NC Compassionate Care Act

The “North Carolina Compassionate Care Act” protects patients and their doctors who use or give medical cannabis. 

• Cannabis: Marijuana

• It does not change rules about using cannabis for non-medical reasons.

The main goal is to set up a system for growing, processing, and selling medical cannabis.

This bill explains words and ideas that are important to know in the suggested changes, such as:

• Adequate supply – The amount of usable cannabis, decided by the patient's doctor, that’s in North Carolina. 

  • This can be shared between the patient and their designated caregiver. 

  • Should be enough to last about 30 days. 

  • It can be in any form suggested by the doctor to help with the patient’s serious medical issue.

• Bona fide physician-patient relationship – A good connection between a doctor and their patient to treat medical conditions. 

  • The doctor has fully checked on the patient's past medical needs

  • And has checked if they’ve ever used medication the wrong way. 

  • And has checked the patient in person. 

  • The doctor is able to provide care and follow-up over a long period of time, to see how well cannabis is working for the patient.

• Cannabis. – Marijuana.  

• Cannabis-infused product. – A product that has cannabis in it. 

  • Meant to be used other than by breathing it in, smoking, or vaping. 

    • Vaping – using a special device that heats up cannabis (a plant) to make a mist or smoke that you can breathe in.

• Commission. – The Medical Cannabis Production Commission.  

  • The Commission can make rules to protect people, 

  • Set up with 11 members, all chosen by the governor. 

    • The governor: the main leader of North Carolina.

  • They can be on the commission for Four-year starting July 1 of the year they’re chosen.  

  • Members can do another 4 years after finishing the first 4 years.

  • Members can’t be patients, caregivers, or doctors who check to see if patients need medical cannabis.

• Debilitating medical condition. – One or more of the following, with a written note from a doctor:  

  • Cancer.  

  • Epilepsy.  

  • Positive HIV test.  

  • AIDS.  

  • ALS (Lou Gehrig’s disease).  

  • Crohn's disease.  

  • Sickle cell anemia.  

  • Parkinson’s disease.  

  • Post-traumatic stress disorder, if there’s proof the patient experienced some trauma. 

    • This proof could include: 

      • Military service in a combat zone, 

      • Being a victim of a violent or sexual crime, 

      • Being a first responder.  

  • Multiple sclerosis.  

  • Cachexia or wasting syndrome, with intense or ongoing nausea, especially if it is ending the person’s life with less than six months left to live.  

  • A condition that leads to hospice care or other serious medical issues.

    • Hospice care: Special care that helps people who are very sick and near the end of their life feel comfortable and not in pain.

• Department – The North Carolina Department of Health and Human Services, which is a group in the state government that helps take care of people's health and well-being in North Carolina.  

• Designated caregiver – Someone with a special ID card from the Department that allows them to help a patient use cannabis for medical reasons.  

• Medical cannabis center – A place run by someone who grows and sells cannabis and cannabis items to patients with a card.

• Medical use of cannabis or medical use – The buying, giving, having, making, moving, or use of cannabis and cannabis items, or equipment used to: 

  • take cannabis 

  • treat or ease symptoms of a qualifying patient’s serious medical condition 

    • Including transferring cannabis from a caregiver to a patient they’re authorized to help.

• Physician – A doctor with a medical license who: 

  • Is respected

  • Has completed continuing education classes, which are classes to make sure doctors stay up to date on medical info after finishing medical school.

• Production facility – A place run by a supplier that grows, holds, and makes cannabis and infused products.

• Qualified patient – Someone a doctor decided has a serious medical problem that marijuana can help.

• Registry identification card – A card issued by the North Carolina Department of Health and Human Services, showing someone is a qualified patient or caregiver.

• Registry identification cardholder – A qualified patient or a caregiver who has a special card called a “registry ID card”

  • Only the Department of Health and Human Services can give out this card.

• Regulated medical cannabis supply system or system – A system set up by the Department to safely make and give out cannabis and cannabis-infused items to patients or caregivers.

• Smoking – Using or having a lit cannabis item.

• Supplier – A person licensed to make or sell cannabis and similar items. They:

  • grow cannabis, and

  • owns and runs one or more medical cannabis centers, and 

  • owns and runs places where items are made.

• Supplier identification cardholder – Someone who has been given a supplier registry ID card.

• Supplier registry identification card – A card issued by the Department.

• Usable cannabis – 

  • The dried buds and mature female flowers of the Cannabis plant

  • any mixture of them that can be legally used medically.

• Written certification – A statement signed by a doctor that explains:

  • The patient’s serious medical condition.

  • That the doctor thinks the medical benefits of using cannabis are bigger than the risks

  • How the cannabis will be delivered.

  • The amount, not more than needed.

  • The doctor’s national provider ID, if applicable.

  • Any other info required by the Commission.

  • The certification’s valid for up to one year.

• Compassionate Use Advisory Board – An 11-member group of people that all know different things.

  • All group members will be chosen by the governor, who is the leader of North Carolina

If this bill passes, doctors have to follow rules about getting their patients cannabis. Like:

• Before giving out a written certification, a doctor has to take a 10-hour class on prescribing medical cannabis.  

• Doctors need to do a three-hour extra course every year when giving out a written certification.  

• Proof must be kept for six years and can be checked by the Department or the NC Medical Board.   

  • NC Medical board: A group of doctors and experts that makes sure other doctors in North Carolina are doing their jobs safely and correctly.

• A doctor should only give a certification to a patient they have an honest doctor-patient relationship with.  

• Doctors must have a physical office in North Carolina to do in-person exams.  

• Each patient should be checked for mental health and whether they’re at risk of using drugs the wrong way.  

• Written certifications must be put into the safe computer file that will hold info about patients and caregivers who can use marijuana.

• Doctors need to educate patients once a year about the risks of cannabis.

• Doctors should regularly check on patients' progress, treatment, delivery methods, and side effects

  • at least every 3 months in the first year and then every year after that.  

• When renewing, doctors must check the patient's drug history in the system for reporting who’s using which drugs.

• Doctors have to update the safe computer file holding info about patients within 48 hours if there’s any change.

• Doctors aren’t allowed to check on patients at a medical cannabis center.  

  • Medical cannabis center: A place where people with certain health problems can get medicine made from the cannabis plant, if a doctor says it might help them feel better.

• Doctors cannot advertise that they are able to give out certifications.  

• Doctors giving certifications can’t have financial interests in suppliers or testing labs, and they shouldn’t profit from the certification itself — though they can charge fees.  

• If a patient is less than 18 years old, he doctor has to explain the risks and benefits of medical cannabis to the patient and their parent or guardian.  

  • The patient under 18 cannot smoke marijuana, but they can take it other ways.  

  • The patient and caregivers must agree to this

The Department of Health and Human Services will also have to follow rules.

If this bill passes, the parent or person legally in charge of a minor using Marijuana, has to write down that they agree to:  

• The minor is using cannabis medically  

• Take care of the minor while they are using marijuana

• Handle buying the marijuana and how often the minor uses it 

If this bill passes, Registry Identification Cards have to have info about who the person is, their picture, an ID number, and how they get marijuana. 

If a person’s info changes, they or their caregiver have to let the Department know within 15 days 

• They also have to pay $50.  

• Not letting the department know in time may mean they have to pay even more money.

• New cards will be sent out within 10 days after they tell the department and pay the $50.

• When caregiver changes happen, the Department will tell the old caregiver within 15 days, and their protection ends after 30 days.  

People with cards have to tell the Department if their card is lost within 15 days 

• They also have to pay $50 fee to get a new card.  

• New cards will be ready within five days, with a new ID number.  

People with cards must carry their card and regular, current ID (like a driver’s license) when they have cannabis.  

• They have to show both to police if police talk to them about having marijuana.  

• Police can check with the department to make sure they are who they say they are.

If people with cards break these rules, the Department can take away cards.

• People who have their cards taken away can argue that they should still have a card.

The Department will set the rules for how cards are given out.  

A safe computer file will hold info about patients and caregivers who can use cannabis. This info will include: 

• Who the people with cards

• Where they live 

• A photo of them

• Who their doctor is.

• How much marijuana they can have, and how they get it.   

If this bill passes, info from patients, caregivers, and doctors is private.   

• Only Department staff and police can see them as needed.  

• It is illegal for anyone to share this private info:

  • They will get in trouble for a crime called a “Class 2 misdemeanor.” 

  • They will have to pay up to $1000

Department staff might tell the police about fake or info submitted for registry cards.

If this bill passes, the Medical Cannabis Production Commission will: 

• Set up a system allowing suppliers to grow cannabis and infused products.

• Make rules about this system so that it is safe, clean, and organized

• Set up and be in charge of a computer system that tracks cannabis from when it is planted to to when it is sold. 

  If this bill passes, no one is allowed to:

• Grow, make, or sell cannabis or infused items without getting a “medical cannabis supplier” license from the Commission.

• Run a business that makes cannabis or infused products without a license.

• Open or run a medical cannabis center that sells cannabis, infused products, or related items for patients and caregivers.

To apply to be a supplier people need to turn in paperwork given by the Department, which will include info about who they are and what they will be doing.

If this bill passes, they will have to pay money to the government to get and keep their license and follow certain rules.

• If suppliers break the rules, they will have to pay more money to the government.

If this bill passes, people with cards to use medical cannabis can’t get in trouble for having or buying cannabis as long as they have about the amount the doctor suggested for them

This bill also puts in place rules about the packaging cannabis is sold in. 

If this bill passes, state workers should not treat a cardholder using cannabis differently from someone using other medicine given by a doctor.

This bill does not allow smoking and vaping cannabis in public places.

• People who break this rule will have to pay up to $25

Making or selling cannabis illegally, or fake cannabis, are serious crimes. 

If people with cards are caught with cannabis illegally, they could get in big trouble.

• Using a fake ID to get cannabis is also a crime.

If this bill passes, every cannabis label should at least include:

• The name of the medical cannabis center.

• The amount of tetrahydrocannabinol (THC) and cannabidiol (CBD).

•  The name of where it was made.

• A statement in all capital letters, with a color that stands out, saying, "NOT FOR RESALE. FOR MEDICAL USE ONLY. KEEP OUT OF THE REACH OF CHILDREN AND ANIMALS."

• How long it usually takes for the product to kick in.

• For items that can be eaten: 

  • a list of ingredients

  • the things people could be allergic to

  • a list of facts about how it affects the body

  • a symbol showing it has cannabis in it.

• Who it is for

• The doctor who gave permission.

• The recommended amount from the doctor.

The leaders of North Carolina want the North Carolina Collaboratory to research using cannabis in medical treatments. 

• North Carolina Collaboratory: A team of researchers at North Carolina universities that studies big problems in the state and helps the government make smart decisions using science.

If this bill passes, money will be set aside to support the department in doing what this bill says they have to do. 

• Any leftover money will go to the state’s bank account at the start of the next year.

This bill does NOT:

• Allow anyone to break other laws. 

• Let anyone have cannabis who does not medically need it.

• Allow people to drive vehicles right after having cannabis  

• Make places like schools and jobs let people use cannabis there.

• Change laws about doctors, patients, or suppliers who do things wrong

• Stop community groups from setting their own rules about using cannabis

If this bill passes, these changes start when it is signed into law.