88R8470 JSC-D
By: Raymond H.B. No. 2995
A BILL TO BE ENTITLED
AN ACT
relating to the prescribing of medical cannabis for medical use to
certain veterans with combat-related injuries or medical
conditions and the licensing of dispensing organizations under the
Texas Compassionate Use Program.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
ARTICLE 1. CHANGES TO CHAPTER 169, OCCUPATIONS CODE
SECTION 1.01. The heading to Chapter 169, Occupations Code,
is amended to read as follows:
CHAPTER 169. AUTHORITY TO PRESCRIBE LOW-THC CANNABIS OR MEDICAL
CANNABIS TO CERTAIN PATIENTS FOR COMPASSIONATE USE
SECTION 1.02. Section 169.001, Occupations Code, is amended
by adding Subdivisions (3-a) and (6) and amending Subdivision (4)
to read as follows:
(3-a) "Medical cannabis" means the plant Cannabis
sativa L., and any part of that plant or any compound, manufacture,
salt, derivative, mixture, preparation, resin, or oil of that plant
that contains more than one percent by weight of
tetrahydrocannabinols.
(4) "Medical use" means the ingestion [by a means of
administration other than by smoking] of a prescribed amount of
low-THC cannabis or medical cannabis by a person for whom low-THC
cannabis or medical cannabis is prescribed under this chapter.
(6) "Veteran" means a person who has served in:
(A) the army, navy, air force, space force, coast
guard, or marine corps of the United States; or
(B) the Texas Army National Guard or the Texas
Air National Guard.
SECTION 1.03. Section 169.0011, Occupations Code, is
amended to read as follows:
Sec. 169.0011. PRESCRIPTION FOR MEDICAL USE. A reference
in this chapter, Chapter 487, Health and Safety Code, or other law
to a prescription for medical use or a prescription for low-THC
cannabis or medical cannabis means an entry in the
compassionate-use registry established under Section 487.054,
Health and Safety Code.
SECTION 1.04. The heading to Section 169.002, Occupations
Code, is amended to read as follows:
Sec. 169.002. PHYSICIAN QUALIFIED TO PRESCRIBE LOW-THC
CANNABIS OR MEDICAL CANNABIS TO PATIENTS WITH CERTAIN MEDICAL
CONDITIONS.
SECTION 1.05. Sections 169.002(a) and (b), Occupations
Code, are amended to read as follows:
(a) Only a physician qualified with respect to a patient's
particular medical condition as provided by this section may
prescribe low-THC cannabis or medical cannabis, as applicable, in
accordance with this chapter to treat the applicable medical
condition.
(b) A physician is qualified to prescribe low-THC cannabis
or medical cannabis with respect to a patient's particular medical
condition if the physician:
(1) is licensed under this subtitle;
(2) is board certified in a medical specialty relevant
to the treatment of the patient's particular medical condition by a
specialty board approved by the American Board of Medical
Specialties or the Bureau of Osteopathic Specialists; and
(3) dedicates a significant portion of clinical
practice to the evaluation and treatment of the patient's
particular medical condition.
SECTION 1.06. Section 169.003, Occupations Code, is amended
to read as follows:
Sec. 169.003. PRESCRIPTION OF LOW-THC CANNABIS OR MEDICAL
CANNABIS. (a) A physician described by Section 169.002 may
prescribe low-THC cannabis to a patient if:
(1) the patient is a permanent resident of the state;
(2) the physician complies with the registration
requirements of Section 169.004; and
(3) the physician certifies to the department that:
(A) the patient is diagnosed with:
(i) epilepsy;
(ii) a seizure disorder;
(iii) multiple sclerosis;
(iv) spasticity;
(v) amyotrophic lateral sclerosis;
(vi) autism;
(vii) cancer;
(viii) an incurable neurodegenerative
disease;
(ix) post-traumatic stress disorder; or
(x) a medical condition that is approved
for a research program under Subchapter F, Chapter 487, Health and
Safety Code, and for which the patient is receiving treatment under
that program; and
(B) the physician determines the risk of the
medical use of low-THC cannabis by the patient is reasonable in
light of the potential benefit for the patient.
(b) A physician described by Section 169.002 may prescribe
medical cannabis to a patient who is a veteran if:
(1) the patient is a permanent resident of the state;
(2) the physician complies with the registration
requirements of Section 169.004; and
(3) the physician certifies to the department that:
(A) the patient is diagnosed with:
(i) post-traumatic stress disorder
resulting from combat engaged in during the patient's military
service; or
(ii) a physical injury or serious health
condition resulting from combat engaged in during the patient's
military service; and
(B) the physician determines the risk of the
medical use of medical cannabis by the patient is reasonable in
light of the potential benefit for the patient.
SECTION 1.07. The heading to Section 169.004, Occupations
Code, is amended to read as follows:
Sec. 169.004. [LOW-THC CANNABIS] PRESCRIBER REGISTRATION.
SECTION 1.08. Section 169.004(a), Occupations Code, is
amended to read as follows:
(a) Before a physician qualified to prescribe low-THC
cannabis or medical cannabis under Section 169.002 may prescribe or
renew a prescription for low-THC cannabis or medical cannabis for a
patient under this chapter, the physician must register as the
prescriber for that patient in the compassionate-use registry
maintained by the department under Section 487.054, Health and
Safety Code. The physician's registration must indicate:
(1) the physician's name;
(2) the patient's name and date of birth;
(3) whether the patient is prescribed low-THC cannabis
or medical cannabis and the dosage prescribed to the patient,
including the appropriate concentration of tetrahydrocannabinol in
medical cannabis, as applicable;
(4) the means of administration ordered for the
patient; and
(5) the total amount of low-THC cannabis or medical
cannabis with the appropriate concentration of
tetrahydrocannabinol in medical cannabis, as applicable, required
to fill the patient's prescription.
SECTION 1.09. Section 169.005, Occupations Code, is amended
to read as follows:
Sec. 169.005. PATIENT TREATMENT PLAN. (a) A physician
described by Section 169.002 who prescribes low-THC cannabis for a
patient's medical use under this chapter must maintain a patient
treatment plan that indicates:
(1) the dosage, means of administration, and planned
duration of treatment for the low-THC cannabis;
(2) a plan for monitoring the patient's symptoms; and
(3) a plan for monitoring indicators of tolerance or
reaction to low-THC cannabis.
(b) A physician described by Section 169.002 who prescribes
medical cannabis for a patient's medical use under this chapter
must maintain a patient treatment plan that indicates:
(1) the dosage, concentration of
tetrahydrocannabinol, means of administration, and planned
duration of treatment for the medical cannabis;
(2) a plan for monitoring the patient's symptoms; and
(3) a plan for monitoring indicators of tolerance or
reaction to medical cannabis.
(c) Notwithstanding any other provision of this chapter, a
physician described by Section 169.002 may authorize
administration by smoking, in addition to other means of
administration, only for a patient who is a veteran described by
Section 169.003(b).
ARTICLE 2. CHANGES TO CHAPTER 487, HEALTH AND SAFETY CODE
SECTION 2.01. Sections 487.001(3) and (4), Health and
Safety Code, are amended to read as follows:
(3) "Dispensing organization" means an organization
licensed by the department to cultivate and [,] process low-THC
cannabis and medical cannabis, and to dispense low-THC cannabis or
medical cannabis to a patient for whom low-THC cannabis or medical
cannabis is prescribed under Chapter 169, Occupations Code.
(4) "Low-THC cannabis" and "medical cannabis" have
[has] the meanings [meaning] assigned by Section 169.001,
Occupations Code.
SECTION 2.02. Section 487.054, Health and Safety Code, is
amended to read as follows:
Sec. 487.054. COMPASSIONATE-USE REGISTRY. (a) The
department shall establish and maintain a secure online
compassionate-use registry that contains:
(1) the name of each physician who registers as the
prescriber for a patient under Section 169.004, Occupations Code,
and for each patient for whom the physician has registered as the
prescriber:
(A) the patient's name;
(B) the patient's [and] date of birth;
(C) whether low-THC cannabis or medical cannabis
is prescribed and [of the patient,] the dosage prescribed,
including the appropriate concentration of tetrahydrocannabinol in
medical cannabis, as applicable;
(D) [,] the means of administration ordered; [,]
and
(E) the total amount of low-THC cannabis or
medical cannabis with the appropriate concentration of
tetrahydrocannabinol in medical cannabis, as applicable, required
to fill the patient's prescription; and
(2) a record of each amount of low-THC cannabis or
medical cannabis and the concentration of tetrahydrocannabinol in
medical cannabis, as applicable, dispensed by a dispensing
organization to a patient under a prescription.
(b) The department shall ensure the registry:
(1) is designed to prevent more than one qualified
physician from registering as the prescriber for a single patient;
(2) is accessible to law enforcement agencies and
dispensing organizations for the purpose of verifying whether a
patient is one for whom low-THC cannabis or medical cannabis is
prescribed and whether the patient's prescriptions have been
filled; and
(3) allows a physician qualified to prescribe low-THC
cannabis or medical cannabis under Section 169.002, Occupations
Code, to input safety and efficacy data derived from the treatment
of patients for whom low-THC cannabis or medical cannabis is
prescribed under Chapter 169, Occupations Code.
SECTION 2.03. Section 487.102, Health and Safety Code, is
amended to read as follows:
Sec. 487.102. ELIGIBILITY FOR LICENSE. An applicant for a
license to operate as a dispensing organization is eligible for the
license if:
(1) as determined by the department, the applicant
possesses:
(A) the technical and technological ability to
cultivate and produce low-THC cannabis or medical cannabis;
(B) the ability to secure:
(i) the resources and personnel necessary
to operate as a dispensing organization; and
(ii) premises reasonably located to allow
patients listed on the compassionate-use registry access to the
organization through existing infrastructure;
(C) the ability to maintain accountability for
the raw materials, the finished product, and any by-products used
or produced in the cultivation or production of low-THC cannabis or
medical cannabis to prevent unlawful access to or unlawful
diversion or possession of those materials, products, or
by-products; and
(D) the financial ability to maintain operations
for not less than two years from the date of application;
(2) each director, manager, or employee of the
applicant is registered under Subchapter D; and
(3) the applicant satisfies any additional criteria
determined by the director to be necessary to safely implement this
chapter.
SECTION 2.04. Section 487.104(a), Health and Safety Code,
is amended to read as follows:
(a) The department shall issue or renew a license to operate
as a dispensing organization only if:
(1) the department determines the applicant meets the
eligibility requirements described by Section 487.102; and
(2) issuance or renewal of the license is necessary to
ensure reasonable statewide access to, and the availability of,
low-THC cannabis or medical cannabis for patients registered in the
compassionate-use registry and for whom low-THC cannabis or medical
cannabis is prescribed under Chapter 169, Occupations Code.
SECTION 2.05. Section 487.107, Health and Safety Code, is
amended to read as follows:
Sec. 487.107. DUTIES RELATING TO DISPENSING
PRESCRIPTION. (a) Before dispensing low-THC cannabis or medical
cannabis to a person for whom the low-THC cannabis or medical
cannabis is prescribed under Chapter 169, Occupations Code, the
dispensing organization must verify that the prescription
presented:
(1) is for a person listed as a patient in the
compassionate-use registry;
(2) matches the entry in the compassionate-use
registry with respect to the total amount of low-THC cannabis or
medical cannabis required to fill the prescription; and
(3) has not previously been filled by a dispensing
organization as indicated by an entry in the compassionate-use
registry.
(b) After dispensing low-THC cannabis or medical cannabis
to a patient for whom the low-THC cannabis or medical cannabis is
prescribed under Chapter 169, Occupations Code, the dispensing
organization shall record in the compassionate-use registry the
form and quantity of low-THC cannabis or medical cannabis
dispensed, the concentration of tetrahydrocannabinol in the
medical cannabis dispensed, as applicable, and the date and time of
dispensation.
SECTION 2.06. Section 487.108(c), Health and Safety Code,
is amended to read as follows:
(c) After suspending or revoking a license issued under this
chapter, the director may seize or place under seal all low-THC
cannabis, medical cannabis, and drug paraphernalia owned or
possessed by the dispensing organization. If the director orders
the revocation of the license, a disposition may not be made of the
seized or sealed low-THC cannabis, medical cannabis, or drug
paraphernalia until the time for administrative appeal of the order
has elapsed or until all appeals have been concluded. When a
revocation order becomes final, all low-THC cannabis, medical
cannabis, and drug paraphernalia may be forfeited to the state as
provided under Subchapter E, Chapter 481.
SECTION 2.07. Section 487.201, Health and Safety Code, is
amended to read as follows:
Sec. 487.201. COUNTIES AND MUNICIPALITIES MAY NOT PROHIBIT
LOW-THC CANNABIS OR MEDICAL CANNABIS. A municipality, county, or
other political subdivision may not enact, adopt, or enforce a
rule, ordinance, order, resolution, or other regulation that
prohibits the cultivation, production, dispensing, or possession
of low-THC cannabis or medical cannabis, as authorized by this
chapter.
ARTICLE 3. CONFORMING CHANGES
SECTION 3.01. Section 443.202(a), Health and Safety Code,
is amended to read as follows:
(a) This section does not apply to low-THC cannabis or
medical cannabis regulated under Chapter 487.
SECTION 3.02. Section 443.2025(a), Health and Safety Code,
is amended to read as follows:
(a) This section does not apply to low-THC cannabis or
medical cannabis regulated under Chapter 487.
SECTION 3.03. Section 481.062(a), Health and Safety Code,
is amended to read as follows:
(a) The following persons may possess a controlled
substance under this chapter without registering with the Federal
Drug Enforcement Administration:
(1) an agent or employee of a manufacturer,
distributor, analyzer, or dispenser of the controlled substance who
is registered with the Federal Drug Enforcement Administration and
acting in the usual course of business or employment;
(2) a common or contract carrier, a warehouseman, or
an employee of a carrier or warehouseman whose possession of the
controlled substance is in the usual course of business or
employment;
(3) an ultimate user or a person in possession of the
controlled substance under a lawful order of a practitioner or in
lawful possession of the controlled substance if it is listed in
Schedule V;
(4) an officer or employee of this state, another
state, a political subdivision of this state or another state, or
the United States who is lawfully engaged in the enforcement of a
law relating to a controlled substance or drug or to a customs law
and authorized to possess the controlled substance in the discharge
of the person's official duties;
(5) if the substance is tetrahydrocannabinol or one of
its derivatives:
(A) a Department of State Health Services
official, a medical school researcher, or a research program
participant possessing the substance as authorized under
Subchapter G; or
(B) a practitioner or an ultimate user possessing
the substance as a participant in a federally approved therapeutic
research program that the commissioner has reviewed and found, in
writing, to contain a medically responsible research protocol; or
(6) a dispensing organization licensed under
Subchapter C, Chapter 487, that possesses low-THC cannabis or
medical cannabis.
SECTION 3.04. Section 481.111(e), Health and Safety Code,
is amended to read as follows:
(e) Sections 481.120, 481.121, 481.122, and 481.125 do not
apply to a person who engages in the acquisition, possession,
production, cultivation, delivery, or disposal of a raw material
used in or by-product created by the production or cultivation of
low-THC cannabis or medical cannabis if the person:
(1) for an offense involving possession only of
marihuana or drug paraphernalia:
(A) [,] is a patient for whom low-THC cannabis or
medical cannabis is prescribed under Chapter 169, Occupations Code,
or the patient's legal guardian; [,] and
(B) [the person] possesses low-THC cannabis or
medical cannabis obtained under a valid prescription from a
dispensing organization; or
(2) is a director, manager, or employee of a
dispensing organization and the person, solely in performing the
person's regular duties at the organization, acquires, possesses,
produces, cultivates, dispenses, or disposes of:
(A) in reasonable quantities, any low-THC
cannabis or medical cannabis or raw materials used in or
by-products created by the production or cultivation of low-THC
cannabis or medical cannabis; or
(B) any drug paraphernalia used in the
acquisition, possession, production, cultivation, delivery, or
disposal of low-THC cannabis or medical cannabis.
SECTION 3.05. Section 481.111(f)(2), Health and Safety
Code, is amended to read as follows:
(2) "Low-THC cannabis" and "medical cannabis" have
[has] the meanings [meaning] assigned by Section 169.001,
Occupations Code.
SECTION 3.06. Section 551.004(a), Occupations Code, is
amended to read as follows:
(a) This subtitle does not apply to:
(1) a practitioner licensed by the appropriate state
board who supplies a patient of the practitioner with a drug in a
manner authorized by state or federal law and who does not operate a
pharmacy for the retailing of prescription drugs;
(2) a member of the faculty of a college of pharmacy
recognized by the board who is a pharmacist and who performs the
pharmacist's services only for the benefit of the college;
(3) a person who procures prescription drugs for
lawful research, teaching, or testing and not for resale;
(4) a home and community support services agency that
possesses a dangerous drug as authorized by Section 142.0061,
142.0062, or 142.0063, Health and Safety Code; or
(5) a dispensing organization, as defined by Section
487.001, Health and Safety Code, that cultivates, processes, and
dispenses low-THC cannabis or medical cannabis, as authorized by a
license issued under Subchapter C, Chapter 487, Health and Safety
Code, to a patient listed in the compassionate-use registry
established under that chapter.
ARTICLE 4. TRANSITIONS AND EFFECTIVE DATE
SECTION 4.01. Not later than October 1, 2023, the public
safety director of the Department of Public Safety shall adopt
rules as required to implement, administer, and enforce Chapter
487, Health and Safety Code, as amended by this Act.
SECTION 4.02. This Act takes effect September 1, 2023.