Bill Summaries: S711 NC COMPASSIONATE CARE ACT.

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  • Summary date: Aug 26 2021 - More information

    Senate committee substitute to the 4th edition makes the following changes.

    Revises new Article 5H, the NC Compassionate Care Act, as follows. Adds to the Article's legislative purposes stated to include (1) prioritizing the protection of public health and safety in the creation of a system for the cultivation, processing, and selling of medical cannabis and (2) ensuring that the regulatory system created by the Article be nimble and able to respond quickly to changes in the rapidly evolving cannabis industry. 

    Makes the following revisions to the Article's defined terms. Adds to the defined term physician to include a new requirement that the licensed physician have a valid DEA registration as well as an explicit requirement for the physician to have completed continuing medical education courses as required by new GS 90-113.114, as enacted. Adds to the indications that must be included in a physician's signed written certification: (1) the physician's DEA number; (2) the physician's national provider identification number, if applicable; and (3) any other information required by the Medical Cannabis Production Commission (Commission). 

    Revises the membership of the Compassionate Use Advisory Board (Advisory Board), now consisting of 11 rather than 13 members. Now includes 7 gubernatorially appointed members, including a licensed medical doctor or doctor of osteopathy, a licensed medical doctor or doctor of osteopathy specializing in primary care, and a medical doctor or doctor of osteopathy board-certified to practice addiction medicine (replacing previous member criteria requiring a physician specializing in pain management, a general physician, a physician specializing in osteopathic medicine, and a physician who is board-certified to practice addiction medicine). No longer includes a gubernatorially appointed member representing a licensed supplier. Adds a new provision specifying that the Department of Health and Human Services (DHHS) is responsible for all administrative support and other services required by the Advisory Board. Makes technical changes. 

    Revises the continuing education requirements for physicians and adds to physician restrictions as follows. Now requires a physician to complete a 10-hour continuing education course on prescribing medical cannabis before providing a written certification, and completing a three-hour supplemental continuing medical education course thereafter in any year in which the physician issues a written certification (replacing the previous requirement for a three-hour continuing medical education course on cannabis and an annual one-hour supplemental medical education course thereafter). Now describes required topics of the initial 10-hour continuing education course. Requires a physician to issue a written certification only for a patient with whom the physician has a bona fide physician-patient relationship. Adds a new requirement for a physician to have a physical office in the state in which to conduct in-person examinations. Now requires physicians to assess each patient for the initial and ongoing risk of mental health and substance abuse disorders and for the development of mental health and substance use disorders. Requires physicians to issue a written certification in the electronic cannabis registry database (rather than registering a written certification in the database electronically). Adds to the required patient education upon initial written certification and annually thereafter, education on the risk of impairment while operating a motor vehicle under the influence of cannabis or cannabis-infused products. Replaces the provisions regarding required reevaluations with the following. Now requires a physician to reevaluate a patient for whom the physician has issued a written certification as frequently as necessary to determine the efficacy of the use of cannabis as a treatment for the patient's particular medical condition, the appropriateness of the delivery method and dosage included in the written certification, and any adverse side effects, with reevaluation at least quarterly in the first year and at least annually thereafter. Requires the physician to check the patient's prescription history in the Controlled Substances Reporting System when renewing a written certification (similar to previous requirements). Authorizes the Commission to set a shorter interval for mandatory patient re-evaluations and set requirements for in-person physical examination during re-evaluations. Now requires physicians to update the medical cannabis registry database within three days (was, seven days) after any change is made to the original written certification. Adds a new directive for DHHS to monitor physician written certifications in the medical cannabis registry database for practices that could facilitate diversion or misuse of cannabis or other harm and refer cases to the NC Medical Board and the State Bureau of Investigation as appropriate. Authorizes DHHS to conduct outreach and education to physicians who represent statistical outliers in any manner of their issuing of written certifications. Deletes the prohibition against physicians who provide written certifications to qualified patients from being employed by or have any direct or indirect economic interest in a supplier or cannabis testing laboratory. Now bars a physician from advertising on the site of a medical cannabis center. Adds new authority for the Commission to adopt rules regarding physicians to ensure the protection of individuals with a debilitating medical condition, the prevention of diversion, and the integrity of the medical cannabis system. 

    Regarding registry identification cards, adds new language limiting an individual to serving as a designated caregiver for up to two qualified patients. Authorizes the Commission to create exceptions by rule for the limit on the number of designated caregivers a qualified patient may have and exceptions to the limit on the number of qualified patients a designated caregiver can serve. Also authorizes the Commission to establish rules to allow a facility to serve as a designated caregiver. 

    Regarding the medical cannabis registry database, deletes the provisions requiring DHHS to monitor the database and inform the Attorney General's Office of any findings of patterns of written certifications that are unusual and requiring the AG's office to determine if they should be reported to the State Bureau of Investigation and the appropriate sheriff for investigation of possible state or federal violations. Makes a technical correction to an internal cross-reference.

    Now requires at least one (was, two) of the four medical cannabis centers a supplier can own and operate under the Article to be located in Tier 1 counties. Adds new restrictions to prohibit Commission members from owning, operating, having a direct or indirect financial interest in, or being employed by a licensed supplier or a licensed lab, or their subcontractors. Bars Commission members from being a qualified patient, a designated caregiver, or a physician who issues written certifications. 

    Adds the following relating to the medical cannabis supply system the Commission must establish. Requires the Commission to adopt rules to regulate the supply system, to include without limitation 14 enumerated components including physical plant requirements, odor control and mitigation, security, sanitation and workplace safety conditions, reportable events, procedures for mandatory and voluntary recall of unsafe cannabis or cannabis-infused products, and transportation of cannabis and cannabis-infused products. Directs the Commission to establish, maintain, and control a computer software tracking system that traces cannabis from seed to sale and allows real time, 24-hour access by DHHS and the Commission to data from all production facilities, medical cannabis centers, and testing labs. Details further requirements of the tracking system. Explicitly requires medical cannabis suppliers to use the tracking system or integrate its own system with the system established by the Commission. Authorizes the Commission to contract to establish the tracking system, so long as the vendor does not have a direct or indirect financial interest in a medical cannabis supplier or testing lab. Makes organizational changes. 

    Replaces the requirements of a supplier license application regarding required documentation demonstrating that the applicant possesses certain skills and experience, now requiring documentation demonstrating (1) requisite expertise in controlled environment agriculture and the ability to engage in growing or processing of cannabis, as well as product development, quality control, and inventory management of cannabis meeting standards that the Commission specifies by rule; (2) technical and technological ability to cultivate, produce, and distribute medical cannabis in a manner that meets Commission standards for production consistency and safe handling; and (3) ability to secure cannabis production, testing, resources, transportation, and personnel to operate as a safe and secure supplier in compliance with all state regulations in which the applicant has prior experience. Adds to the required components of the supplier license application, evidence of compliance with applicable laws and regulations of another state in which the applicant or proposed owners, officers, board members, or managers have engaged in medical or adult use of cannabis operations outside of the state. Now requires a supplier to begin selling cannabis and cannabis-infused products in medical cannabis centers within 270 days (was, within 180 days) of initiating cultivation. Makes technical corrections to internal cross-references in the provisions governing supplier restrictions. 

    Now requires licensed suppliers to submit monthly rather than quarterly reports to DHHS on all financial transactions. Adds the following authorities. Authorizes DHHS to impose a fine of up to $10,000 on a supplier for any of ten enumerated violations, including endangering the health, safety, or security of a qualified patient; improperly disclosing confidential information of a qualified patient; and willfully impeding or obstructing an employee or agent of DHHS in the furtherance of their official duties. Clarifies that this fine is in addition to any other penalties imposed under the Article. Adds that multiple incidents resulting in more than one violation of the same provision can result in a fine for each violation up to the maximum. Specifies that each day a violation continues constitutes a distinct violation. Authorizes the Commission to establish criteria for fine amounts. Permits suppliers to appeal fines to the Commission. Requires the Commission to adopt rules governing the appeal of DHHS fines. Authorizes the Commission to require an audit of the financial transactions of a supplier to be conducted by an independent certified accountant, in its discretion. Specifies that DHHS reserves the right to select the accountant to be used. Makes costs associated with the audit the responsibility of the supplier. 

    Modifies and adds to the restrictions set forth for medical cannabis centers. Previously, required an individual to be 18 years of age or older to enter a medical cannabis center unless the individual is a registry identification cardholder. Now provides that entry is strictly limited to qualified patients, designated caregivers, and persons whose job duties require their presence at the center, including employees and contractors of the center and state employees with an inspection or regulatory role. Authorizes the Commission to set other limitations necessary to protect the public. Adds a new requirement for medical cannabis center employees to be 21 or older. Adds a new prohibition against consuming cannabis or cannabis-infused products on the site of the medical cannabis center. Prohibits cannabis, cannabis-infused products, and paraphernalia from being visible to the public from the outside of the medical cannabis center. Authorizes the Commission to establish rules to allow the delivery of cannabis, cannabis-infused products, and paraphernalia used to administer cannabis products by medical cannabis centers to the home of a qualified patient or designated caregiver in a manner that ensures public safety, the safety of persons delivering the products, and the prevention of diversion. 

    Changes the required content of the rules DHHS is directed to adopt regarding the testing of cannabis and cannabis-infused products. Now requires the adoption of standards for testing cannabis and cannabis-infused products to specifically include active ingredient analyses; potency analyses; homogeneity requirements; and specifying of prohibited concentrations of heavy metals, pesticides, residual solvents, microbiological contaminants, mycotoxins, and other contaminants that are injurious to human health (was, including specifying prohibited concentrations of heavy metals, pesticides, microbes, and other contaminants that are injurious to human health only). Adds that the standards and requirements necessary for an independent testing lab to be licensed must also include such for the renewal, suspension, and revocation of the license. Now requires inclusion of the amount of the licensing fee payable to DHHS by an independent testing lab (was, a fee schedule for independent testing labs). 

    Expands the advertising restrictions by adding the following. Enumerates eight prohibited activities of medical cannabis suppliers and medical cannabis centers, including (1) distributing handbills in public areas; (2) advertising on television, radio, print, digital, or electronic media; (3) publicly sponsoring sporting events, concerts, or other community or cultural events; and (4) selling or giving away promotional products such as t-shirts or any other items containing the name of the medical cannabis center. Adds authority for the Commission to take against against a licensee or designated retailer who engages in non-conforming signage or advertising, including specifying a period of time by which the licensee or designated retailer must cease or remove the non-compliant signage or advertising or risk a fine, suspension, or both. Makes organizational changes.

    Adds to the label requirements for cannabis and cannabis-infused products sold that medical cannabis centers must adhere to, adding to the required information the batch number and the harvest number from which cannabis originates, the name of the qualified patient, the name of the physician who issued the written certification, and the recommended dose according to the written certification. 

    Regarding the NC Cannabis Research Program required to be created by UNC, adds authority for the UNC System to possess, transport, store, test, and dispose of cannabis as necessary to conduct scientific research, subject to requirements of the Commission.

    Changes the nine required components of the annual reports required of DHHS regarding the effectiveness of the medical cannabis program operated under the Article. Now includes (1) the number of written certifications provided by physicians and the percentage distribution by areas of physician specialty; (2) the nature and percentage distribution of delivery methods of cannabis and cannabis-infused products used and the average daily doses dispensed per delivery method; and (3) the number of physicians providing written certifications for qualifying patients and the percentage distribution of their areas of specialty (previously, did not include the percentage distribution of their areas of specialty). No longer includes a requirement for the report to include the efficacy of or satisfaction with cannabis and cannabis-infused products on a yes-no questionnaire as submitted by qualifying patients in a voluntary, anonymous survey, which may be conducted online or through medical cannabis centers. Instead of requiring the annual reports to begin in 2022, now requires reports beginning in the first year in which cannabis or cannabis-infused products are sold in medical cannabis centers. Authorizes DHHS to develop a methodologically valid survey to be taken by qualified patients to determine the effects of the use of medical cannabis. Allows the Commission to require completion of the survey by each patient dispensed medical cannabis in order to assure the methodological validity of survey results and avoid selection bias. Requires patient survey results to be reported with no individually identifying information. 

    Modifies the directives regarding the initial appointments made to the Advisory Board under new GS 90-113.113 to reflect the revised membership of the Advisory Board. 

    Eliminates the uncodified provision requiring the NC Medical Board to approve a continuing education medical course and supplemental medical education course on cannabis and cannabis-infused products within 30 days of the date the act becomes law. 


  • Summary date: Aug 25 2021 - More information

    Senate committee substitute to the 3rd edition makes the following changes.

    Revises new Article 5H, the NC Compassionate Care Act, as follows. Makes organizational changes by renumbering the statutes in the Article; making conforming changes to internal cross-references. Makes the following revisions to the Article's defined terms. Changes the inclusive list of cannabis-infused products provided to now include a tablet, capsule, concentrated liquid or viscous oil, liquid suspension, topical preparation, transdermal preparation, sublingual preparation, gelatinous cube, gelatinous rectangular cuboid, lozenge in a cube or rectangular cuboid shape, resin or wax (was, edible cannabis product, topical product, ointment, oil, patch, spray, suppository, or tincture). Adds to the enumerated diagnoses included as a debilitating medical condition: (1) a terminal illness when the patient's remaining life expectancy is less than six months; and (2) a condition resulting in the individual receiving hospice care; no longer includes other debilitating conditions of the same kind or class as or comparable to those enumerated. Eliminates the requirement in the defined term for a physician to have completed a three hour continuing education course on cannabis and an annual one hour supplemental medical education course thereafter (see new GS 90-113.114 instead). Adds and defines smoking as the use or possession of a lighted cannabis product. Adds and defines vaping as the use of a product which heats a liquid or other form of cannabis in a manner so as to release an aerosol. Now requires a written certification to include the patient's debilitating medical condition, the amount and dosage of the cannabis or cannabis-infused product within an adequate supply, and the period of time for which the written certification is valid (not to exceed one year), in addition to the previously stated requirements, which include declaring that the patient has a debilitating medical condition whereby the potential benefits of the medical use of cannabis would likely outweigh the health risk for the patient, and stating the delivery method of the cannabis. 

    Renames the Medical Cannabis Advisory Board as the Compassionate Use Advisory Board. Makes conforming changes throughout the Article to reflect the change. Clarifies that the gubernatorially appointed member who is a representative of a supplier must be licensed. Adds a new subsection to provide for filling member vacancies. 

    Adds a new statute to the Article as follows. Requires physicians to complete a three-hour continuing medical education course on cannabis and an annual one-hour supplemental medical education course thereafter, as approved by the NC Medical Board. Requires maintaining records of compliance for six consecutive years with permitted inspection by the Department of Health and Human Services (DHHS) or the NC Medical Board or its agents. Adds a new requirement for physicians to register written certifications in the medical cannabis registry database electronically. Requires physicians to reevaluate an existing qualified patient as needed to determine the efficacy of the use of cannabis as a treatment for the patient's medical condition, at least once a year, to include an in-person physical examination and checking of the patient's prescription history. Requires physicians to update the medical cannabis registry database within seven days after any change is made to the original written certification. Requires physicians to provide education to a qualified patient on the risk and symptoms of cannabis use disorder and cannabis-induced psychosis upon initial written certification and at least annually thereafter. Prohibits physicians who provide written certifications to qualified patients from being employed by or have any direct or indirect economic interest in a supplier or cannabis testing laboratory. Prohibits physicians from evaluating patients or advertising on the site of a medical cannabis center. Adds to the components that must be covered by rules required to be adopted by the NC Medical Care Commission to implement registry identification cards, now requiring adopted rules to include a limitation on the number of written certifications a physician can issue at any given time. Makes a technical change to eliminate the statutory requirement for the rules to be adopted within 270 days of the act's effective date, and instead provides an uncodified requirement for the NC Medical Care Commission to adopt such rules within 270 days of the date the act becomes law. 

    Adds a new statute to the Article requiring registry identification cardholders to carry the card and valid identification whenever the cardholder is carrying cannabis or cannabis-infused products. Also requires the cardholder to disclose to any law enforcement officer that the cardholder holds a valid registry identification card when approached or addressed by the officer and display both the registry identification card and valid identification at the request of a law enforcement officer. 

    Makes organizational changes throughout the remaining content of the Article, with the following changes. 

    Adds to the membership of the Medical Cannabis Production Commission (Commission), now totaling 11 members: (1) the Agriculture Commissioner, or designee, (2) a chief of police designated by the North Carolina Association of Chiefs of Police, and (3) a physician member of the NC Medical Board designated by the NC Medical Board. Grants authority for the Commission to suspend or revoke a medical cannabis supplier license if the Commission determines that the supplier is not in substantial compliance with the Chapter or with rules adopted by the Commission. Adds a new requirement for the Commission to give a supplier 14 days' notice of a proposed suspension or revocation, including basis and possible remedial options. Makes a technical change to eliminate the statutory requirement for the Commission to adopt rules implementing the medical cannabis supply system, supplier licensing, and supplier sales and supply restrictions within 270 days of the date the act becomes law, and instead provides an uncodified requirement for the Commission to adopt such rules within 270 days of the Commission's first meeting.

    Divides the content of previous GS 90-113.120, Regulated medical cannabis supply system, now enacting the previous content in six distinct statutes, GS 90-113.119 through GS 90-113.123, GS 90-113.128 and GS 90-113.137, with the following changes. Makes a technical change to eliminate the statutory time period for the Commission to establish a medical cannabis supply system within 270 days of the date the act becomes law, and instead provides an uncodified requirement for the Commission to establish a system within 270 days of the Commission's first meeting.  Makes technical changes to consistently refer to suppliers rather than licensees. Clarifies that both applicants and suppliers are required to notify DHHS of any change in information submitted in a license application or renewal form within 30 days after the change. Makes technical changes to consistently refer to cannabis production rather than medical cannabis production. Eliminates the requirement for a supplier to grow cannabis in a controlled, secured environment and prohibits sites where cannabis is grown from being open to the public. Adds to the items the system revenues from license fees and monthly gross revenue fees are appropriated to the Commission to fund, to include the NC Cannabis Research Program established by the Article, limited to an amount of funding to be determined by the Commission, and subject to the priority given to costs associated with establishing and operating the regulated medical cannabis supply system, and the registry system. Makes further clarifying and organizational changes, including adding descriptive captions to subsections. Makes conforming changes to reflect organizational changes. 

    Amends and adds to the proposed protections for the medical use of cannabis. Qualifies the requirement that the weight of other ingredients that are not usable cannabis cannot be included for the purpose of determining whether a qualified patient is in possession of an amount of cannabis that exceeds the qualified patient's adequate supply, limiting the restriction to when usable cannabis is infused or added as an ingredient to an edible cannabis product, salve, tincture, or any other preparation to be consumed or used by a qualified patient. Adds the following. Prohibits an employee, officer, or agent of the State who makes a finding, determination, or otherwise considers a qualified patient or designated caregiver's possession or use of cannabis, or a cannabis-infused product from considering such use or possession any differently than the lawful possession or use of any prescribed controlled substance if the qualified patient or designated caregiver's possession or use complies with the Article. 

    Adds the following new statute. Specifies that the new Article does not authorize a registry identification cardholder to engage in the smoking of cannabis or the vaping of cannabis for medical use in seven places identified by the act, including (1) in a public place or a place open to the public, (2) in any place of employment, (3) in a vehicle, (4) in or within 1,000 feet of the property line of a church, child care facility, public school or nonpublic school, community college or UNC facility or grounds, unless the use occurs within a private residence. Provides further specifications relating to smoking or vaping near a child care facility or community college or UNC facility or grounds. Makes smoking or vaping cannabis in violation of these prohibitions an infraction punishable by a fine of up to $25. 

    Makes clarifying changes to the required determinations and actions of medical cannabis center employees prior to dispensing cannabis or cannabis-infused products to a registry identification cardholder. 

    Enacts a new statute providing hour, location, and age restrictions for medical cannabis centers. Prohibits licensed medical cannabis centers from selling cannabis or cannabis-infused products between 7:00 p.m. and 7:00 a.m. Bars locating a medical cannabis center within 1,000 linear feet of the property line of a church, child care facility, public school or nonpublic school, or community college or UNC facility or grounds. Requires an individual to be 18 or older to enter a medical cannabis center, unless the individual is a registry identification cardholder. 

    Revises and adds to the provisions governing advertising and packaging of cannabis and cannabis-infused products under the Article. Divides the previous substantive content of GS 90-113.126 into two distinct statutes, GS 90-113.131 and GS 90-113.132, with the following changes. Limits medical cannabis center signage to the center's name, logo, and hours of operation, notwithstanding local government ordinances prohibiting signage. Adds new authority for medical cannabis centers to maintain a website that includes specified information, including the logo and hours of operation, the product or service available, affiliated personnel, best practices the center upholds, and education materials. Adds a new provision directing DHHS to adopt rules to define standards for a medical cannabis center's name, signage, and logo to ensure a medical rather than recreational disposition. 

    Regarding the disposal of cannabis, more specifically requires a medical cannabis center to destroy all cannabis and cannabis-infused products that are not sold to registry identification cardholders (was, qualifying patients or designated caregivers) in accordance with DHHS rules. 

    Adds to the guidelines for the construction of the Article to prohibit construction of the Article to (1) impair the ability of any party to prohibit or limit smoking or vaping of cannabis on his or her private property, or (2) impair the ability of a community association to prohibit or limit sampling or vaping of cannabis in a common area through the community association's declaration or bylaws. 

    Adds new uncodified content to require initial appointments to the Compassionate Use Advisory Board and the Medical Cannabis Production Commission under the Article be made within 45 days after the effective date of the act. Provides guidelines for the appointment of members to staggered terms, with terms ranging from one year to four years, as specified. Requires the Medical Cannabis Production Commission to hold their first meeting within 60 days of the date the act becomes law. 

    Updates statutory cross-references in new GS 105-164.13(13e).

    Further amends GS 106-121 (definitions under Food, Drugs, and Cosmetics Act) to also exclude cannabis from the defined terms drug and food. Updates statutory cross-references. 

    Effective December 1, 2021, amends GS 15A-974, regarding the exclusion or suppression of unlawfully obtained evidence. Adds new subsection (a1) to bar the suppression of evidence obtained as the result of a search that was supported by probable cause at the time of the search solely on the basis that either: (1) a subsequent determination that a substance believed to be a controlled substance at the time of the search was not a controlled substance; or (2) a subsequent determination that the presence of a controlled substance at the time of the search was not a violation of law. 

    Updates statutory cross-references in the proposed changes to GS 90-87(16). 

    Eliminates the proposed repeal of Sections 8.5(a) and 8.5(b) of S.L. 2015-154, which repeal Article 5G of GS Chapter 90 (Epilepsy Alternative Treatment Act), effective July 1, 2021.


  • Summary date: Jul 21 2021 - More information

    Senate committee substitute to the 2nd edition makes the following changes.

    Revises new Article 5H, the NC Compassionate Care Act, as follows. Amends new GS 90-113.120, Regulated medical cannabis supply system, to appropriate the system revenues from license fees and monthly gross revenue fees to the Medical Cannabis Production Commission (rather than direct the Commission to use such fees) in order to fund the three previously specified cost categories, in order of priority. Adds that the required transfer to the General Fund of excess revenues remaining after fully funding the specified priorities must align with the fiscal calendar, requiring that the transfer be made at the beginning of the subsequent fiscal year.


  • Summary date: Jul 1 2021 - More information

    Senate committee substitute to the 1st edition makes the following changes.

    Revises new Article 5H, the NC Compassionate Care Act, as follows. Makes organizational and technical changes; correct statutory cross-references. Modifies the legislative findings to reflect the action of other states related to criminal penalties for the medical use, cultivation, and distribution of cannabis as of May 2021 (was, January). Adds to the defined terms: Advisory Board; Department (defined as the Department of Health and Human Services/DHHS); production facility; and supplier. Replaces the term licensed cannabis products facility with production facility, defined as a facility owned and operated by a supplier that cultivates, possesses, and produces cannabis and cannabis-infused products. Replaces the term licensed medical cannabis supplier with supplier, defined as a person licensed pursuant to GS 90-113.120 to supply cannabis and cannabis-infused products as authorized by the Article, cultivating cannabis, owning and operating one or more medical cannabis centers, and owning and operating one or more production facilities as set forth in GS 90-113.120. Makes changes throughout the Article to refer to a "production facility" and "supplier," as now defined, instead of a "licensed cannabis product facility" or a "licensed medical cannabis supplier;" deletes those terms as previously defined. Adds checking the patient's prescription history in the physician's duty under a bona-fide physician-patient relationship. Now includes an edible cannabis product, topical product, ointment, oil, patch, spray, suppository, or tincture in the definition of cannabis-infused product (was, edible products, ointments, and tinctures). Expands upon the diagnoses for which a physician provides a written certification that constitutes a debilitating medical condition. Now defines designated caregiver as a person who has a valid registry identification card issued by DHHS authorizing the person to assist a qualifying patient with the medical use of cannabis, who is at least 21, unless the person is the parent or legal guardian of each qualifying patient the person assists (was, a person who is at least 21 years of age and who has agreed to assist with a qualified patient's medical use of cannabis).

    Replaces the term licensed medical cannabis center with the term medical cannabis center, defined as a facility owned and operated by a supplier that possesses and dispenses cannabis and cannabis-infused products to registry identification cardholders for human consumption; makes conforming changes throughout to reflect the change in terminology. Now defines medical use of cannabis or medical use as the acquisition, administration, possession, preparation, transportation, or use of cannabis and cannabis-infused products, or paraphernalia used to administer cannabis products, to treat or alleviate a qualifying patient's debilitating medical condition or symptoms associated with the qualifying patient's debilitating medical condition and includes the transfer of cannabis products from a designated caregiver to a qualifying patient whom the designated caregiver is authorized to assist; excludes the extraction of resin from cannabis by solvent extraction other than water, glycerin, propylene glycol, vegetable oil, or food grade ethanol (ethyl alcohol), unless the extraction is done by a processing facility. Changes the definition of physician. Adds to qualified patient to require receipt of a written certification. Specifies that a registry identification card is issuable by DHHS. No longer includes a statement in the patient's medical records as an alternative to a signed statement by a physician as a written certification. Adds that a written certification must indicate the delivery method of the cannabis. Makes changes throughout to refer to "cannabis" rather than "medical cannabis" (cannabis is a defined term in the new Article). 

    Establishes a 13-member Medical Cannabis Advisory Board (Advisory Board), consisting of nine gubernatorially appointed members and four legislatively appointed members, appointed for up to two four-year terms. States member qualifications. Provides for meetings, and member expenses. Grants the Advisory Board authority to approve adding a debilitating medical condition by majority vote and requires the Board to meet at least two times per year for that purpose.

    Adds a new requirement for the registry identification cards to be printed with tamper-resistant technology. Adds to the information that must be included on the cards issued by DHHS to include the name, address, and date of birth of the cardholder, and a designation of whether the cardholder is a designated caregiver or qualifying patient. Also requires the card to indicate the delivery method of the cannabis. Requires the unique registry number to be alphanumeric, and cards issued to designated caregivers to have the alphanumeric number of the respective qualifying patient. Decreases the cap for the fine for a qualified patient or a designated caregiver to fail to notify DHHS of a change in information contained on the card from no more than $150 to no more than $100. No longer requires mens rea for a violation of the Article to result in suspension or revocation of the card by DHHS (previously required willful violation to trigger card suspension or revocation).

    Now requires DHHS to create a secure, confidential, electronic medical cannabis registry database of all qualified patients and designated caregivers to whom DHHS has issued cards, consisting of the name, address, and photo of the cardholder and the name, address, and hospital affiliation of the physician that issued the respective written certification (previously required that DHHS maintain a confidential list of persons to whom cards are issued). Eliminates the previous provision which required DHHS to verify cards to law enforcement. Instead, allows law enforcement agencies to contact DHHS to confirm cardholders. Charges DHHS with monitoring the database and informing the Attorney General's Office (AG) of any patterns of unusual written certifications found, with the AG charged with determining whether to report findings to the SBI and the appropriate sheriff for possible legal violations. Extends the previous confidentiality provisions to cover individual names and other identifying information in the registry. Makes it a Class 2 misdemeanor (was, Class 1 misdemeanor) for any person (including a State or local employee) to breach confidentiality of such protected information, as previously described. Now requires the Medical Care Commission to adopt implementing rules within 270 days of the date the act becoming law (was, 120 days). 

    Now charges DHHS rather than the Department of Agriculture and Consumer Services with maintenance and operation of the medical cannabis supply system. No longer defines nonresident employee in relation to the supply system. Now requires the Medical Cannabis Production Commission (established by the act) to establish the supply system within 270 days of the date the act becomes law (was, 120 days), authorizing suppliers to produce cannabis and cannabis-infused products in production facilities and distribute thorough medical cannabis centers. Adds that the Commission must include a seed-to-sale tracking system in establishing the supply system's regulation, and establish a system that is also financially viable for suppliers.

    Now requires a supplier license to grow, cultivate, produce or sell (was, cultivate only) cannabis or cannabis-infused products, or operate a business to produce cannabis or cannabis-infused products (was, establish and operate a business to produce cannabis products); maintains that a license is required to establish or operate a medical cannabis center. Revises the application requirements for a supplier license to include (1) requisite expertise in controlled environment agriculture, and at least five years of experience in cultivation, production, extraction, product development, quality control, and inventory management of medical cannabis in a state-licensed medical or adult use cannabis operation meeting standards specified by the Medical Cannabis Production Commission (Commission); (2) significant technical and technological ability to cultivate, produce, and distribute medical cannabis in a manner that meets industry standards for production consistency and safe handling; (3) relevant experience in securing cannabis production, testing, resources, transportation, and personnel to operate as a safe and secure supplier in compliance with all state regulations in which the applicant has prior experience (replacing the requirements for requisite expertise in controlled environment agriculture and the processing of cannabis to produce medical cannabis meeting standards and appropriate experience and qualifications for processing medical cannabis into cannabis-infused products in a manner that meets industry standards for production consistency and safe handling). Also requires proposed recordkeeping procedures of each component of the supply system to be included in license applications.

    Changes the residency requirements for a supplier license as follows. Requires proof that the applicant has been a State resident for at least two years and will be the majority owner of each medical cannabis center and production facility the applicant proposes to operate (previously required proof of North Carolina residency for each principal officer, board member, and employee of the medical cannabis supplier). Allows for the applicant to include nonresident partners with demonstrated ownership and operation experience and proof of residency as specified. Adds to the required application information the name, address, and date of birth of any individual owning more than 5% of the medical cannabis center and production facility the licensee operates. Specifies that the proof of necessary assets to operate includes operation as a supplier for two years.

    Establishes further procedures and parameters regarding criminal history record checks of owners, directors, and employees of a supplier. Authorizes national criminal history record checks for persons who have not resided in the State for the past five years. Details procedures for State and national checks. Provides for confidentiality and privilege of information obtained. 

    Now requires DHHS to issue a medical cannabis production site cards to each supplier for each production facility approved, to be posted at each production facility (previously required to issue a medical cannabis production site card to each licensed medical cannabis supplier for each property, location, or premises approved for cannabis production and each cannabis products facility approved for production of cannabis-infused products under the statute). 

    Establishes new performance requirements for licensees. Requires licensees to begin cultivation of cannabis within 120 days of receiving a medical cannabis supplier license and begin selling cannabis and cannabis-infused products in medical cannabis centers within 180 days of initiating cultivation. Revises licensing disqualifications to except from disqualification of persons who have not been a State resident for at least two years prior to the date of the application, a person who is a minority partner of a State resident who is the majority owner of the applicant. Specifies that suppliers can only sell cannabis or cannabis-infused products through the medical cannabis centers to qualified patients, designated caregivers, or by the supplier to resale to another licensed supplier. Specifies that the immunity from exemption from criminal laws apply to individuals (rather than suppliers) in compliance (was, substantial compliance) with the Article and rules adopted thereunder. Adds to the acts which trigger loss of the exemption to include (1) driving while impaired in violation of specified state laws, and (2) delivering cannabis to any individual the person has reason to know is not a qualified patient or designated caregiver who holds a valid card or a supplier who holds a license. No longer specifies driving while impaired by cannabis specifically as a triggering offense, or that a person should not be considered impaired solely for having cannabis metabolites in his system.

    Requires DHHS to perform annual inspections of the premises of licensees, including any production facility or medical cannabis center (was, permitted to inspect the premises of licensees, including any cannabis products facility, medical cannabis center, and facilities or locations used for production of medical cannabis). Establishes security measures and inspection requirements of suppliers, production facilities, and medical cannabis centers, including requiring suppliers to implement security measures adopted by the Commission in consultation with the SBI, and subjecting production facilities and medical cannabis centers owned and operated by a supplier to random inspection by DHHS and the SBI in accordance with rules adopted by the Commission. Requires that of the medical cannabis centers operated by each supplier that at least two be located in Tier 1 counties. Makes technical changes. 

    Adds the following offenses and penalties. Makes it a Class G felony to manufacture, sell, deliver, or possess with intent to manufacture, sell, or deliver cannabis in violation of this Article at a medical cannabis center or production facility. Makes it a Class H felony to create, sell, deliver, or possess with intent to sell or deliver counterfeit cannabis in violation of this Article at a medical cannabis center or production facility. Makes it a Class A1 misdemeanor to possess an amount of cannabis up to 1 1/2 ounces in violation of this Article, at a medical cannabis center or production facility. Makes it a Class H felony to possess an amount of cannabis that exceeds 1 1/2 ounces in violation of this Article, at a medical cannabis center or production facility. Makes it a Class 1 misdemeanor to provide DHHS with false or misleading information in relation to a registry identification card or license. Makes it a Class I felony for any person who has been issued a valid registry identification card who is found to be in possession of cannabis in violation of this Article. Adds that if a person is convicted of a violation of GS 90-95(h)(1) (trafficking in marijuana), and it is found that the offense was committed at a medical cannabis center or production facility or with cannabis from a medical cannabis center or production facility, then the person must be sentenced at a felony class level one class higher than the principal felony for which the person was convicted, and an additional 12 months will be added to the mandatory minimum sentence. Prohibits sentencing at a level higher than a Class C felony. Requires an indictment or information for the felony to allege the facts that qualify the offense for an enhancement under this provision. Adds that one pleading is sufficient for all felonies that are tried at a single trial. Specifies that these new penalties can be imposed in addition to any other penalties provided by law.

    Changes membership and appointment of the nine-member Commission as follows. Now includes (1) a qualified patient representative and two industry representatives meeting specified qualifications, appointed by the Governor; (2) two legislatively appointed members; (3) the Secretary of DHHS or a designee; (4) the Director of the SBI or a designee; (5) a sheriff designated by the NC Sheriffs' Association; and (6) a member of the NC Medical Board (previously provided for five members appointed by the Governor and four members appointed by the NCGA with no further criteria). Regarding the licensing power of the Commission, now charges DHHS with evaluating the applications and submitting a list of 20 applicant to the Commission for the Commission to approve 10 licenses from the list by majority vote. Now directs the Commission to adopt implementing rules within 270 days of the date the act becomes law. Adds to the requirements of the rules to include ensuring the equitable distribution of medical cannabis centers throughout the State as specified. 

    Enacts new GS 90-113.124 requiring DHHS to establish standards for and license up to five independent testing labs to test cannabis and cannabis-infused products that are to be sold in this State. Requires an independent testing lab to analyze a representative sample before the sale or transfer to a medical cannabis center by a production facility; requires the lab to report the results of all required testing to DHHS. Makes an independent testing lab responsible for selecting, picking up, and testing samples. Requires DHHS to adopt rules to establish, at least: (1) standards for testing cannabis and cannabis products, including specifying prohibited concentrations of contaminants that are injurious to human health; (2) standards for independent testing labs; (3) standards and requirements necessary for the licensing of an independent testing lab; (4) remedial actions to be taken if the representative sample does not meet DHHS standards; and (5) a fee schedule for independent testing labs.

    Enacts new GS 90-113.126 requiring the production facility or medical cannabis center logo, advertising, and signage to be tasteful, respectful, and medically focused; prohibits it from appealing to minors or containing cartoon-like figures or attempts at humor. Prohibits suppliers from using marijuana leaves or cannabis slang on their signs, logos, packaging or structures, as well as prohibiting the use of neon in signs, logos, packaging, or on structures. Requires suppliers to submit logos or signs to DHHS for review. Requires production facilities and medical cannabis centers owned and operated by a supplier to have a discreet, professional appearance compatible with existing commercial structures or land uses in the immediate area. Requires suppliers to safely package and accurately label cannabis or cannabis-infused products and requires items sold at a medical cannabis center to be properly labeled and in child-resistant packaging. Prohibits labels from including strain names and requires labels to include at least six specified items, including the name of the medical cannabis center, the percentage of tetrahydrocannabinol and the percentage of cannabidiol within a profile tolerance range of 10%, and the length of time it takes for the product to take effect. Requires cannabis products to be placed in child-resistant packaging before leaving the medical cannabis center. Requires DHHS to adopt rules that at least: (1) establish requirements and procedures for the safe, appropriate, and accurate packaging and labeling of cannabis and cannabis-infused products for human consumption, including prohibiting the use of any images designed or likely to appeal to minors; (2) establish requirements to ensure that cannabis and cannabis-infused products for human consumption are designed, marketed, and packaged in a manner appropriate for a medicinal product and that does not resemble food typically marketed to children; and (3) establish restrictions on the forms and appearance of edible cannabis-infused products in order to reduce their appeal to minors.

    Enacts new GS 90-113.128 requiring the destruction or disposal of production center cannabis by-product, cannabis scrap, and harvested cannabis not intended for distribution to a medical cannabis center or independent testing lab. Requires keeping documentation of the destruction or disposal for at least one year and requires a record of the date of destruction and the amount destroyed. Requires a medical cannabis center to destroy all cannabis and cannabis-infused products that are not sold to qualifying patients or designated caregivers. Requires documentation of the destruction and disposal for no less than a year and requires a record of the date of destruction and the amount destroyed. Requires a medical cannabis center to also destroy all unused cannabis products that are returned to the center by a formerly qualifying patient who no longer qualifies or by the former qualifying patient’s caregiver.

    Enacts new GS 90-113.130 requiring DHHS to establish a web-based verification system allowing DHHS personnel, State and local law enforcement personnel, and medical cannabis centers to enter a registry identification card number to determine whether the number corresponds with a current, valid registry identification card. Limits the information that the system may disclose to seven specified items. Specifies who may have access to the system. Requires before cannabis or cannabis-infused products are dispensed to a registry identification cardholder that a medical cannabis center employee access the system and determine that: (1) the registry identification card presented at the medical cannabis center is valid; (2) each person presenting a registry identification card is the person identified on the card; (3) the amount to be dispensed would not cause a qualifying patient to exceed the limit on obtaining no more than an adequate supply of cannabis or cannabis-infused products during any thirty-day period; (4) the cannabis to be dispensed complies with the delivery method; and (5) after making the determinations required in (3), but before dispensing cannabis or cannabis-infused products to a registry identification cardholder, a medical cannabis center employee must enter specified information into the system on the amount of the product, who it is dispensed to, date and time it is to be dispensed, and the dispensing center’s registry identification number.

    Recodifies proposed GS 90-113.128 (North Carolina Cannabis Research Program) as GS 90-113.132 and makes the following changes. Expands upon the NCGA’s stated intent to also include that the UNC System undertake objective, scientific research on the administration of cannabis-infused products (in addition to cannabis) as part of medical treatment. Deletes the provision stating that if the UNC BOG accepts this responsibility via resolution, then UNC must create a program to be known as the North Carolina Cannabis Research Program and instead requires UNC to create the program without BOG mention. Makes additional clarifying changes.

    Enacts new GS 90-113.134 establishing the North Carolina Medical Cannabis Program Fund within DHHS to ensure there are funds to carry out DHHS’s responsibilities under this Article. Requires revenues in excess of the amount needed to implement, administer, and enforce the Article to be distributed to the General Fund annually.

    Enacts new GS 90-113.136 protecting a registry identification cardholder from arrest, prosecution, or penalty for the possession or purchase of cannabis or medical use by the qualified patient of the quantity if the cannabis possessed or purchased does not exceed an adequate supply; sets out provisions for calculating the amount the patient possesses. Prohibits arresting, prosecuting, or penalizing a supplier for producing, possessing, distributing, or dispending cannabis or cannabis-infused products in a manner that is consistent with this Article.

    Enacts new GS 90-113.138 requiring DHHS, in consultation with medical professionals, to develop an education campaign about the regulated medical cannabis supply system, with the campaign regularly advertised through television, online, or social media. Sets out elements that must be included in the educational campaign. Also requires DHHS to make the information available online.

    Enacts new GS 90-113.144 requiring DHHS, in consultation with the Commission and Advisory Board, to report annually on the effectiveness of the medical cannabis program and any recommended changes. Sets out eight items that must be included in the report, while protecting the identify of specified individuals and entities, including the number of qualifying patients and designated caregivers served by each medical cannabis center during the report year; the nature of the debilitating medical conditions of the qualifying patients and a breakdown of qualifying patients by age group; the number of registry identification cards denied, suspended, or revoked; and the number of suppliers, production facilities, and medical cannabis centers by county. Requires the report to be submitted to the specified NCGA committees annually by October 1, beginning in 2022.

    Recodifies proposed GS 90-113.130 (Construction of Article) as GS 90-113.146 and makes the following changes. Replaces references to "marijuana" with "cannabis." Specifies that the Article is not to be construed to require a health insurance provider, health care plan, property and casualty insurer, or medical assistance program to be liable for or reimburse a claim for the medical use of cannabis (was, to require any health insurance provider or any government agency or authority to reimburse any person for expenses related to the medical use of marijuana). Requires consultations in which physicians diagnose debilitating medical conditions and complete written certifications to be reimbursed consistent with any other visit to a health care facility. Also provides that the Article does not affect or repeal laws relating to negligence or professional malpractice on the supplier, or supplier's agents or employees (was, medical marijuana treatment center or its agents or employees).

    Requires the North Carolina Medical Board, no later than 30 days after the act becomes effective, to approve a three-hour continuing medical education course and a one-hour supplemental medical education course on cannabis and cannabis-infused products.

    Deletes the previous Section 2 of the act, which set out provisions that applied during the period between the effective date of this act and 30 days after the effective date of adopted rules.

    Deletes the proposed changes to GS 105-164.4, which imposed a privilege tax of 18% on specified cannabis sales.

    Amends GS 105-164.13 to exempt from sales tax cannabis or cannabis-infused products sold by a medical cannabis center to a registry identification cardholder.

    Further amends GS 106-121 (definitions under Food, Drugs, and Cosmetics Act) by making clarifying changes to the exclusion of cannabis-infused products manufactured by a production facility or sold by a medical cannabis center from the definition of the terms drug and food.

    Repeals Section 8.5(a) and (b) of SL 2015-154, which would have repealed Article 5G of GS Chapter 90 (Epilepsy Alternative Treatment Act), effective July 1, 2021.

    Amends GS 90-87 to exclude from the defined term marijuana, an adequate supply of cannabis for medical use in compliance with new Article 5H.


  • Summary date: Apr 9 2021 - More information

    Enacts new Article 5H to GS Chapter 90, to be cited as the "NC Compassionate Care Act," requiring the Department of Health and Human Services (DHHS) to issue "registry identification cards" to persons who qualify as qualified patients or designated caregivers. Sets forth legislative findings, the purpose of the Act, and defined terms for the Article. Specifies conditions under which provisions of the act are applicable to minors. Specifies criteria and procedures for DHHS issuance or renewal of registry identification cards and requires that DHHS maintain a confidential list of persons to whom cards are issued. Allows DHHS to verify for law enforcement whether a card is valid and to report to law enforcement about falsified or fraudulent information submitted to DHHS. Makes violation of the confidentiality provision a Class 1 misdemeanor, subject to a fine of up to $1,000. Directs the NC Medical Care Commission to adopt rules to implement the provisions regarding registry cards, establishing requirements for the issuance of registry identification cards to qualified patients and designated caregivers who meet certain minimum specifications. Requires the rules be adopted no later than 120 days after the effective date of the act.

    Provides civil and criminal immunity for a registry identification card holder for purchasing or possessing cannabis for medical use if the quantity does not exceed an "adequate supply" for the patient as determined by his or her physician. Adequate supply is defined by the act to, among other things, (1) apply only to cannabis from an intrastate source and (2) limit permitted supply to an amount needed for a 30-day period. Provides for exclusion of the weight of other ingredients infused or added to cannabis for consumption or use by a qualified patient in determining whether the patient is in possession of an amount that exceeds the patient's adequate supply. Also provides immunity and protection from penalties for licensed producers and distributors of cannabis or cannabis-infused products consistent with the Article. 

    Directs the Medical Cannabis Production Commission, as established below, to establish a medical cannabis supply system to provide a safe, regulated supply of cannabis appropriate for medical use by qualified patients with a valid registry identification card and to generate revenue sufficient to maintain and operate the system. Allows for legislative appropriations to establish the system, but requires operation to be funded by authorized fees. Establishes criteria for licensing of medical cannabis suppliers (for the sale of cannabis, cannabis-infused products, and related paraphernalia to qualified patients and caregivers holding a valid registry identification card, establishing or operating a business to produce cannabis-infused products, and cultivating cannabis for use by a licensed medical cannabis center or licensed producer of cannabis-infused products), as well as for suspending or revoking licenses. States sales and supply restrictions of licensees. Provides for criminal immunity for licensed medical cannabis suppliers as specified, excluding conduct described in four instances, such as driving while impaired by cannabis. Provides for monthly fees and reporting of licensees. Requires revenues remaining after fully funding the established priorities to be transferred to the General Fund. Limits the Commission to licensing 10 medical cannabis suppliers, with each supplier limiting to operating no more than four medical cannabis centers. Provides for administrative and judicial review of administrative decisions. 

    Establishes the Medical Cannabis Production Commission with oversight of medical cannabis supplier licensing and licensee discipline. Requires approval of licensee applications upon recommendation by the Department of Agriculture and Consumer Services by majority vote of members present and voting. Details Commission membership, terms, leadership, vacancies, removal, quorum, and member expenses. Details disciplinary authority. Requires the Commission to consult with the NC Medical Care Commission to adopt implementing provisions to establish qualifications and requirements of licensure, for production be a supplier, and for proper regulation of medical cannabis centers and cannabis product facilities operated by suppliers, and well as establishing civil penalties for minor violations.

    Expresses the General Assembly's intent that the University of North Carolina system undertake scientific research regarding the administration of cannabis as a part of medical treatment and, subject to approval by the UNC Board of Governors, directs the university to create the North Carolina Cannabis Research Program.

    Provides for construction of the Article. Provides a severability clause. Directs the Department of Health and Human Services to issue temporary certificates for participation in the regulated medical supply system, as established, in the manner specified, and maintain a list of all temporary certificates issued. Makes conforming changes to GS 106-121 (definitions under Food, Drugs, and Cosmetics Act). Amends GS 105-164.4(a) to impose a privilege tax of 18% on specified cannabis sales.


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