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.