "Medical cannabis pharmacy agent" means an individual who:
155          (a) is an employee of a medical cannabis pharmacy; and
156          (b) who holds a valid medical cannabis pharmacy agent registration card.
157          [(27)] (25) "Medical cannabis pharmacy agent registration card" means a registration
158     card issued by the department that authorizes an individual to act as a medical cannabis
159     pharmacy agent.
160          [(28)] (26) "Medical cannabis treatment" means cannabis in a medicinal dosage form, a
161     cannabis product in a medicinal dosage form, or a medical cannabis device.
162          [(29)] (27) (a) "Medicinal dosage form" means:
163          (i) for processed medical cannabis or a medical cannabis product, the following in
164     single dosage form with a specific and consistent cannabinoid content:
165          (A) a tablet;
166          (B) a capsule;
167          (C) a concentrated oil;
168          (D) a liquid suspension;
169          (E) a topical preparation;
170          (F) a transdermal preparation;
171          (G) a sublingual preparation;
172          (H) a gelatinous cube, gelatinous rectangular cuboid, or lozenge in a cube or
173     rectangular cuboid shape; [or]
174          (I) unprocessed cannabis flower; or
175          [(I)] (J) for use only after the individual's qualifying condition has failed to
176     substantially respond to at least two other forms described in this Subsection [(29)(a)(i)]
177     (27)(a)(i), a resin or wax; and
178          [(ii) for unprocessed cannabis flower, a blister pack, with each individual blister:]
179          [(A) containing a specific and consistent weight that does not exceed one gram and that
180     varies by no more than 10% from the stated weight; and]
181          [(B) labeled with a barcode that provides information connected to an inventory control
182     system and the individual blister's content and weight; and]
183          [(iii)] (ii) a form measured in grams, milligrams, or milliliters.
184          [(b) "Medicinal dosage form" includes a portion of unprocessed cannabis flower that:]
185          [(i) the medical cannabis cardholder has recently removed from the blister pack
186     described in Subsection (29)(a)(ii) for use; and]
187          [(ii) does not exceed the quantity described in Subsection (29)(a)(ii).]
188          [(c)] (b) "Medicinal dosage form" does not include[:(i) any unprocessed cannabis
189     flower outside of the blister pack, except as provided in Subsection (29)(b); or(ii) ] a process of
190     vaporizing and inhaling concentrated cannabis by placing the cannabis on a nail or other metal
191     object that is heated by a flame, including a blowtorch.
192          [(30)] (28) "Pharmacy medical provider" means the medical provider required to be on
193     site at a medical cannabis pharmacy under Section 26-61a-403.
194          [(31)] (29) "Provisional patient card" means a card that:
195          (a) the department issues to a minor with a qualifying condition for whom:
196          (i) a qualified medical provider has recommended a medical cannabis treatment; and
197          (ii) the department issues a medical cannabis guardian card to the minor's parent or
198     legal guardian; and
199          (b) is connected to the electronic verification system.
200          [(32)] (30) "Qualified medical provider" means an individual who is qualified to
201     recommend treatment with cannabis in a medicinal dosage form under Section 26-61a-106.
202          [(33)] (31) "Qualified Distribution Enterprise Fund" means the enterprise fund created
203     in Section 26-61a-110.
204          [(34)] (32) "Qualified Patient Enterprise Fund" means the enterprise fund created in
205     Section 26-61a-109.
206          [(35)] (33) "Qualifying condition" means a condition described in Section 26-61a-104.
207          [(36)] (34) "State central fill agent" means an employee of the state central fill medical
208     cannabis pharmacy that the department registers in accordance with Section 26-61a-602.
209          [(37)] (35) "State central fill medical cannabis pharmacy" means the central fill
210     pharmacy that the department creates in accordance with Section 26-61a-601.
211          [(38)] (36) "State central fill medical provider" means a physician or pharmacist that
212     the state central fill medical cannabis pharmacy employs to consult with medical cannabis
213     cardholders in accordance with Section 26-61a-601.
214          [(39)] (37) "State central fill shipment" means a shipment of cannabis in a medicinal
215     dosage form, cannabis product in a medicinal dosage form, or a medical cannabis device that
216     the state central fill medical cannabis pharmacy prepares and ships for distribution to a medical
217     cannabis cardholder in a local health department.
218          [(40)] (38) "State electronic verification system" means the system described in Section
219     26-61a-103.
220          Section 3. Section 26-61a-106 is amended to read:
221          26-61a-106. Qualified medical provider registration -- Continuing education --
222     Treatment recommendation.
223          (1) An individual may not recommend a medical cannabis treatment unless the
224     department registers the individual as a qualified medical provider in accordance with this
225     section.
226          (2) (a) The department shall, within 15 days after the day on which the department
227     receives an application from an individual, register and issue a qualified medical provider
228     registration card to the individual if the individual:
229          (i) provides to the department the individual's name and address;
230          (ii) provides to the department a report detailing the individual's completion of the
231     applicable continuing education requirement described in Subsection (3);
232          (iii) provides to the department evidence that the individual:
233          (A) has the authority to write a prescription;
234          (B) is licensed to prescribe a controlled substance under Title 58, Chapter 37, Utah
235     Controlled Substances Act; and
236          (C) possesses the authority, in accordance with the individual's scope of practice, to
237     prescribe a Schedule II controlled substance;
238          (iv) provides to the department evidence that the individual is:
239          (A) an advanced practice registered nurse licensed under Title 58, Chapter 31b, Nurse
240     Practice Act;
241          (B) a physician licensed under Title 58, Chapter 67, Utah Medical Practice Act, or
242     Title 58, Chapter 68, Utah Osteopathic Medical Practice Act; or
243          (C) a physician assistant licensed under Title 58, Chapter 70a, Physician Assistant Act,
244     whose declaration of services agreement, as that term is defined in Section 58-70a-102,
245     includes the recommending of medical cannabis, and whose supervising physician is a
246     qualified medical provider; and
247          (v) pays the department a fee in an amount that:
248          (A) the department sets, in accordance with Section 63J-1-504; and
249          (B) does not exceed $300 for an initial registration.
250          (b) The department may not register an individual as a qualified medical provider if the
251     individual is:
252          (i) a pharmacy medical provider or a state central fill medical provider; or
253          (ii) an owner, officer, director, board member, employee, or agent of a cannabis
254     production establishment or a medical cannabis pharmacy.
255          (3) (a) An individual shall complete the continuing education described in this
256     Subsection (3) in the following amounts:
257          (i) for an individual as a condition precedent to registration, four hours; and
258          (ii) for a qualified medical provider as a condition precedent to renewal, four hours
259     every two years.
260          (b) In accordance with Subsection (3)(a), a qualified medical provider shall:
261          (i) complete continuing education:
262          (A) regarding the topics described in Subsection (3)(d); and
263          (B) offered by the department under Subsection (3)(c) or an accredited or approved
264     continuing education provider that the department recognizes as offering continuing education
265     appropriate for the recommendation of cannabis to patients; and
266          (ii) make a continuing education report to the department in accordance with a process
267     that the department establishes by rule, in accordance with Title 63G, Chapter 3, Utah
268     Administrative Rulemaking Act, and in collaboration with the Division of Occupational and
269     Professional Licensing and:
270          (A) for an advanced practice registered nurse licensed under Title 58, Chapter 31b,
271     Nurse Practice Act, the Board of Nursing;
272          (B) for a qualified medical provider licensed under Title 58, Chapter 67, Utah Medical
273     Practice Act, the Physicians Licensing Board;
274          (C) for a qualified medical provider licensed under Title 58, Chapter 68, Utah
275     Osteopathic Medical Practice Act, the Osteopathic Physician and Surgeon's Licensing Board;
276     and
277          (D) for a physician assistant licensed under Title 58, Chapter 70a, Physician Assistant
278     Act, the Physician Assistant Licensing Board.
279          (c) The department may, in consultation with the Division of Occupational and
280     Professional Licensing, develop the continuing education described in this Subsection (3).
281          (d) The continuing education described in this Subsection (3) may discuss:
282          (i) the provisions of this chapter;
283          (ii) general information about medical cannabis under federal and state law;
284          (iii) the latest scientific research on the endocannabinoid system and medical cannabis,
285     including risks and benefits;
286          (iv) recommendations for medical cannabis as it relates to the continuing care of a
287     patient in pain management, risk management, potential addiction, or palliative care; and
288          (v) best practices for recommending the form and dosage of medical cannabis products
289     based on the qualifying condition underlying a medical cannabis recommendation.
290          (4) (a) Except as provided in Subsection (4)(b) [or (c)], a qualified medical provider
291     may not recommend a medical cannabis treatment to more than [175] 500 of the qualified
292     medical provider's patients at the same time, as determined by the number of medical cannabis
293     cards under the qualified medical provider's name in the state electronic verification system.
294          [(b) Except as provided in Subsection (4)(c), a qualified medical provider may
295     recommend a medical cannabis treatment to up to 300 of the qualified medical provider's
296     patients at any given time, as determined by the number of medical cannabis cards under the
297     qualified medical provider's name in the state electronic verification system, if:]
298          [(i) the appropriate American medical board has certified the qualified medical
299     provider in the specialty of anesthesiology, gastroenterology, neurology, oncology, pain,
300     hospice and palliative medicine, physical medicine and rehabilitation, rheumatology, or
301     psychiatry; or]
302          [(ii) a licensed business employs or contracts the qualified medical provider for the
303     specific purpose of providing hospice and palliative care.]
304          [(c)] (b) (i) Notwithstanding Subsection (4)[(b)](a), a qualified medical provider
305     [described in Subsection (4)(b)] may petition the Division of Occupational and Professional
306     Licensing for authorization to exceed the limit described in Subsection (4)[(b)](a) by
307     graduating increments of 100 patients per authorization, not to exceed three authorizations.
308          (ii) The Division of Occupational and Professional Licensing shall grant the
309     authorization described in Subsection [(4)(c)(i)] (4)(b)(i) if:
310          (A) the petitioning qualified medical provider pays a $100 fee;
311          (B) the division performs a review that includes the qualified medical provider's
312     medical cannabis recommendation activity in the state electronic verification system, relevant
313     information related to patient demand, and any patient medical records that the division
314     determines would assist in the division's review; and
315          (C) after the review described in this Subsection [(4)(c)(ii)] (4)(b)(ii), the division
316     determines that granting the authorization would not adversely affect public safety, adversely
317     concentrate the overall patient population among too few qualified medical providers, or
318     adversely concentrate the use of medical cannabis among the provider's patients.
319          (5) A qualified medical provider may recommend medical cannabis to an individual
320     under this chapter only in the course of a qualified medical provider-patient relationship after
321     the qualifying medical provider has completed and documented in the patient's medical record
322     a thorough assessment of the patient's condition and medical history based on the appropriate
323     standard of care for the patient's condition.
324          (6) (a) Except as provided in Subsection (6)(b), a qualified medical provider may not
325     advertise that the qualified medical provider recommends medical cannabis treatment.
326          (b) For purposes of Subsection (6)(a), the communication of the following, through a
327     website does not constitute advertising:
328          (i) a green cross;
329          (ii) a qualifying condition that the qualified medical provider treats; or
330          (iii) a scientific study regarding medical cannabis use.
331          (7) (a) A qualified medical provider registration card expires two years after the day on
332     which the department issues the card.
333          (b) The department shall renew a qualified medical provider's registration card if the
334     provider:
335          (i) applies for renewal;
336          (ii) is eligible for a qualified medical provider registration card under this section,
337     including maintaining an unrestricted license as described in Subsection (2)(a)(iii);
338          (iii) certifies to the department in a renewal application that the information in
339     Subsection (2)(a) is accurate or updates the information;
340          (iv) submits a report detailing the completion of the continuing education requirement
341     described in Subsection (3); and
342          (v) pays the department a fee in an amount that:
343          (A) the department sets, in accordance with Section 63J-1-504; and
344          (B) does not exceed $50 for a registration renewal.
345          (8) The department may revoke the registration of a qualified medical provider who
346     fails to maintain compliance with the requirements of this section.
347          (9) A qualified medical provider may not receive any compensation or benefit for the
348     qualified medical provider's medical cannabis treatment recommendation from:
349          (a) a cannabis production establishment or an owner, officer, director, board member,
350     employee, or agent of a cannabis production establishment;
351          (b) a medical cannabis pharmacy or an owner, officer, director, board member,
352     employee, or agent of a medical cannabis pharmacy; or
353          (c) a qualified medical provider or pharmacy medical provider.
354          Section 4. Section 26-61a-201 is amended to read:
355          26-61a-201. Medical cannabis patient card -- Medical cannabis guardian card
356     application -- Fees -- Studies.
357          (1) On or before March 1, 2020, the department shall, within 15 days after the day on
358     which an individual who satisfies the eligibility criteria in this section or Section 26-61a-202
359     submits an application in accordance with this section or Section 26-61a-202:
360          (a) issue a medical cannabis patient card to an individual described in Subsection
361     (2)(a);
362          (b) issue a medical cannabis guardian card to an individual described in Subsection
363     (2)(b);
364          (c) issue a provisional patient card to a minor described in Subsection (2)(c); and
365          (d) issue a medical cannabis caregiver card to an individual described in Subsection
366     26-61a-202(4).
367          (2) (a) An individual is eligible for a medical cannabis patient card if:
368          (i) [(A)] the individual is at least [21] 18 years old; [or]
369          [(B) the individual is 18, 19, or 20 years old, the individual petitions the compassionate
370     use board under Section 26-61a-105, and the compassionate use board recommends department
371     approval of the petition;]
372          (ii) the individual is a Utah resident;
373          (iii) the individual's qualified medical provider recommends treatment with medical
374     cannabis in accordance with Subsection (4);
375          (iv) the individual signs an acknowledgment stating that the individual received the
376     information described in Subsection (8); and
377          (v) the individual pays to the department a fee in an amount that, subject to Subsection
378     26-61a-109(5), the department sets in accordance with Section 63J-1-504.
379          (b) (i) An individual is eligible for a medical cannabis guardian card if the individual:
380          (A) is at least 18 years old;
381          (B) is a Utah resident;
382          (C) is the parent or legal guardian of a minor for whom the minor's qualified medical
383     provider recommends a medical cannabis treatment, the individual petitions the compassionate
384     use board under Section 26-61a-105, and the compassionate use board recommends department
385     approval of the petition;
386          (D) the individual signs an acknowledgment stating that the individual received the
387     information described in Subsection (8);
388          (E) pays to the department a fee in an amount that, subject to Subsection
389     26-61a-109(5), the department sets in accordance with Section 63J-1-504, plus the cost of the
390     criminal background check described in Section 26-61a-203; and
391          (F) the individual has not been convicted of a misdemeanor or felony drug distribution
392     offense under either state or federal law, unless the individual completed any imposed sentence
393     six months or more before the day on which the individual applies for a medical cannabis
394     guardian card.
395          (ii) The department shall notify the Department of Public Safety of each individual that
396     the department registers for a medical cannabis guardian card.
397          (c) (i) A minor is eligible for a provisional patient card if:
398          (A) the minor has a qualifying condition;
399          (B) the minor's qualified medical provider recommends a medical cannabis treatment
400     to address the minor's qualifying condition;
401          (C) the minor's parent or legal guardian petitions the compassionate use board under
402     Section 26-61a-105, and the compassionate use board recommends department approval of the
403     petition; and
404          (D) the minor's parent or legal guardian is eligible for a medical cannabis guardian card
405     under Subsection (2)(b).
406          (ii) The department shall automatically issue a provisional patient card to the minor
407     described in Subsection (2)(c)(i) at the same time the department issues a medical cannabis
408     guardian card to the minor's parent or legal guardian.
409          (3) (a) An individual who is eligible for a medical cannabis card described in
410     Subsection (2)(a) or (b) shall submit an application for a medical cannabis card to the
411     department:
412          (i) through an electronic application connected to the state electronic verification
413     system;
414          (ii) with the recommending qualified medical provider while in the recommending
415     qualified medical provider's office; and
416          (iii) with information including:
417          (A) the applicant's name, gender, age, and address;
418          (B) the number of the applicant's valid form of identification that is a valid United
419     States federal- or state-issued photo identification, including a driver license, a United States
420     passport, a United States passport card, or a United States military identification card;
421          (C) for a medical cannabis guardian card, the name, gender, and age of the minor
422     receiving a medical cannabis treatment under the cardholder's medical cannabis guardian card;
423     and
424          (D) for a provisional patient card, the name of the minor's parent or legal guardian who
425     holds the associated medical cannabis guardian card.
426          (b) The department shall ensure that a medical cannabis card the department issues
427     under this section contains the information described in Subsection (3)(a)(iii).
428          (c) (i) If a qualified medical provider determines that, because of age, illness, or
429     disability, a medical cannabis patient cardholder requires assistance in administering the
430     medical cannabis treatment that the qualified medical provider recommends, the qualified
431     medical provider may indicate the cardholder's need in the state electronic verification system.
432          (ii) If a qualified medical provider makes the indication described in Subsection
433     (3)(c)(i):
434          (A) the department shall add a label to the relevant medical cannabis patient card
435     indicating the cardholder's need for assistance; and
436          (B) any adult who is 21 years old or older and who is physically present with the
437     cardholder at the time the cardholder needs to use the recommended medical cannabis
438     treatment may handle the medical cannabis treatment and any associated medical cannabis
439     device as needed to assist the cardholder in administering the recommended medical cannabis
440     treatment, including in the event of an emergency medical condition under Subsection
441     26-61a-204(2).
442          (iii) A non-cardholding individual acting under Subsection (3)(c)(ii)(B) may not:
443          (A) ingest or inhale medical cannabis;
444          (B) possess, transport, or handle medical cannabis or a medical cannabis device outside
445     of the immediate area where the cardholder is present or with an intent other than to provide
446     assistance to the cardholder; or
447          (C) possess, transport, or handle medical cannabis or a medical cannabis device when
448     the cardholder is not in the process of being dosed with medical cannabis.
449          (4) To recommend a medical cannabis treatment to a patient or to renew a
450     recommendation, a qualified medical provider shall:
451          (a) before recommending cannabis in a medicinal dosage form or a cannabis product in
452     a medicinal dosage form:
453          (i) verify the patient's and, for a minor patient, the minor patient's parent or legal
454     guardian's valid form of identification described in Subsection (3)(a);
455          (ii) review any record related to the patient and, for a minor patient, the patient's parent
456     or legal guardian in:
457          (A) the state electronic verification system; and
458          (B) the controlled substance database created in Section 58-37f-201; and
459          (iii) consider the recommendation in light of the patient's qualifying condition and
460     history of medical cannabis and controlled substance use; and
461          (b) state in the qualified medical provider's recommendation that the patient:
462          (i) suffers from a qualifying condition, including the type of qualifying condition; and
463          (ii) may benefit from treatment with cannabis in a medicinal dosage form or a cannabis
464     product in a medicinal dosage form.
465          (5) (a) Except as provided in Subsection (5)(b), a medical cannabis card that the
466     department issues under this section is valid for the lesser of:
467          (i) an amount of time that the qualified medical provider determines; or
468          (ii) (A) for the first issuance, 30 days; or
469          (B) for a renewal, six months.
470          (b) (i) A medical cannabis card that the department issues in relation to a terminal
471     illness described in Section 26-61a-104 does not expire.
472          (ii) The recommending qualified medical provider may revoke a recommendation that
473     the provider made in relation to a terminal illness described in Section 26-61a-104 if the
474     medical cannabis cardholder no longer has the terminal illness.
475          (6) (a) A medical cannabis patient card or a medical cannabis guardian card is
476     renewable if:
477          (i) at the time of renewal, the cardholder meets the requirements of Subsection (2)(a) or
478     (b); or
479          (ii) the cardholder received the medical cannabis card through the recommendation of
480     the compassionate use board under Section 26-61a-105.
481          (b) A cardholder described in Subsection (6)(a) may renew the cardholder's card:
482          (i) using the application process described in Subsection (3); or
483          (ii) through phone or video conference with the qualified medical provider who made
484     the recommendation underlying the card, at the qualifying medical provider's discretion.
485          (c) A cardholder under Subsection (2)(a) or (b) who renews the cardholder's card shall
486     pay to the department a renewal fee in an amount that:
487          (i) subject to Subsection 26-61a-109(5), the department sets in accordance with Section
488     63J-1-504; and
489          (ii) may not exceed the cost of the relatively lower administrative burden of renewal in
490     comparison to the original application process.
491          (d) If a minor meets the requirements of Subsection (2)(c), the minor's provisional
492     patient card renews automatically at the time the minor's parent or legal guardian renews the
493     parent or legal guardian's associated medical cannabis guardian card.
494          (e) The department may revoke a medical cannabis guardian card if the cardholder
495     under Subsection (2)(b) is convicted of a misdemeanor or felony drug distribution offense
496     under either state or federal law.
497          (7) (a) A cardholder under this section shall carry the cardholder's valid medical
498     cannabis card with the patient's name.
499          (b) (i) A medical cannabis patient cardholder or a provisional patient cardholder may
500     purchase, in accordance with this chapter and the recommendation underlying the card,
501     cannabis in a medicinal dosage form, a cannabis product in a medicinal dosage form, or a
502     medical cannabis device.
503          (ii) A cardholder under this section may possess or transport, in accordance with this
504     chapter and the recommendation underlying the card, cannabis in a medicinal dosage form, a
505     cannabis product in a medicinal dosage form, or a medical cannabis device.
506          (iii) To address the qualifying condition underlying the medical cannabis treatment
507     recommendation:
508          (A) a medical cannabis patient cardholder or a provisional patient cardholder may use
509     cannabis in a medicinal dosage form, a medical cannabis product in a medicinal dosage form,
510     or a medical cannabis device; and
511          (B) a medical cannabis guardian cardholder may assist the associated provisional
512     patient cardholder with the use of cannabis in a medicinal dosage form, a medical cannabis
513     product in a medicinal dosage form, or a medical cannabis device.
514          (c) If neither a licensed medical cannabis pharmacy nor the state central fill medical
515     cannabis pharmacy is operating within the state after January 1, 2021, a cardholder under this
516     section is not subject to prosecution for the possession of:
517          (i) no more than 113 grams of marijuana in a medicinal dosage form;
518          (ii) an amount of cannabis product in a medicinal dosage form that contains no more
519     than 20 grams of tetrahydrocannabinol; or
520          (iii) marijuana drug paraphernalia.
521          (8) The department shall establish by rule, in accordance with Title 63G, Chapter 3,
522     Utah Administrative Rulemaking Act, a process to provide information regarding the following
523     to an individual receiving a medical cannabis card:
524          (a) risks associated with medical cannabis treatment;
525          (b) the fact that a condition's listing as a qualifying condition does not suggest that
526     medical cannabis treatment is an effective treatment or cure for that condition, as described in
527     Subsection 26-61a-104(1); and
528          (c) other relevant warnings and safety information that the department determines.
529          (9) The department may establish procedures by rule, in accordance with Title 63G,
530     Chapter 3, Utah Administrative Rulemaking Act, to implement the application and issuance
531     provisions of this section.
532          (10) (a) A person may submit, to the department a request to conduct a medical
533     research study using medical cannabis cardholder data that the state electronic verification
534     system contains.
535          (b) The department shall review a request described in Subsection (10)(a) to determine
536     whether the medical research study is valid.
537          (c) If the department makes a determination under Subsection (10)(b) that the medical
538     research study is valid, the department shall notify each relevant cardholder asking for the
539     cardholder's consent to participate in the study.
540          (d) The department may release, for the purposes of a study described in this
541     Subsection (10), information about a cardholder under this section who consents to participate
542     under Subsection (10)(c).
543          (e) The department may establish standards for a medical research study's validity, by
544     rule made in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act.
545          Section 5. Section 26-61a-502 is amended to read:
546          26-61a-502. Dispensing -- Amount a medical cannabis pharmacy may dispense --
547     Reporting -- Form of cannabis or cannabis product.
548          (1) (a) A medical cannabis pharmacy may not sell a product other than, subject to this
549     chapter:
550          (i) cannabis in a medicinal dosage form that the medical cannabis pharmacy acquired
551     from a cannabis processing facility that is licensed under Section 4-41a-201;
552          (ii) a cannabis product in a medicinal dosage form that the medical cannabis pharmacy
553     acquired from a cannabis processing facility that is licensed under Section 4-41a-201;
554          (iii) a medical cannabis device; or
555          (iv) educational material related to the medical use of cannabis.
556          (b) A medical cannabis pharmacy may only sell an item listed in Subsection (1)(a) to
557     an individual with:
558          (i) a medical cannabis card; and
559          (ii) corresponding identification that is a valid United States federal- or state-issued
560     photo identification, including a driver license, a United States passport, a United States
561     passport card, or a United States military identification card.
562          (c) Notwithstanding Subsection (1)(a), a medical cannabis pharmacy may not sell a
563     cannabis-based drug that the United States Food and Drug Administration has approved.
564          (2) A medical cannabis pharmacy may not dispense:
565          (a) to a medical cannabis cardholder in any one 12-day period, more than the lesser of:
566          (i) an amount sufficient to provide 14 days of treatment based on the dosing parameters
567     that the relevant qualified medical provider recommends; or
568          (ii) (A) 56 grams by weight of unprocessed cannabis that is in a medicinal dosage form
569     and that carries a label clearly displaying the amount of tetrahydrocannabinol and cannabidiol
570     in the cannabis; or
571          (B) an amount of cannabis products that is in a medicinal dosage form and that
572     contains, in total, greater than 10 grams of total composite tetrahydrocannabinol;
573          (b) to a medical cannabis cardholder whose primary residence is located more than 100
574     miles from the nearest medical cannabis pharmacy or local health department, in any one
575     28-day period, more than the lesser of:
576          (i) an amount sufficient to provide 30 days of treatment based on the dosing parameters
577     that the relevant qualified medical provider recommends; or
578          (ii) (A) 113 grams by weight of unprocessed cannabis that is in a medicinal dosage
579     form and that carries a label clearly displaying the amount of tetrahydrocannabinol and
580     cannabidiol in the cannabis; or
581          (B) an amount of cannabis products that is in a medicinal dosage form and that
582     contains, in total, greater than 20 grams of total composite tetrahydrocannabinol; or
583          (c) to an individual whose qualified medical provider did not recommend dosing
584     parameters, until the individual consults with the pharmacy medical provider in accordance
585     with Subsection (4), any cannabis or cannabis products.
586          (3) An individual with a medical cannabis card may not purchase:
587          (a) more cannabis or cannabis products than the amounts designated in Subsection (2)
588     in any one 12-day period; or
589          (b) if the relevant qualified medical provider did not recommend dosing parameters,
590     until the individual consults with the pharmacy medical provider in accordance with
591     Subsection (4), any cannabis or cannabis products.
592          (4) If a qualified medical provider recommends treatment with medical cannabis or a
593     cannabis product but does not provide dosing parameters:
594          (a) the qualified medical provider shall document in the recommendation:
595          (i) an evaluation of the qualifying condition underlying the recommendation;
596          (ii) prior treatment attempts with cannabis and cannabis products; and
597          (iii) the patient's current medication list; and
598          (b) before the relevant medical cannabis cardholder may obtain cannabis in a medicinal
599     dosage form or a cannabis product in a medicinal dosage form, the pharmacy medical provider
600     shall:
601          (i) review pertinent medical records, including the qualified medical provider
602     documentation described in Subsection (4)(a); and
603          (ii) after completing the review described in Subsection (4)(b)(i) and consulting with
604     the recommending qualified medical provider as needed, determine the best course of treatment
605     through consultation with the cardholder regarding:
606          (A) the patient's qualifying condition underlying the recommendation from the
607     qualified medical provider;
608          (B) indications for available treatments;
609          (C) dosing parameters; and
610          (D) potential adverse reactions.
611          (5) A medial cannabis pharmacy shall:
612          (a) (i) access the state electronic verification system before dispensing cannabis or a
613     cannabis product to a medical cannabis cardholder in order to determine if the cardholder or,
614     where applicable, the associated patient has met the maximum amount of cannabis or cannabis
615     products described in Subsection (2); and
616          (ii) if the verification in Subsection (5)(a)(i) indicates that the individual has met the
617     maximum amount described in Subsection (2):
618          (A) decline the sale; and
619          (B) notify the qualified medical provider who made the underlying recommendation;
620          (b) submit a record to the state electronic verification system each time the medical
621     cannabis pharmacy dispenses cannabis or a cannabis product to a medical cannabis cardholder;
622     and
623          [(c) package any cannabis or cannabis product that is in a blister pack in a container
624     that:]
625          [(i) complies with Subsection 4-41a-602(2);]
626          [(ii) is tamper-resistant and tamper-evident; and]
627          [(iii) opaque; and]
628          [(d)] (c) for a product that is a cube that is designed for ingestion through chewing or
629     holding in the mouth for slow dissolution, include a separate, off-label warning about the risks
630     of over-consumption.
631          (6) (a) Except as provided in Subsection (6)(b), a medical cannabis pharmacy may not
632     sell medical cannabis in the form of a cigarette or a medical cannabis device that is
633     intentionally designed or constructed to resemble a cigarette.
634          (b) A medial cannabis pharmacy may sell a medical cannabis device that warms
635     cannabis material into a vapor without the use of a flame and that delivers cannabis to an
636     individual's respiratory system.
637          (7) A medical cannabis pharmacy may not give, at no cost, a product that the medical
638     cannabis pharmacy is allowed to sell under Subsection (1).
639          (8) The department may impose a uniform fee on each medical cannabis cardholder
640     transaction in a medical cannabis pharmacy in an amount that, subject to Subsection
641     26-61a-109(5), the department sets in accordance with Section 63J-1-504.
642          Section 6. Section 26-61a-604 is amended to read:
643          26-61a-604. State central fill shipment preparation.
644          (1) (a) The state central fill medical cannabis pharmacy may not prepare or ship to a
645     local health department a product other than:
646          (i) cannabis in medicinal dosage form that the state central fill medical cannabis
647     pharmacy acquired from a cannabis processing facility that is licensed under Section
648     4-41a-201;
649          (ii) a cannabis product in medicinal dosage form that the state central fill medical
650     cannabis pharmacy acquired from a cannabis processing facility that is licensed under Section
651     4-41a-201;
652          (iii) a medical cannabis device; or
653          (iv) educational material related to the medical use of cannabis.
654          (b) The state central fill medical cannabis pharmacy may only sell or ship an item listed
655     in Subsection (1)(a) in response to a request for shipment described in Subsection
656     26-61a-603(1).
657          (c) Notwithstanding Subsection (1)(a), the state central fill medical cannabis pharmacy
658     may not sell a cannabis-based drug that the United States Food and Drug Administration has
659     approved.
660          (2) The state central fill medical cannabis pharmacy may not prepare a shipment:
661          (a) for a medical cannabis cardholder in any one 12-day period, more than the lesser of:
662          (i) an amount sufficient to provide 14 days of treatment based on the dosing parameters
663     that the relevant qualified medical provider recommends; or
664          (ii) (A) 56 grams by weight of unprocessed cannabis that is in a medicinal dosage form
665     and that carries a label clearly displaying the amount of tetrahydrocannabinol and cannabidiol
666     in the cannabis; or
667          (B) an amount of cannabis products that is in a medicinal dosage form and that
668     contains, in total, greater than 10 grams of total composite tetrahydrocannabinol;
669          (b) to a medical cannabis cardholder whose primary residence is located more than 100
670     miles from the nearest medical cannabis pharmacy or local health department, in any one
671     28-day period, more than the lesser of:
672          (i) an amount sufficient to provide 30 days of treatment based on the dosing parameters
673     that the relevant qualified medical provider recommends; or
674          (ii) (A) 113 grams by weight of unprocessed cannabis that is in a medicinal dosage
675     form and that carries a label clearly displaying the amount of tetrahydrocannabinol and
676     cannabidiol in the cannabis; or
677          (B) an amount of cannabis products that is in a medicinal dosage form and that
678     contains, in total, greater than 20 grams of total composite tetrahydrocannabinol; or
679          (c) for an individual whose qualified medical provider did not recommend dosing
680     parameters, any cannabis or cannabis product, until the individual consults with the state
681     central fill medical provider in accordance with Subsection (4).
682          (3) A medical cannabis cardholder may not receive a state central fill shipment
683     containing:
684          (a) more cannabis or cannabis products than the amounts designated in Subsection (2)
685     in any one 12-day period; or
686          (b) if the relevant qualified medical provider did not recommend dosing parameters,
687     any cannabis or cannabis product, until the cardholder consults with the state central fill
688     medical provider in accordance with Subsection (4).
689          (4) If a qualified medical provider recommends treatment with medical cannabis or a
690     cannabis product but does not provide dosing parameters:
691          (a) the qualified medical provider shall document in the recommendation:
692          (i) an evaluation of the qualifying condition underlying the recommendation;
693          (ii) prior treatment attempts with cannabis and cannabis products; and
694          (iii) the patient's current medication list; and
695          (b) before the relevant medical cannabis cardholder may receive a state central fill
696     shipment, the state central fill medical provider shall:
697          (i) review pertinent medical records, including the qualified medical provider
698     documentation described in Subsection (4)(a); and
699          (ii) after completing the review described in Subsection (4)(b)(i) and consulting with
700     the recommending qualified medical provider as needed, determine the best course of treatment
701     through consultation with the cardholder regarding:
702          (A) the patient's qualifying condition underlying the recommendation from the
703     qualified medical provider;
704          (B) indications for available treatments;
705          (C) dosing parameters; and
706          (D) potential adverse reactions.
707          (5) The state central fill medical cannabis pharmacy shall:
708          (a) (i) access the state electronic verification system before preparing a shipment of
709     cannabis or a cannabis product to determine if the medical cannabis cardholder or, where
710     applicable, the associated patient has met the maximum amount of cannabis or cannabis
711     product described in Subsection (2); and
712          (ii) if the verification in Subsection (5)(a)(i) indicates that the individual has met the
713     maximum amount described in Subsection (2):
714          (A) decline the request to prepare the shipment; and
715          (B) notify the qualified medical provider that made the recommendation;
716          (b) submit a record to the state electronic verification system each time the state central
717     fill medical cannabis pharmacy prepares and ships a shipment of cannabis, a cannabis product,
718     or a medical cannabis device; and
719          [(c) package any cannabis or cannabis product that is in a blister pack in a container
720     that:]
721          [(i) complies with Subsection 4-41a-602(2);]
722          [(ii) is tamper-resistant and tamper-evident; and]
723          [(iii) is opaque; and]
724          [(d)] (c) for any product that is a cube that is designed for ingestion through chewing or
725     holding in the mouth for slow dissolution, include a separate, off-label warning about the risks
726     of over-consumption.
727          (6) (a) Except as provided in Subsection (6)(b), the state central fill medical cannabis
728     pharmacy may not sell medical cannabis in the form of a cigarette or a medical cannabis device
729     that is intentionally designed or constructed to resemble a cigarette.
730          (b) The state central fill medical cannabis pharmacy may sell a medical cannabis
731     device that warms cannabis material into a vapor without the use of a flame and that delivers
732     cannabis to an individual's respiratory system.
733          (7) The state central fill medical cannabis pharmacy may not give, at no cost, a product
734     that the medical cannabis pharmacy is allowed to sell under Subsection (1).
735          (8) (a) The state central fill medical cannabis pharmacy shall retain in the pharmacy's
736     records the following information regarding each recommendation underlying a transaction:
737          (i) the qualified medical provider's name, address, and telephone number;
738          (ii) the patient's name and address;
739          (iii) the date of issuance;
740          (iv) dosing parameters or an indication that the qualified medical provider did not
741     recommend specific dosing parameters; and
742          (v) the name and the address of the medical cannabis cardholder if the cardholder is not
743     the patient.
744          (b) The state central fill medical cannabis pharmacy may not sell cannabis or a
745     cannabis product unless the cannabis or cannabis product has a label securely affixed to the
746     container indicating the following minimum information:
747          (i) the name and telephone number of the state central fill medical cannabis pharmacy;
748          (ii) the unique identification number that the state central fill medical cannabis
749     pharmacy assigns;
750          (iii) the date of the sale;
751          (iv) the name of the medical cannabis cardholder;
752          (v) the name of the qualified medical provider who recommends the medical cannabis
753     treatment;
754          (vi) directions for use and cautionary statements, if any;
755          (vii) the amount dispensed and the cannabinoid content;
756          (viii) the beyond use date; and
757          (ix) any other requirements that the department determines, in consultation with the
758     Division of Occupational and Professional Licensing and the Board of Pharmacy.
759          (9) A pharmacy medical provider at the state central fill medical cannabis pharmacy or
760     a state central fill agent shall:
761          (a) include in each state central fill shipment written counseling regarding the state
762     central fill shipment; and
763          (b) provide a telephone number or website by which a medical cannabis cardholder
764     may contact a pharmacy medical provider for counseling.
765          (10) The department shall establish by rule, in accordance with Title 63G, Chapter 3,
766     Utah Administrative Rulemaking Act, protocols for a recall of cannabis and cannabis products
767     by the state central fill medical cannabis pharmacy.
768          (11) The department may impose a uniform fee on each medical cannabis cardholder
769     transaction for a state central fill shipment in an amount that, subject to Subsection
770     26-61a-109(5), the department sets in accordance with Section 63J-1-504.
771          Section 7. Section 58-37-3.7 is amended to read:
772          58-37-3.7. Medical cannabis decriminalization.
773          (1) As used in this section:
774          (a) "Cannabis" means the same as that term is defined in Section 26-61a-102.
775          (b) "Cannabis product" means the same as that term is defined in Section 26-61a-102.
776          (c) "Medical cannabis card" means the same as that term is defined in Section
777     26-61a-102.
778          (d) "Medical cannabis device" means the same as that term is defined in Section
779     26-61a-102.
780          (e) "Medical cannabis pharmacy" means the same as that term is defined in Section
781     26-61a-102.
782          (f) "Medicinal dosage form" means the same as that term is defined in Section
783     26-61a-102.
784          (g) "Qualified medical provider" means the same as that term is defined in Section
785     26-61a-102.
786          (h) "Qualifying condition" means the same as that term is defined in Section
787     26-61a-102.
788          (i) "Tetrahydrocannabinol" means the same as that term is defined in Section
789     58-37-3.9.
790          (2) Before January 1, 2021, an individual is not guilty under this chapter for the use or
791     possession of marijuana, tetrahydrocannabinol, or marijuana drug paraphernalia if[:(a) ] at the
792     time of the arrest[,]:
793          (a) the individual[:(i) (A) ] had been diagnosed with a qualifying condition; and
794          [(B) had a pre-existing provider-patient relationship with an advanced practice
795     registered nurse licensed under Title 58, Chapter 31b, Nurse Practice Act, a physician licensed
796     under Title 58, Chapter 67, Utah Medical Practice Act, a physician licensed under Title 58,
797     Chapter 68, Utah Osteopathic Medical Practice Act, or a physician assistant licensed under
798     Title 58, Chapter 70a, Physician Assistant Act, who believed that the individual's illness
799     described in Subsection (2)(a)(i)(A) could benefit from the use in question; or]
800          [(ii) (A) for possession, was a medical cannabis cardholder; or]
801          [(B) for use, was a medical cannabis patient cardholder or a minor with a qualifying
802     condition under the supervision of a medical cannabis guardian cardholder; and]
803          (b) the marijuana or tetrahydrocannabinol was in [a medicinal dosage form in a
804     quantity described in Subsection 26-61a-502(2).] one of the following amounts:
805          (i) no more than 56 grams by weight of unprocessed cannabis; or
806          (ii) an amount of cannabis products that contains, in total, no more than 10 grams of
807     total composite tetrahydrocannabinol.
808          (3) An individual is not guilty under this chapter for the use or possession of marijuana,
809     tetrahydrocannabinol, or marijuana drug paraphernalia under this chapter if:
810          (a) at the time of the arrest, the individual:
811          (i) was not a resident of Utah or has been a resident of Utah for less than 45 days;
812          (ii) had a currently valid medical cannabis card or the equivalent of a medical cannabis
813     card under the laws of another state, district, territory, commonwealth, or insular possession of
814     the United States; and
815          (iii) had been diagnosed with a qualifying condition as described in Section
816     26-61a-104; and
817          (b) the marijuana or tetrahydrocannabinol is in a medicinal dosage form in a quantity
818     described in Subsection 26-61a-502(2).