Senator Luz Escamilla proposes the following substitute bill:


1     
CONSUMER PROTECTION FOR CANNABIS PATIENTS

2     
2021 GENERAL SESSION

3     
STATE OF UTAH

4     
Chief Sponsor: Luz Escamilla

5     
House Sponsor: Raymond P. Ward

6     

7     LONG TITLE
8     General Description:
9          This bill amends provisions relating to patient access to medical cannabis
10     recommendations from medical providers.
11     Highlighted Provisions:
12          This bill:
13          ▸     defines terms;
14          ▸     amends a labeling requirement for consistency;
15          ▸     allows a licensed podiatrist to recommend medical cannabis within the course and
16     scope of a practice of podiatry;
17          ▸     requires the state electronic verification system to allow a medical cannabis
18     pharmacy to record a medical cannabis recommendation from a limited medical
19     provider;
20          ▸     allows certain medical providers to operate as limited medical providers to
21     recommend cannabis to a limited number of the provider's patients without
22     registering with the Department of Health (department) as a qualified medical
23     provider;
24          ▸     amends provisions to accommodate the allowance for limited medical providers;
25          ▸     allows a licensed podiatrist to become a qualified medical provider;

26          ▸     requires the department to issue an electronic conditional medical cannabis card to
27     allow certain medical cannabis card applicants access to medical cannabis;
28          ▸     requires medical cannabis pharmacies to record information in an order from a
29     limited medical provider in the state electronic verification system;
30          ▸     imposes certain verification requirements on a medical cannabis pharmacy before
31     entering certain orders from a limited medical provider or processing a transaction
32     for certain conditional medical cannabis cardholders;
33          ▸     requires a medical cannabis component in required continuing education for
34     controlled substance prescribers;
35          ▸     extends a deadline that imposes a limitation on an individual's use or possession of
36     medical cannabis from outside the state; and
37          ▸     makes technical and conforming changes.
38     Money Appropriated in this Bill:
39          None
40     Other Special Clauses:
41          This bill provides a special effective date.
42          This bill provides revisor instructions.
43     Utah Code Sections Affected:
44     AMENDS:
45          4-41a-102, as last amended by Laws of Utah 2020, Chapters 12, 148 and last amended
46     by Coordination Clause, Laws of Utah 2020, Chapter 148
47          4-41a-602, as last amended by Laws of Utah 2020, Chapter 12
48          26-61a-102, as last amended by Laws of Utah 2020, Chapters 12, 148 and last amended
49     by Coordination Clause, Laws of Utah 2020, Chapter 148
50          26-61a-103, as last amended by Laws of Utah 2020, Chapter 12
51          26-61a-106, as last amended by Laws of Utah 2020, Chapter 12
52          26-61a-107, as last amended by Laws of Utah 2020, Chapters 12, 148 and last amended
53     by Coordination Clause, Laws of Utah 2020, Chapter 148
54          26-61a-201, as last amended by Laws of Utah 2020, Chapters 12 and 148
55          26-61a-202, as last amended by Laws of Utah 2020, Chapter 12
56          26-61a-401, as last amended by Laws of Utah 2019, First Special Session, Chapter 5

57          26-61a-403, as last amended by Laws of Utah 2019, First Special Session, Chapter 5
58          26-61a-501, as last amended by Laws of Utah 2020, Chapter 12
59          26-61a-502, as last amended by Laws of Utah 2020, Chapters 12, 148 and last amended
60     by Coordination Clause, Laws of Utah 2020, Chapter 148
61          26-61a-503, as last amended by Laws of Utah 2019, First Special Session, Chapter 5
62          26-61a-601, as last amended by Laws of Utah 2020, Chapter 12
63          58-5a-102, as last amended by Laws of Utah 2020, Chapter 25
64          58-31b-502, as last amended by Laws of Utah 2020, Fifth Special Session, Chapter 4
65          58-37-3.7, as last amended by Laws of Utah 2020, Chapter 12
66          58-37-6.5, as last amended by Laws of Utah 2018, Chapter 318
67          58-67-502, as last amended by Laws of Utah 2020, Chapter 25
68          58-68-502, as last amended by Laws of Utah 2020, Chapter 25
69          58-70a-503, as last amended by Laws of Utah 2020, Chapter 25
70          62A-4a-404, as last amended by Laws of Utah 2020, Chapter 193
71          78A-2-231, as last amended by Laws of Utah 2020, Chapter 12
72          78A-6-115, as last amended by Laws of Utah 2020, Chapters 12, 132, 250, and 354
73     Utah Code Sections Affected by Revisor Instructions:
74          26-61a-201, as last amended by Laws of Utah 2020, Chapters 12 and 148
75          58-37-3.7, as last amended by Laws of Utah 2020, Chapter 12
76     

77     Be it enacted by the Legislature of the state of Utah:
78          Section 1. Section 4-41a-102 is amended to read:
79          4-41a-102. Definitions.
80          As used in this chapter:
81          (1) "Active tetrahydrocannabinol" means delta-9-tetrahydrocannabinol and
82     tetrahydrocannabinolic acid.
83          (2) "Cannabis" means the same as that term is defined in Section 26-61a-102.
84          (3) "Cannabis cultivation facility" means a person that:
85          (a) possesses cannabis;
86          (b) grows or intends to grow cannabis; and
87          (c) sells or intends to sell cannabis to a cannabis cultivation facility, a cannabis

88     processing facility, or a medical cannabis research licensee.
89          (4) "Cannabis cultivation facility agent" means an individual who:
90          (a) is an employee of a cannabis cultivation facility; and
91          (b) holds a valid cannabis production establishment agent registration card.
92          (5) "Cannabis processing facility" means a person that:
93          (a) acquires or intends to acquire cannabis from a cannabis production establishment;
94          (b) possesses cannabis with the intent to manufacture a cannabis product;
95          (c) manufactures or intends to manufacture a cannabis product from unprocessed
96     cannabis or a cannabis extract; and
97          (d) sells or intends to sell a cannabis product to a medical cannabis pharmacy or a
98     medical cannabis research licensee.
99          (6) "Cannabis processing facility agent" means an individual who:
100          (a) is an employee of a cannabis processing facility; and
101          (b) holds a valid cannabis production establishment agent registration card.
102          (7) "Cannabis product" means the same as that term is defined in Section 26-61a-102.
103          (8) "Cannabis production establishment" means a cannabis cultivation facility, a
104     cannabis processing facility, or an independent cannabis testing laboratory.
105          (9) "Cannabis production establishment agent" means a cannabis cultivation facility
106     agent, a cannabis processing facility agent, or an independent cannabis testing laboratory agent.
107          (10) "Cannabis production establishment agent registration card" means a registration
108     card that the department issues that:
109          (a) authorizes an individual to act as a cannabis production establishment agent; and
110          (b) designates the type of cannabis production establishment for which an individual is
111     authorized to act as an agent.
112          (11) "Community location" means a public or private elementary or secondary school,
113     a church, a public library, a public playground, or a public park.
114          (12) "Cultivation space" means, quantified in square feet, the horizontal area in which
115     a cannabis cultivation facility cultivates cannabis, including each level of horizontal area if the
116     cannabis cultivation facility hangs, suspends, stacks, or otherwise positions plants above other
117     plants in multiple levels.
118          (13) "Department" means the Department of Agriculture and Food.

119          (14) "Family member" means a parent, step-parent, spouse, child, sibling, step-sibling,
120     uncle, aunt, nephew, niece, first cousin, mother-in-law, father-in-law, brother-in-law,
121     sister-in-law, son-in-law, daughter-in-law, grandparent, or grandchild.
122          (15) (a) "Independent cannabis testing laboratory" means a person that:
123          (i) conducts a chemical or other analysis of cannabis or a cannabis product; or
124          (ii) acquires, possesses, and transports cannabis or a cannabis product with the intent to
125     conduct a chemical or other analysis of the cannabis or cannabis product.
126          (b) "Independent cannabis testing laboratory" includes a laboratory that the department
127     operates in accordance with Subsection 4-41a-201(14).
128          (16) "Independent cannabis testing laboratory agent" means an individual who:
129          (a) is an employee of an independent cannabis testing laboratory; and
130          (b) holds a valid cannabis production establishment agent registration card.
131          (17) "Inventory control system" means a system described in Section 4-41a-103.
132          (18) "Medical cannabis" means the same as that term is defined in Section 26-61a-102.
133          (19) "Medical cannabis card" means the same as that term is defined in Section
134     26-61a-102.
135          (20) "Medical cannabis pharmacy" means the same as that term is defined in Section
136     26-61a-102.
137          (21) "Medical cannabis pharmacy agent" means the same as that term is defined in
138     Section 26-61a-102.
139          (22) "Medical cannabis research license" means a license that the department issues to
140     a research university for the purpose of obtaining and possessing medical cannabis for
141     academic research.
142          (23) "Medical cannabis research licensee" means a research university that the
143     department licenses to obtain and possess medical cannabis for academic research, in
144     accordance with Section 4-41a-901.
145          (24) "Medical cannabis treatment" means the same as that term is defined in Section
146     26-61a-102.
147          (25) "Medicinal dosage form" means the same as that term is defined in Section
148     26-61a-102.
149          (26) "Qualified medical provider" means the same as that term is defined in Section

150     26-61a-102.
151          (27) "Qualified Production Enterprise Fund" means the fund created in Section
152     4-41a-104.
153          (28) "Recommending medical provider" means the same as that term is defined in
154     Section 26-61a-102.
155          [(28)] (29) "Research university" means the same as that term is defined in Section
156     53B-7-702 and a private, nonprofit college or university in the state that:
157          (a) is accredited by the Northwest Commission on Colleges and Universities;
158          (b) grants doctoral degrees; and
159          (c) has a laboratory containing or a program researching a schedule I controlled
160     substance described in Section 58-37-4.
161          [(29)] (30) "State electronic verification system" means the system described in Section
162     26-61a-103.
163          [(30)] (31) "Tetrahydrocannabinol" means a substance derived from cannabis or a
164     synthetic equivalent as described in Subsection 58-37-4(2)(a)(iii)(AA).
165          [(31)] (32) "Total composite tetrahydrocannabinol" means all detectable forms of
166     tetrahydrocannabinol.
167          Section 2. Section 4-41a-602 is amended to read:
168          4-41a-602. Cannabis product -- Labeling and child-resistant packaging.
169          (1) For any cannabis product that a cannabis processing facility processes or produces
170     and for any raw cannabis that the facility packages, the facility shall:
171          (a) label the cannabis or cannabis product with a label that:
172          (i) clearly and unambiguously states that the cannabis product or package contains
173     cannabis;
174          (ii) clearly displays the amount of total composite tetrahydrocannabinol and
175     cannabidiol in the labeled container;
176          (iii) has a unique identification number that:
177          (A) is connected to the inventory control system; and
178          (B) identifies the unique cannabis product manufacturing process the cannabis
179     processing facility used to manufacture the cannabis product;
180          (iv) identifies the cannabinoid extraction process that the cannabis processing facility

181     used to create the cannabis product;
182          (v) does not display an image, word, or phrase that the facility knows or should know
183     appeals to children; and
184          (vi) discloses each active or potentially active ingredient, in order of prominence, and
185     possible allergen; and
186          (b) package the raw cannabis or cannabis product in a medicinal dosage form in a
187     container that:
188          (i) is tamper evident and tamper resistant;
189          (ii) does not appeal to children;
190          (iii) does not mimic a candy container;
191          (iv) is opaque;
192          (v) complies with child-resistant effectiveness standards that the United States
193     Consumer Product Safety Commission establishes; and
194          (vi) includes a warning label that states:
195          (A) for a container labeled before July 1, 2021, "WARNING: Cannabis has
196     intoxicating effects and may be addictive. Do not operate a vehicle or machinery under its
197     influence. KEEP OUT OF REACH OF CHILDREN. This product is for medical use only. Use
198     only as directed by a qualified medical provider."; or
199          (B) for a container labeled on or after July 1, 2021, "WARNING: Cannabis has
200     intoxicating effects and may be addictive. Do not operate a vehicle or machinery under its
201     influence. KEEP OUT OF REACH OF CHILDREN. This product is for medical use only. Use
202     only as directed by a recommending medical provider.".
203          (2) For any cannabis or cannabis product that the cannabis processing facility processes
204     into a gelatinous cube, gelatinous rectangular cuboid, or lozenge in a cube or rectangular
205     cuboid shape, the facility shall:
206          (a) ensure that the label described in Subsection (1)(a) does not contain a photograph or
207     other image of the content of the container; and
208          (b) include on the label described in Subsection (1)(a) a warning about the risks of
209     over-consumption.
210          (3) The department shall make rules in accordance with Title 63G, Chapter 3, Utah
211     Administrative Rulemaking Act to establish:

212          (a) a standard labeling format that:
213          (i) complies with the requirements of this section; and
214          (ii) ensures inclusion of a pharmacy label; and
215          (b) additional requirements on packaging for cannabis and cannabis products to ensure
216     safety and product quality.
217          Section 3. Section 26-61a-102 is amended to read:
218          26-61a-102. Definitions.
219          As used in this chapter:
220          (1) "Cannabis" means marijuana.
221          (2) "Cannabis cultivation facility" means the same as that term is defined in Section
222     4-41a-102.
223          (3) "Cannabis processing facility" means the same as that term is defined in Section
224     4-41a-102.
225          (4) "Cannabis product" means a product that:
226          (a) is intended for human use; and
227          (b) contains cannabis or tetrahydrocannabinol.
228          (5) "Cannabis production establishment" means the same as that term is defined in
229     Section 4-41a-102.
230          (6) "Cannabis production establishment agent" means the same as that term is defined
231     in Section 4-41a-102.
232          (7) "Cannabis production establishment agent registration card" means the same as that
233     term is defined in Section 4-41a-102.
234          (8) "Community location" means a public or private elementary or secondary school, a
235     church, a public library, a public playground, or a public park.
236          (9) "Conditional medical cannabis card" means an electronic medical cannabis card
237     that the department issues in accordance with Subsection 26-61a-201(1)(b) to allow an
238     applicant for a medical cannabis card to access medical cannabis during the department's
239     review of the application.
240          [(9)] (10) "Department" means the Department of Health.
241          [(10)] (11) "Designated caregiver" means:
242          (a) an individual:

243          (i) whom an individual with a medical cannabis patient card or a medical cannabis
244     guardian card designates as the patient's caregiver; and
245          (ii) who registers with the department under Section 26-61a-202; or
246          (b) (i) a facility that an individual designates as a designated caregiver in accordance
247     with Subsection 26-61a-202(1)(b); or
248          (ii) an assigned employee of the facility described in Subsection 26-61a-202(1)(b)(ii).
249          [(11)] (12) "Directions of use" means recommended routes of administration for a
250     medical cannabis treatment and suggested usage guidelines.
251          [(12)] (13) "Dosing guidelines" means a quantity range and frequency of administration
252     for a recommended treatment of medical cannabis.
253          [(13)] (14) "Financial institution" means a bank, trust company, savings institution, or
254     credit union, chartered and supervised under state or federal law.
255          [(14)] (15) "Home delivery medical cannabis pharmacy" means a medical cannabis
256     pharmacy that the department authorizes, as part of the pharmacy's license, to deliver medical
257     cannabis shipments to a medical cannabis cardholder's home address to fulfill electronic orders
258     that the state central patient portal facilitates.
259          [(15)] (16) "Inventory control system" means the system described in Section
260     4-41a-103.
261          [(16)] (17) "Legal dosage limit" means an amount that:
262          (a) is sufficient to provide 30 days of treatment based on the dosing guidelines that the
263     relevant [qualified] recommending medical provider or the pharmacy medical provider, in
264     accordance with Subsection 26-61a-201(4) or (5), recommends; and
265          (b) may not exceed:
266          (i) for unprocessed cannabis in a medicinal dosage form, 113 grams by weight; and
267          (ii) for a cannabis product in a medicinal dosage form, a quantity that contains, in total,
268     greater than 20 grams of active tetrahydrocannabinol.
269          [(17)] (18) "Legal use termination date" means a date on the label of a container of
270     unprocessed cannabis flower:
271          (a) that is 60 days after the date of purchase of the cannabis; and
272          (b) after which, the cannabis is no longer in a medicinal dosage form outside of the
273     primary residence of the relevant medical cannabis patient cardholder.

274          (19) "Limited medical provider" means an individual who:
275          (a) meets the recommending qualifications; and
276          (b) has no more than 15 patients with a valid medical cannabis patient card or
277     provisional patient card as a result of the individual's recommendation, in accordance with
278     Subsection 26-61a-106(1)(b).
279          [(18)] (20) "Marijuana" means the same as that term is defined in Section 58-37-2.
280          [(19)] (21) "Medical cannabis" means cannabis in a medicinal dosage form or a
281     cannabis product in a medicinal dosage form.
282          [(20)] (22) "Medical cannabis card" means a medical cannabis patient card, a medical
283     cannabis guardian card, [or] a medical cannabis caregiver card, or a conditional medical
284     cannabis card.
285          [(21)] (23) "Medical cannabis cardholder" means:
286          (a) a holder of a medical cannabis card; or
287          (b) a facility or assigned employee, described in Subsection [(10)] (11)(b), only:
288          (i) within the scope of the facility's or assigned employee's performance of the role of a
289     medical cannabis patient cardholder's caregiver designation under Subsection
290     26-61a-202(1)(b); and
291          (ii) while in possession of documentation that establishes:
292          (A) a caregiver designation described in Subsection 26-61a-202(1)(b);
293          (B) the identity of the individual presenting the documentation; and
294          (C) the relation of the individual presenting the documentation to the caregiver
295     designation.
296          [(22)] (24) "Medical cannabis caregiver card" means an electronic document that a
297     cardholder may print or store on an electronic device or a physical card or document that:
298          (a) the department issues to an individual whom a medical cannabis patient cardholder
299     or a medical cannabis guardian cardholder designates as a designated caregiver; and
300          (b) is connected to the electronic verification system.
301          (25) "Medical cannabis courier agent" means an individual who:
302          (a) is an employee of a medical cannabis courier; and
303          (b) who holds a valid medical cannabis courier agent registration card.
304          [(23)] (26) "Medical cannabis courier" means a courier that:

305          (a) the department licenses in accordance with Section 26-61a-604; and
306          (b) contracts with a home delivery medical cannabis pharmacy to deliver medical
307     cannabis shipments to fulfill electronic orders that the state central patient portal facilitates.
308          [(24)] (27) (a) "Medical cannabis device" means a device that an individual uses to
309     ingest or inhale cannabis in a medicinal dosage form or a cannabis product in a medicinal
310     dosage form.
311          (b) "Medical cannabis device" does not include a device that:
312          (i) facilitates cannabis combustion; or
313          (ii) an individual uses to ingest substances other than cannabis.
314          [(25)] (28) "Medical cannabis guardian card" means an electronic document that a
315     cardholder may print or store on an electronic device or a physical card or document that:
316          (a) the department issues to the parent or legal guardian of a minor with a qualifying
317     condition; and
318          (b) is connected to the electronic verification system.
319          [(26)] (29) "Medical cannabis patient card" means an electronic document that a
320     cardholder may print or store on an electronic device or a physical card or document that:
321          (a) the department issues to an individual with a qualifying condition; and
322          (b) is connected to the electronic verification system.
323          [(27)] (30) "Medical cannabis pharmacy" means a person that:
324          (a) (i) acquires or intends to acquire:
325          (A) cannabis in a medicinal dosage form or a cannabis product in a medicinal dosage
326     form from a cannabis processing facility; or
327          (B) a medical cannabis device; or
328          (ii) possesses cannabis in a medicinal dosage form, a cannabis product in a medicinal
329     dosage form, or a medical cannabis device; and
330          (b) sells or intends to sell cannabis in a medicinal dosage form, a cannabis product in a
331     medicinal dosage form, or a medical cannabis device to a medical cannabis cardholder.
332          [(28)] (31) "Medical cannabis pharmacy agent" means an individual who:
333          (a) is an employee of a medical cannabis pharmacy; and
334          (b) who holds a valid medical cannabis pharmacy agent registration card.
335          [(29)] (32) "Medical cannabis pharmacy agent registration card" means a registration

336     card issued by the department that authorizes an individual to act as a medical cannabis
337     pharmacy agent.
338          [(30)] (33) "Medical cannabis shipment" means a shipment of medical cannabis or a
339     medical cannabis product that a home delivery medical cannabis pharmacy or a medical
340     cannabis courier delivers to a medical cannabis cardholder's home address to fulfill an
341     electronic medical cannabis order that the state central patient portal facilitates.
342          [(31)] (34) "Medical cannabis treatment" means cannabis in a medicinal dosage form, a
343     cannabis product in a medicinal dosage form, or a medical cannabis device.
344          [(32)] (35) (a) "Medicinal dosage form" means:
345          (i) for processed medical cannabis or a medical cannabis product, the following with a
346     specific and consistent cannabinoid content:
347          (A) a tablet;
348          (B) a capsule;
349          (C) a concentrated liquid or viscous oil;
350          (D) a liquid suspension;
351          (E) a topical preparation;
352          (F) a transdermal preparation;
353          (G) a sublingual preparation;
354          (H) a gelatinous cube, gelatinous rectangular cuboid, or lozenge in a cube or
355     rectangular cuboid shape; or
356          (I) a resin or wax;
357          (ii) for unprocessed cannabis flower, a container described in Section 4-41a-602 that:
358          (A) contains cannabis flowers in a quantity that varies by no more than 10% from the
359     stated weight at the time of packaging;
360          (B) at any time the medical cannabis cardholder transports or possesses the container in
361     public, is contained within an opaque, child-resistant bag that the medical cannabis pharmacy
362     provides; and
363          (C) is labeled with the container's content and weight, the date of purchase, the legal
364     use termination date, and after December 31, 2020, a barcode that provides information
365     connected to an inventory control system; and
366          (iii) a form measured in grams, milligrams, or milliliters.

367          (b) "Medicinal dosage form" includes a portion of unprocessed cannabis flower that:
368          (i) the medical cannabis cardholder has recently removed from the container described
369     in Subsection [(32)] (35)(a)(ii) for use; and
370          (ii) does not exceed the quantity described in Subsection [(32)] (35)(a)(ii).
371          (c) "Medicinal dosage form" does not include:
372          (i) any unprocessed cannabis flower outside of the container described in Subsection
373     [(32)] (35)(a)(ii), except as provided in Subsection [(32)] (35)(b);
374          (ii) any unprocessed cannabis flower in a container described in Subsection [(32)]
375     (35)(a)(ii) after the legal use termination date; or
376          (iii) a process of vaporizing and inhaling concentrated cannabis by placing the cannabis
377     on a nail or other metal object that is heated by a flame, including a blowtorch.
378          [(33)] (36) "Nonresident patient" means an individual who:
379          (a) is not a resident of Utah or has been a resident of Utah for less than 45 days;
380          (b) has a currently valid medical cannabis card or the equivalent of a medical cannabis
381     card under the laws of another state, district, territory, commonwealth, or insular possession of
382     the United States; and
383          (c) has been diagnosed with a qualifying condition as described in Section 26-61a-104.
384          [(34)] (37) "Payment provider" means an entity that contracts with a cannabis
385     production establishment or medical cannabis pharmacy to facilitate transfers of funds between
386     the establishment or pharmacy and other businesses or individuals.
387          [(35)] (38) "Pharmacy medical provider" means the medical provider required to be on
388     site at a medical cannabis pharmacy under Section 26-61a-403.
389          [(36)] (39) "Provisional patient card" means a card that:
390          (a) the department issues to a minor with a qualifying condition for whom:
391          (i) a [qualified] recommending medical provider has recommended a medical cannabis
392     treatment; and
393          (ii) the department issues a medical cannabis guardian card to the minor's parent or
394     legal guardian; and
395          (b) is connected to the electronic verification system.
396          [(37)] (40) "Qualified medical provider" means an individual [who is qualified]:
397          (a) who meets the recommending qualifications; and

398          (b) whom the department registers to recommend treatment with cannabis in a
399     medicinal dosage form under Section 26-61a-106.
400          [(38)] (41) "Qualified Patient Enterprise Fund" means the enterprise fund created in
401     Section 26-61a-109.
402          [(39)] (42) "Qualifying condition" means a condition described in Section 26-61a-104.
403          [(40)] (43) "Recommend" or "recommendation" means, for a [qualified]
404     recommending medical provider, the act of suggesting the use of medical cannabis treatment,
405     which:
406          (a) certifies the patient's eligibility for a medical cannabis card; and
407          (b) may include, at the [qualified] recommending medical provider's discretion,
408     directions of use, with or without dosing guidelines.
409          (44) "Recommending medical provider" means a qualified medical provider or a
410     limited medical provider.
411          (45) "Recommending qualifications" means that an individual:
412          (a) (i) has the authority to write a prescription;
413          (ii) is licensed to prescribe a controlled substance under Title 58, Chapter 37, Utah
414     Controlled Substances Act; and
415          (iii) possesses the authority, in accordance with the individual's scope of practice, to
416     prescribe a Schedule II controlled substance; and
417          (b) who is licensed as:
418          (i) a podiatrist under Title 58, Chapter 5a, Podiatric Physician Licensing Act;
419          (ii) an advanced practice registered nurse under Title 58, Chapter 31b, Nurse Practice
420     Act;
421          (iii) a physician under Title 58, Chapter 67, Utah Medical Practice Act, or Title 58,
422     Chapter 68, Utah Osteopathic Medical Practice Act; or
423          (iv) a physician assistant under Title 58, Chapter 70a, Utah Physician Assistant Act
424     whose:
425          (A) declaration of services agreement, as that term is defined in Section 58-70a-102,
426     includes the recommending of medical cannabis; and
427          (B) supervising physician is a qualified medical provider.
428          [(41)] (46) "State central patient portal" means the website the department creates, in

429     accordance with Section 26-61a-601, to facilitate patient safety, education, and an electronic
430     medical cannabis order.
431          [(42)] (47) "State central patient portal medical provider" means a physician or
432     pharmacist that the department employs in relation to the state central patient portal to consult
433     with medical cannabis cardholders in accordance with Section 26-61a-602.
434          [(43)] (48) "State electronic verification system" means the system described in Section
435     26-61a-103.
436          [(44)] (49) "Valid form of photo identification" means any of the following forms of
437     identification that is either current or has expired within the previous six months:
438          (a) a valid state-issued driver license or identification card;
439          (b) a valid United States [federal- or state-issued] federal-issued photo identification,
440     including:
441          [(a) a driver license;]
442          [(b)] (i) a United States passport;
443          [(c)] (ii) a United States passport card; [or]
444          [(d)] (iii) a United States military identification card[.]; or
445          (iv) a permanent resident card or alien registration receipt card; or
446          (c) a passport that another country issued.
447          Section 4. Section 26-61a-103 is amended to read:
448          26-61a-103. Electronic verification system.
449          (1) The Department of Agriculture and Food, the department, the Department of Public
450     Safety, and the Department of Technology Services shall:
451          (a) enter into a memorandum of understanding in order to determine the function and
452     operation of the state electronic verification system in accordance with Subsection (2);
453          (b) coordinate with the Division of Purchasing, under Title 63G, Chapter 6a, Utah
454     Procurement Code, to develop a request for proposals for a third-party provider to develop and
455     maintain the state electronic verification system in coordination with the Department of
456     Technology Services; and
457          (c) select a third-party provider who:
458          (i) meets the requirements contained in the request for proposals issued under
459     Subsection (1)(b); and

460          (ii) may not have any commercial or ownership interest in a cannabis production
461     establishment or a medical cannabis pharmacy.
462          (2) The Department of Agriculture and Food, the department, the Department of Public
463     Safety, and the Department of Technology Services shall ensure that, on or before March 1,
464     2020, the state electronic verification system described in Subsection (1):
465          (a) allows an individual to apply for a medical cannabis patient card or, if applicable, a
466     medical cannabis guardian card, provided that the card may not become active until:
467          (i) the relevant qualified medical provider completes the associated medical cannabis
468     recommendation; or
469          (ii) for medical cannabis card related to a limited medical provider's recommendation,
470     the medical cannabis pharmacy completes the recording described in Subsection (2)(d);
471          (b) allows an individual to apply to renew a medical cannabis patient card or a medical
472     cannabis guardian card in accordance with Section 26-61a-201;
473          (c) allows a qualified medical provider, or an employee described in Subsection (3)
474     acting on behalf of the qualified medical provider, to:
475          (i) access dispensing and card status information regarding a patient:
476          (A) with whom the qualified medical provider has a provider-patient relationship; and
477          (B) for whom the qualified medical provider has recommended or is considering
478     recommending a medical cannabis card;
479          (ii) electronically recommend, after an initial face-to-face visit with a patient described
480     in Subsection 26-61a-201(4)(b), treatment with cannabis in a medicinal dosage form or a
481     cannabis product in a medicinal dosage form and optionally recommend dosing guidelines;
482          (iii) electronically renew a recommendation to a medical cannabis patient cardholder or
483     medical cannabis guardian cardholder:
484          (A) using telehealth services, for the qualified medical provider who originally
485     recommended a medical cannabis treatment during a face-to-face visit with the patient; or
486          (B) during a face-to-face visit with the patient, for a qualified medical provider who
487     did not originally recommend the medical cannabis treatment during a face-to-face visit; and
488          (iv) notate a determination of physical difficulty or undue hardship, described in
489     Subsection 26-61a-202(1), to qualify a patient to designate a caregiver;
490          (d) beginning on the earlier of September 1, 2021, or the date on which the electronic

491     verification system is functionally capable of facility medical cannabis pharmacy recording,
492     allows a medical cannabis pharmacy medical provider or medical cannabis pharmacy agent, in
493     accordance with Subsection 26-61a-501(11)(a), to record:
494          (i) a patient's recommendation from a limited medical provider, including any
495     directions of use, dosing guidelines, or caregiver indications from the limited medical provider;
496     and
497          (ii) a limited medical provider's renewal of the provider's previous recommendation;
498          [(d)] (e) connects with:
499          (i) an inventory control system that a medical cannabis pharmacy uses to track in real
500     time and archive purchases of any cannabis in a medicinal dosage form, cannabis product in a
501     medicinal dosage form, or a medical cannabis device, including:
502          (A) the time and date of each purchase;
503          (B) the quantity and type of cannabis, cannabis product, or medical cannabis device
504     purchased;
505          (C) any cannabis production establishment, any medical cannabis pharmacy, or any
506     medical cannabis courier associated with the cannabis, cannabis product, or medical cannabis
507     device; and
508          (D) the personally identifiable information of the medical cannabis cardholder who
509     made the purchase; and
510          (ii) any commercially available inventory control system that a cannabis production
511     establishment utilizes in accordance with Section 4-41a-103 to use data that the Department of
512     Agriculture and Food requires by rule, in accordance with Title 63G, Chapter 3, Utah
513     Administrative Rulemaking Act, from the inventory tracking system that a licensee uses to
514     track and confirm compliance;
515          [(e)] (f) provides access to:
516          (i) the department to the extent necessary to carry out the department's functions and
517     responsibilities under this chapter;
518          (ii) the Department of Agriculture and Food to the extent necessary to carry out the
519     functions and responsibilities of the Department of Agriculture and Food under Title 4, Chapter
520     41a, Cannabis Production Establishments; and
521          (iii) the Division of Occupational and Professional Licensing to the extent necessary to

522     carry out the functions and responsibilities related to the participation of the following in the
523     recommendation and dispensing of medical cannabis:
524          (A) a podiatrist licensed under Title 58, Chapter 5a, Podiatric Physician Licensing Act;
525          [(A)] (B) a pharmacist licensed under Title 58, Chapter 17b, Pharmacy Practice Act;
526          [(B)] (C) an advanced practice registered nurse licensed under Title 58, Chapter 31b,
527     Nurse Practice Act;
528          [(C)] (D) a physician licensed under Title 58, Chapter 67, Utah Medical Practice Act,
529     or Title 58, Chapter 68, Utah Osteopathic Medical Practice Act; or
530          [(D)] (E) a physician assistant licensed under Title 58, Chapter 70a, Utah Physician
531     Assistant Act;
532          [(f)] (g) provides access to and interaction with the state central patient portal;
533          [(g)] (h) provides access to state or local law enforcement:
534          (i) during a law enforcement encounter, without a warrant, using the individual's driver
535     license or state ID, only for the purpose of determining if the individual subject to the law
536     enforcement encounter has a valid medical cannabis card; or
537          (ii) after obtaining a warrant; and
538          [(h)] (i) creates a record each time a person accesses the database that identifies the
539     person who accesses the database and the individual whose records the person accesses.
540          (3) (a) Beginning on the earlier of January 1, 2021, or the date on which the electronic
541     verification system is functionally capable of allowing employee access under this Subsection
542     (3), an employee of a qualified medical provider may access the electronic verification system
543     for a purpose described in Subsection (2)(c) on behalf of the qualified medical provider if:
544          (i) the qualified medical provider has designated the employee as an individual
545     authorized to access the electronic verification system on behalf of the qualified medical
546     provider;
547          (ii) the qualified medical provider provides written notice to the department of the
548     employee's identity and the designation described in Subsection (3)(a)(i); and
549          (iii) the department grants to the employee access to the electronic verification system.
550          (b) An employee of a business that employs a qualified medical provider may access
551     the electronic verification system for a purpose described in Subsection (2)(c) on behalf of the
552     qualified medical provider if:

553          (i) the qualified medical provider has designated the employee as an individual
554     authorized to access the electronic verification system on behalf of the qualified medical
555     provider;
556          (ii) the qualified medical provider and the employing business jointly provide written
557     notice to the department of the employee's identity and the designation described in Subsection
558     (3)(b)(i); and
559          (iii) the department grants to the employee access to the electronic verification system.
560          (4) (a) As used in this Subsection (4), "prescribing provider" means:
561          (i) a podiatrist licensed under Title 58, Chapter 5a, Podiatric Physician Licensing Act;
562          [(i)] (ii) an advanced practice registered nurse licensed under Title 58, Chapter 31b,
563     Nurse Practice Act;
564          [(ii)] (iii) a physician licensed under Title 58, Chapter 67, Utah Medical Practice Act,
565     or Title 58, Chapter 68, Utah Osteopathic Medical Practice Act; or
566          [(iii)] (iv) a physician assistant licensed under Title 58, Chapter 70a, Utah Physician
567     Assistant Act.
568          (b) Beginning on the earlier of January 1, 2021, or the date on which the electronic
569     verification system is functionally capable of allowing provider access under this Subsection
570     (4), a prescribing provider may access information in the electronic verification system
571     regarding a patient the prescribing provider treats.
572          (5) The department may release limited data that the system collects for the purpose of:
573          (a) conducting medical and other department approved research;
574          (b) providing the report required by Section 26-61a-703; and
575          (c) other official department purposes.
576          (6) The department shall make rules, in accordance with Title 63G, Chapter 3, Utah
577     Administrative Rulemaking Act, to establish:
578          (a) the limitations on access to the data in the state electronic verification system as
579     described in this section; and
580          (b) standards and procedures to ensure accurate identification of an individual
581     requesting information or receiving information in this section.
582          (7) (a) Any person who knowingly and intentionally releases any information in the
583     state electronic verification system in violation of this section is guilty of a third degree felony.

584          (b) Any person who negligently or recklessly releases any information in the state
585     electronic verification system in violation of this section is guilty of a class C misdemeanor.
586          (8) (a) Any person who obtains or attempts to obtain information from the state
587     electronic verification system by misrepresentation or fraud is guilty of a third degree felony.
588          (b) Any person who obtains or attempts to obtain information from the state electronic
589     verification system for a purpose other than a purpose this chapter authorizes is guilty of a third
590     degree felony.
591          (9) (a) Except as provided in Subsection (9)(e), a person may not knowingly and
592     intentionally use, release, publish, or otherwise make available to any other person information
593     obtained from the state electronic verification system for any purpose other than a purpose
594     specified in this section.
595          (b) Each separate violation of this Subsection (9) is:
596          (i) a third degree felony; and
597          (ii) subject to a civil penalty not to exceed $5,000.
598          (c) The department shall determine a civil violation of this Subsection (9) in
599     accordance with Title 63G, Chapter 4, Administrative Procedures Act.
600          (d) Civil penalties assessed under this Subsection (9) shall be deposited into the
601     General Fund.
602          (e) This Subsection (9) does not prohibit a person who obtains information from the
603     state electronic verification system under Subsection (2)(a), (c), or (f) from:
604          (i) including the information in the person's medical chart or file for access by a person
605     authorized to review the medical chart or file;
606          (ii) providing the information to a person in accordance with the requirements of the
607     Health Insurance Portability and Accountability Act of 1996; or
608          (iii) discussing or sharing that information about the patient with the patient.
609          Section 5. Section 26-61a-106 is amended to read:
610          26-61a-106. Qualified medical provider registration -- Continuing education --
611     Treatment recommendation -- Limited medical provider.
612          (1) (a) (i) Except as provided in Subsection (1)(b), an individual may not recommend a
613     medical cannabis treatment unless the department registers the individual as a qualified
614     medical provider in accordance with this section.

615          (ii) Notwithstanding Subsection (1)(a)(i), a qualified medical provider who is podiatrist
616     licensed under Title 58, Chapter 5a, Podiatric Physician Licensing Act, may not recommend a
617     medical cannabis treatment except within the course and scope of a practice of podiatry, as that
618     term is defined in Section 58-5a-102.
619          (b) [An] Beginning on the earlier of September 1, 2021, or the date on which the
620     department gives notice of that the electronic verification system is functionally capable as
621     described in Subsection 26-61a-103(2)(d), an individual who meets the recommending
622     qualifications [in Subsections 26-61a-106(2)(a)(iii) and (iv)] may recommend a medical
623     cannabis treatment as a limited medical provider without registering under Subsection (1)(a)
624     [until January 1, 2021.] if:
625          (i) the individual recommends the use of medical cannabis to the patient through an
626     order described in Subsection (1)(c) after:
627          (A) a face-to-face visit for an initial recommendation or the renewal of a
628     recommendation for a patient for whom the limited medical provider did not make the patient's
629     original recommendation; or
630          (B) a visit using telehealth services for a renewal of a recommendation for a patient for
631     whom the limited medical provider made the patient's original recommendation; and
632          (ii) the individual's recommendation or renewal would not cause the total number of
633     the individual's patients who have a valid medical cannabis patient card or provisional patient
634     card resulting from the individual's recommendation to exceed 15.
635          (c) The individual described in Subsection (1)(b) shall communicate the individual's
636     recommendation through an order for the medical cannabis pharmacy to record the individual's
637     recommendation or renewal in the state electronic verification system under the individual's
638     recommendation that:
639          (i) (A) that the individual or the individual's employee sends electronically to a medical
640     cannabis pharmacy; or
641          (B) that the individual gives to the patient in writing for the patient to deliver to a
642     medical cannabis pharmacy; and
643          (ii) may include:
644          (A) directions of use or dosing guidelines; and
645          (B) an indication of a need for a caregiver in accordance with Subsection

646     26-61a-201(3)(c).
647          (d) If the limited medical provider gives the patient a written recommendation to
648     deliver to a medical cannabis pharmacy under Subsection (1)(c)(i)(B), the limited medical
649     provider shall ensure that the document includes all of the information that is included on a
650     prescription the provider would issue for a controlled substance, including:
651          (i) the date of issuance;
652          (ii) the provider's name, address and contact information, controlled substance license
653     information, and signature; and
654          (iii) the patient's name, address and contact information, age, and diagnosed qualifying
655     condition.
656          (e) In considering making a recommendation as a limited medical provider, an
657     individual may consult information that the department makes available on the department's
658     website for recommending providers.
659          (2) (a) The department shall, within 15 days after the day on which the department
660     receives an application from an individual, register and issue a qualified medical provider
661     registration card to the individual if the individual:
662          (i) provides to the department the individual's name and address;
663          (ii) provides to the department a report detailing the individual's completion of the
664     applicable continuing education requirement described in Subsection (3);
665          (iii) provides to the department evidence that the individual[:] meets the
666     recommending qualifications; and
667          [(A) has the authority to write a prescription;]
668          [(B) is licensed to prescribe a controlled substance under Title 58, Chapter 37, Utah
669     Controlled Substances Act; and]
670          [(C) possesses the authority, in accordance with the individual's scope of practice, to
671     prescribe a Schedule II controlled substance;]
672          [(iv) provides to the department evidence that the individual is:]
673          [(A) an advanced practice registered nurse licensed under Title 58, Chapter 31b, Nurse
674     Practice Act;]
675          [(B) a physician licensed under Title 58, Chapter 67, Utah Medical Practice Act, or
676     Title 58, Chapter 68, Utah Osteopathic Medical Practice Act; or]

677          [(C) a physician assistant licensed under Title 58, Chapter 70a, Utah Physician
678     Assistant Act, whose declaration of services agreement, as that term is defined in Section
679     58-70a-102, includes the recommending of medical cannabis, and whose supervising physician
680     is a qualified medical provider; and]
681          [(v)] (iv) pays the department a fee in an amount that:
682          (A) the department sets, in accordance with Section 63J-1-504; and
683          (B) does not exceed $300 for an initial registration.
684          (b) The department may not register an individual as a qualified medical provider if the
685     individual is:
686          (i) a pharmacy medical provider; or
687          (ii) an owner, officer, director, board member, employee, or agent of a cannabis
688     production establishment, a medical cannabis pharmacy, or a medical cannabis courier.
689          (3) (a) An individual shall complete the continuing education described in this
690     Subsection (3) in the following amounts:
691          (i) for an individual as a condition precedent to registration, four hours; and
692          (ii) for a qualified medical provider as a condition precedent to renewal, four hours
693     every two years.
694          (b) In accordance with Subsection (3)(a), a qualified medical provider shall:
695          (i) complete continuing education:
696          (A) regarding the topics described in Subsection (3)(d); and
697          (B) offered by the department under Subsection (3)(c) or an accredited or approved
698     continuing education provider that the department recognizes as offering continuing education
699     appropriate for the recommendation of cannabis to patients; and
700          (ii) make a continuing education report to the department in accordance with a process
701     that the department establishes by rule, in accordance with Title 63G, Chapter 3, Utah
702     Administrative Rulemaking Act, and in collaboration with the Division of Occupational and
703     Professional Licensing and:
704          (A) for a podiatrist licensed under Title 58, Chapter 5a, Podiatric Physician Licensing
705     Act, the Podiatric Physician Board;
706          [(A)] (B) for an advanced practice registered nurse licensed under Title 58, Chapter
707     31b, Nurse Practice Act, the Board of Nursing;

708          [(B)] (C) for a qualified medical provider licensed under Title 58, Chapter 67, Utah
709     Medical Practice Act, the Physicians Licensing Board;
710          [(C)] (D) for a qualified medical provider licensed under Title 58, Chapter 68, Utah
711     Osteopathic Medical Practice Act, the Osteopathic Physician and Surgeon's Licensing Board;
712     and
713          [(D)] (E) for a physician assistant licensed under Title 58, Chapter 70a, Utah Physician
714     Assistant Act, the Physician Assistant Licensing Board.
715          (c) The department may, in consultation with the Division of Occupational and
716     Professional Licensing, develop the continuing education described in this Subsection (3).
717          (d) The continuing education described in this Subsection (3) may discuss:
718          (i) the provisions of this chapter;
719          (ii) general information about medical cannabis under federal and state law;
720          (iii) the latest scientific research on the endocannabinoid system and medical cannabis,
721     including risks and benefits;
722          (iv) recommendations for medical cannabis as it relates to the continuing care of a
723     patient in pain management, risk management, potential addiction, or palliative care; and
724          (v) best practices for recommending the form and dosage of medical cannabis products
725     based on the qualifying condition underlying a medical cannabis recommendation.
726          (4) (a) Except as provided in Subsection (4)(b), a qualified medical provider may not
727     recommend a medical cannabis treatment to more than 275 of the qualified medical provider's
728     patients at the same time, as determined by the number of medical cannabis cards under the
729     qualified medical provider's name in the state electronic verification system.
730          (b) A qualified medical provider may recommend a medical cannabis treatment to up to
731     600 of the qualified medical provider's patients at any given time, as determined by the number
732     of medical cannabis cards under the qualified medical provider's name in the state electronic
733     verification system, if:
734          (i) the appropriate American medical board has certified the qualified medical provider
735     in the specialty of anesthesiology, gastroenterology, neurology, oncology, pain, hospice and
736     palliative medicine, physical medicine and rehabilitation, rheumatology, endocrinology, or
737     psychiatry; or
738          (ii) a licensed business employs or contracts with the qualified medical provider for the

739     specific purpose of providing hospice and palliative care.
740          (5) A [qualified] recommending medical provider may recommend medical cannabis to
741     an individual under this chapter only in the course of a [qualified medical] provider-patient
742     relationship after the [qualifying] recommending medical provider has completed and
743     documented in the patient's medical record a thorough assessment of the patient's condition and
744     medical history based on the appropriate standard of care for the patient's condition.
745          (6) (a) Except as provided in Subsection (6)(b), an individual may not advertise that the
746     individual recommends medical cannabis treatment in accordance with this chapter.
747          (b) For purposes of Subsection (6)(a), the communication of the following, through a
748     website, by [an individual described in Subsection (6)(c)] a qualified medical provider, does
749     not constitute advertising:
750          (i) a green cross;
751          (ii) a qualifying condition that the qualified medical provider treats; or
752          (iii) a scientific study regarding medical cannabis use.
753          [(c) The following are subject to Subsection (6)(b):]
754          [(i) before the department begins registering qualified medical providers:]
755          [(A) an advanced practice registered nurse described in Subsection (2)(a)(iv)(A);]
756          [(B) a physician described in Subsection (2)(a)(iv)(B); or]
757          [(C) a physician assistant described in Subsection (2)(a)(iv)(C); and]
758          [(ii) after the department begins registering qualified medical providers, a qualified
759     medical provider.]
760          (7) (a) A qualified medical provider registration card expires two years after the day on
761     which the department issues the card.
762          (b) The department shall renew a qualified medical provider's registration card if the
763     provider:
764          (i) applies for renewal;
765          (ii) is eligible for a qualified medical provider registration card under this section,
766     including maintaining an unrestricted license [as described in Subsection (2)(a)(iii)] under the
767     recommending qualifications;
768          (iii) certifies to the department in a renewal application that the information in
769     Subsection (2)(a) is accurate or updates the information;

770          (iv) submits a report detailing the completion of the continuing education requirement
771     described in Subsection (3); and
772          (v) pays the department a fee in an amount that:
773          (A) the department sets, in accordance with Section 63J-1-504; and
774          (B) does not exceed $50 for a registration renewal.
775          (8) The department may revoke the registration of a qualified medical provider who
776     fails to maintain compliance with the requirements of this section.
777          (9) A [qualified] recommending medical provider may not receive any compensation
778     or benefit for the qualified medical provider's medical cannabis treatment recommendation
779     from:
780          (a) a cannabis production establishment or an owner, officer, director, board member,
781     employee, or agent of a cannabis production establishment;
782          (b) a medical cannabis pharmacy or an owner, officer, director, board member,
783     employee, or agent of a medical cannabis pharmacy; or
784          (c) a [qualified] recommending medical provider or pharmacy medical provider.
785          Section 6. Section 26-61a-107 is amended to read:
786          26-61a-107. Standard of care -- Physicians and pharmacists not liable -- No
787     private right of action.
788          (1) An individual described in Subsection (2) is not subject to the following solely for
789     violating a federal law or regulation that would otherwise prohibit recommending, prescribing,
790     or dispensing medical cannabis, a medical cannabis product, or a cannabis-based drug that the
791     United States Food and Drug Administration has not approved:
792          (a) civil or criminal liability; or
793          (b) licensure sanctions under Title 58, Chapter 17b, Pharmacy Practice Act, Title 58,
794     Chapter 31b, Nurse Practice Act, Title 58, Chapter 67, Utah Medical Practice Act, Title 58,
795     Chapter 68, Utah Osteopathic Medical Practice Act, or Title 58, Chapter 70a, Utah Physician
796     Assistant Act.
797          (2) The limitations of liability described in Subsection (1) apply to:
798          (a) a podiatrist licensed under Title 58, Chapter 5a, Podiatric Physician Licensing Act,
799     an advanced practice registered nurse licensed under Title 58, Chapter 31b, Nurse Practice Act,
800     a physician licensed under Title 58, Chapter 67, Utah Medical Practice Act, or Title 58,

801     Chapter 68, Utah Osteopathic Medical Practice Act, or a physician assistant licensed under
802     Title 58, Chapter 70a, Utah Physician Assistant Act:
803          (i) (A) whom the department has registered as a qualified medical provider; [and] or
804          (B) who makes a recommendation as a limited medical provider; and
805          [(B)] (ii) who recommends treatment with cannabis in a medicinal dosage form or a
806     cannabis product in a medicinal dosage form to a patient in accordance with this chapter; [or]
807     and
808          [(ii) before January 1, 2021, who:]
809          [(A) has the authority to write a prescription; and]
810          [(B) recommends a medical cannabis treatment to a patient who has a qualifying
811     condition; and]
812          (b) a pharmacist licensed under Title 58, Chapter 17b, Pharmacy Practice Act:
813          (i) whom the department has registered as a pharmacy medical provider; and
814          (ii) who dispenses, in a medical cannabis pharmacy, treatment with cannabis in a
815     medicinal dosage form or a cannabis product in a medicinal dosage form to a medical cannabis
816     cardholder in accordance with this chapter.
817          (3) Nothing in this section or chapter reduces or in any way negates the duty of an
818     individual described in Subsection (2) to use reasonable and ordinary care in the treatment of a
819     patient:
820          (a) who may have a qualifying condition; and
821          (b) (i) for whom the individual described in Subsection (2)(a)(i) or (ii) has
822     recommended or might consider recommending a treatment with cannabis or a cannabis
823     product; or
824          (ii) with whom the pharmacist described in Subsection (2)(b) has interacted in the
825     dosing or dispensing of cannabis or a cannabis product.
826          (4) (a) As used in this Subsection (4), "healthcare facility" means the same as that term
827     is defined in Section 26-21-2.
828          (b) A healthcare facility may adopt restrictions on the possession, use, and storage of
829     medical cannabis on the premises of the healthcare facility by a medical cannabis cardholder
830     who resides at or is actively receiving treatment or care at the healthcare facility.
831          (c) An employee or agent of a healthcare facility described in this Subsection (4) is not

832     subject to civil or criminal liability for carrying out employment duties, including:
833          (i) providing or supervising care to a medical cannabis cardholder; or
834          (ii) in accordance with a caregiver designation under Section [26-61a-201] 26-61a-202
835     for a medical cannabis cardholder residing at the healthcare facility, purchasing, transporting,
836     or possessing medical cannabis for the relevant patient and in accordance with the designation.
837          (d) Nothing in this section requires a healthcare facility to adopt a restriction under
838     Subsection (4)(b).
839          Section 7. Section 26-61a-201 is amended to read:
840          26-61a-201. Medical cannabis patient card -- Medical cannabis guardian card --
841     Conditional medical cannabis card -- Application -- Fees -- Studies.
842          (1) (a) [On or before March 1, 2020, the] The department shall, within 15 days after the
843     day on which an individual who satisfies the eligibility criteria in this section or Section
844     26-61a-202 submits an application in accordance with this section or Section 26-61a-202:
845          [(a)] (i) issue a medical cannabis patient card to an individual described in Subsection
846     (2)(a);
847          [(b)] (ii) issue a medical cannabis guardian card to an individual described in
848     Subsection (2)(b);
849          [(c)] (iii) issue a provisional patient card to a minor described in Subsection (2)(c); and
850          [(d)] (iv) issue a medical cannabis caregiver card to an individual described in
851     Subsection 26-61a-202(4).
852          (b) (i) Beginning on the earlier of September 1, 2021, or the date on which the
853     electronic verification system is functionally capable of facilitating a conditional medical
854     cannabis card under this Subsection (1)(b), upon the entry of a recommending medical
855     provider's medical cannabis recommendation for a patient in the state electronic verification
856     system, either by the provider or the provider's employee or by a medical cannabis pharmacy
857     medical provider or medical cannabis pharmacy in accordance with Subsection
858     26-61a-501(11)(a), the department shall issue to the patient an electronic conditional medical
859     cannabis card, in accordance with this Subsection (1)(b).
860          (ii) A conditional medical cannabis card is valid for the lesser of:
861          (A) 60 days; or
862          (B) the day on which the department completes the department's review and issues a

863     medical cannabis card under Subsection (1)(a), denies the patient's medical cannabis card
864     application, or revokes the conditional medical cannabis card under Subsection (8).
865          (iii) The department may issue a conditional medical cannabis card to an individual
866     applying for a medical cannabis patient card for which approval of the Compassionate Use
867     Board is not required.
868          (iv) An individual described in Subsection (1)(b)(iii) has the rights, restrictions, and
869     obligations under law applicable to a holder of the medical cannabis card for which the
870     individual applies and for which the department issues the conditional medical cannabis card.
871          (2) (a) An individual is eligible for a medical cannabis patient card if:
872          (i) (A) the individual is at least 21 years old; or
873          (B) the individual is 18, 19, or 20 years old, the individual petitions the Compassionate
874     Use Board under Section 26-61a-105, and the Compassionate Use Board recommends
875     department approval of the petition;
876          (ii) the individual is a Utah resident;
877          (iii) the individual's [qualified] recommending medical provider recommends treatment
878     with medical cannabis in accordance with Subsection (4);
879          (iv) the individual signs an acknowledgment stating that the individual received the
880     information described in Subsection (8); and
881          (v) the individual pays to the department a fee in an amount that, subject to Subsection
882     26-61a-109(5), the department sets in accordance with Section 63J-1-504.
883          (b) (i) An individual is eligible for a medical cannabis guardian card if the individual:
884          (A) is at least 18 years old;
885          (B) is a Utah resident;
886          (C) is the parent or legal guardian of a minor for whom the minor's qualified medical
887     provider recommends a medical cannabis treatment, the individual petitions the Compassionate
888     Use Board under Section 26-61a-105, and the Compassionate Use Board recommends
889     department approval of the petition;
890          (D) the individual signs an acknowledgment stating that the individual received the
891     information described in Subsection [(8)] (9);
892          (E) pays to the department a fee in an amount that, subject to Subsection
893     26-61a-109(5), the department sets in accordance with Section 63J-1-504, plus the cost of the

894     criminal background check described in Section 26-61a-203; and
895          (F) the individual has not been convicted of a misdemeanor or felony drug distribution
896     offense under either state or federal law, unless the individual completed any imposed sentence
897     six months or more before the day on which the individual applies for a medical cannabis
898     guardian card.
899          (ii) The department shall notify the Department of Public Safety of each individual that
900     the department registers for a medical cannabis guardian card.
901          (c) (i) A minor is eligible for a provisional patient card if:
902          (A) the minor has a qualifying condition;
903          (B) the minor's qualified medical provider recommends a medical cannabis treatment
904     to address the minor's qualifying condition;
905          (C) the minor's parent or legal guardian petitions the Compassionate Use Board under
906     Section 26-61a-105, and the Compassionate Use Board recommends department approval of
907     the petition; and
908          (D) the minor's parent or legal guardian is eligible for a medical cannabis guardian card
909     under Subsection (2)(b) or designates a caregiver under Subsection (2)(d) who is eligible for a
910     medical cannabis caregiver card under Section 26-61a-202.
911          (ii) The department shall automatically issue a provisional patient card to the minor
912     described in Subsection (2)(c)(i) at the same time the department issues a medical cannabis
913     guardian card to the minor's parent or legal guardian.
914          (d) Beginning on the earlier of January 1, 2021, or the date on which the electronic
915     verification system is functionally capable of servicing the designation, if the parent or legal
916     guardian of a minor described in Subsections (2)(c)(i)(A) through (C) does not qualify for a
917     medical cannabis guardian card under Subsection (2)(b), the parent or legal guardian may
918     designate up to two caregivers in accordance with Subsection 26-61a-202(1)(c) to ensure that
919     the minor has adequate and safe access to the recommended medical cannabis treatment.
920          (3) (a) An individual who is eligible for a medical cannabis card described in
921     Subsection (2)(a) or (b) shall submit an application for a medical cannabis card to the
922     department:
923          (i) through an electronic application connected to the state electronic verification
924     system;

925          (ii) with the recommending [qualified] medical provider; and
926          (iii) with information including:
927          (A) the applicant's name, gender, age, and address;
928          (B) the number of the applicant's valid form of photo identification;
929          (C) for a medical cannabis guardian card, the name, gender, and age of the minor
930     receiving a medical cannabis treatment under the cardholder's medical cannabis guardian card;
931     and
932          (D) for a provisional patient card, the name of the minor's parent or legal guardian who
933     holds the associated medical cannabis guardian card.
934          (b) The department shall ensure that a medical cannabis card the department issues
935     under this section contains the information described in Subsection (3)(a)(iii).
936          (c) (i) If a [qualified] recommending medical provider determines that, because of age,
937     illness, or disability, a medical cannabis patient cardholder requires assistance in administering
938     the medical cannabis treatment that the [qualified] recommending medical provider
939     recommends, the [qualified] recommending medical provider may indicate the cardholder's
940     need in the state electronic verification system, either directly or, for a limited medical
941     provider, through the order described in Subsections 26-61a-106(1)(c) and (d).
942          (ii) If a [qualified] recommending medical provider makes the indication described in
943     Subsection (3)(c)(i):
944          (A) the department shall add a label to the relevant medical cannabis patient card
945     indicating the cardholder's need for assistance; and
946          (B) any adult who is 18 years old or older and who is physically present with the
947     cardholder at the time the cardholder needs to use the recommended medical cannabis
948     treatment may handle the medical cannabis treatment and any associated medical cannabis
949     device as needed to assist the cardholder in administering the recommended medical cannabis
950     treatment; and
951          (C) an individual of any age who is physically present with the cardholder in the event
952     of an emergency medical condition, as that term is defined in Section 31A-22-627, may handle
953     the medical cannabis treatment and any associated medical cannabis device as needed to assist
954     the cardholder in administering the recommended medical cannabis treatment.
955          (iii) A non-cardholding individual acting under Subsection (3)(c)(ii)(B) or (C) may not:

956          (A) ingest or inhale medical cannabis;
957          (B) possess, transport, or handle medical cannabis or a medical cannabis device outside
958     of the immediate area where the cardholder is present or with an intent other than to provide
959     assistance to the cardholder; or
960          (C) possess, transport, or handle medical cannabis or a medical cannabis device when
961     the cardholder is not in the process of being dosed with medical cannabis.
962          (4) To recommend a medical cannabis treatment to a patient or to renew a
963     recommendation, a [qualified] recommending medical provider shall:
964          (a) before recommending cannabis in a medicinal dosage form or a cannabis product in
965     a medicinal dosage form:
966          (i) verify the patient's and, for a minor patient, the minor patient's parent or legal
967     guardian's valid form of identification described in Subsection (3)(a);
968          (ii) review any record related to the patient and, for a minor patient, the patient's parent
969     or legal guardian in:
970          (A) for a qualified medical provider, the state electronic verification system; and
971          (B) the controlled substance database created in Section 58-37f-201; and
972          (iii) consider the recommendation in light of the patient's qualifying condition and
973     history of medical cannabis and controlled substance use during an initial face-to-face visit
974     with the patient; and
975          (b) state in the [qualified] recommending medical provider's recommendation that the
976     patient:
977          (i) suffers from a qualifying condition, including the type of qualifying condition; and
978          (ii) may benefit from treatment with cannabis in a medicinal dosage form or a cannabis
979     product in a medicinal dosage form.
980          (5) (a) Except as provided in Subsection (5)(b), a medical cannabis card that the
981     department issues under this section is valid for the lesser of:
982          (i) an amount of time that the [qualified] recommending medical provider determines;
983     or
984          (ii) (A) six months for the first issuance, [90 days; (B)] and, except as provided in
985     Subsection (5)(a)(ii)[(C)](B), for a renewal[, six months]; or
986          [(C)] (B) for a renewal, one year if, after at least one year following the issuance of the

987     original medical cannabis card, the [qualified] recommending medical provider determines that
988     the patient has been stabilized on the medical cannabis treatment and a one-year renewal period
989     is justified.
990          (b) (i) A medical cannabis card that the department issues in relation to a terminal
991     illness described in Section 26-61a-104 does not expire.
992          (ii) The recommending [qualified] medical provider may revoke a recommendation
993     that the provider made in relation to a terminal illness described in Section 26-61a-104 if the
994     medical cannabis cardholder no longer has the terminal illness.
995          (6) (a) A medical cannabis patient card or a medical cannabis guardian card is
996     renewable if:
997          (i) at the time of renewal, the cardholder meets the requirements of Subsection (2)(a) or
998     (b); or
999          (ii) the cardholder received the medical cannabis card through the recommendation of
1000     the Compassionate Use Board under Section 26-61a-105.
1001          (b) A cardholder described in Subsection (6)(a) may renew the cardholder's card:
1002          (i) using the application process described in Subsection (3); or
1003          (ii) through phone or video conference with the [qualified] recommending medical
1004     provider who made the recommendation underlying the card, at the qualifying medical
1005     provider's discretion.
1006          (c) A cardholder under Subsection (2)(a) or (b) who renews the cardholder's card shall
1007     pay to the department a renewal fee in an amount that:
1008          (i) subject to Subsection 26-61a-109(5), the department sets in accordance with Section
1009     63J-1-504; and
1010          (ii) may not exceed the cost of the relatively lower administrative burden of renewal in
1011     comparison to the original application process.
1012          (d) If a minor meets the requirements of Subsection (2)(c), the minor's provisional
1013     patient card renews automatically at the time the minor's parent or legal guardian renews the
1014     parent or legal guardian's associated medical cannabis guardian card.
1015          (e) The department may revoke a medical cannabis guardian card if the cardholder
1016     under Subsection (2)(b) is convicted of a misdemeanor or felony drug distribution offense
1017     under either state or federal law.

1018          (7) (a) A cardholder under this section shall carry the cardholder's valid medical
1019     cannabis card with the patient's name.
1020          (b) (i) A medical cannabis patient cardholder or a provisional patient cardholder may
1021     purchase, in accordance with this chapter and the recommendation underlying the card,
1022     cannabis in a medicinal dosage form, a cannabis product in a medicinal dosage form, or a
1023     medical cannabis device.
1024          (ii) A cardholder under this section may possess or transport, in accordance with this
1025     chapter and the recommendation underlying the card, cannabis in a medicinal dosage form, a
1026     cannabis product in a medicinal dosage form, or a medical cannabis device.
1027          (iii) To address the qualifying condition underlying the medical cannabis treatment
1028     recommendation:
1029          (A) a medical cannabis patient cardholder or a provisional patient cardholder may use
1030     cannabis in a medicinal dosage form, a medical cannabis product in a medicinal dosage form,
1031     or a medical cannabis device; and
1032          (B) a medical cannabis guardian cardholder may assist the associated provisional
1033     patient cardholder with the use of cannabis in a medicinal dosage form, a medical cannabis
1034     product in a medicinal dosage form, or a medical cannabis device.
1035          (c) If a licensed medical cannabis pharmacy is not operating within the state after
1036     January 1, 2021, a cardholder under this section:
1037          (i) may possess:
1038          (A) up to the legal dosage limit of unprocessed cannabis in a medicinal dosage form;
1039          (B) up to the legal dosage limit of a cannabis product in a medicinal dosage form; and
1040          (C) marijuana drug paraphernalia; and
1041          (ii) is not subject to prosecution for the possession described in Subsection (7)(c)(i).
1042          (8) The department may revoke a medical cannabis card that the department issues
1043     under this section if the cardholder:
1044          (a) violates this chapter; or
1045          (b) is convicted under state or federal law of:
1046          (i) a felony; or
1047          (ii) after the effective date of this bill, a misdemeanor for drug distribution.
1048          [(8)] (9) The department shall establish by rule, in accordance with Title 63G, Chapter

1049     3, Utah Administrative Rulemaking Act, a process to provide information regarding the
1050     following to an individual receiving a medical cannabis card:
1051          (a) risks associated with medical cannabis treatment;
1052          (b) the fact that a condition's listing as a qualifying condition does not suggest that
1053     medical cannabis treatment is an effective treatment or cure for that condition, as described in
1054     Subsection 26-61a-104(1); and
1055          (c) other relevant warnings and safety information that the department determines.
1056          [(9)] (10) The department may establish procedures by rule, in accordance with Title
1057     63G, Chapter 3, Utah Administrative Rulemaking Act, to implement the application and
1058     issuance provisions of this section.
1059          [(10)] (11) (a) On or before January 1, 2021, the department shall establish by rule, in
1060     accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, a process to allow
1061     an individual from another state to register with the Department of Health in order to purchase
1062     medical cannabis or a medical cannabis device from a medical cannabis pharmacy while the
1063     individual is visiting the state.
1064          (b) The department may only provide the registration process described in Subsection
1065     [(10)] (11)(a):
1066          (i) to a nonresident patient; and
1067          (ii) for no more than two visitation periods per calendar year of up to 21 calendar days
1068     per visitation period.
1069          [(11)] (12) (a) A person may submit to the department a request to conduct a research
1070     study using medical cannabis cardholder data that the state electronic verification system
1071     contains.
1072          (b) The department shall review a request described in Subsection [(11)] (12)(a) to
1073     determine whether an institutional review board, as that term is defined in Section 26-61-102,
1074     could approve the research study.
1075          (c) At the time an individual applies for a medical cannabis card, the department shall
1076     notify the individual:
1077          (i) of how the individual's information will be used as a cardholder;
1078          (ii) that by applying for a medical cannabis card, unless the individual withdraws
1079     consent under Subsection [(11)] (12)(d), the individual consents to the use of the individual's

1080     information for external research; and
1081          (iii) that the individual may withdraw consent for the use of the individual's
1082     information for external research at any time, including at the time of application.
1083          (d) An applicant may, through the medical cannabis card application, and a medical
1084     cannabis cardholder may, through the state central patient portal, withdraw the applicant's or
1085     cardholder's consent to participate in external research at any time.
1086          (e) The department may release, for the purposes of a study described in this
1087     Subsection [(11)] (12), information about a cardholder under this section who consents to
1088     participate under Subsection [(11)] (12)(c).
1089          (f) If an individual withdraws consent under Subsection [(11)] (12)(d), the withdrawal
1090     of consent:
1091          (i) applies to external research that is initiated after the withdrawal of consent; and
1092          (ii) does not apply to research that was initiated before the withdrawal of consent.
1093          (g) The department may establish standards for a medical research study's validity, by
1094     rule made in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act.
1095          Section 8. Section 26-61a-202 is amended to read:
1096          26-61a-202. Medical cannabis caregiver card -- Registration -- Renewal --
1097     Revocation.
1098          (1) (a) (i) A cardholder described in Section 26-61a-201 may designate, through the
1099     state central patient portal, up to two individuals, or an individual and a facility in accordance
1100     with Subsection (1)(b), to serve as a designated caregiver for the cardholder [if a qualified
1101     medical provider notates in].
1102          (ii) The designation described in Subsection (1)(a)(i) takes effect if the state electronic
1103     verification system reflects a recommending medical provider's indication that the provider
1104     determines that, due to physical difficulty or undue hardship, including concerns of distance to
1105     a medical cannabis pharmacy, the cardholder needs assistance to obtain the medical cannabis
1106     treatment that the [qualified] recommending medical provider recommends.
1107          (b) (i) Beginning on the earlier of January 1, 2021, or the date on which the electronic
1108     verification system is functionally capable of servicing the designation, a cardholder described
1109     in Section 26-61a-201 who is a patient in one of the following types of facilities may designate
1110     the facility as one of the caregivers described in Subsection (1)(a):

1111          (A) an assisted living facility, as that term is defined in Section 26-21-2;
1112          (B) a nursing care facility, as that term is defined in Section 26-21-2; or
1113          (C) a general acute hospital, as that term is defined in Section 26-21-2.
1114          (ii) A facility may assign one or more employees to assist patients with medical
1115     cannabis treatment under the caregiver designation described in this Subsection (1)(b).
1116          (iii) The department shall make rules to regulate the practice of facilities and facility
1117     employees serving as designated caregivers under this Subsection (1)(b).
1118          (c) A parent or legal guardian described in Subsection 26-61a-201(2)(d), in
1119     consultation with the minor and the minor's qualified medical provider, may designate, through
1120     the state central patient portal, up to two individuals to serve as a designated caregiver for the
1121     minor, if the department determines that the parent or legal guardian is not eligible for a
1122     medical cannabis guardian card under Section 26-61a-201.
1123          (2) An individual that the department registers as a designated caregiver under this
1124     section and a facility described in Subsection (1)(b):
1125          (a) for an individual designated caregiver, may carry a valid medical cannabis caregiver
1126     card;
1127          (b) in accordance with this chapter, may purchase, possess, transport, or assist the
1128     patient in the use of cannabis in a medicinal dosage form, a cannabis product in a medicinal
1129     dosage form, or a medical cannabis device on behalf of the designating medical cannabis
1130     cardholder;
1131          (c) may not charge a fee to an individual to act as the individual's designated caregiver
1132     or for a service that the designated caregiver provides in relation to the role as a designated
1133     caregiver;
1134          (d) may accept reimbursement from the designating medical cannabis cardholder for
1135     direct costs the designated caregiver incurs for assisting with the designating cardholder's
1136     medicinal use of cannabis; and
1137          (e) if a licensed medical cannabis pharmacy is not operating within the state after
1138     January 1, 2021:
1139          (i) may possess up to the legal dosage limit of:
1140          (A) unprocessed medical cannabis in a medicinal dosage form; and
1141          (B) a cannabis product in a medicinal dosage form; [and]

1142          (ii) may possess marijuana drug paraphernalia; and
1143          (iii) is not subject to prosecution for the possession described in Subsection (2)(e)(i).
1144          (3) (a) The department shall:
1145          (i) within 15 days after the day on which an individual submits an application in
1146     compliance with this section, issue a medical cannabis card to the applicant if the applicant:
1147          (A) is designated as a caregiver under Subsection (1);
1148          (B) is eligible for a medical cannabis caregiver card under Subsection (4); and
1149          (C) complies with this section; and
1150          (ii) notify the Department of Public Safety of each individual that the department
1151     registers as a designated caregiver.
1152          (b) The department shall ensure that a medical cannabis caregiver card contains the
1153     information described in Subsection (5)(b).
1154          (4) An individual is eligible for a medical cannabis caregiver card if the individual:
1155          (a) is at least 21 years old;
1156          (b) is a Utah resident;
1157          (c) pays to the department a fee in an amount that, subject to Subsection
1158     26-61a-109(5), the department sets in accordance with Section 63J-1-504, plus the cost of the
1159     criminal background check described in Section 26-61a-203;
1160          (d) signs an acknowledgment stating that the applicant received the information
1161     described in Subsection 26-61a-201[(8)](9); and
1162          (e) has not been convicted of a misdemeanor or felony drug distribution offense that is
1163     a felony under either state or federal law, unless the individual completes any imposed sentence
1164     two or more years before the day on which the individual submits the application.
1165          (5) An eligible applicant for a medical cannabis caregiver card shall:
1166          (a) submit an application for a medical cannabis caregiver card to the department
1167     through an electronic application connected to the state electronic verification system; and
1168          (b) submit the following information in the application described in Subsection (5)(a):
1169          (i) the applicant's name, gender, age, and address;
1170          (ii) the name, gender, age, and address of the cardholder described in Section
1171     26-61a-201 who designated the applicant; and
1172          (iii) if a medical cannabis guardian cardholder designated the caregiver, the name,

1173     gender, and age of the minor receiving a medical cannabis treatment in relation to the medical
1174     cannabis guardian cardholder.
1175          (6) Except as provided in Subsection (6)(b), a medical cannabis caregiver card that the
1176     department issues under this section is valid for the lesser of:
1177          (a) an amount of time that the cardholder described in Section 26-61a-201 who
1178     designated the caregiver determines; or
1179          (b) the amount of time remaining before the card of the cardholder described in Section
1180     26-61a-201 expires.
1181          (7) (a) If a designated caregiver meets the requirements of Subsection (4), the
1182     designated caregiver's medical cannabis caregiver card renews automatically at the time the
1183     cardholder described in Section 26-61a-201 who designated the caregiver:
1184          (i) renews the cardholder's card; and
1185          (ii) renews the caregiver's designation, in accordance with Subsection (7)(b).
1186          (b) The department shall provide a method in the card renewal process to allow a
1187     cardholder described in Section 26-61a-201 who has designated a caregiver to:
1188          (i) signify that the cardholder renews the caregiver's designation;
1189          (ii) remove a caregiver's designation; or
1190          (iii) designate a new caregiver.
1191          (8) The department may revoke a medical cannabis caregiver card if the designated
1192     caregiver:
1193          (a) violates this chapter; or
1194          (b) is convicted under state or federal law of:
1195          (i) a felony; or
1196          (ii) after December 3, 2018, a misdemeanor for drug distribution.
1197          Section 9. Section 26-61a-401 is amended to read:
1198          26-61a-401. Medical cannabis pharmacy agent -- Registration.
1199          (1) An individual may not serve as a medical cannabis pharmacy agent of a medical
1200     cannabis pharmacy unless the department registers the individual as a medical cannabis
1201     pharmacy agent.
1202          (2) [Except as provided in Section 26-61a-403, a qualified] A recommending medical
1203     provider may not act as a medical cannabis pharmacy agent, have a financial or voting interest

1204     of 2% or greater in a medical cannabis pharmacy, or have the power to direct or cause the
1205     management or control of a medical cannabis pharmacy.
1206          (3) (a) The department shall, within 15 days after the day on which the department
1207     receives a complete application from a medical cannabis pharmacy on behalf of a prospective
1208     medical cannabis pharmacy agent, register and issue a medical cannabis pharmacy agent
1209     registration card to the prospective agent if the medical cannabis pharmacy:
1210          (i) provides to the department:
1211          (A) the prospective agent's name and address;
1212          (B) the name and location of the licensed medical cannabis pharmacy where the
1213     prospective agent seeks to act as the medical cannabis pharmacy agent; and
1214          (C) the submission required under Subsection (3)(b); and
1215          (ii) pays a fee to the department in an amount that, subject to Subsection
1216     26-61a-109(5), the department sets in accordance with Section 63J-1-504.
1217          (b) Except for an applicant reapplying for a medical cannabis pharmacy agent
1218     registration card within less than one year after the expiration of the applicant's previous
1219     medical cannabis pharmacy agent registration card, each prospective agent described in
1220     Subsection (3)(a) shall:
1221          (i) submit to the department:
1222          (A) a fingerprint card in a form acceptable to the Department of Public Safety; and
1223          (B) a signed waiver in accordance with Subsection 53-10-108(4) acknowledging the
1224     registration of the prospective agent's fingerprints in the Federal Bureau of Investigation Next
1225     Generation Identification System's Rap Back Service; and
1226          (ii) consent to a fingerprint background check by:
1227          (A) the Bureau of Criminal Identification; and
1228          (B) the Federal Bureau of Investigation.
1229          (c) The Bureau of Criminal Identification shall:
1230          (i) check the fingerprints the prospective agent submits under Subsection (3)(b) against
1231     the applicable state, regional, and national criminal records databases, including the Federal
1232     Bureau of Investigation Next Generation Identification System;
1233          (ii) report the results of the background check to the department;
1234          (iii) maintain a separate file of fingerprints that prospective agents submit under

1235     Subsection (3)(b) for search by future submissions to the local and regional criminal records
1236     databases, including latent prints;
1237          (iv) request that the fingerprints be retained in the Federal Bureau of Investigation Next
1238     Generation Identification System's Rap Back Service for search by future submissions to
1239     national criminal records databases, including the Next Generation Identification System and
1240     latent prints; and
1241          (v) establish a privacy risk mitigation strategy to ensure that the department only
1242     receives notifications for an individual with whom the department maintains an authorizing
1243     relationship.
1244          (d) The department shall:
1245          (i) assess an individual who submits fingerprints under Subsection (3)(b) a fee in an
1246     amount that the department sets in accordance with Section 63J-1-504 for the services that the
1247     Bureau of Criminal Identification or another authorized agency provides under this section; and
1248          (ii) remit the fee described in Subsection (3)(d)(i) to the Bureau of Criminal
1249     Identification.
1250          (4) The department shall designate, on an individual's medical cannabis pharmacy
1251     agent registration card the name of the medical cannabis pharmacy where the individual is
1252     registered as an agent.
1253          (5) A medical cannabis pharmacy agent shall comply with a certification standard that
1254     the department develops in collaboration with the Division of Occupational and Professional
1255     Licensing and the Board of Pharmacy, or a third-party certification standard that the department
1256     designates by rule, in collaboration with the Division of Occupational and Professional
1257     Licensing and the Board of Pharmacy and in accordance with Title 63G, Chapter 3, Utah
1258     Administrative Rulemaking Act.
1259          (6) The department shall ensure that the certification standard described in Subsection
1260     (5) includes training in:
1261          (a) Utah medical cannabis law; and
1262          (b) medical cannabis pharmacy best practices.
1263          (7) The department may revoke the medical cannabis pharmacy agent registration card
1264     of, or refuse to issue a medical cannabis pharmacy agent registration card to, an individual
1265     who:

1266          (a) violates the requirements of this chapter; or
1267          (b) is convicted under state or federal law of:
1268          (i) a felony; or
1269          (ii) after December 3, 2018, a misdemeanor for drug distribution.
1270          (8) (a) A medical cannabis pharmacy agent registration card expires two years after the
1271     day on which the department issues or renews the card.
1272          (b) A medical cannabis pharmacy agent may renew the agent's registration card if the
1273     agent:
1274          (i) is eligible for a medical cannabis pharmacy agent registration card under this
1275     section;
1276          (ii) certifies to the department in a renewal application that the information in
1277     Subsection (3)(a) is accurate or updates the information; and
1278          (iii) pays to the department a renewal fee in an amount that:
1279          (A) subject to Subsection 26-61a-109(5), the department sets in accordance with
1280     Section 63J-1-504; and
1281          (B) may not exceed the cost of the relatively lower administrative burden of renewal in
1282     comparison to the original application process.
1283          Section 10. Section 26-61a-403 is amended to read:
1284          26-61a-403. Pharmacy medical providers -- Registration -- Continuing education.
1285          (1) (a) A medical cannabis pharmacy:
1286          (i) shall employ a pharmacist who is licensed under Title 58, Chapter 17b, Pharmacy
1287     Practice Act, as a pharmacy medical provider;
1288          (ii) may employ a physician who has the authority to write a prescription and is
1289     licensed under Title 58, Chapter 67, Utah Medical Practice Act, or Title 58, Chapter 68, Utah
1290     Osteopathic Medical Practice Act, as a pharmacy medical provider;
1291          (iii) shall ensure that a pharmacy medical provider described in Subsection (1)(a)(i)
1292     works onsite during all business hours; and
1293          (iv) shall designate one pharmacy medical provider described in Subsection (1)(a)(i) as
1294     the pharmacist-in-charge to oversee the operation of and generally supervise the medical
1295     cannabis pharmacy.
1296          (b) An individual may not serve as a pharmacy medical provider unless the department

1297     registers the individual as a pharmacy medical provider in accordance with Subsection (2).
1298          (2) (a) The department shall, within 15 days after the day on which the department
1299     receives an application from a medical cannabis pharmacy on behalf of a prospective pharmacy
1300     medical provider, register and issue a pharmacy medical provider registration card to the
1301     prospective pharmacy medical provider if the medical cannabis pharmacy:
1302          (i) provides to the department:
1303          (A) the prospective pharmacy medical provider's name and address;
1304          (B) the name and location of the licensed medical cannabis pharmacy where the
1305     prospective pharmacy medical provider seeks to act as a pharmacy medical provider;
1306          (C) a report detailing the completion of the continuing education requirement described
1307     in Subsection (3); and
1308          (D) evidence that the prospective pharmacy medical provider is a pharmacist who is
1309     licensed under Title 58, Chapter 17b, Pharmacy Practice Act, or a physician who has the
1310     authority to write a prescription and is licensed under Title 58, Chapter 67, Utah Medical
1311     Practice Act, or Title 58, Chapter 68, Utah Osteopathic Medical Practice Act; and
1312          (ii) pays a fee to the department in an amount that, subject to Subsection
1313     26-61a-109(5), the department sets in accordance with Section 63J-1-504.
1314          (b) The department may not register a [qualified] recommending medical provider or a
1315     state central patient portal medical provider as a pharmacy medical provider.
1316          (3) (a) A pharmacy medical provider shall complete the continuing education described
1317     in this Subsection (3) in the following amounts:
1318          (i) as a condition precedent to registration, four hours; and
1319          (ii) as a condition precedent to renewal of the registration, four hours every two years.
1320          (b) In accordance with Subsection (3)(a), the pharmacy medical provider shall:
1321          (i) complete continuing education:
1322          (A) regarding the topics described in Subsection (3)(d); and
1323          (B) offered by the department under Subsection (3)(c) or an accredited or approved
1324     continuing education provider that the department recognizes as offering continuing education
1325     appropriate for the medical cannabis pharmacy practice; and
1326          (ii) make a continuing education report to the department in accordance with a process
1327     that the department establishes by rule, in accordance with Title 63G, Chapter 3, Utah

1328     Administrative Rulemaking Act, and in collaboration with the Division of Occupational and
1329     Professional Licensing and:
1330          (A) for a pharmacy medical provider who is licensed under Title 58, Chapter 17b,
1331     Pharmacy Practice Act, the Board of Pharmacy;
1332          (B) for a pharmacy medical provider licensed under Title 58, Chapter 67, Utah Medical
1333     Practice Act, the Physicians Licensing Board; and
1334          (C) for a pharmacy medical provider licensed under Title 58, Chapter 68, Utah
1335     Osteopathic Medical Practice Act, the Osteopathic Physician and Surgeon's Licensing Board.
1336          (c) The department may, in consultation with the Division of Occupational and
1337     Professional Licensing, develop the continuing education described in this Subsection (3).
1338          (d) The continuing education described in this Subsection (3) may discuss:
1339          (i) the provisions of this chapter;
1340          (ii) general information about medical cannabis under federal and state law;
1341          (iii) the latest scientific research on the endocannabinoid system and medical cannabis,
1342     including risks and benefits;
1343          (iv) recommendations for medical cannabis as it relates to the continuing care of a
1344     patient in pain management, risk management, potential addiction, and palliative care; or
1345          (v) best practices for recommending the form and dosage of a medical cannabis
1346     product based on the qualifying condition underlying a medical cannabis recommendation.
1347          (4) (a) A pharmacy medical provider registration card expires two years after the day
1348     on which the department issues or renews the card.
1349          (b) A pharmacy medical provider may renew the provider's registration card if the
1350     provider:
1351          (i) is eligible for a pharmacy medical provider registration card under this section;
1352          (ii) certifies to the department in a renewal application that the information in
1353     Subsection (2)(a) is accurate or updates the information;
1354          (iii) submits a report detailing the completion of the continuing education requirement
1355     described in Subsection (3); and
1356          (iv) pays to the department a renewal fee in an amount that:
1357          (A) subject to Subsection 26-61a-109(5), the department sets in accordance with
1358     Section 63J-1-504; and

1359          (B) may not exceed the cost of the relatively lower administrative burden of renewal in
1360     comparison to the original application process.
1361          Section 11. Section 26-61a-501 is amended to read:
1362          26-61a-501. Operating requirements -- General.
1363          (1) (a) A medical cannabis pharmacy shall operate:
1364          (i) at the physical address provided to the department under Section 26-61a-301; and
1365          (ii) in accordance with the operating plan provided to the department under Section
1366     26-61a-301 and, if applicable, 26-61a-304.
1367          (b) A medical cannabis pharmacy shall notify the department before a change in the
1368     medical cannabis pharmacy's physical address or operating plan.
1369          (2) An individual may not enter a medical cannabis pharmacy unless the individual:
1370          (a) is at least 18 years old; and
1371          (b) except as provided in Subsection (5), possesses a valid:
1372          (i) medical cannabis pharmacy agent registration card;
1373          (ii) pharmacy medical provider registration card; or
1374          (iii) medical cannabis card.
1375          (3) A medical cannabis pharmacy may not employ an individual who is younger than
1376     21 years old.
1377          (4) A medical cannabis pharmacy may not employ an individual who has been
1378     convicted of a felony under state or federal law.
1379          (5) Notwithstanding Subsection (2), a medical cannabis pharmacy may authorize an
1380     individual who is not a medical cannabis pharmacy agent or pharmacy medical provider to
1381     access the medical cannabis pharmacy if the medical cannabis pharmacy tracks and monitors
1382     the individual at all times while the individual is at the medical cannabis pharmacy and
1383     maintains a record of the individual's access.
1384          (6) A medical cannabis pharmacy shall operate in a facility that has:
1385          (a) a single, secure public entrance;
1386          (b) a security system with a backup power source that:
1387          (i) detects and records entry into the medical cannabis pharmacy; and
1388          (ii) provides notice of an unauthorized entry to law enforcement when the medical
1389     cannabis pharmacy is closed; and

1390          (c) a lock on each area where the medical cannabis pharmacy stores cannabis or a
1391     cannabis product.
1392          (7) A medical cannabis pharmacy shall post, both clearly and conspicuously in the
1393     medical cannabis pharmacy, the limit on the purchase of cannabis described in Subsection
1394     26-61a-502(2).
1395          (8) A medical cannabis pharmacy may not allow any individual to consume cannabis
1396     on the property or premises of the medical cannabis pharmacy.
1397          (9) A medical cannabis pharmacy may not sell cannabis or a cannabis product without
1398     first indicating on the cannabis or cannabis product label the name of the medical cannabis
1399     pharmacy.
1400          (10) (a) Each medical cannabis pharmacy shall retain in the pharmacy's records the
1401     following information regarding each recommendation underlying a transaction:
1402          (i) the [qualified] recommending medical provider's name, address, and telephone
1403     number;
1404          (ii) the patient's name and address;
1405          (iii) the date of issuance;
1406          (iv) directions of use and dosing guidelines or an indication that the [qualified]
1407     recommending medical provider did not recommend specific directions of use or dosing
1408     guidelines; and
1409          (v) if the patient did not complete the transaction, the name of the medical cannabis
1410     cardholder who completed the transaction.
1411          (b) (i) Except as provided in Subsection (10)(b)(ii), a medical cannabis pharmacy may
1412     not sell medical cannabis unless the medical cannabis has a label securely affixed to the
1413     container indicating the following minimum information:
1414          (A) the name, address, and telephone number of the medical cannabis pharmacy;
1415          (B) the unique identification number that the medical cannabis pharmacy assigns;
1416          (C) the date of the sale;
1417          (D) the name of the patient;
1418          (E) the name of the [qualified] recommending medical provider who recommended the
1419     medical cannabis treatment;
1420          (F) directions for use and cautionary statements, if any;

1421          (G) the amount dispensed and the cannabinoid content;
1422          (H) the suggested use date;
1423          (I) for unprocessed cannabis flower, the legal use termination date; and
1424          (J) any other requirements that the department determines, in consultation with the
1425     Division of Occupational and Professional Licensing and the Board of Pharmacy.
1426          (ii) A medical cannabis pharmacy may sell medical cannabis to another medical
1427     cannabis pharmacy without a label described in Subsection (10)(b)(i).
1428          (11) A pharmacy medical provider or medical cannabis pharmacy agent shall:
1429          (a) upon receipt of an order from a limited medical provider in accordance with
1430     Subsections 26-61a-106(1)(b) and (c):
1431          (i) for a written order, contact the limited medical provider or the limited medical
1432     provider's office to verify the validity of the recommendation; and
1433          (ii) for a written order that the pharmacy medical provider or medical cannabis
1434     pharmacy agent verifies under Subsection (11)(a)(i) or an electronic order, enter the limited
1435     medical provider's recommendation or renewal, including any associated directions of use,
1436     dosing guidelines, or caregiver indication, in the state electronic verification system;
1437          (b) in processing an order for a holder of a conditional medical cannabis card described
1438     in Subsection 26-61a-201(1)(b) that appears irregular or suspicious in the judgment of the
1439     pharmacy medical provider or medical cannabis pharmacy agent, contact the recommending
1440     medical provider or the recommending medical provider's office to verify the validity of the
1441     recommendation before processing the cardholder's order;
1442          [(a)] (c) unless the medical cannabis cardholder has had a consultation under
1443     Subsection 26-61a-502(4) or (5), verbally offer to a medical cannabis cardholder at the time of
1444     a purchase of cannabis, a cannabis product, or a medical cannabis device, personal counseling
1445     with the pharmacy medical provider; and
1446          [(b)] (d) provide a telephone number or website by which the cardholder may contact a
1447     pharmacy medical provider for counseling.
1448          (12) (a) A medical cannabis pharmacy may create a medical cannabis disposal program
1449     that allows an individual to deposit unused or excess medical cannabis, cannabis residue from a
1450     medical cannabis device, or medical cannabis product in a locked box or other secure
1451     receptacle within the medical cannabis pharmacy.

1452          (b) A medical cannabis pharmacy with a disposal program described in Subsection
1453     (12)(a) shall ensure that only a medical cannabis pharmacy agent or pharmacy medical provider
1454     can access deposited medical cannabis or medical cannabis products.
1455          (c) A medical cannabis pharmacy shall dispose of any deposited medical cannabis or
1456     medical cannabis products by:
1457          (i) rendering the deposited medical cannabis or medical cannabis products unusable
1458     and unrecognizable before transporting deposited medical cannabis or medical cannabis
1459     products from the medical cannabis pharmacy; and
1460          (ii) disposing of the deposited medical cannabis or medical cannabis products in
1461     accordance with:
1462          (A) federal and state law, rules, and regulations related to hazardous waste;
1463          (B) the Resource Conservation and Recovery Act, 42 U.S.C. Sec. 6991 et seq.;
1464          (C) Title 19, Chapter 6, Part 5, Solid Waste Management Act; and
1465          (D) other regulations that the department makes in accordance with Title 63G, Chapter
1466     3, Utah Administrative Rulemaking Act.
1467          (13) The department shall establish by rule, in accordance with Title 63G, Chapter 3,
1468     Utah Administrative Rulemaking Act, protocols for a recall of cannabis and cannabis products
1469     by a medical cannabis pharmacy.
1470          Section 12. Section 26-61a-502 is amended to read:
1471          26-61a-502. Dispensing -- Amount a medical cannabis pharmacy may dispense --
1472     Reporting -- Form of cannabis or cannabis product.
1473          (1) (a) A medical cannabis pharmacy may not sell a product other than, subject to this
1474     chapter:
1475          (i) cannabis in a medicinal dosage form that the medical cannabis pharmacy acquired
1476     from a cannabis processing facility that is licensed under Section 4-41a-201;
1477          (ii) a cannabis product in a medicinal dosage form that the medical cannabis pharmacy
1478     acquired from a cannabis processing facility that is licensed under Section 4-41a-201;
1479          (iii) a medical cannabis device; or
1480          (iv) educational material related to the medical use of cannabis.
1481          (b) A medical cannabis pharmacy may only sell an item listed in Subsection (1)(a) to
1482     an individual with:

1483          (i) (A) a medical cannabis card;
1484          (B) a department registration described in [Subsection 26-61a-202(10)] Section
1485     26-61a-201; or
1486          (C) until December 31, 2020, a letter from a medical provider in accordance with
1487     Subsection (10); and
1488          (ii) a corresponding valid form of photo identification.
1489          (c) Notwithstanding Subsection (1)(a), a medical cannabis pharmacy may not sell a
1490     cannabis-based drug that the United States Food and Drug Administration has approved.
1491          (d) Notwithstanding Subsection (1)(b), a medical cannabis pharmacy may not sell a
1492     medical cannabis device to an individual described in Subsection 26-61a-201(2)(a)(i)(B) or to a
1493     minor described in Subsection 26-61a-201(2)(c) unless the individual or minor has the
1494     approval of the Compassionate Use Board in accordance with Subsection 26-61a-105(5).
1495          (2) A medical cannabis pharmacy:
1496          (a) may dispense to a medical cannabis cardholder or to an individual described in
1497     Subsection (10)(b), in any one 28-day period, up to the legal dosage limit of:
1498          (i) unprocessed cannabis that:
1499          (A) is in a medicinal dosage form; and
1500          (B) carries a label clearly displaying the amount of tetrahydrocannabinol and
1501     cannabidiol in the cannabis; and
1502          (ii) a cannabis product that is in a medicinal dosage form; and
1503          (b) may not dispense:
1504          (i) more medical cannabis than described in Subsection (2)(a); or
1505          (ii) to an individual whose [qualified] recommending medical provider[, or for an
1506     individual described in Subsection (10)(a), the medical professional described in Subsection
1507     (10)(a)(i),] did not recommend directions of use and dosing guidelines, until the individual
1508     consults with the pharmacy medical provider in accordance with Subsection (4), any medical
1509     cannabis.
1510          (3) An individual with a medical cannabis card [or an individual described in
1511     Subsection (10)(a)]:
1512          (a) may purchase, in any one 28-day period, up to the legal dosage limit of:
1513          (i) unprocessed cannabis in a medicinal dosage form; and

1514          (ii) a cannabis product in a medicinal dosage form;
1515          (b) may not purchase:
1516          (i) more medical cannabis than described in Subsection (3)(a); or
1517          (ii) if the relevant [qualified] recommending medical provider did not recommend
1518     directions of use and dosing guidelines, until the individual consults with the pharmacy
1519     medical provider in accordance with Subsection (4), any medical cannabis; and
1520          (c) may not use a route of administration that the relevant [qualified] recommending
1521     medical provider or the pharmacy medical provider, in accordance with Subsection (4) or (5),
1522     has not recommended.
1523          (4) If a [qualified] recommending medical provider recommends treatment with
1524     medical cannabis but does not provide directions of use and dosing guidelines:
1525          (a) the qualified medical provider or the medical cannabis pharmacy recording a
1526     recommendation under the order of a limited medical provider, shall document in the
1527     recommendation:
1528          (i) an evaluation of the qualifying condition underlying the recommendation;
1529          (ii) prior treatment attempts with medical cannabis; and
1530          (iii) the patient's current medication list; and
1531          (b) before the relevant medical cannabis cardholder may obtain medical cannabis, the
1532     pharmacy medical provider shall:
1533          (i) review pertinent medical records, including the [qualified] recommending medical
1534     provider documentation described in Subsection (4)(a); and
1535          (ii) unless the pertinent medical records show directions of use and dosing guidelines
1536     from a state central patient portal medical provider in accordance with Subsection (5), after
1537     completing the review described in Subsection (4)(b)(i) and consulting with the recommending
1538     [qualified] medical provider as needed, determine the best course of treatment through
1539     consultation with the cardholder regarding:
1540          (A) the patient's qualifying condition underlying the recommendation from the
1541     [qualified] recommending medical provider;
1542          (B) indications for available treatments;
1543          (C) directions of use and dosing guidelines; and
1544          (D) potential adverse reactions.

1545          (5) (a) A state central patient portal medical provider may provide the consultation and
1546     make the determination described in Subsection (4)(b) for a medical cannabis patient
1547     cardholder regarding an electronic order that the state central patient portal facilitates.
1548          (b) The state central patient portal medical provider described in Subsection (5)(a)
1549     shall document the directions of use and dosing guidelines, determined under Subsection (5)(a)
1550     in the pertinent medical records.
1551          (6) A medical cannabis pharmacy shall:
1552          (a) (i) access the state electronic verification system before dispensing cannabis or a
1553     cannabis product to a medical cannabis cardholder in order to determine if the cardholder or,
1554     where applicable, the associated patient has met the maximum amount of medical cannabis
1555     described in Subsection (2); and
1556          (ii) if the verification in Subsection (6)(a)(i) indicates that the individual has met the
1557     maximum amount described in Subsection (2):
1558          (A) decline the sale; and
1559          (B) notify the [qualified] recommending medical provider who made the underlying
1560     recommendation;
1561          (b) submit a record to the state electronic verification system each time the medical
1562     cannabis pharmacy dispenses medical cannabis to a medical cannabis cardholder;
1563          (c) package any medical cannabis that is in a container that:
1564          (i) complies with Subsection 4-41a-602(2) or, if applicable, [26-61a-102(32)(a)(ii)]
1565     provisions related to a container for unprocessed cannabis flower in the definition of
1566     "medicinal dosage form" in Section 26-61a-102;
1567          (ii) is tamper-resistant and tamper-evident; and
1568          (iii) opaque; and
1569          (d) for a product that is a cube that is designed for ingestion through chewing or
1570     holding in the mouth for slow dissolution, include a separate, off-label warning about the risks
1571     of over-consumption.
1572          (7) (a) Except as provided in Subsection (7)(b), a medical cannabis pharmacy may not
1573     sell medical cannabis in the form of a cigarette or a medical cannabis device that is
1574     intentionally designed or constructed to resemble a cigarette.
1575          (b) A medical cannabis pharmacy may sell a medical cannabis device that warms

1576     cannabis material into a vapor without the use of a flame and that delivers cannabis to an
1577     individual's respiratory system.
1578          (8) A medical cannabis pharmacy may not give, at no cost, a product that the medical
1579     cannabis pharmacy is allowed to sell under Subsection (1).
1580          (9) The department may impose a uniform fee on each medical cannabis transaction in
1581     a medical cannabis pharmacy in an amount that, subject to Subsection 26-61a-109(5), the
1582     department sets in accordance with Section 63J-1-504.
1583          [(10) (a) Except as provided in Subsection (10)(b), until December 31, 2020, an
1584     individual may purchase up to the legal dosage limit of an item listed in Subsection (1)(a) from
1585     a licensed medical cannabis pharmacy if:]
1586          [(i) the individual presents to the medical cannabis pharmacy a letter from the medical
1587     professional described in Subsection 58-37-3.7(2)(a)(i)(B) that indicates the medical
1588     professional's medical cannabis recommendation for the individual;]
1589          [(ii) the medical cannabis pharmacy receives independent confirmation from the
1590     medical professional described in Subsection (10)(a)(i) or an employee of the medical
1591     professional that the letter is valid;]
1592          [(iii) the medical cannabis pharmacy:]
1593          [(A) scans or photocopies the individual's letter and the individual's valid form of
1594     photo identification;]
1595          [(B) creates a record of the transaction, including the documents described in
1596     Subsection (10)(a)(iii)(A), the date of purchase, and the type and quantity of medical cannabis
1597     the individual purchased; and]
1598          [(C) provides information to the individual about obtaining a medical cannabis card;
1599     and]
1600          [(iv) unless the medical professional recommends specific directions of using and
1601     dosing guidelines in the letter, the pharmacy medical provider determines the best course of
1602     treatment through consultation with the individual regarding:]
1603          [(A) the individual's qualifying condition underlying the recommendation from the
1604     medical professional;]
1605          [(B) indications for available treatments;]
1606          [(C) directions of use and dosing guidelines; and]

1607          [(D) potential adverse reactions.]
1608          [(b) (i) An individual who purchases medical cannabis from a medical cannabis
1609     pharmacy under Subsection (10)(a) may not purchase medical cannabis from a different
1610     medical cannabis pharmacy under Subsection (10)(a).]
1611          [(ii) If the department notifies a medical cannabis pharmacy, in accordance with
1612     Subsection (10)(c), of an individual purchasing medical cannabis under Subsection (10)(a)
1613     from more than one medical cannabis pharmacy, a medical cannabis pharmacy may not sell an
1614     item listed in Subsection (1)(a) to the individual under Subsection (10)(a).]
1615          [(iii) An individual may not purchase medical cannabis under Subsection (10)(a) if the
1616     individual is a medical cannabis cardholder.]
1617          [(c) (i) Until December 31, 2020, on or before the first day of each month, each
1618     medical cannabis pharmacy shall provide to the department, in a secure manner, information
1619     identifying each individual who has purchased medical cannabis from the medical cannabis
1620     pharmacy under Subsection (10)(a).]
1621          [(ii) The department shall review information the department receives under
1622     Subsection (10)(c)(i) to identify any individuals who:]
1623          [(A) have purchased medical cannabis under Subsection (10)(a) from more than one
1624     pharmacy; or]
1625          [(B) hold a medical cannabis card.]
1626          [(iii) If the department identifies an individual described in Subsection (10)(c)(ii), the
1627     department shall notify each medical cannabis pharmacy regarding:]
1628          [(A) the identification of the individual; and]
1629          [(B) the individual's ineligibility to purchase medical cannabis for a reason described in
1630     Subsection (10)(b).]
1631          [(11)] (10) A medical cannabis pharmacy may purchase and store medical cannabis
1632     devices regardless of whether the seller has a cannabis-related license under this title or Title 4,
1633     Chapter 41a, Cannabis Production Establishments.
1634          Section 13. Section 26-61a-503 is amended to read:
1635          26-61a-503. Partial filling.
1636          (1) As used in this section, "partially fill" means to provide less than the full amount of
1637     cannabis or cannabis product that the [qualified] recommending medical provider recommends,

1638     if the [qualified] recommending medical provider recommended specific dosing parameters.
1639          (2) A pharmacy medical provider may partially fill a recommendation for a medical
1640     cannabis treatment at the request of the [qualified] recommending medical provider who issued
1641     the medical cannabis treatment recommendation or the medical cannabis cardholder.
1642          (3) The department shall make rules, in collaboration with the Division of
1643     Occupational and Professional Licensing and the Board of Pharmacy and in accordance with
1644     Title 63G, Chapter 3, Utah Administrative Rulemaking Act, specifying how to record the date,
1645     quantity supplied, and quantity remaining of a partially filled medical cannabis treatment
1646     recommendation.
1647          (4) A pharmacy medical provider who is a pharmacist may, upon the request of a
1648     medical cannabis cardholder, determine different dosing parameters, subject to the dosing
1649     limits in Subsection 26-61a-502(2), to fill the quantity remaining of a partially filled medical
1650     cannabis treatment recommendation if:
1651          (a) the pharmacy medical provider determined dosing parameters for the partial fill
1652     under Subsection 26-61a-502(4) or (5); and
1653          (b) the medical cannabis cardholder reports that:
1654          (i) the partial fill did not substantially affect the qualifying condition underlying the
1655     medical cannabis recommendation; or
1656          (ii) the patient experienced an adverse reaction to the partial fill or was otherwise
1657     unable to successfully use the partial fill.
1658          Section 14. Section 26-61a-601 is amended to read:
1659          26-61a-601. State central patient portal -- Department duties.
1660          (1) On or before July 1, 2020, the department shall establish or contract to establish, in
1661     accordance with Title 63G, Chapter 6a, Utah Procurement Code, a state central patient portal as
1662     described in this section.
1663          (2) The state central patient portal shall:
1664          (a) authenticate each user to ensure the user is a valid medical cannabis patient
1665     cardholder;
1666          (b) allow a medical cannabis patient cardholder to:
1667          (i) obtain and download the cardholder's medical cannabis card;
1668          (ii) review the cardholder's medical cannabis purchase history; and

1669          (iii) manage the cardholder's personal information, including withdrawing consent for
1670     the use of the cardholder's information for a study described in Subsection
1671     26-61a-201[(11)](12);
1672          (c) if the cardholder's [qualified] recommending medical provider recommended the
1673     use of medical cannabis without providing directions of use and dosing guidelines and the
1674     cardholder has not yet received the counseling or consultation required in Subsection
1675     26-61a-502(4):
1676          (i) alert the cardholder of the outstanding need for consultation; and
1677          (ii) provide the cardholder with access to the contact information for each state central
1678     patient portal medical provider and each pharmacy medical provider;
1679          (d) except as provided in Subsection (2)(e), facilitate an electronic medical cannabis
1680     order:
1681          (i) to a home delivery medical cannabis pharmacy for a medical cannabis shipment; or
1682          (ii) to a medical cannabis pharmacy for a medical cannabis cardholder to obtain in
1683     person from the pharmacy;
1684          (e) prohibit a patient from completing an electronic medical cannabis order described
1685     in Subsection (2)(d) if the purchase would exceed the limitations described in Subsection
1686     26-61a-502(2)(a) or (b);
1687          (f) provide educational information to medical cannabis patient cardholders regarding
1688     the state's medical cannabis laws and regulatory programs and other relevant information
1689     regarding medical cannabis; and
1690          (g) allow the patient to designate up to two caregivers who may receive a medical
1691     cannabis caregiver card to purchase and transport medical cannabis on behalf of the patient in
1692     accordance with this chapter.
1693          (3) The department may make rules in accordance with Title 63G, Chapter 3, Utah
1694     Administrative Rulemaking Act, to implement the state central patient portal.
1695          Section 15. Section 58-5a-102 is amended to read:
1696          58-5a-102. Definitions.
1697          In addition to the definitions under Section 58-1-102, as used in this chapter:
1698          (1) "Board" means the Podiatric Physician Board created in Section 58-5a-201.
1699          (2) "Indirect supervision" means the same as that term is defined by the division by

1700     rule made in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act.
1701          (3) "Medical assistant" means an unlicensed individual working under the indirect
1702     supervision of a licensed podiatric physician and engaging in specific tasks assigned by the
1703     licensed podiatric physician in accordance with the standards and ethics of the podiatry
1704     profession.
1705          (4) "Practice of podiatry" means the diagnosis and treatment of conditions affecting the
1706     human foot and ankle and their manifestations of systemic conditions by all appropriate and
1707     lawful means, subject to Section 58-5a-103.
1708          (5) "Unlawful conduct" includes:
1709          (a) the conduct that constitutes unlawful conduct under Section 58-1-501; and
1710          (b) for an individual who is not licensed under this chapter:
1711          (i) using the title or name podiatric physician, podiatrist, podiatric surgeon, foot doctor,
1712     foot specialist, or D.P.M.; or
1713          (ii) implying or representing that the individual is qualified to practice podiatry.
1714          (6) (a) "Unprofessional conduct" includes, for an individual licensed under this
1715     chapter:
1716          [(a)] (i) the conduct that constitutes unprofessional conduct under Section 58-1-501;
1717          [(b)] (ii) communicating to a third party, without the consent of the patient, information
1718     the individual acquires in treating the patient, except as necessary for professional consultation
1719     regarding treatment of the patient;
1720          [(c)] (iii) allowing the individual's name or license to be used by an individual who is
1721     not licensed to practice podiatry under this chapter;
1722          [(d)] (iv) except as described in Section 58-5a-306, employing, directly or indirectly,
1723     any unlicensed individual to practice podiatry;
1724          [(e)] (v) using alcohol or drugs, to the extent the individual's use of alcohol or drugs
1725     impairs the individual's ability to practice podiatry;
1726          [(f)] (vi) unlawfully prescribing, selling, or giving away any prescription drug,
1727     including controlled substances, as defined in Section 58-37-2;
1728          [(g)] (vii) gross incompetency in the practice of podiatry;
1729          [(h)] (viii) willfully and intentionally making a false statement or entry in hospital
1730     records, medical records, or reports;

1731          [(i)] (ix) willfully making a false statement in reports or claim forms to governmental
1732     agencies or insurance companies with the intent to secure payment not rightfully due;
1733          [(j)] (x) willfully using false or fraudulent advertising;
1734          [(k)] (xi) conduct the division defines as unprofessional conduct by rule made in
1735     accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act; or
1736          [(l)] (xii) falsely making an entry in, or altering, a medical record with the intent to
1737     conceal:
1738          [(i)] (A) a wrongful or negligent act or omission of an individual licensed under this
1739     chapter or an individual under the direction or control of an individual licensed under this
1740     chapter; or
1741          [(ii)] (B) conduct described in Subsections (6)(a)(i) through [(k)] (xi) or Subsection
1742     58-1-501(1).
1743          (b) "Unprofessional conduct" does not include, in accordance with Title 26, Chapter
1744     61a, Utah Medical Cannabis Act, when registered as a qualified medical provider or acting as a
1745     limited medical provider, as those terms are defined in Section 26-61a-102, recommending the
1746     use of medical cannabis within the scope of a practice of podiatry.
1747          Section 16. Section 58-31b-502 is amended to read:
1748          58-31b-502. Unprofessional conduct.
1749          (1) "Unprofessional conduct" includes:
1750          (a) failure to safeguard a patient's right to privacy as to the patient's person, condition,
1751     diagnosis, personal effects, or any other matter about which the licensee is privileged to know
1752     because of the licensee's or person with a certification's position or practice as a nurse or
1753     practice as a medication aide certified;
1754          (b) failure to provide nursing service or service as a medication aide certified in a
1755     manner that demonstrates respect for the patient's human dignity and unique personal character
1756     and needs without regard to the patient's race, religion, ethnic background, socioeconomic
1757     status, age, sex, or the nature of the patient's health problem;
1758          (c) engaging in sexual relations with a patient during any:
1759          (i) period when a generally recognized professional relationship exists between the
1760     person licensed or certified under this chapter and the patient; or
1761          (ii) extended period when a patient has reasonable cause to believe a professional

1762     relationship exists between the person licensed or certified under the provisions of this chapter
1763     and the patient;
1764          (d) (i) as a result of any circumstance under Subsection (1)(c), exploiting or using
1765     information about a patient or exploiting the licensee's or the person with a certification's
1766     professional relationship between the licensee or holder of a certification under this chapter and
1767     the patient; or
1768          (ii) exploiting the patient by use of the licensee's or person with a certification's
1769     knowledge of the patient obtained while acting as a nurse or a medication aide certified;
1770          (e) unlawfully obtaining, possessing, or using any prescription drug or illicit drug;
1771          (f) unauthorized taking or personal use of nursing supplies from an employer;
1772          (g) unauthorized taking or personal use of a patient's personal property;
1773          (h) unlawful or inappropriate delegation of nursing care;
1774          (i) failure to exercise appropriate supervision of persons providing patient care services
1775     under supervision of the licensed nurse;
1776          (j) employing or aiding and abetting the employment of an unqualified or unlicensed
1777     person to practice as a nurse;
1778          (k) failure to file or record any medical report as required by law, impeding or
1779     obstructing the filing or recording of such a report, or inducing another to fail to file or record
1780     such a report;
1781          (l) breach of a statutory, common law, regulatory, or ethical requirement of
1782     confidentiality with respect to a person who is a patient, unless ordered by a court;
1783          (m) failure to pay a penalty imposed by the division;
1784          (n) prescribing a Schedule II controlled substance without complying with the
1785     requirements in Section 58-31b-803, if applicable;
1786          (o) violating Section 58-31b-801;
1787          (p) violating the dispensing requirements of Section 58-17b-309 or Chapter 17b, Part
1788     8, Dispensing Medical Practitioner and Dispensing Medical Practitioner Clinic Pharmacy, if
1789     applicable;
1790          (q) establishing or operating a pain clinic without a consultation and referral plan for
1791     Schedule II or III controlled substances; or
1792          (r) falsely making an entry in, or altering, a medical record with the intent to conceal:

1793          (i) a wrongful or negligent act or omission of an individual licensed under this chapter
1794     or an individual under the direction or control of an individual licensed under this chapter; or
1795          (ii) conduct described in Subsections (1)(a) through (q) or Subsection 58-1-501(1).
1796          (2) "Unprofessional conduct" does not include, in accordance with Title 26, Chapter
1797     61a, Utah Medical Cannabis Act, when registered as a qualified medical provider or acting as a
1798     limited medical provider, as [that term is] those terms are defined in Section 26-61a-102,
1799     recommending the use of medical cannabis.
1800          (3) Notwithstanding Subsection (2), the division, in consultation with the board and in
1801     accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, shall define
1802     unprofessional conduct for an advanced practice registered nurse described in Subsection (2).
1803          Section 17. Section 58-37-3.7 is amended to read:
1804          58-37-3.7. Medical cannabis decriminalization.
1805          (1) As used in this section:
1806          (a) "Cannabis" means the same as that term is defined in Section 26-61a-102.
1807          (b) "Cannabis product" means the same as that term is defined in Section 26-61a-102.
1808          (c) "Legal dosage limit" means the same as that term is defined in Section 26-61a-102.
1809          (d) "Medical cannabis card" means the same as that term is defined in Section
1810     26-61a-102.
1811          (e) "Medical cannabis device" means the same as that term is defined in Section
1812     26-61a-102.
1813          (f) "Medicinal dosage form" means the same as that term is defined in Section
1814     26-61a-102.
1815          (g) "Nonresident patient" means the same as that term is defined in Section
1816     26-61a-102.
1817          (h) "Qualifying condition" means the same as that term is defined in Section
1818     26-61a-102.
1819          (i) "Tetrahydrocannabinol" means the same as that term is defined in Section
1820     58-37-3.9.
1821          (2) Before [January] July 1, 2021, including during the period between January 1,
1822     2021, and the effective date of this bill, an individual is not guilty under this chapter for the use
1823     or possession of marijuana, tetrahydrocannabinol, or marijuana drug paraphernalia if:

1824          (a) at the time of the arrest or citation, the individual:
1825          [(i) (A) had been diagnosed with a qualifying condition; and]
1826          [(B) had a pre-existing provider-patient relationship with an advanced practice
1827     registered nurse licensed under Title 58, Chapter 31b, Nurse Practice Act, a physician licensed
1828     under Title 58, Chapter 67, Utah Medical Practice Act, a physician licensed under Title 58,
1829     Chapter 68, Utah Osteopathic Medical Practice Act, or a physician assistant licensed under
1830     Title 58, Chapter 70a, Utah Physician Assistant Act, who believed that the individual's illness
1831     described in Subsection (2)(a)(i)(A) could benefit from the use in question;]
1832          [(ii) for possession, was:]
1833          [(A) the parent or legal guardian of an individual described in Subsection (2)(a)(i) who
1834     is a minor; or]
1835          [(B) the spouse of an individual described in Subsection (2)(a)(i); or]
1836          [(iii) (A)] (i) for possession, was a medical cannabis cardholder; or
1837          [(B)] (ii) for use, was a medical cannabis patient cardholder or a minor with a
1838     [qualifying condition] provisional patient card under the supervision of a medical cannabis
1839     guardian cardholder; and
1840          (b) (i) for use or possession of marijuana or tetrahydrocannabinol, the marijuana or
1841     tetrahydrocannabinol is one of the following in an amount that does not exceed the legal
1842     dosage limit:
1843          (A) unprocessed cannabis in a medicinal dosage form; or
1844          (B) a cannabis product in a medicinal dosage form; and
1845          (ii) for use or possession of marijuana drug paraphernalia, the paraphernalia is a
1846     medical cannabis device.
1847          (3) A nonresident patient is not guilty under this chapter for the use or possession of
1848     marijuana, tetrahydrocannabinol, or marijuana drug paraphernalia under this chapter if:
1849          (a) for use or possession of marijuana or tetrahydrocannabinol, the marijuana or
1850     tetrahydrocannabinol is one of the following in an amount that does not exceed the legal
1851     dosage limit:
1852          (i) unprocessed cannabis in a medicinal dosage form; or
1853          (ii) a cannabis product in a medicinal dosage form; and
1854          (b) for use or possession of marijuana drug paraphernalia, the paraphernalia is a

1855     medical cannabis device.
1856          (4) (a) There is a rebuttable presumption against an allegation of use or possession of
1857     marijuana or tetrahydrocannabinol if:
1858          (i) an individual fails a drug test based on the presence of [tetahyrdrocannabinol]
1859     tetrahydrocannabinol in the sample; and
1860          (ii) the individual provides evidence that the individual possessed or used cannabidiol
1861     or a cannabidiol product.
1862          (b) The presumption described in Subsection (4)(a) may be rebutted with evidence that
1863     the individual purchased or possessed marijuana or tetrahydrocannabinol that is not authorized
1864     under:
1865          (i) Section 4-41-402; or
1866          (ii) Title 26, Chapter 61a, Utah Medical Cannabis Act.
1867          Section 18. Section 58-37-6.5 is amended to read:
1868          58-37-6.5. Continuing education for controlled substance prescribers.
1869          (1) For the purposes of this section:
1870          (a) "Controlled substance prescriber" means an individual, other than a veterinarian,
1871     who:
1872          (i) is licensed to prescribe a controlled substance under Title 58, Chapter 37, Utah
1873     Controlled Substances Act; and
1874          (ii) possesses the authority, in accordance with the individual's scope of practice, to
1875     prescribe schedule II controlled substances and schedule III controlled substances that are
1876     applicable to opioid narcotics, hypnotic depressants, or psychostimulants.
1877          (b) "D.O." means an osteopathic physician and surgeon licensed under Title 58,
1878     Chapter 68, Utah Osteopathic Medical Practice Act.
1879          (c) "FDA" means the United States Food and Drug Administration.
1880          (d) "M.D." means a physician and surgeon licensed under Title 58, Chapter 67, Utah
1881     Medical Practice Act.
1882          (e) "SBIRT" means the Screening, Brief Intervention, and Referral to Treatment
1883     approach used by the federal Substance Abuse and Mental Health Services Administration or
1884     defined by the division, in consultation with the Division of Substance Abuse and Mental
1885     Health, by administrative rule, in accordance with Title 63G, Chapter 3, Utah Administrative

1886     Rulemaking Act.
1887          (2) (a) Beginning with the licensing period that begins after January 1, 2014, as a
1888     condition precedent for license renewal, each controlled substance prescriber shall complete at
1889     least 3.5 continuing education hours per licensing period that satisfy the requirements of
1890     Subsection (3).
1891          (b) (i) Beginning with the licensing period that begins after January 1, 2024, as a
1892     condition precedent for license renewal, each controlled substance prescriber shall complete at
1893     least 3.5 continuing education hours in an SBIRT-training class that satisfies the requirements
1894     of Subsection (4).
1895          (ii) Completion of the SBIRT-training class, in compliance with Subsection (2)(b)(i),
1896     fulfills the continuing education hours requirement in Subsection (3) for the licensing period in
1897     which the class was completed.
1898          (iii) A controlled substance prescriber:
1899          (A) need only take the SBIRT-training class once during the controlled substance
1900     prescriber's licensure in the state; and
1901          (B) shall provide a completion record of the SBIRT-training class in order to be
1902     reimbursed for SBIRT services to patients, in accordance with [Section] Sections 26-18-22 and
1903     [Section] 49-20-416.
1904          (3) A controlled substance prescriber shall complete at least 3.5 hours of continuing
1905     education in one or more controlled substance prescribing classes, except dentists who shall
1906     complete at least two hours, that satisfy the requirements of Subsections (4) and (6).
1907          (4) A controlled substance prescribing class shall:
1908          (a) satisfy the division's requirements for the continuing education required for the
1909     renewal of the controlled substance prescriber's respective license type;
1910          (b) be delivered by an accredited or approved continuing education provider
1911     recognized by the division as offering continuing education appropriate for the controlled
1912     substance prescriber's respective license type; and
1913          (c) include a postcourse knowledge assessment.
1914          (5) An M.D. or D.O. completing continuing professional education hours under
1915     Subsection (4) shall complete those hours in classes that qualify for the American Medical
1916     Association Physician's Recognition Award Category 1 Credit.

1917          (6) The 3.5 hours of the controlled substance prescribing classes under Subsection (4)
1918     shall include educational content covering the following:
1919          (a) the scope of the controlled substance abuse problem in Utah and the nation;
1920          (b) all elements of the FDA Blueprint for Prescriber Education under the FDA's
1921     Extended-Release and Long-Acting Opioid Analgesics Risk Evaluation and Mitigation
1922     Strategy, as published July 9, 2012, or as it may be subsequently revised;
1923          (c) the national and Utah-specific resources available to prescribers to assist in
1924     appropriate controlled substance and opioid prescribing;
1925          (d) patient record documentation for controlled substance and opioid prescribing; [and]
1926          (e) office policies, procedures, and implementation[.]; and
1927          (f) some training regarding medical cannabis, as that term is defined in Section
1928     26-61a-102.
1929          (7) (a) The division, in consultation with the Utah Medical Association Foundation,
1930     shall determine whether a particular controlled substance prescribing class satisfies the
1931     educational content requirements of Subsections (4) and (6) for an M.D. or D.O.
1932          (b) The division, in consultation with the applicable professional licensing boards,
1933     shall determine whether a particular controlled substance prescribing class satisfies the
1934     educational content requirements of Subsections (4) and (6) for a controlled substance
1935     prescriber other than an M.D. or D.O.
1936          (c) The division may by rule establish a committee that may audit compliance with the
1937     Utah Risk Evaluation and Mitigation Strategy (REMS) Educational Programming Project
1938     grant, that satisfies the educational content requirements of Subsections (4) and (6) for a
1939     controlled substance prescriber.
1940          (d) The division shall consult with the Department of Health regarding the medical
1941     cannabis training described in Subsection (6)(f).
1942          (8) A controlled substance prescribing class required under this section:
1943          (a) may be held:
1944          (i) in conjunction with other continuing professional education programs; and
1945          (ii) online; and
1946          (b) does not increase the total number of state-required continuing professional
1947     education hours required for prescriber licensing.

1948          (9) The division may establish rules, in accordance with Title 63G, Chapter 3, Utah
1949     Administrative Rulemaking Act, to implement this section.
1950          (10) A controlled substance prescriber who, on or after July 1, 2017, obtains a waiver
1951     to treat opioid dependency with narcotic medications, in accordance with the Drug Addiction
1952     Treatment Act of 2000, 21 U.S.C. Sec. 823 et seq., may use the waiver to satisfy the 3.5 hours
1953     of the continuing education requirement under Subsection (3) for two consecutive licensing
1954     periods.
1955          Section 19. Section 58-67-502 is amended to read:
1956          58-67-502. Unprofessional conduct.
1957          (1) "Unprofessional conduct" includes, in addition to the definition in Section
1958     58-1-501:
1959          (a) using or employing the services of any individual to assist a licensee in any manner
1960     not in accordance with the generally recognized practices, standards, or ethics of the
1961     profession, state law, or division rule;
1962          (b) making a material misrepresentation regarding the qualifications for licensure under
1963     Section 58-67-302.7 or Section 58-67-302.8;
1964          (c) violating the dispensing requirements of Chapter 17b, Part 8, Dispensing Medical
1965     Practitioner and Dispensing Medical Practitioner Clinic Pharmacy, if applicable;
1966          (d) violating the requirements of Title 26, Chapter 61a, Utah Medical Cannabis Act; or
1967          (e) falsely making an entry in, or altering, a medical record with the intent to conceal:
1968          (i) a wrongful or negligent act or omission of an individual licensed under this chapter
1969     or an individual under the direction or control of an individual licensed under this chapter; or
1970          (ii) conduct described in Subsections (1)(a) through (d) or Subsection 58-1-501(1).
1971          (2) "Unprofessional conduct" does not include:
1972          (a) in compliance with Section 58-85-103:
1973          (i) obtaining an investigational drug or investigational device;
1974          (ii) administering the investigational drug to an eligible patient; or
1975          (iii) treating an eligible patient with the investigational drug or investigational device;
1976     or
1977          (b) in accordance with Title 26, Chapter 61a, Utah Medical Cannabis Act:
1978          (i) when registered as a qualified medical provider or acting as a limited medical

1979     provider, as [that term is] those terms are defined in Section 26-61a-102, recommending the
1980     use of medical cannabis;
1981          (ii) when registered as a pharmacy medical provider, as that term is defined in Section
1982     26-61a-102, providing pharmacy medical provider services in a medical cannabis pharmacy; or
1983          (iii) when registered as a state central patient portal medical provider, as that term is
1984     defined in Section 26-61a-102, providing state central patient portal medical provider services.
1985          (3) Notwithstanding Subsection (2)(b), the division, in consultation with the board and
1986     in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, shall define
1987     unprofessional conduct for a physician described in Subsection (2)(b).
1988          Section 20. Section 58-68-502 is amended to read:
1989          58-68-502. Unprofessional conduct.
1990          (1) "Unprofessional conduct" includes, in addition to the definition in Section
1991     58-1-501:
1992          (a) using or employing the services of any individual to assist a licensee in any manner
1993     not in accordance with the generally recognized practices, standards, or ethics of the
1994     profession, state law, or division rule;
1995          (b) violating the dispensing requirements of Chapter 17b, Part 8, Dispensing Medical
1996     Practitioner and Dispensing Medical Practitioner Clinic Pharmacy, if applicable;
1997          (c) making a material misrepresentation regarding the qualifications for licensure under
1998     Section 58-68-302.5;
1999          (d) violating the requirements of Title 26, Chapter 61a, Utah Medical Cannabis Act; or
2000          (e) falsely making an entry in, or altering, a medical record with the intent to conceal:
2001          (i) a wrongful or negligent act or omission of an individual licensed under this chapter
2002     or an individual under the direction or control of an individual licensed under this chapter; or
2003          (ii) conduct described in Subsections (1)(a) through (d) or Subsection 58-1-501(1).
2004          (2) "Unprofessional conduct" does not include:
2005          (a) in compliance with Section 58-85-103:
2006          (i) obtaining an investigational drug or investigational device;
2007          (ii) administering the investigational drug to an eligible patient; or
2008          (iii) treating an eligible patient with the investigational drug or investigational device;
2009     or

2010          (b) in accordance with Title 26, Chapter 61a, Utah Medical Cannabis Act:
2011          (i) when registered as a qualified medical provider or acting as a limited medical
2012     provider, as [that term is] those terms are defined in Section 26-61a-102, recommending the
2013     use of medical cannabis;
2014          (ii) when registered as a pharmacy medical provider, as that term is defined in Section
2015     26-61a-102, providing pharmacy medical provider services in a medical cannabis pharmacy; or
2016          (iii) when registered as a state central patient portal medical provider, as that term is
2017     defined in Section 26-61a-102, providing state central patient portal medical provider services.
2018          (3) Notwithstanding Subsection (2)(b), the division, in consultation with the board and
2019     in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, shall define
2020     unprofessional conduct for a physician described in Subsection (2)(b).
2021          Section 21. Section 58-70a-503 is amended to read:
2022          58-70a-503. Unprofessional conduct.
2023          (1) "Unprofessional conduct" includes:
2024          (a) violation of a patient confidence to any person who does not have a legal right and a
2025     professional need to know the information concerning the patient;
2026          (b) knowingly prescribing, selling, giving away, or directly or indirectly administering,
2027     or offering to prescribe, sell, furnish, give away, or administer any prescription drug except for
2028     a legitimate medical purpose upon a proper diagnosis indicating use of that drug in the amounts
2029     prescribed or provided;
2030          (c) prescribing prescription drugs for oneself or administering prescription drugs to
2031     oneself, except those that have been legally prescribed for the physician assistant by a licensed
2032     practitioner and that are used in accordance with the prescription order for the condition
2033     diagnosed;
2034          (d) failure to maintain at the practice site a delegation of services agreement that
2035     accurately reflects current practices;
2036          (e) failure to make the delegation of services agreement available to the division for
2037     review upon request;
2038          (f) in a practice that has physician assistant ownership interests, failure to allow the
2039     supervising physician the independent final decision making authority on patient treatment
2040     decisions, as set forth in the delegation of services agreement or as defined by rule;

2041          (g) violating the dispensing requirements of Chapter 17b, Part 8, Dispensing Medical
2042     Practitioner and Dispensing Medical Practitioner Clinic Pharmacy, if applicable; or
2043          (h) falsely making an entry in, or altering, a medical record with the intent to conceal:
2044          (i) a wrongful or negligent act or omission of an individual licensed under this chapter
2045     or an individual under the direction or control of an individual licensed under this chapter; or
2046          (ii) conduct described in Subsections (1)(a) through (g) or Subsection 58-1-501(1).
2047          (2) "Unprofessional conduct" does not include, in accordance with Title 26, Chapter
2048     61a, Utah Medical Cannabis Act, when registered as a qualified medical provider or acting as a
2049     limited medical provider, as [that term is] those terms are defined in Section 26-61a-102,
2050     recommending the use of medical cannabis.
2051          (3) Notwithstanding Subsection (2), the division, in consultation with the board and in
2052     accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, shall define
2053     unprofessional conduct for a physician assistant described in Subsection (2).
2054          Section 22. Section 62A-4a-404 is amended to read:
2055          62A-4a-404. Fetal alcohol syndrome or spectrum disorder and drug dependency
2056     -- Reporting requirements.
2057          (1) As used in this section:
2058          (a) "Health care provider" means:
2059          (i) an individual licensed under:
2060          (A) Title 58, Chapter 31b, Nurse Practice Act;
2061          (B) Title 58, Chapter 44a, Nurse Midwife Practice Act;
2062          (C) Title 58, Chapter 67, Utah Medical Practice Act;
2063          (D) Title 58, Chapter 68, Utah Osteopathic Medical Practice Act;
2064          (E) Title 58, Chapter 70a, Utah Physician Assistant Act; or
2065          (F) Title 58, Chapter 77, Direct-Entry Midwife Act; or
2066          (ii) an unlicensed individual who practices midwifery.
2067          (b) "Newborn child" means a child who is 30 days of age or younger.
2068          (c) "[Qualified] Recommending medical provider" means the same as that term is
2069     defined in Section 26-61a-102.
2070          (d) (i) "Substance abuse" means the misuse or excessive use of alcohol or other drugs
2071     or substances.

2072          (ii) "Substance abuse" does not include use of drugs or other substances that are:
2073          (A) obtained by lawful prescription and used as prescribed; or
2074          (B) obtained in accordance with Title 26, Chapter 61a, Utah Medical Cannabis Act,
2075     and used as recommended by a [qualified] recommending medical provider.
2076          (2) A health care provider who attends the birth of a newborn child or cares for a
2077     newborn child and determines any of the following, shall report the determination to the
2078     division as soon as possible:
2079          (a) the newborn child:
2080          (i) is adversely affected by the child's mother's substance abuse during pregnancy;
2081          (ii) has fetal alcohol syndrome or fetal alcohol spectrum disorder; or
2082          (iii) demonstrates drug or alcohol withdrawal symptoms; or
2083          (b) the parent of the newborn child or a person responsible for the child's care
2084     demonstrates functional impairment or an inability to care for the child as a result of the
2085     parent's or person's substance abuse.
2086          Section 23. Section 78A-2-231 is amended to read:
2087          78A-2-231. Consideration of lawful use or possession of medical cannabis.
2088          (1) As used in this section:
2089          (a) "Cannabis product" means the same as that term is defined in Section 26-61a-102.
2090          (b) "Directions of use" means the same as that term is defined in Section 26-61a-102.
2091          (c) "Dosing guidelines" means the same as that term is defined in Section 26-61a-102.
2092          (d) "Medical cannabis" means the same as that term is defined in Section 26-61a-102.
2093          (e) "Medical cannabis card" means the same as that term is defined in Section
2094     26-61a-102.
2095          (f) "Medical cannabis device" means the same as that term is defined in Section
2096     26-61a-102.
2097          (g) "[Qualified] Recommending medical provider" means the same as that term is
2098     defined in Section 26-61a-102.
2099          (2) In any judicial proceeding in which a judge, panel, jury, or court commissioner
2100     makes a finding, determination, or otherwise considers an individual's possession or use of
2101     medical cannabis, a cannabis product, or a medical cannabis device, the judge, panel, jury, or
2102     court commissioner may not consider or treat the individual's possession or use any differently

2103     than the lawful possession or use of any prescribed controlled substance if:
2104          (a) the individual's possession complies with Title 4, Chapter 41a, Cannabis Production
2105     Establishments;
2106          (b) the individual's possession or use complies with Subsection 58-37-3.7(2) or (3); or
2107          (c) (i) the individual's possession or use complies with Title 26, Chapter 61a, Utah
2108     Medical Cannabis Act; and
2109          (ii) the individual reasonably complies with the directions of use and dosing guidelines
2110     determined by the individual's [qualified] recommending medical provider or through a
2111     consultation described in Subsection 26-61a-502(4) or (5).
2112          (3) Notwithstanding Sections 77-18-1 and 77-2a-3, for probation, release, a plea in
2113     abeyance agreement, a diversion agreement, or a tendered admission under Utah Rules of
2114     Juvenile Procedure, Rule 25, a term or condition may not require that an individual abstain
2115     from the use or possession of medical cannabis, a cannabis product, or a medical cannabis
2116     device, either directly or through a general prohibition on violating federal law, without an
2117     exception related to medical cannabis use, if the individual's use or possession complies with:
2118          (a) Title 26, Chapter 61a, Utah Medical Cannabis Act; or
2119          (b) Subsection 58-37-3.7(2) or (3).
2120          Section 24. Section 78A-6-115 is amended to read:
2121          78A-6-115. Hearings -- Record -- County attorney or district attorney
2122     responsibilities -- Attorney general responsibilities -- Disclosure -- Admissibility of
2123     evidence -- Cannabis.
2124          (1) (a) A verbatim record of the proceedings shall be taken in all cases that might result
2125     in deprivation of custody as defined in this chapter. In all other cases a verbatim record shall
2126     also be made unless dispensed with by the court.
2127          (b) (i) For purposes of this Subsection (1)(b):
2128          (A) "Record of a proceeding" does not include documentary materials of any type
2129     submitted to the court as part of the proceeding, including items submitted under Subsection
2130     (4)(a).
2131          (B) "Subjects of the record" includes the child's guardian ad litem, the child's legal
2132     guardian, the Division of Child and Family Services, and any other party to the proceeding.
2133          (ii) Notwithstanding any other provision, including Title 63G, Chapter 2, Government

2134     Records Access and Management Act, the court shall release a record of a proceeding made
2135     under Subsection (1)(a) to any person upon a finding on the record for good cause.
2136          (iii) Following a petition for a record of a proceeding made under Subsection (1)(a),
2137     the court shall:
2138          (A) provide notice to all subjects of the record that a request for release of the record
2139     has been made; and
2140          (B) allow sufficient time for the subjects of the record to respond before making a
2141     finding on the petition.
2142          (iv) A record of a proceeding may not be released under this Subsection (1)(b) if the
2143     court's jurisdiction over the subjects of the proceeding ended more than 12 months before the
2144     day on which the request is made.
2145          (2) (a) Except as provided in Subsection (2)(b), the county attorney or, if within a
2146     prosecution district, the district attorney shall represent the state in any proceeding in a minor's
2147     case.
2148          (b) Subject to the attorney general's prosecutorial discretion in civil enforcement
2149     actions, the attorney general shall enforce all provisions of Title 62A, Chapter 4a, Child and
2150     Family Services, and this chapter, relating to:
2151          (i) protection or custody of an abused, neglected, or dependent child; and
2152          (ii) petitions for termination of parental rights.
2153          (3) The board may adopt special rules of procedure to govern proceedings involving
2154     violations of traffic laws or ordinances, wildlife laws, and boating laws. However, proceedings
2155     involving offenses under Section 78A-6-606 are governed by that section regarding suspension
2156     of driving privileges.
2157          (4) (a) For the purposes of determining proper disposition of the minor in dispositional
2158     hearings and establishing the fact of abuse, neglect, or dependency in adjudication hearings and
2159     in hearings upon petitions for termination of parental rights, written reports and other material
2160     relating to the minor's mental, physical, and social history and condition may be received in
2161     evidence and may be considered by the court along with other evidence. The court may require
2162     that the individual who wrote the report or prepared the material appear as a witness if the
2163     individual is reasonably available.
2164          (b) For the purpose of determining proper disposition of a minor alleged to be or

2165     adjudicated as abused, neglected, or dependent, dispositional reports prepared by the division
2166     under Section 78A-6-315 may be received in evidence and may be considered by the court
2167     along with other evidence. The court may require any individual who participated in preparing
2168     the dispositional report to appear as a witness, if the individual is reasonably available.
2169          (5) (a) Except as provided in Subsections (5)(c) through (e), in an abuse, neglect, or
2170     dependency proceeding occurring after the commencement of a shelter hearing under Section
2171     78A-6-306 or the filing of a petition under Section 78A-6-304, each party to the proceeding
2172     shall provide in writing to the other parties or their counsel any information which the party:
2173          (i) plans to report to the court at the proceeding; or
2174          (ii) could reasonably expect would be requested of the party by the court at the
2175     proceeding.
2176          (b) The disclosure required under Subsection (5)(a) shall be made:
2177          (i) for dispositional hearings under Sections 78A-6-311 and 78A-6-312, no less than
2178     five days before the day on which the proceeding is held;
2179          (ii) for proceedings under Chapter 6, Part 5, Termination of Parental Rights Act, in
2180     accordance with Utah Rules of Civil Procedure; and
2181          (iii) for all other proceedings, no less than five days before the day on which the
2182     proceeding is held.
2183          (c) The division is not required to provide a court report or a child and family plan to
2184     each party to the proceeding if:
2185          (i) the information is electronically filed with the court; and
2186          (ii) each party to the proceeding has access to the electronically filed information.
2187          (d) If a party to a proceeding obtains information after the deadline in Subsection
2188     (5)(b), the information is exempt from the disclosure required under Subsection (5)(a) if the
2189     party certifies to the court that the information was obtained after the deadline.
2190          (e) Subsection (5)(a) does not apply to:
2191          (i) pretrial hearings; and
2192          (ii) the frequent, periodic review hearings held in a dependency drug court case to
2193     assess and promote the parent's progress in substance use disorder treatment.
2194          (6) For the purpose of establishing the fact of abuse, neglect, or dependency, the court
2195     may, in the court's discretion, consider evidence of statements made by a child under eight

2196     years of age to an individual in a trust relationship.
2197          (7) (a) As used in this Subsection (7):
2198          (i) "Cannabis" means the same as that term is defined in Section 26-61a-102.
2199          (ii) "Cannabis product" means the same as that term is defined in Section 26-61a-102.
2200          (iii) (A) "Chronic" means repeated or patterned.
2201          (B) "Chronic" does not mean an isolated incident.
2202          (iv) "Directions of use" means the same as that term is defined in Section 26-61a-102.
2203          (v) "Dosing guidelines" means the same as that term is defined in Section 26-61a-102.
2204          (vi) "Medical cannabis" means the same as that term is defined in Section 26-61a-102.
2205          (vii) "Medical cannabis cardholder" means the same as that term is defined in Section
2206     26-61a-102.
2207          (viii) "[Qualified] Recommending medical provider" means the same as that term is
2208     defined in Section 26-61a-102.
2209          (b) In any child welfare proceeding in which the court makes a finding, determination,
2210     or otherwise considers an individual's possession or use of medical cannabis, a cannabis
2211     product, or a medical cannabis device, the court may not consider or treat the individual's
2212     possession or use any differently than the lawful possession or use of any prescribed controlled
2213     substance if:
2214          (i) the individual's possession or use complies with Title 4, Chapter 41a, Cannabis
2215     Production Establishments;
2216          (ii) the individual's possession or use complies with Subsection 58-37-3.7(2) or (3); or
2217          (iii) (A) the individual's possession or use complies with Title 26, Chapter 61a, Utah
2218     Medical Cannabis Act; and
2219          (B) the individual reasonably complies with the directions of use and dosing guidelines
2220     determined by the individual's [qualified] recommending medical provider or through a
2221     consultation described in Subsection 26-61a-502(4) or (5).
2222          (c) In a child welfare proceeding, a parent's or guardian's use of cannabis or a cannabis
2223     product is not abuse or neglect of a child under Section 78A-6-105 unless there is evidence
2224     showing that:
2225          (i) the child is harmed because of the child's inhalation or ingestion of cannabis, or
2226     because of cannabis being introduced to the child's body in another manner; or

2227          (ii) the child is at an unreasonable risk of harm because of chronic inhalation or
2228     ingestion of cannabis or chronic introduction of cannabis to the child's body in another manner.
2229          (d) Unless there is harm or an unreasonable risk of harm to the child as described in
2230     Subsection (7)(c), in a child welfare proceeding a parent's or guardian's use of medical cannabis
2231     or a cannabis product is not contrary to the best interests of a child if:
2232          (i) for a medical cannabis cardholder after January 1, 2021, the parent's or guardian's
2233     possession or use complies with Title 26, Chapter 61a, Utah Medical Cannabis Act, and there
2234     is no evidence that the parent's or guardian's use of medical cannabis unreasonably deviates
2235     from the directions of use and dosing guidelines determined by the parent's or guardian's
2236     [qualified] recommending medical provider or through a consultation described in Subsection
2237     26-61a-502(4) or (5); or
2238          (ii) before January 1, 2021, the parent's or guardian's possession or use complies with
2239     Subsection 58-37-3.7(2) or (3).
2240          (e) Subsection (7)(c) does not prohibit a finding of abuse or neglect of a child under
2241     Section 78A-6-105, and Subsection (7)(d) does not prohibit a finding that a parent's or
2242     guardian's use of medical cannabis or a cannabis product is contrary to the best interests of a
2243     child, if there is evidence showing a nexus between the parent's or guardian's use of cannabis or
2244     a cannabis product and behavior that would separately constitute abuse or neglect of the child.
2245          Section 25. Effective date.
2246          If approved by two-thirds of all the members elected to each house, this bill takes effect
2247     upon approval by the governor, or the day following the constitutional time limit of Utah
2248     Constitution, Article VII, Section 8, without the governor's signature, or in the case of a veto,
2249     the date of veto override.
2250          Section 26. Revisor instructions.
2251          The Legislature intends that the Office of Legislative Research and General Counsel, in
2252     preparing the Utah Code database for publication, replace the language "the effective date of
2253     this bill" in Subsections 26-61a-201(8)(b)(ii) and 58-37-3.7(2) to the bill's actual effective date.