This docum ent does not reflect the intent or official position of the bill sponsor or House of Representatives.
STORAGE NAME: h1435.HRS
DATE: 1/31/2024
HOUSE OF REPRESENTATIVES STAFF ANALYSIS
BILL #: HB 1435 Medical Marijuana Use Registry Identification Cards for Veterans
SPONSOR(S): Valdés
TIED BILLS: IDEN./SIM. BILLS: SB 1514
REFERENCE ACTION ANALYST STAFF DIRECTOR or
BUDGET/POLICY CHIEF
1) Healthcare Regulation Subcommittee McElroy McElroy
2) Health Care Appropriations Subcommittee
3) Health & Human Services Committee
SUMMARY ANALYSIS
Section 381.986, F.S., authorizes patients with certain debilitating medical conditions to obtain medical
marijuana from Medical Marijuana Treatment Centers (MMTC). To certify a patient for medical use of
marijuana, a qualified physician must conduct a physical examination of the patient and determine that the
patient has a qualifying medical condition and that medical marijuana would likely outweigh the health risks to
the patient. After diagnosing a patient with a qualifying condition, a qualified physician must review and enter
certain data into the medical marijuana use registry.
A qualified patient must have a physician certification in the medical marijuana use registry and have a valid
medical marijuana use registry identification card to obtain medical marijuana and medical marijuana delivery
devices from a MMTC. The Department of Health (DOH), through the Office of Medical Marijuana Use
(OMMU), must issue medical marijuana use registry identification cards to qualified patients and caregivers
who are residents of this state. The identification cards must be resistant to counterfeiting and tampering and
must include, at a minimum, the following:
The name, address, and date of birth of the qualified patient or caregiver;
A full-face, passport-type, color photograph of the qualified patient or caregiver taken within the 90
days immediately preceding registration or the Florida driver license or Florida identification card
photograph of the qualified patient or caregiver obtained directly from the Department of Highway
Safety and Motor Vehicles;
Identification as a qualified patient or a caregiver;
The unique numeric identifier used for the qualified patient in the medical marijuana use registry;
and
The expiration date of the identification card.
As of January 26, 2024, there are 871,459 qualified patients with active medical marijuana use registry
identification cards. The OMMU processes applications for identification cards within 5 business days of
receipt of a complete application. The annual application fee is $75 and OMMU does not currently offer a
reduction or waiver of this fee.
Florida is home to 21 military installations and 69,290 military personnel. Florida also has the nation’s third-
largest veteran population with almost 1.4 million veterans.
HB 1435 exempts individuals who can prove their status as veterans from the annual medical marijuana use
registry identification card fee.
The bill has an indeterminate, negative fiscal impact on DOH and no fiscal impact local government.
The bill provides an effective date of July 1, 2024. STORAGE NAME: h1435.HRS PAGE: 2
DATE: 1/31/2024
FULL ANALYSIS
I. SUBSTANTIVE ANALYSIS
A. EFFECT OF PROPOSED CHANGES:
Marijuana for Medical Use
Section 381.986, F.S., authorizes patients with any of the following debilitating medical conditions to
obtain medical marijuana from Medical Marijuana Treatment Centers (MMTC):
Cancer
Epilepsy
Glaucoma
Positive status for human immunodeficiency virus
Acquired immune deficiency syndrome
Post-traumatic stress disorder
Amyotrophic lateral sclerosis
Crohn’s disease
Parkinson’s disease
Multiple sclerosis
Medical conditions of the same kind or class as or comparable to those enumerated above
To obtain marijuana for medical use from a MMTC, and maintain the immunity from criminal
prosecution, the patient must obtain a physician certification from a qualified physician
1
and an
identification card from DOH.
Physician Certification
To certify a patient for medical use of marijuana, a qualified physician must conduct a physical
examination of the patient and determine that the patient has a qualifying medical condition and that
medical marijuana would likely outweigh the health risks to the patient.
2
A qualified physician must be
physically present in the same room when conducting the initial examination on a qualified patient.
3
The
physician must evaluate an existing patient at least once every 30 weeks before issuing a renewal
physician certification.
4
Under current law, the physician must conduct the in-person
5
physical
examination of the patient to issue the initial certification and may conduct any subsequent
examinations for renewal certifications through telehealth.
6
After diagnosing a patient with a qualifying condition, a qualified physician must review and enter
certain data into the medical marijuana use registry. The physician must review the medical marijuana
use registry and confirm that the patient does not have an active physician certification from another
qualified physician.
7
The physician must then register as the issuer of the physician certification for the
named qualified patient in the medical marijuana use registry and enter into the registry the contents of
the physician certification, including the patient’s qualifying condition, the dosage, the amount and
forms of marijuana authorized, and any types of marijuana delivery devices needed by the patient.
8
Medical Marijuana Use Registry Identification Card
1
To certify patients for medical use of marijuana, a physician must hold an active, unrestricted license as an allopathic physician under
chapter 458 or as an osteopathic physician under chapter 459 and comply with certain physician education requirements. See ss.
381.986(1)(m), F.S. and 381.986(3)(a), F.S.
2
S. 381.986, F.S.
3
S. 381.986(a), F.S.
4
S. 381.986(4)(g), F.S.
5
This means that the physician must be physically present and in the same room as the patient. S. 381.986(4)(a)1, F.S.
6
S. 381.986, F.S.
7
Id.
8
Id. STORAGE NAME: h1435.HRS PAGE: 3
DATE: 1/31/2024
A qualified patient must have a physician certification in the medical marijuana use registry and have a
valid medical marijuana use registry identification card to obtain medical marijuana and medical
marijuana delivery devices from a MMTC. The Department of Health (DOH) must issue medical
marijuana use registry identification cards to qualified patients and caregivers who are residents of this
state. The identification cards must be resistant to counterfeiting and tampering and must include, at a
minimum, the following:
The name, address, and date of birth of the qualified patient or caregiver;
A full-face, passport-type, color photograph of the qualified patient or caregiver taken within the 90
days immediately preceding registration or the Florida driver license or Florida identification card
photograph of the qualified patient or caregiver obtained directly from the Department of Highway
Safety and Motor Vehicles;
Identification as a qualified patient or a caregiver;
The unique numeric identifier used for the qualified patient in the medical marijuana use registry;
For a caregiver, the name and unique numeric identifier of the caregiver and the qualified patient or
patients that the caregiver is assisting; and
The expiration date of the identification card.
As of January 26, 2024, there are 871,459 qualified patients with active medical marijuana use registry
identification cards.
9
The Office of Medical Marijuana Use (OMMU) processes applications for
identification cards within 5 business days of receipt of a complete application. The annual application
fee is $75 and OMMU does not currently offer a reduction or waiver of this fee.
Veterans
Florida is home to 21 military installations
10
and 69,290 military personnel.
11
Florida also has the
nation’s third-largest veteran
12
population with almost 1.4 million veterans.
13
Many of these veterans
are recently transitioned servicemembers.
The U.S. Department of Veterans Affairs has issued informational guidance for the use of medical
marijuana by veterans:
14
Veterans will not be denied VA benefits because of marijuana use.
Veterans are encouraged to discuss marijuana use with their VA providers.
VA health care providers will record marijuana use in the Veteran's VA medical record in order
to have the information available in treatment planning. As with all clinical information, this is
part of the confidential medical record and protected under patient privacy and confidentiality
laws and regulations.
VA clinicians may not recommend medical marijuana.
9
Office of Medical Marijuana Use Weekly Updates, January 26, 2024, DOH, Office of Medical Marijuana Use, available at
https://knowthefactsmmj.com/wp-content/uploads/ommu_updates/2024/012624-OMMU-Update.pdf (last visited on
January 29, 2024).
10
Select Florida, Defense & Homeland Security, 2, https://selectflorida.org/wp-content/uploads/defense-and-homeland-
security-industry-profile.pdf (last visited Jan. 26, 2024).
11
Data from September 2021. Florida Military & Defense, Economic Impact Summary (2022), 2, available at
https://selectflorida.org/wp-content/uploads/Florida-2022-EIS-Summary-Book-Final.pdf (last visited Jan. 26, 2024).
12
S. 1.01(14), F.S., defines a “veteran” as a person who served in the active military, naval, or air service and who was
discharged or released under honorable conditions, or who later received an upgraded discharge under honorable
conditions. The definition in s. 1.01(14), F.S., is cited in numerous statutes, including ss. 117.02, 265.003, 292.055,
295.02, 295.07, 295.187, 295.188, 296.02, 296.08, 296.33, 296.36, 409.1664, 548.06, 943.17, and 1009.26, F.S.
13
U.S. Department of Veterans Affairs (VA), National Center for Veterans Analysis and Statistics, VetPop2020 by State,
Age Group, Gender, 2020-2050, available at https://www.va.gov/vetdata/veteran_population.asp (last visited Jan. 25,
2024). The Veteran Population Projection Model 2020 (VetPop2020) provides an official veteran population projection
from the U.S. Department of Veterans Affairs.
14
VA and Marijuana – What Veterans need to know, U.S. Department of Veterans Affairs,
https://www.publichealth.va.gov/marijuana.asp (last visited on January 26, 2024). STORAGE NAME: h1435.HRS PAGE: 4
DATE: 1/31/2024
VA clinicians may only prescribe medications that have been approved by the U.S. Food and
Drug Administration (FDA) for medical use. At present most products containing
tetrahydrocannabinol (THC), cannabidiol (CBD), or other cannabinoids are not approved for this
purpose by the FDA.
VA clinicians may not complete paperwork/forms required for Veteran patients to participate in
state-approved marijuana programs.
VA pharmacies may not fill prescriptions for medical marijuana.
VA will not pay for medical marijuana prescriptions from any source.
VA scientists may conduct research on marijuana benefits and risks, and potential for abuse,
under regulatory approval.
The use or possession of marijuana is prohibited at all VA medical centers, locations and
grounds. When you are on VA grounds it is federal law that is in force, not the laws of the state.
Veterans who are VA employees are subject to drug testing under the terms of employment.
The number of veterans who hold active medical marijuana use registry identification cards is unknown.
Effect of the Bill
HB 1435 exempts veterans from the annual medical marijuana use registry identification card fee. The
bill requires individuals to prove their status as a veteran by providing any of the following documents to
OMMU:
A DD Form 214, issued by the United States Department of Defense;
A veteran health identification card, issued by the United States Department of Veterans Affairs;
or
A veteran identification card, issued by the United States Department of Veterans Affairs
pursuant to the Veterans Identification Card Act of 2015, Pub. L. No. 114-31.
The bill provides an effective date of July 1, 2024.
B. SECTION DIRECTORY:
Section 1: Amends s. 381.986, F.S., relating to medical use of marijuana.
Section 2: Provides an effective date of July 1, 2024.
II. FISCAL ANALYSIS & ECONOMIC IMPACT STATEMENT
A. FISCAL IMPACT ON STATE GOVERNMENT:
1. Revenues:
None.
2. Expenditures:
The bill has an indeterminate, negative fiscal impact on DOH. Currently, there are 871,459 qualified
patients with active medical marijuana use registry identification cards who must pay $75 annually
to retain an active identification card. The number of veterans who hold active medical marijuana
use registry identification cards is unknown however, DOH will no longer be able to collect fees
from these patients.
B. FISCAL IMPACT ON LOCAL GOVERNMENTS:
1. Revenues:
None.
2. Expenditures:
None. STORAGE NAME: h1435.HRS PAGE: 5
DATE: 1/31/2024
C. DIRECT ECONOMIC IMPACT ON PRIVATE SECTOR:
The bill will have a positive fiscal impact on veterans who will not be required to pay the annual $75
identification card fee.
D. FISCAL COMMENTS:
None.
III. COMMENTS
A. CONSTITUTIONAL ISSUES:
1. Applicability of Municipality/County Mandates Provision:
Not applicable. The bill does not appear to affect county or municipal governments.
2. Other:
None.
B. RULE-MAKING AUTHORITY:
DOH has sufficient rulemaking authority to implement the bill’s provisions.
C. DRAFTING ISSUES OR OTHER COMMENTS:
None.
IV. AMENDMENTS/COMMITTEE SUBSTITUTE CHANGES