LCO \\PRDFS1\HCOUSERS\BARRYJN\WS\2022HB-05147-R01- HB.docx 1 of 16 General Assembly Substitute Bill No. 5147 February Session, 2022 AN ACT CONCERNING PHYSICIAN ASSISTANTS AND THE PALLIATIVE USE OF MARIJUANA. Be it enacted by the Senate and House of Representatives in General Assembly convened: Section 1. Section 21a-408 of the 2022 supplement to the general 1 statutes is repealed and the following is substituted in lieu thereof 2 (Effective January 1, 2023): 3 As used in this section, sections 21a-408a to 21a-408o, inclusive, as 4 amended by this act, and sections 21a-408r to 21a-408v, inclusive, unless 5 the context otherwise requires: 6 (1) "Advanced practice registered nurse" means an advanced practice 7 registered nurse licensed pursuant to chapter 378; 8 (2) "Cannabis establishment" has the same meaning as provided in 9 section 21a-420; 10 (3) "Cultivation" includes planting, propagating, cultivating, growing 11 and harvesting; 12 (4) "Debilitating medical condition" means (A) cancer, glaucoma, 13 positive status for human immunodeficiency virus or acquired immune 14 deficiency syndrome, Parkinson's disease, multiple sclerosis, damage to 15 the nervous tissue of the spinal cord with objective neurological 16 Substitute Bill No. 5147 LCO {\\PRDFS1\HCOUSERS\BARRYJN\WS\2022HB-05147- R01-HB.docx } 2 of 16 indication of intractable spasticity, epilepsy or uncontrolled intractable 17 seizure disorder, cachexia, wasting syndrome, Crohn's disease, 18 posttraumatic stress disorder, irreversible spinal cord injury with 19 objective neurological indication of intractable spasticity, cerebral palsy, 20 cystic fibrosis or terminal illness requiring end-of-life care, except, if the 21 qualifying patient is under eighteen years of age, "debilitating medical 22 condition" means terminal illness requiring end-of-life care, irreversible 23 spinal cord injury with objective neurological indication of intractable 24 spasticity, cerebral palsy, cystic fibrosis, severe epilepsy or uncontrolled 25 intractable seizure disorder, or (B) any medical condition, medical 26 treatment or disease approved for qualifying patients by the 27 Department of Consumer Protection and posted online pursuant to 28 section 21a-408l; 29 (5) "Dispensary facility" means a place of business where marijuana 30 may be dispensed, sold or distributed in accordance with this chapter 31 and any regulations adopted thereunder to qualifying patients and 32 caregivers and for which the department has issued a dispensary facility 33 license pursuant to this chapter; 34 (6) "Employee" has the same meaning as provided in section 21a-420; 35 (7) "Institutional animal care and use committee" means a committee 36 that oversees an organization's animal program, facilities and 37 procedures to ensure compliance with federal policies, guidelines and 38 principles related to the care and use of animals in research; 39 (8) "Institutional review board" means a specifically constituted 40 review body established or designated by an organization to protect the 41 rights and welfare of persons recruited to participate in biomedical, 42 behavioral or social science research; 43 (9) "Laboratory" means a laboratory located in the state that is 44 licensed by the department to provide analysis of marijuana and that 45 meets the licensure requirements set forth in section 21a-246, as 46 amended by this act; 47 Substitute Bill No. 5147 LCO {\\PRDFS1\HCOUSERS\BARRYJN\WS\2022HB-05147- R01-HB.docx } 3 of 16 (10) "Laboratory employee" means a person who is registered as a 48 laboratory employee pursuant to section 21a-408r; 49 (11) "Licensed dispensary" or "dispensary" means an individual who 50 is a licensed pharmacist employed by a dispensary facility or hybrid 51 retailer; 52 (12) "Producer" means a person who is licensed as a producer 53 pursuant to section 21a-408i; 54 (13) "Marijuana" means marijuana, as defined in section 21a-240; 55 (14) "Nurse" means a person who is licensed as a nurse under chapter 56 378; 57 (15) "Palliative use" means the acquisition, distribution, transfer, 58 possession, use or transportation of marijuana or paraphernalia relating 59 to marijuana, including the transfer of marijuana and paraphernalia 60 relating to marijuana from the patient's caregiver to the qualifying 61 patient, to alleviate a qualifying patient's symptoms of a debilitating 62 medical condition or the effects of such symptoms, but does not include 63 any such use of marijuana by any person other than the qualifying 64 patient; 65 (16) "Paraphernalia" means drug paraphernalia, as defined in section 66 21a-240; 67 (17) "Physician" means a person who is licensed as a physician under 68 chapter 370; [, but does not include a physician assistant, as defined in 69 section 20-12a;] 70 (18) "Physician assistant" means a person who is licensed as a 71 physician assistant under chapter 370; 72 [(18)] (19) "Caregiver" means a person, other than the qualifying 73 patient and the qualifying patient's physician, physician assistant or 74 advanced practice registered nurse, who is eighteen years of age or older 75 Substitute Bill No. 5147 LCO {\\PRDFS1\HCOUSERS\BARRYJN\WS\2022HB-05147- R01-HB.docx } 4 of 16 and has agreed to undertake responsibility for managing the well-being 76 of the qualifying patient with respect to the palliative use of marijuana, 77 provided (A) in the case of a qualifying patient (i) under eighteen years 78 of age and not an emancipated minor, or (ii) otherwise lacking legal 79 capacity, such person shall be a parent, guardian or person having legal 80 custody of such qualifying patient, and (B) in the case of a qualifying 81 patient eighteen years of age or older or an emancipated minor, the need 82 for such person shall be evaluated by the qualifying patient's physician, 83 physician assistant or advanced practice registered nurse and such need 84 shall be documented in the written certification; 85 [(19)] (20) "Qualifying patient" means a person who: (A) Is a resident 86 of Connecticut, (B) has been diagnosed by a physician, physician 87 assistant or [an] advanced practice registered nurse as having a 88 debilitating medical condition, and (C) (i) is eighteen years of age or 89 older, (ii) is an emancipated minor, or (iii) has written consent from a 90 custodial parent, guardian or other person having legal custody of such 91 person that indicates that such person has permission from such parent, 92 guardian or other person for the palliative use of marijuana for a 93 debilitating medical condition and that such parent, guardian or other 94 person will (I) serve as a caregiver for the qualifying patient, and (II) 95 control the acquisition and possession of marijuana and any related 96 paraphernalia for palliative use on behalf of such person. "Qualifying 97 patient" does not include an inmate confined in a correctional institution 98 or facility under the supervision of the Department of Correction; 99 [(20)] (21) "Research program" means a study approved by the 100 Department of Consumer Protection in accordance with this chapter 101 and undertaken to increase information or knowledge regarding the 102 growth or processing of marijuana, or the medical attributes, dosage 103 forms, administration or use of marijuana to treat or alleviate symptoms 104 of any medical conditions or the effects of such symptoms; 105 [(21)] (22) "Research program employee" means a person who (A) is 106 registered as a research program employee under section 21a-408t, or 107 (B) holds a temporary certificate of registration issued pursuant to 108 Substitute Bill No. 5147 LCO {\\PRDFS1\HCOUSERS\BARRYJN\WS\2022HB-05147- R01-HB.docx } 5 of 16 section 21a-408t; 109 [(22)] (23) "Research program subject" means a person registered as a 110 research program subject pursuant to section 21a-408v; 111 [(23)] (24) "Usable marijuana" means the dried leaves and flowers of 112 the marijuana plant, and any mixtures or preparations of such leaves 113 and flowers, that are appropriate for the palliative use of marijuana, but 114 does not include the seeds, stalks and roots of the marijuana plant; and 115 [(24)] (25) "Written certification" means a written certification issued 116 by a physician, physician assistant or [an] advanced practice registered 117 nurse pursuant to section 21a-408c, as amended by this act. 118 Sec. 2. Section 21a-408a of the 2022 supplement to the general statutes 119 is repealed and the following is substituted in lieu thereof (Effective 120 January 1, 2023): 121 (a) A qualifying patient shall register with the Department of 122 Consumer Protection pursuant to section 21a-408d, as amended by this 123 act, prior to engaging in the palliative use of marijuana. A qualifying 124 patient who has a valid registration certificate from the Department of 125 Consumer Protection pursuant to subsection (a) of section 21a-408d, as 126 amended by this act, and complies with the requirements of sections 127 21a-408 to 21a-408m, as amended by this act, inclusive, shall not be 128 subject to arrest or prosecution, penalized in any manner, including, but 129 not limited to, being subject to any civil penalty, or denied any right or 130 privilege, including, but not limited to, being subject to any disciplinary 131 action by a professional licensing board, for the palliative use of 132 marijuana if: 133 (1) The qualifying patient's physician, physician assistant or 134 advanced practice registered nurse has issued a written certification to 135 the qualifying patient for the palliative use of marijuana after the 136 physician, physician assistant or advanced practice registered nurse has 137 prescribed, or determined it is not in the best interest of the patient to 138 prescribe, prescription drugs to address the symptoms or effects for 139 Substitute Bill No. 5147 LCO {\\PRDFS1\HCOUSERS\BARRYJN\WS\2022HB-05147- R01-HB.docx } 6 of 16 which the certification is being issued; 140 (2) The combined amount of marijuana possessed by the qualifying 141 patient and the caregiver for palliative use does not exceed five ounces; 142 (3) The qualifying patient has not more than one caregiver at any 143 time; and 144 (4) Any cannabis plants grown by the qualifying patient in his or 145 home is in compliance with subsection (b) of section 21a-408d, as 146 amended by this act, and any applicable regulations. 147 (b) The provisions of subsection (a) of this section do not apply to: 148 (1) Any palliative use of marijuana that endangers the health or well-149 being of a person other than the qualifying patient or the caregiver; or 150 (2) The ingestion of marijuana (A) in a motor bus or a school bus or 151 in any other moving vehicle, (B) in the workplace, (C) on any school 152 grounds or any public or private school, dormitory, college or university 153 property, unless such college or university is participating in a research 154 program and such use is pursuant to the terms of the research program, 155 (D) in any public place, or (E) in the presence of a person under the age 156 of eighteen, unless such person is a qualifying patient or research 157 program subject. For the purposes of this subdivision, (i) "presence" 158 means within the direct line of sight of the palliative use of marijuana or 159 exposure to second-hand marijuana smoke, or both; (ii) "public place" 160 means any area that is used or held out for use by the public whether 161 owned or operated by public or private interests; (iii) "vehicle" means a 162 vehicle, as defined in section 14-1; (iv) "motor bus" means a motor bus, 163 as defined in section 14-1; and (v) "school bus" means a school bus, as 164 defined in section 14-1. 165 Sec. 3. Section 21a-408c of the 2022 supplement to the general statutes 166 is repealed and the following is substituted in lieu thereof (Effective 167 January 1, 2023): 168 Substitute Bill No. 5147 LCO {\\PRDFS1\HCOUSERS\BARRYJN\WS\2022HB-05147- R01-HB.docx } 7 of 16 (a) A physician, physician assistant or [an] advanced practice 169 registered nurse may issue a written certification to a qualifying patient 170 that authorizes the palliative use of marijuana by the qualifying patient. 171 Such written certification shall be in the form prescribed by the 172 Department of Consumer Protection and shall include a statement 173 signed and dated by the qualifying patient's physician, physician 174 assistant or advanced practice registered nurse stating that, in such 175 physician's, physician assistant's or advanced practice registered nurse's 176 professional opinion, the qualifying patient has a debilitating medical 177 condition and the potential benefits of the palliative use of marijuana 178 would likely outweigh the health risks of such use to the qualifying 179 patient. 180 (b) Any written certification for the palliative use of marijuana issued 181 by a physician, physician assistant or [an] advanced practice registered 182 nurse under subsection (a) of this section shall be valid for a period not 183 to exceed one year from the date such written certification is signed and 184 dated by the physician, physician assistant or advanced practice 185 registered nurse. Not later than ten calendar days after the expiration of 186 such period, or at any time before the expiration of such period should 187 the qualifying patient no longer wish to possess marijuana for palliative 188 use, the qualifying patient or the caregiver shall destroy all usable 189 marijuana possessed by the qualifying patient and the caregiver for 190 palliative use. 191 (c) A physician, physician assistant or [an] advanced practice 192 registered nurse shall not be subject to arrest or prosecution, penalized 193 in any manner, including, but not limited to, being subject to any civil 194 penalty, or denied any right or privilege, including, but not limited to, 195 being subject to any disciplinary action by the Connecticut Medical 196 Examining Board, the Connecticut State Board of Examiners for Nursing 197 or other professional licensing board, for providing a written 198 certification for the palliative use of marijuana under subdivision (1) of 199 subsection (a) of section 21a-408a, as amended by this act, if: 200 (1) The physician, physician assistant or advanced practice registered 201 Substitute Bill No. 5147 LCO {\\PRDFS1\HCOUSERS\BARRYJN\WS\2022HB-05147- R01-HB.docx } 8 of 16 nurse has diagnosed the qualifying patient as having a debilitating 202 medical condition; 203 (2) The physician, physician assistant or advanced practice registered 204 nurse has explained the potential risks and benefits of the palliative use 205 of marijuana to the qualifying patient and, if the qualifying patient lacks 206 legal capacity, to a parent, guardian or person having legal custody of 207 the qualifying patient; 208 (3) The written certification issued by the physician, physician 209 assistant or advanced practice registered nurse is based upon the 210 physician's, physician assistant's or advanced practice registered nurse's 211 professional opinion after having completed a medically reasonable 212 assessment of the qualifying patient's medical history and current 213 medical condition made in the course of a bona fide health care 214 professional-patient relationship; and 215 (4) The physician, physician assistant or advanced practice registered 216 nurse has no financial interest in a cannabis establishment, except for 217 retailers and delivery services, as such terms are defined in section 21a-218 420. 219 (d) A physician assistant or nurse shall not be subject to arrest or 220 prosecution, penalized in any manner, including, but not limited to, 221 being subject to any civil penalty, or denied any right or privilege, 222 including, but not limited to, being subject to any disciplinary action by 223 the Connecticut Medical Examining Board, Board of Examiners for 224 Nursing [,] or other professional licensing board, for administering 225 marijuana to a qualifying patient or research program subject in a 226 hospital or health care facility licensed by the Department of Public 227 Health. 228 (e) Notwithstanding the provisions of this section, sections 21a-408 to 229 21a-408b, inclusive, as amended by this act, and sections 21a-408d to 230 21a-408o, inclusive, as amended by this act, a physician assistant or an 231 advanced practice registered nurse shall not issue a written certification 232 Substitute Bill No. 5147 LCO {\\PRDFS1\HCOUSERS\BARRYJN\WS\2022HB-05147- R01-HB.docx } 9 of 16 to a qualifying patient when the qualifying patient's debilitating medical 233 condition is glaucoma. 234 Sec. 4. Section 21a-408d of the 2022 supplement to the general statutes 235 is repealed and the following is substituted in lieu thereof (Effective 236 January 1, 2023): 237 (a) Each qualifying patient who is issued a written certification for the 238 palliative use of marijuana under subdivision (1) of subsection (a) of 239 section 21a-408a, as amended by this act, and the caregiver of such 240 qualifying patient, shall register with the Department of Consumer 241 Protection. Such registration shall be effective from the date the 242 Department of Consumer Protection issues a certificate of registration 243 until the expiration of the written certification issued by the physician, 244 physician assistant or advanced practice registered nurse. The 245 qualifying patient and the caregiver shall provide sufficient identifying 246 information, as determined by the department, to establish the personal 247 identity of the qualifying patient and the caregiver. If the qualifying 248 patient is under eighteen years of age and not an emancipated minor, 249 the custodial parent, guardian or other person having legal custody of 250 the qualifying patient shall also provide a letter from both the qualifying 251 patient's care provider and a physician who is board certified in an area 252 of medicine involved in the treatment of the debilitating condition for 253 which the qualifying patient was certified that confirms that the 254 palliative use of marijuana is in the best interest of the qualifying 255 patient. A physician may issue a written certification for the palliative 256 use of marijuana by a qualifying patient who is under eighteen years of 257 age, provided such written certification shall not be for marijuana in a 258 dosage form that requires that the marijuana be smoked, inhaled or 259 vaporized. The qualifying patient or the caregiver shall report any 260 change in the identifying information to the department not later than 261 five business days after such change. The department shall issue a 262 registration certificate to the qualifying patient and to the caregiver and 263 may charge a reasonable fee, not to exceed twenty-five dollars, for each 264 registration certificate issued under this subsection. Any registration 265 Substitute Bill No. 5147 LCO {\\PRDFS1\HCOUSERS\BARRYJN\WS\2022HB-05147- R01-HB.docx } 10 of 16 fees collected by the department under this subsection shall be paid to 266 the State Treasurer and credited to the General Fund. 267 (b) Any qualifying patient who is eighteen years of age or older may 268 cultivate up to three mature cannabis plants and three immature 269 cannabis plants in the patient's primary residence at any given time, 270 provided such plants are secure from access by any individual other 271 than the patient or patient's caregiver and no more than twelve cannabis 272 plants may be grown per household. 273 (c) A dispensary shall not dispense any marijuana products in a 274 smokable, inhalable or vaporizable form to a qualifying patient who is 275 under eighteen years of age or such qualifying patient's caregiver. 276 (d) Information obtained under this section shall be confidential and 277 shall not be subject to disclosure under the Freedom of Information Act, 278 as defined in section 1-200, except that reasonable access to registry 279 information obtained under this section shall be provided to: (1) State 280 agencies, federal agencies and local law enforcement agencies for the 281 purpose of investigating or prosecuting a violation of law; (2) 282 physicians, physician assistants, advanced practice registered nurses 283 and pharmacists for the purpose of providing patient care and drug 284 therapy management and monitoring controlled substances obtained by 285 the qualifying patient; (3) public or private entities for research or 286 educational purposes, provided no individually identifiable health 287 information may be disclosed; (4) a licensed dispensary for the purpose 288 of complying with sections 21a-408 to 21a-408m, inclusive, as amended 289 by this act; (5) a qualifying patient, but only with respect to information 290 related to such qualifying patient or such qualifying patient's caregiver; 291 or (6) a caregiver, but only with respect to information related to such 292 caregiver's qualifying patient. 293 Sec. 5. Section 21a-408m of the 2022 supplement to the general 294 statutes is repealed and the following is substituted in lieu thereof 295 (Effective January 1, 2023): 296 Substitute Bill No. 5147 LCO {\\PRDFS1\HCOUSERS\BARRYJN\WS\2022HB-05147- R01-HB.docx } 11 of 16 (a) The Commissioner of Consumer Protection may adopt 297 regulations, in accordance with chapter 54, to establish (1) a standard 298 form for written certifications for the palliative use of marijuana issued 299 by physicians, physician assistants and advanced practice registered 300 nurses under subdivision (1) of subsection (a) of section 21a-408a, as 301 amended by this act, and (2) procedures for registrations under section 302 21a-408d, as amended by this act. Such regulations, if any, shall be 303 adopted after consultation with the Board of Physicians established in 304 section 21a-408l. 305 (b) The Commissioner of Consumer Protection shall adopt 306 regulations, in accordance with chapter 54, to establish a reasonable fee 307 to be collected from each qualifying patient to whom a written 308 certification for the palliative use of marijuana is issued under 309 subdivision (1) of subsection (a) of section 21a-408a, as amended by this 310 act, for the purpose of offsetting the direct and indirect costs of 311 administering the provisions of sections 21a-408 to 21a-408m, inclusive, 312 as amended by this act. The commissioner shall collect such fee at the 313 time the qualifying patient registers with the Department of Consumer 314 Protection under subsection (a) of section 21a-408d, as amended by this 315 act. Such fee shall be in addition to any registration fee that may be 316 charged under said subsection. The fees required to be collected by the 317 commissioner from qualifying patients under this subsection shall be 318 paid to the State Treasurer and credited to the General Fund. 319 (c) The Commissioner of Consumer Protection shall adopt or amend 320 regulations, as applicable, in accordance with chapter 54, to implement 321 the provisions of sections 21a-408 to 21a-408g, inclusive, as amended by 322 this act, and section 21a-408l. Notwithstanding the requirements of 323 sections 4-168 to 4-172, inclusive, in order to effectuate the purposes of 324 sections 21a-408 to 21a-408g, inclusive, as amended by this act, and 325 section 21a-408l, and protect public health and safety, prior to adopting 326 or amending such regulations the commissioner shall adopt policies and 327 procedures to implement the provisions of sections 21a-408 to 21a-408g, 328 inclusive, as amended by this act, and section 21a-408, as amended by 329 Substitute Bill No. 5147 LCO {\\PRDFS1\HCOUSERS\BARRYJN\WS\2022HB-05147- R01-HB.docx } 12 of 16 this act, that shall have the force and effect of law. The commissioner 330 shall post all policies and procedures on the department's Internet web 331 site, and submit such policies and procedures to the Secretary of the 332 State for posting on the eRegulations System, at least fifteen days prior 333 to the effective date of any policy or procedure. Any such policy or 334 procedure shall no longer be effective upon the earlier of either adoption 335 of such policies or procedures as a final regulation pursuant to section 336 4-172 or forty-eight months from October 1, 2021, if such policies or 337 procedures have not been submitted to the legislative regulation review 338 committee for consideration under section 4-170. Such policies and 339 procedures and regulations shall include, but not be limited to, how the 340 department shall: 341 (1) Accept applications for the issuance and renewal of registration 342 certificates for qualifying patients and caregivers; 343 (2) Establish criteria for adding medical conditions, medical 344 treatments or diseases to the list of debilitating medical conditions that 345 qualify for the palliative use of marijuana; 346 (3) Establish a petition process under which members of the public 347 may submit petitions, regarding the addition of medical conditions, 348 medical treatments or diseases to the list of debilitating medical 349 conditions; 350 (4) Establish requirements for the growing of cannabis plants by a 351 qualifying patient in his or her primary residence as authorized under 352 section 21a-408d, as amended by this act, including requirements for 353 securing such plants to prevent access by any individual other than the 354 patient or the patient's caregiver, the location of such plants and any 355 other requirements necessary to protect public health or safety; 356 (5) Develop a distribution system for marijuana for palliative use that 357 provides for: 358 (A) Marijuana production facilities within this state that are housed 359 on secured grounds and operated by producers; 360 Substitute Bill No. 5147 LCO {\\PRDFS1\HCOUSERS\BARRYJN\WS\2022HB-05147- R01-HB.docx } 13 of 16 (B) The transfer of marijuana between dispensary facilities; and 361 (C) Distribution of marijuana for palliative use to qualifying patients 362 or their caregivers by dispensary facilities, hybrid retailers and delivery 363 services, as such terms are defined in section 21a-420; and 364 (6) Ensure an adequate supply and variety of marijuana to dispensary 365 facilities and hybrid retailers to ensure uninterrupted availability for 366 qualifying patients, based on historical marijuana purchase patterns by 367 qualifying patients. 368 Sec. 6. Subsection (a) of section 21a-246 of the general statutes is 369 repealed and the following is substituted in lieu thereof (Effective January 370 1, 2023): 371 (a) No person within this state shall manufacture, wholesale, 372 repackage, supply, compound, mix, cultivate or grow, or by other 373 process produce or prepare, controlled substances without first 374 obtaining a license to do so from the Commissioner of Consumer 375 Protection and no person within this state shall operate a laboratory for 376 the purpose of research or analysis using controlled substances without 377 first obtaining a license to do so from the Commissioner of Consumer 378 Protection, except that such activities by pharmacists or pharmacies in 379 the filling and dispensing of prescriptions or activities incident thereto, 380 or the dispensing or administering of controlled substances by dentists, 381 podiatrists, physicians, physician assistants, advanced practice 382 registered nurses or veterinarians, or other persons acting under their 383 supervision, in the treatment of patients shall not be subject to the 384 provisions of this section, and provided laboratories for instruction in 385 dentistry, medicine, nursing, pharmacy, pharmacology and 386 pharmacognosy in institutions duly licensed for such purposes in this 387 state shall not be subject to the provisions of this section except with 388 respect to narcotic drugs and schedule I and II controlled substances. 389 Upon application of any physician or physician assistant licensed 390 pursuant to chapter 370, or an advanced practice registered nurse 391 licensed pursuant to chapter 378, the Commissioner of Consumer 392 Substitute Bill No. 5147 LCO {\\PRDFS1\HCOUSERS\BARRYJN\WS\2022HB-05147- R01-HB.docx } 14 of 16 Protection shall without unnecessary delay, (1) license such physician to 393 possess and supply marijuana for the treatment of glaucoma or the side 394 effects of chemotherapy, or (2) license such physician assistant or 395 advanced practice registered nurse to possess and supply marijuana for 396 the treatment of the side effects of chemotherapy. No person outside this 397 state shall sell or supply controlled substances within this state without 398 first obtaining a license to do so from the Commissioner of Consumer 399 Protection, provided no such license shall be required of a manufacturer 400 whose principal place of business is located outside this state and who 401 is registered with the federal Drug Enforcement Administration or other 402 federal agency, and who files a copy of such registration with the 403 appropriate licensing authority under this chapter. 404 Sec. 7. Section 21a-253 of the general statutes is repealed and the 405 following is substituted in lieu thereof (Effective January 1, 2023): 406 Any person may possess or have under his control a quantity of 407 marijuana less than or equal to that quantity supplied to him pursuant 408 to a prescription made in accordance with the provisions of section 21a-409 249 by (1) a physician licensed under the provisions of chapter 370 and 410 further authorized by subsection (a) of section 21a-246, as amended by 411 this act, by the Commissioner of Consumer Protection to possess and 412 supply marijuana for the treatment of glaucoma or the side effects of 413 chemotherapy, or (2) a physician assistant licensed under the provisions 414 of chapter 370, or an advanced practice registered nurse licensed under 415 the provisions of chapter 378, and further authorized by subsection (a) 416 of section 21a-246, as amended by this act, by said commissioner to 417 possess and supply marijuana for the treatment of the side effects of 418 chemotherapy. 419 Sec. 8. Section 7 of public act 21-9 is repealed and the following is 420 substituted in lieu thereof (Effective January 1, 2023): 421 (a) As used in this section: 422 (1) "Advanced practice registered nurse" means an advanced practice 423 Substitute Bill No. 5147 LCO {\\PRDFS1\HCOUSERS\BARRYJN\WS\2022HB-05147- R01-HB.docx } 15 of 16 registered nurse licensed pursuant to chapter 378 of the general statutes; 424 (2) "Physician" has the same meaning as provided in section 21a-408 425 of the general statutes, as amended by this act; 426 (3) "Physician assistant" has the same meaning as provided in section 427 21a-408 of the general statutes, as amended by this act; 428 [(3)] (4) "Qualifying patient" has the same meaning as provided in 429 section 21a-408 of the general statutes, as amended by this act; and 430 [(4)] (5) "Written certification" has the same meaning as provided in 431 section 21a-408 of the general statutes, as amended by this act. 432 (b) Notwithstanding the provisions of sections 21a-408 to 21a-408n, 433 inclusive, of the general statutes, as amended by this act, or any other 434 section, regulation, rule, policy or procedure concerning the certification 435 of medical marijuana patients, a physician, physician assistant or 436 advanced practice registered nurse may issue a written certification to a 437 qualifying patient and provide any follow-up care using telehealth 438 services during the period beginning on the effective date of this section 439 and ending on June 30, 2023, provided all other requirements for issuing 440 the written certification to the qualifying patient and all recordkeeping 441 requirements are satisfied. 442 This act shall take effect as follows and shall amend the following sections: Section 1 January 1, 2023 21a-408 Sec. 2 January 1, 2023 21a-408a Sec. 3 January 1, 2023 21a-408c Sec. 4 January 1, 2023 21a-408d Sec. 5 January 1, 2023 21a-408m Sec. 6 January 1, 2023 21a-246(a) Sec. 7 January 1, 2023 21a-253 Sec. 8 January 1, 2023 PA 21-9, Sec. 7 Substitute Bill No. 5147 LCO {\\PRDFS1\HCOUSERS\BARRYJN\WS\2022HB-05147- R01-HB.docx } 16 of 16 Statement of Legislative Commissioners: In Section 6(a)(2), "advanced practice registered nurse or physician assistant" was changed to "physician assistant or advanced practice registered nurse" for consistency; and in section 7(2), "an advanced practice registered nurse licensed under the provisions of chapter 378 or a physician assistant licensed under the provisions of chapter 370" was changed to "a physician assistant licensed under the provisions of chapter 370, or an advanced practice registered nurse licensed under the provisions of chapter 378," for consistency. GL Joint Favorable Subst.