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A BILL TO BE ENTITLED
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AN ACT
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relating to the prescribing of medical cannabis for medical use to |
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certain veterans with combat-related injuries or medical |
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conditions and the licensing of dispensing organizations under the |
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Texas Compassionate Use Program. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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ARTICLE 1. CHANGES TO CHAPTER 169, OCCUPATIONS CODE |
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SECTION 1.01. The heading to Chapter 169, Occupations Code, |
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is amended to read as follows: |
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CHAPTER 169. AUTHORITY TO PRESCRIBE LOW-THC CANNABIS OR MEDICAL |
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CANNABIS TO CERTAIN PATIENTS FOR COMPASSIONATE USE |
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SECTION 1.02. Section 169.001, Occupations Code, is amended |
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by adding Subdivisions (3-a) and (6) and amending Subdivision (4) |
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to read as follows: |
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(3-a) "Medical cannabis" means the plant Cannabis |
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sativa L., and any part of that plant or any compound, manufacture, |
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salt, derivative, mixture, preparation, resin, or oil of that plant |
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that contains more than one percent by weight of |
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tetrahydrocannabinols. |
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(4) "Medical use" means the ingestion [by a means of |
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administration other than by smoking] of a prescribed amount of |
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low-THC cannabis or medical cannabis by a person for whom low-THC |
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cannabis or medical cannabis is prescribed under this chapter. |
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(6) "Veteran" means a person who has served in: |
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(A) the army, navy, air force, space force, coast |
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guard, or marine corps of the United States; or |
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(B) the Texas Army National Guard or the Texas |
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Air National Guard. |
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SECTION 1.03. Section 169.0011, Occupations Code, is |
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amended to read as follows: |
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Sec. 169.0011. PRESCRIPTION FOR MEDICAL USE. A reference |
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in this chapter, Chapter 487, Health and Safety Code, or other law |
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to a prescription for medical use or a prescription for low-THC |
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cannabis or medical cannabis means an entry in the |
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compassionate-use registry established under Section 487.054, |
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Health and Safety Code. |
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SECTION 1.04. The heading to Section 169.002, Occupations |
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Code, is amended to read as follows: |
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Sec. 169.002. PHYSICIAN QUALIFIED TO PRESCRIBE LOW-THC |
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CANNABIS OR MEDICAL CANNABIS TO PATIENTS WITH CERTAIN MEDICAL |
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CONDITIONS. |
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SECTION 1.05. Sections 169.002(a) and (b), Occupations |
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Code, are amended to read as follows: |
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(a) Only a physician qualified with respect to a patient's |
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particular medical condition as provided by this section may |
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prescribe low-THC cannabis or medical cannabis, as applicable, in |
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accordance with this chapter to treat the applicable medical |
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condition. |
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(b) A physician is qualified to prescribe low-THC cannabis |
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or medical cannabis with respect to a patient's particular medical |
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condition if the physician: |
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(1) is licensed under this subtitle; |
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(2) is board certified in a medical specialty relevant |
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to the treatment of the patient's particular medical condition by a |
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specialty board approved by the American Board of Medical |
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Specialties or the Bureau of Osteopathic Specialists; and |
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(3) dedicates a significant portion of clinical |
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practice to the evaluation and treatment of the patient's |
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particular medical condition. |
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SECTION 1.06. Section 169.003, Occupations Code, is amended |
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to read as follows: |
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Sec. 169.003. PRESCRIPTION OF LOW-THC CANNABIS OR MEDICAL |
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CANNABIS. (a) A physician described by Section 169.002 may |
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prescribe low-THC cannabis to a patient if: |
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(1) the patient is a permanent resident of the state; |
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(2) the physician complies with the registration |
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requirements of Section 169.004; and |
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(3) the physician certifies to the department that: |
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(A) the patient is diagnosed with: |
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(i) epilepsy; |
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(ii) a seizure disorder; |
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(iii) multiple sclerosis; |
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(iv) spasticity; |
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(v) amyotrophic lateral sclerosis; |
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(vi) autism; |
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(vii) cancer; |
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(viii) an incurable neurodegenerative |
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disease; |
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(ix) post-traumatic stress disorder; or |
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(x) a medical condition that is approved |
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for a research program under Subchapter F, Chapter 487, Health and |
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Safety Code, and for which the patient is receiving treatment under |
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that program; and |
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(B) the physician determines the risk of the |
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medical use of low-THC cannabis by the patient is reasonable in |
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light of the potential benefit for the patient. |
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(b) A physician described by Section 169.002 may prescribe |
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medical cannabis to a patient who is a veteran if: |
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(1) the patient is a permanent resident of the state; |
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(2) the physician complies with the registration |
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requirements of Section 169.004; and |
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(3) the physician certifies to the department that: |
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(A) the patient is diagnosed with: |
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(i) post-traumatic stress disorder |
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resulting from combat engaged in during the patient's military |
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service; or |
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(ii) a physical injury or serious health |
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condition resulting from combat engaged in during the patient's |
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military service; and |
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(B) the physician determines the risk of the |
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medical use of medical cannabis by the patient is reasonable in |
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light of the potential benefit for the patient. |
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SECTION 1.07. The heading to Section 169.004, Occupations |
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Code, is amended to read as follows: |
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Sec. 169.004. [LOW-THC CANNABIS] PRESCRIBER REGISTRATION. |
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SECTION 1.08. Section 169.004(a), Occupations Code, is |
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amended to read as follows: |
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(a) Before a physician qualified to prescribe low-THC |
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cannabis or medical cannabis under Section 169.002 may prescribe or |
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renew a prescription for low-THC cannabis or medical cannabis for a |
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patient under this chapter, the physician must register as the |
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prescriber for that patient in the compassionate-use registry |
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maintained by the department under Section 487.054, Health and |
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Safety Code. The physician's registration must indicate: |
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(1) the physician's name; |
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(2) the patient's name and date of birth; |
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(3) whether the patient is prescribed low-THC cannabis |
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or medical cannabis and the dosage prescribed to the patient, |
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including the appropriate concentration of tetrahydrocannabinol in |
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medical cannabis, as applicable; |
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(4) the means of administration ordered for the |
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patient; and |
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(5) the total amount of low-THC cannabis or medical |
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cannabis with the appropriate concentration of |
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tetrahydrocannabinol in medical cannabis, as applicable, required |
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to fill the patient's prescription. |
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SECTION 1.09. Section 169.005, Occupations Code, is amended |
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to read as follows: |
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Sec. 169.005. PATIENT TREATMENT PLAN. (a) A physician |
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described by Section 169.002 who prescribes low-THC cannabis for a |
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patient's medical use under this chapter must maintain a patient |
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treatment plan that indicates: |
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(1) the dosage, means of administration, and planned |
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duration of treatment for the low-THC cannabis; |
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(2) a plan for monitoring the patient's symptoms; and |
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(3) a plan for monitoring indicators of tolerance or |
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reaction to low-THC cannabis. |
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(b) A physician described by Section 169.002 who prescribes |
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medical cannabis for a patient's medical use under this chapter |
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must maintain a patient treatment plan that indicates: |
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(1) the dosage, concentration of |
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tetrahydrocannabinol, means of administration, and planned |
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duration of treatment for the medical cannabis; |
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(2) a plan for monitoring the patient's symptoms; and |
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(3) a plan for monitoring indicators of tolerance or |
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reaction to medical cannabis. |
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(c) Notwithstanding any other provision of this chapter, a |
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physician described by Section 169.002 may authorize |
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administration by smoking, in addition to other means of |
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administration, only for a patient who is a veteran described by |
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Section 169.003(b). |
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ARTICLE 2. CHANGES TO CHAPTER 487, HEALTH AND SAFETY CODE |
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SECTION 2.01. Sections 487.001(3) and (4), Health and |
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Safety Code, are amended to read as follows: |
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(3) "Dispensing organization" means an organization |
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licensed by the department to cultivate and [,] process low-THC |
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cannabis and medical cannabis, and to dispense low-THC cannabis or |
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medical cannabis to a patient for whom low-THC cannabis or medical |
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cannabis is prescribed under Chapter 169, Occupations Code. |
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(4) "Low-THC cannabis" and "medical cannabis" have |
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[has] the meanings [meaning] assigned by Section 169.001, |
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Occupations Code. |
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SECTION 2.02. Section 487.054, Health and Safety Code, is |
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amended to read as follows: |
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Sec. 487.054. COMPASSIONATE-USE REGISTRY. (a) The |
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department shall establish and maintain a secure online |
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compassionate-use registry that contains: |
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(1) the name of each physician who registers as the |
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prescriber for a patient under Section 169.004, Occupations Code, |
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and for each patient for whom the physician has registered as the |
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prescriber: |
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(A) the patient's name; |
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(B) the patient's [and] date of birth; |
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(C) whether low-THC cannabis or medical cannabis |
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is prescribed and [of the patient,] the dosage prescribed, |
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including the appropriate concentration of tetrahydrocannabinol in |
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medical cannabis, as applicable; |
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(D) [,] the means of administration ordered; [,] |
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and |
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(E) the total amount of low-THC cannabis or |
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medical cannabis with the appropriate concentration of |
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tetrahydrocannabinol in medical cannabis, as applicable, required |
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to fill the patient's prescription; and |
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(2) a record of each amount of low-THC cannabis or |
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medical cannabis and the concentration of tetrahydrocannabinol in |
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medical cannabis, as applicable, dispensed by a dispensing |
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organization to a patient under a prescription. |
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(b) The department shall ensure the registry: |
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(1) is designed to prevent more than one qualified |
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physician from registering as the prescriber for a single patient; |
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(2) is accessible to law enforcement agencies and |
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dispensing organizations for the purpose of verifying whether a |
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patient is one for whom low-THC cannabis or medical cannabis is |
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prescribed and whether the patient's prescriptions have been |
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filled; and |
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(3) allows a physician qualified to prescribe low-THC |
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cannabis or medical cannabis under Section 169.002, Occupations |
|
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Code, to input safety and efficacy data derived from the treatment |
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of patients for whom low-THC cannabis or medical cannabis is |
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prescribed under Chapter 169, Occupations Code. |
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SECTION 2.03. Section 487.102, Health and Safety Code, is |
|
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amended to read as follows: |
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Sec. 487.102. ELIGIBILITY FOR LICENSE. An applicant for a |
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license to operate as a dispensing organization is eligible for the |
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license if: |
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(1) as determined by the department, the applicant |
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possesses: |
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(A) the technical and technological ability to |
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cultivate and produce low-THC cannabis or medical cannabis; |
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(B) the ability to secure: |
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(i) the resources and personnel necessary |
|
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to operate as a dispensing organization; and |
|
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(ii) premises reasonably located to allow |
|
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patients listed on the compassionate-use registry access to the |
|
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organization through existing infrastructure; |
|
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(C) the ability to maintain accountability for |
|
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the raw materials, the finished product, and any by-products used |
|
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or produced in the cultivation or production of low-THC cannabis or |
|
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medical cannabis to prevent unlawful access to or unlawful |
|
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diversion or possession of those materials, products, or |
|
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by-products; and |
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(D) the financial ability to maintain operations |
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for not less than two years from the date of application; |
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(2) each director, manager, or employee of the |
|
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applicant is registered under Subchapter D; and |
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(3) the applicant satisfies any additional criteria |
|
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determined by the director to be necessary to safely implement this |
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chapter. |
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SECTION 2.04. Section 487.104(a), Health and Safety Code, |
|
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is amended to read as follows: |
|
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(a) The department shall issue or renew a license to operate |
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as a dispensing organization only if: |
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(1) the department determines the applicant meets the |
|
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eligibility requirements described by Section 487.102; and |
|
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(2) issuance or renewal of the license is necessary to |
|
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ensure reasonable statewide access to, and the availability of, |
|
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low-THC cannabis or medical cannabis for patients registered in the |
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compassionate-use registry and for whom low-THC cannabis or medical |
|
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cannabis is prescribed under Chapter 169, Occupations Code. |
|
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SECTION 2.05. Section 487.107, Health and Safety Code, is |
|
|
amended to read as follows: |
|
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Sec. 487.107. DUTIES RELATING TO DISPENSING |
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PRESCRIPTION. (a) Before dispensing low-THC cannabis or medical |
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cannabis to a person for whom the low-THC cannabis or medical |
|
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cannabis is prescribed under Chapter 169, Occupations Code, the |
|
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dispensing organization must verify that the prescription |
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presented: |
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(1) is for a person listed as a patient in the |
|
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compassionate-use registry; |
|
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(2) matches the entry in the compassionate-use |
|
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registry with respect to the total amount of low-THC cannabis or |
|
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medical cannabis required to fill the prescription; and |
|
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(3) has not previously been filled by a dispensing |
|
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organization as indicated by an entry in the compassionate-use |
|
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registry. |
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(b) After dispensing low-THC cannabis or medical cannabis |
|
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to a patient for whom the low-THC cannabis or medical cannabis is |
|
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prescribed under Chapter 169, Occupations Code, the dispensing |
|
|
organization shall record in the compassionate-use registry the |
|
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form and quantity of low-THC cannabis or medical cannabis |
|
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dispensed, the concentration of tetrahydrocannabinol in the |
|
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medical cannabis dispensed, as applicable, and the date and time of |
|
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dispensation. |
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SECTION 2.06. Section 487.108(c), Health and Safety Code, |
|
|
is amended to read as follows: |
|
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(c) After suspending or revoking a license issued under this |
|
|
chapter, the director may seize or place under seal all low-THC |
|
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cannabis, medical cannabis, and drug paraphernalia owned or |
|
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possessed by the dispensing organization. If the director orders |
|
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the revocation of the license, a disposition may not be made of the |
|
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seized or sealed low-THC cannabis, medical cannabis, or drug |
|
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paraphernalia until the time for administrative appeal of the order |
|
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has elapsed or until all appeals have been concluded. When a |
|
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revocation order becomes final, all low-THC cannabis, medical |
|
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cannabis, and drug paraphernalia may be forfeited to the state as |
|
|
provided under Subchapter E, Chapter 481. |
|
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SECTION 2.07. Section 487.201, Health and Safety Code, is |
|
|
amended to read as follows: |
|
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Sec. 487.201. COUNTIES AND MUNICIPALITIES MAY NOT PROHIBIT |
|
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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 |
|
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chapter. |
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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 |
|
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substance under this chapter without registering with the Federal |
|
|
Drug Enforcement Administration: |
|
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(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 |
|
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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. |