Medical Marijuana Update

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Health Services Department Medical Marijuana Update March 7, 2017

Presentation Outline Florida Compassionate Medical Cannabis Act Legalization of Medical Cannabis Amendment 2 Department of Health Rulemaking Process Proposed Legislation County Moratorium Next Steps

Florida Compassionate Medical Cannabis Act Brief History: SB1030 was approved by the FL Legislature and signed by Governor June 18, 2014 Patients suffering from cancer, epilepsy or other medical conditions producing seizures Allows patients and legal representatives to possess & purchase low-thc cannabis Creates standard of care Created Compassionate Use Registry for physicians, law enforcement and dispensers

Florida Compassionate Medical Cannabis Act Requires physicians to complete 8-hour course by FMA or FOMA Department of Health authorized five dispensing organizations 30 years in business Ability to grow 400,000 plants Level 2 background check $5M performance bond

Department of Health Timeline June 2014: May 2015: July 2015: Dec 2015: Feb 2016: Compassionate Use Act signed into law (Low-THC) DOH Final Rule Upheld Dispensing Organization Applications Accepted Challenges Received Five Dispensing Organizations Request Cultivation Authorization Mar 2016: Governor Scott signs HB 307 (Medical Cannabis) into law

Department of Health Timeline Apr 2016: July 2016: The Green Solution approved as Sixth Dispensing Organization All approved Dispensing Organizations Cultivating Cannabis Dispensing began in FL July - Oct 2016: Processing and Dispensing Authorization Inspections Dec 2016: Grow Healthy Approved as Seventh Dispensing Organization

Florida Compassionate Medical Cannabis Act Low-THC & Medical Cannabis Qualified Patient: Must be Florida resident Diagnosed with a qualifying condition Patient of the ordering physician for 90 days prior to receiving the physician s order Patient can fill the order at one of the approved dispensing organizations (45 day supply)

Florida Compassionate Medical Cannabis Act

Presentation Outline Florida Compassionate Medical Cannabis Act Legalization of Medical Cannabis Amendment 2 Florida Rulemaking Process Proposed Legislation County Moratorium Next Steps

Legalization of Medical Cannabis Amendment 2 Medical Marijuana Amendment 2 Ballot Initiative was approved by 71% of registered voters on November 8, 2016 Legalizes medical use of marijuana for individuals with debilitating medical conditions Cancer, epilepsy, glaucoma, positive status for human immunodeficiency virus (HIV), acquired immune deficiency syndrome (AIDS), post-traumatic stress disorder (PTSD), amyotrophic lateral sclerosis (ALS), Crohn's disease, Parkinson's disease, multiple sclerosis, or other debilitating medical conditions of the same kind or class Allows caregivers to assist with patients medical use of marijuana (must be 21 years of age) Department of Health registers and regulates Medical Marijuana Treatment Centers (MMTC)

Legalization of Medical Cannabis Amendment 2 Department of Health shall issue identification cards to patients and caregivers Summary of Limitations: Does not allow operating of a vehicle, aircraft, train or boat while under the influence of marijuana Does not require accommodation of any on-site medical use of marijuana Correctional or Detention Facility Place of education or employment Smoking medical marijuana in any public place Does not require health insurance providers or any government agencies to reimburse for expenses related to medical use of marijuana

Legalization of Medical Cannabis Amendment 2 Department of Health has six months to implement regulations after the effective date Department of Health has nine months after the effective date to issue identification cards for qualifying patients and caregivers and to register MMTCs

Department of Health Rulemaking Process Department of Health issued proposed rule for Medical Marijuana Amendment 2 MMTC same definition as dispensing organization Defines qualifying patient Caregiver 21 years of age and Level 1 Background Screening 45 day supply limit Physician certification Registration with Compassionate Use Registry MMTC follow safety & medical record keeping standards

Presentation Outline Florida Compassionate Medical Cannabis Act Legalization of Medical Cannabis Amendment 2 Dept. of Health Rulemaking Process Proposed Legislation County Moratorium Next Steps

Proposed Legislation Proposed SB614 Florida Medical Marijuana Act by Senator Brandes MMTC not required to be fully vertically integrated Sets up four types of licenses (cultivation, processing, retail and transportation) Retail licenses may not exceed one license for each 25,000 residents in a county Local governments would have power to prohibit dispensaries System for issuing medical marijuana ID cards, patient qualifications, caregiver requirements, restrictions on MMTC on advertising of marijuana or medical marijuana products

Proposed Legislation Proposed SB406 Compassionate Use of low- THC Cannabis and Marijuana by Senator Bradley Expansion of licenses to grow and sell medical marijuana Reduce the 90-day requirement for physician to treat patient Chronic nonmalignant pain definition Four hour course for physicians Expands patient supply of medical marijuana from 45 days to 90 days Ban edible marijuana products that are attractive to children

Proposed Legislation Proposed SB1388 Compassionate Use of Medical Cannabis by Senator Artiles Deletes Low-THC and provides definition for Medical Cannabis Additional MMTC s based on number of qualifying patients Allows MMTC s to make wholesale purchases of medical cannabis from another MMTC Establishes Medical Marijuana Testing Facilities All regulation of cultivation and processing of medical cannabis are preempted to the State

Proposed Legislation Proposed SB1666 Compassionate Use of Marijuana by Senator Braynon Caregiver must be 21 years of age and complete 1 hour course Expands patient supply of medical marijuana from 45 days to 90 days Option for non-florida resident to receive marijuana Creates 30-minute educational program Regulation of cultivation and processing of marijuana are preempted to the state

Proposed Legislation Proposed SB1662 by Senator Clemens Defines personal use of marijuana 1 ounce or less Personal possession of marijuana is a civil violation (18 yrs. or older) - $100 Fine Proposed HB237 Driving Under the Influence of Drugs Act by Representative Silvers Relating to driving or boating under the influence Person has blood level of 5 nanograms or more THC per milliliter of blood

Presentation Outline Florida Compassionate Medical Cannabis Act Legalization of Medical Cannabis Amendment 2 Dept. of Health Rulemaking Process Proposed Legislation County Moratorium Next Steps

County Moratorium Temporary Moratorium on Medical Cannabis Activities County to determine best way to regulate medical cannabis activities Medical Cannabis Activities Derivative Products Low-THC Medical Cannabis Medical Cannabis Activities

County Moratorium During Moratorium Appropriate County personnel will study and review relevant issues relating to medical cannabis activities Appropriate County personnel will then draft and submit proposed land development regulations for medical cannabis activities

County Moratorium Moratorium Period : August 23, 2016 through the earlier of May 23, 2017, or the date an ordinance establishing new or amended land development regulations concerning Medical Cannabis Activities is adopted During moratorium, development permits will not be issued for any medical cannabis activities

Local Ordinances Local Moratoriums on Medical Cannabis Activities: July 2016- City of Orlando enacted temporary moratorium; extended until July 1, 2017 August 2016- City of Winter Garden passed 270- day temporary moratorium November 2016 City of Apopka enacted sixmonth temporary moratorium Numerous cities and counties have enacted temporary moratoriums on medical cannabis throughout the state

Presentation Outline Update on Florida Compassionate Medical Cannabis Act Legalization of Medical Cannabis Amendment 2 Florida Rulemaking Process Proposed Legislation County Moratorium Next Steps

Next Steps Continue to monitor proposed legislation Review local ordinances Monitor Department of Health rulemaking development process Moratorium extension

Health Services Department Medical Marijuana Update March 7, 2017