Policy \ \ Medical (Palliative) Use of Marijuana

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1 Policy \ \ Medical (Palliative) Use of Marijuana DATE: February 13, 2017 PREVIOUS ITEM: None ENCLOSURES: CABE s Suggested Policy \ \ CABE s July 15, 2016 Policy Update REASON: To Remove from Table and Approve Policy \ \ BACKGROUND: This policy was tabled at the January 9, 2017 Board of Education Meeting. This is a suggested policy from CABE, and does not currently exist in our policies. It was reviewed by the Director of Human Resources and he is recommending adopting CABE s suggested policy. CABE s suggested policy reflects current changes in legislative status regarding Medical (Palliative) Use of Marijuana. ACTION: Accept or Reject

2 (a) / A separate policy addressing medical marijuana use, applicable to students and staff, to consider. Students Medical (Palliative) Use of Marijuana This policy sets forth the prohibited use of medical marijuana (palliative use) in the District s schools and on its property. Definitions Palliative use means the acquisition, distribution, transfer, possession or transportation of marijuana or paraphernalia relating to marijuana, including the transfer of marijuana and paraphernalia relating to marijuana from the patient s primary caregiver to the qualifying patient, to alleviate a qualifying patient s symptoms of a debilitating medical condition or the effects of such symptoms, but does not include any such use of marijuana by any person other than the qualifying patient. Qualifying patient means a person who is a resident of Connecticut, has been diagnosed by a physician as having a debilitating medical condition, and is eighteen years of age or older, is an emancipated minor, or has written consent from a custodial parent/guardian or other person having legal custody of such person that indicates that such person has permission from such parent, guardian or other person for the palliative use of marijuana for a debilitating medical condition and that such parent, guardian or other person will serve as a primary caregiver for the qualifying patient and control the acquisition and possession of marijuana and any related paraphernalia for palliative use on behalf of such person. Primary caregiver means a person, other than the qualifying patient and the qualifying patient s physician, who is eighteen years of age or older and has agreed to undertake the responsibility for managing the well-being of the qualifying patient with respect to the palliative use of marijuana, provided in the case of a qualifying patient under eighteen years of age and not an emancipated minor or otherwise lacking legal capacity, such person shall be a parent, guardian or person having legal custody of such qualifying patient and in the case of a qualifying patient eighteen years of age or older or an emancipated minor, the need for such person shall be evaluated by the qualifying patient s physician and such need shall be documented in the written certification, issued by a physician (does not include a physician assistant).

3 (b) / Students Medical (Palliative) Use of Marijuana (continued) Definitions (continued) Debilitating medical condition means cancer, glaucoma, positive status for human immunodeficiency virus or acquired immune deficiency syndrome, Parkinson s Disease, multiple sclerosis, damage to the nervous tissue of the spinal cord with objective neurological indication of intractable spasticity, epilepsy, or uncontrolled intractable seizure disorder, cachexia, wasting syndrome, Crohn s disease, post-traumatic stress disorder, irreversible spinal cord injury with objective neurological indication of intractable spasticity, cerebral palsy, cystic fibrosis or terminal illness requiring end-of-life care, except, if the qualifying patient is under eighteen years of age. debilitating medical condition means terminal illness requiring end-oflife care, irreversible spinal cord injury with objective neurological indication of intractable spasticity, cerebral palsy, cystic fibrosis, severe epilepsy or incontrollable seizure disorder. Research program means a study approved by the Department of Consumer Protection (DEP) and undertaken to increase information or knowledge regarding the growth, processing, medical attributes, dosage forms, administration or use of marijuana to treat or alleviate symptoms of any medical conditions or the effects of such symptoms. Although possession and use of marijuana for certain medical conditions is permitted in Connecticut, the Board of Education (Board) recognizes that the possession and use of marijuana remains illegal under federal law. Consistent with federal law, including the Controlled Substances Act and the Drug Free Schools and Communities Act, the use and/or possession of marijuana continues to be prohibited while a student or employee is on campus, riding a school bus or at school-sponsored activities. To qualify for medical marijuana use, an unemancipated minor must have written consent from a custodial parent/guardian or other person with legal custody, indicating that the person has given permission for the minor to use marijuana for a debilitating condition, as defined. The written consent must state that the person will serve as the minor s primary caregiver and control the acquisition and possession of marijuana and any related paraphernalia on the minor s behalf. The unemancipated minor via the person with legal custody, must provide DEP with a letter from the minor s primary care provider in addition to another letter from a physician certified in an area involved in the treatment of the minor s debilitating condition. Such written certification shall not be for marijuana in a dosage form that requires that the marijuana be smoked, inhaled, or vaporized.

4 (c) / Students Medical (Palliative) Use of Marijuana (continued) The protections provided to patients, both adult and minors, utilizing medical marijuana is prescribed in state statute, do not apply if the patient ingests marijuana in certain settings such as at work, at school, or in public. It is the Board s intent, via this policy to maintain compliance with state and federal laws with regard to the prohibited use of marijuana in the schools, on school property and at school-related activities. This policy is also intended to maintain compliance with the afore-mentioned federal legislation. The Board directs the Superintendent and staff to continue to enforce its current policies regarding controlled substances. Any student or employee who violate District policies prohibiting the manufacture, distribution, dispensation, possession or use of illegal drugs in District schools, on District property or as part of any District activities will be subject to disciplinary and criminal action, up to and including suspension, expulsion or termination of employment. No District school may refuse to enroll any person or discriminate against any student solely on the basis of such person s or student s status as a qualifying patient or primary caregiver, per sections 1 to 15, inclusive, of P.A , as amended by P.A The District shall not refuse to hire a person nor discharge, penalize, or threaten an employee solely on the basis of such person s or employee s status as a qualifying patient or primary caregiver, as described in P.A , as amended. However, the Board retains its ability to prohibit the use of intoxicating substances during work hours and its ability to discipline an employee or student for being under the influence of intoxicating substances during work hours, while on school property or at a school-sponsored activity. (cf / Alcohol, Drugs and Tobacco) (cf / Drug-Free Workplace) (cf Suspension/Expulsion) (cf Inhalant Abuse) (cf Steroid Use) (cf Out of School Grounds Misconduct) (cf Corporal Punishment) (cf Search and Seizure) (cf Use of Dogs to Search School Property) (cf Drugs, Alcohol, Tobacco)

5 (d) / Students Medical (Palliative) Use of Marijuana (continued) Legal Reference: Policy adopted: Connecticut General Statutes 1-21b Smoking prohibited in certain places Teaching about alcohol, nicotine or tobacco, drugs and acquired immune deficiency syndrome. Training of personnel a Professional communications between teacher or nurse and student. Surrender or physical evidence obtained from students b Policy statement on drugs (d) Boards of education to prescribe rules, policies and procedures re sale or possession of alcohol or controlled drugs. 2la-240 Definitions dependency producing drugs. 21a -240(8) Definitions Controlled Drugs, dependency producing drugs. 21a-240(9) Definitions controlled substance. 21a-243 Regulation re schedules of controlled substances. 21a-408 Palliative Use of Marijuana (as amended by P.A ) Smoking in motor buses, railroad cars and school buses. P.A An Act Regulating the Sale and Possession of Synthetic Marijuana and Salvia Divinorum. P.A An Act Concerning the Palliative Use of Marijuana. P.A An Act Concerning the Palliative Use of Marijuana. Federal Regulation 34 CFR Part 85 Drug-free Schools & Communities Act. 20 U.S.C. Section 7181 et. seq., No Child Left Behind Act. Synthetic Drug Abuse Prevention Act of (part of s.3187, the Food and Drug Administration Safety and Innovation Act). New Jersey v. T.L.O, 469 U.S. 325 (1985). Veronia School District 47J v. Acton, 515 U.S (1995). Board of Education of Independent School District No 92 of Pottawatomie County v. Earls U.S. (2002). EAST HARTFORD PUBLIC SCHOOLS East Hartford, Connecticut

6 T P.A An Act Concerning the Palliative Use of Marijuana ~Page 1~ / July 15, 2016 Update Mailing No. 4 his Act makes various changes to the state s medical marijuana program, which the Department of Consumer Protection (DCP) administers. Among other things, the legislation: 1. allows minors to be qualifying patients, subject to certain additional requirements and limitations beyond those that apply for adults; 2. adds to the list of qualifying debilitating conditions for adults; 3. requires patients to select a dispensary from which they will purchase marijuana, and subjects patients to a possible enforcement hearing if they possess marijuana obtained from another source; 7. requires the DCP commissioner to adopt regulations on licensing marijuana laboratories and laboratory employees; 8. makes changes to qualifications of and other matters concerning the medical marijuana board, including allowing the board to recommend that a medical condition, treatment, or disease be removed from the list of qualifying debilitating conditions; and 9. requires dispensaries to report annually to DCP. 1-3 & 5 Minors as Qualifying Patients Under previous law, only state residents age 18 or older could be qualifying medical marijuana patients. The Act extends the program to state residents under age 18. (While the law refers to palliative rather than medical marijuana use, the program is generally referred to as the medical marijuana program.) 4. allows dispensaries to distribute marijuana to hospices and other inpatient care facilities that have protocols for handling and distributing marijuana; 5. specifically allows nurses to administer marijuana in licensed health care facilities; 6. allows the DCP commissioner to approve medical marijuana research programs, requires him to adopt regulations on licensing research program employees and related matters, and requires research program subjects to register with the department; As is the case for adult patients under previous existing law, before using marijuana for medical purposes, minors must have a written certification by a physician who determined, among other things, that the patient has a qualifying debilitating medical condition. Patients, and their primary caregivers, must register with DCP and pay certain fees. The legislation creates additional requirements that must be met for unemancipated minors to qualify. Previous law prohibits the use of medical marijuana in the presence of minors. The bill creates an exception if the minor is a qualifying patient or research program subject.

7 P.A An Act Concerning the Palliative Use of Marijuana ~Page 2~ Written Consent by Parent or Person with Legal Custody and Agreement to Serve as Primary Caregiver To qualify for medical marijuana use, an unemancipated minor must have written consent from a custodial parent, guardian, or other person with legal custody, indicating that the person has given permission for the minor to use marijuana for a debilitating condition. The written consent must also state that the person will (1) serve as the minor s primary caregiver and (2) control the acquisition and possession of marijuana and any related paraphernalia on the minor s behalf. By law, a medical marijuana patient s primary caregiver is someone at least age 18, other than the patient or the patient s physician, who agrees to take responsibility for managing the patient s well-being with respect to palliative marijuana use. Someone convicted of illegally making, selling, or distributing controlled substances cannot serve as a primary caregiver (CGS 21a- 408b). Under previous law, an adult medical marijuana patient s physician must evaluate the patient s need for a primary caregiver and document the need in the certification of palliative use. This legislation also requires this for patients who are emancipated minors. For unemancipated minors, the Act requires a parent or other person with legal custody to serve as the primary caregiver. Letter from Two Physicians Under the Act, if the qualifying patient is an unemancipated minor, the person with legal custody must provide DCP with a letter from the minor s primary care provider and a physician board certified in an area involved in the treatment of the minor s debilitating condition. The letter must confirm that the palliative use of marijuana is in the patient s best interest. Qualifying Debilitating Conditions and Form of Marijuana The Act allows a minor to use marijuana for: 1. a terminal illness requiring end-oflife care; 2. an irreversible spinal cord injury with objective neurological indication of intractable spasticity; 3. cerebral palsy; 4. cystic fibrosis; 5. severe epilepsy or uncontrolled intractable seizure disorder; or 6. any other medical condition, treatment, or disease that DCP approves through regulations. The legislation prohibits a dispensary from dispensing any marijuana product in a smokable, inhalable, or vaporizable form to a patient who is a minor or to a primary caregiver of such a patient. It similarly prohibits a physician from issuing a written certification for a minor s marijuana use in a dosage form requiring that the marijuana be smoked, inhaled, or vaporized. Other Existing Provisions Otherwise, the Act applies the same program requirements and prohibitions when minors are patients as for adults under previous existing law and the bill. For example:

8 P.A An Act Concerning the Palliative Use of Marijuana ~Page 3~ 1. patients who comply with the law may not be arrested, prosecuted, or otherwise penalized, including being subject to civil penalties, or denied any right or privilege, including being disciplined by a professional licensing board, for the medical use of marijuana; 2. these protections do not apply if the patient ingests marijuana in certain settings, such as at work, at school, or in public; 3. schools, landlords, and employers are prohibited from taking certain actions against a medical marijuana patient or caregiver if solely based on the person s status as such, unless the actions are required by federal law or to obtain federal funding; and 4. health insurers are not required to cover medical marijuana use. 1 Debilitating Conditions for Adults The legislation also added to the list of qualifying debilitating conditions for adult medical marijuana patients. 3 & 5 Source of Marijuana When a qualifying medical marijuana patient registers with DCP, he or she must select a licensed, in-state dispensary from which to obtain his or her marijuana. If the patient is an unemancipated minor, the requirement instead applies to the custodial parent, guardian, or other person with legal custody. After registering, patients (or the person with legal custody of the patient) may purchase marijuana only from the selected dispensary, unless they change their selection in accordance with DCP regulations. If a registered medical marijuana patient or person with legal custody is found to possess marijuana that did not originate from the selected dispensary, he or she may be subject to a hearing before the DCP commissioner, on possible enforcement action against the person s registration certificate. 4 & 7 Marijuana Use at Licensed Health Care Facilities The legislation allows licensed marijuana dispensaries or their employees to distribute or dispense marijuana to a hospice or other inpatient care facility licensed by the Department of Public Health (DPH). Legal protections are extended to nurses who administer marijuana to qualifying patients or research program subjects in hospitals or health care facilities licensed by DPH. 1, 2, 7, 8 & Research Programs Under specified conditions contained within the Act, the legislation allows the DCP commissioner to approve medical marijuana research programs (i.e., studies intended to increase knowledge of the growth, processing, medical attributes, dosage forms, administration, or use of marijuana to treat or alleviate symptoms of any medical condition or the symptoms effects.) The Act allows licensed dispensaries or their employees to distribute or dispense marijuana to organizations engaged in approved research programs. It allows licensed producers or their employees to sell or otherwise distribute marijuana to these organizations. It also allows laboratory employees to deliver or distribute marijuana to these organizations.

9 P.A An Act Concerning the Palliative Use of Marijuana ~Page 4~ Previous law prohibited qualifying patients to ingest marijuana on college or university property. This Act creates an exception if the institution is participating in an approved research program and the marijuana is used under the terms of that program. The Act also lists prohibited acts and legal protections for research programs and employees. The legislation generally extends the legal protections previously noted to a research program subject with a valid registration certificate, for the use of marijuana while acting within the scope of an approved research program. However, these protections do not apply to marijuana use in certain settings, similar to the restrictions on other medical marijuana users under existing law and the Act. Thus, the protections for research subjects do not apply if the person s marijuana use endangers the health or well-being of someone else, other than a research program employee. The protections also do not apply if the person ingests marijuana: 1. in a motor bus, school bus, or other moving vehicle; 2. at work; 3. on school grounds or any public or private school, dormitory, college, or university property, unless the college or university is participating in a research program and the marijuana use is part of that program; 4. in any public place; or 5. in the presence of a person under age 18 who is not a qualifying patient or research program subject. Prohibited Acts and Legal Protections The Act prohibits licensed or temporarily certified laboratory employees from acquiring marijuana from, or delivering, transporting, or distributing marijuana to, anyone other than licensed producers or dispensaries or organizations engaged in approved research programs. They also must not obtain or transport marijuana outside of the state in violation of state or federal law. 9 Board of Physicians By law, the DCP commissioner must establish a board of eight physicians knowledgeable about palliative marijuana use. The Act eliminates the requirement that physicians on the board be certified in one of certain listed specialties. It instead requires that (1) at least one member be a board certified pediatrician, appointed in consultation with the state chapter of the American Academy of Pediatrics, and (2) the other members be board certified in the medical specialty in which they practice. The Act allows the board to review the list of qualifying debilitating medical conditions and make recommendations to the General Law and Public Health Committees for removing conditions, treatments, or diseases from the list.

10 P.A An Act Concerning the Palliative Use of Marijuana ~Page 5~ One of the board s existing duties is to review and recommend to DCP additions to the list of debilitating conditions that qualify for medical marijuana use for adults. The Act additionally requires the board to review and recommend to DCP for approval any illnesses defined as severely debilitating in specified federal regulations, to be added to the list of qualifying debilitating conditions for minors. When doing so, the board must consider the effect of medical marijuana use on the brain development of patients who are minors. Under the federal regulation, a disease or condition is severely debilitating if it causes major irreversible morbidity (21 C.F.R (b)). 6 Dispensary Annual Reporting The bill requires licensed dispensaries to annually report to DCP on the types, mixtures, and dosages of palliative marijuana they dispense. The first report is due by January 1, The effective date of this legislation is October 1, Policy Implications Policy language should be considered, pertaining to medical marijuana, for both staff members and students. The previous legislation and as amended by this Act do not require a policy; therefore, policy language is considered optional for inclusion in a district s policy manual. Policy #5131.6, Alcohol Use, Drugs, and Tobacco was previously revised to contain a separate, but optional, section pertaining to the medical use of marijuana by students eighteen years of age or older. This has been revised based on this Act which permits the medical use of marijuana by minors under specified conditions. This policy is a mandated policy for inclusion in a district s policy manual. In addition, the two existing policies pertaining to this topic for consideration have also been revised. They are: 1. # / , Medical Marijuana Standards (Personnel) 2. # / / , Medical (Palliative) Use of Marijuana, which is applicable to students and staff. These two policies are considered optional policies for inclusion in a district s policy manual.