Update: Senate Majority Leader Kathy Harrington, R-Gaston, is now a cosponsor of the Compassionate Care Act
Amid the flurry of cannabis bills North Carolina lawmakers have proposed this session — each with a unique spin on state-level weed reform — one proposal stands out with bipartisan support. Cape Fear Senators Bill Rabon, R-Brunswick, and Michael Lee, R-New Hanover, presented the N.C. Compassionate Care Act before the Senate Judiciary Committee Wednesday afternoon.
Four Democrats have co-sponsored the bill, including Paul Lowe, D-Forsyth. The proposed legislation comes as revisions to cannabis laws sweep the East Coast and beyond. Democrats in N.C. filed bills earlier this year that would legalize cannabis medicinally and recreationally; other Republicans pushed a more cautious approach that would change N.C. cannabis laws only upon federal action.
The Compassionate Care Act answers those other movements with a distinctive regulatory framework that would carefully introduce medical cannabis into the healthcare scene. The bill’s language enumerates a powerful gatekeeping role to be played by state level bureaucracies like the N.C. Department of Health and Human Services (NCDHHS).
“This is the most tightly regulated and controlled bill of its type in the 36, 37 states that now have medical cannabis,” Rabon said at the committee hearing. “A couple of states have reached out to some of our friends and told them they wished theirs had been just as good.”
The backbone of the proposed oversight system lies in two advisory boards, both of which include a mix of political appointees, medical professionals and industry experts.
The Medical Cannabis Advisory Board would make decrees on the type of “debilitating conditions” that would justify a physician’s ability to prescribe medical cannabis. As it stands, at least 15 conditions would qualify an N.C. citizen for a registration card. (Read the full list at the end of this article.)
Lee noted that the exclusion of “chronic pain” as a debilitating condition worthy of a medical cannabis prescription was a deliberate debarment — in order to prevent the gratuitous distribution of cannabis that would cause a “Wild West” effect, which he said occurred in California after medical legalization.
Patients would pay a $50 fee to NCDHHS for their registration card, and their information would be entered into a confidential medical database accessible to law enforcement. Prescribing doctors must complete an educational course and annual refresher courses thereafter. “Designated caregivers,” a role created previously by other states in their medicinal cannabis laws, would go through the same NCDHHS approval processes, and be authorized to assist patients with cannabis treatments.
“Bill sponsors going to great lengths to discuss how this bill is designed for medical cannabis only, clearly an attempt to assuage concerns from members of their party,” tweeted Sen. Jeff Jackson, D-Mecklenburg, during the committee hearing.
Lee and Rabon worked to ease the distaste held by some in the GOP for any measure that could be seen as a gateway to recreational cannabis. “Some of us have a bridge we need to cross to get comfortable with this,” said Sen. Paul Newton, R-Cabarrus. “And I’m hearing you loud and clear that you have made the boundaries of this, the guardrails of this, sort of paramount in your development.”
Sen. Mujtaba Mohammed, D-Mecklenburg, implored Rabon to include in his bill a provision that would decriminalize cannabis possession in small amounts, stating that more than 60% of cannabis-related police apprehensions in N.C. have been against people of color.
Rabon replied the Compassionate Care Act will not be expanded beyond the realm of medical cannabis. The decriminalization angle would have to stand independently in its own bill, Rabon said. Mohammed retorted he had already co-sponsored such a bill, and it currently waits to be heard in Rabon’s committee.
A spokesperson for Attorney General Josh Stein wrote in an email: “Our office is reviewing this legislation and does not currently have a position.”
A spokesperson for the North Carolina Healthcare Association (NCHA) wrote: “NCHA has seen the bills and we do not have a stance on cannabis legalization for either medicinal or recreational uses.”
“To receive medical cannabis, there are a lot of hoops that patients will have to jump through,” Rabon told the judiciary committee.
The Medical Cannabis Production Commission would handle the business and product ends of the cannabis landscape. The bill emphasizes that the plants shall be grown in N.C.
Applicants for a medical cannabis supplier license face a steep hill to climb if the bill were to become law. The number of suppliers statewide will be capped at 10, and each of those entities will be responsible for seed-to-sale oversight. All 10 license-holders must own both a production facility and dispensary, and are limited to eight dispensaries each. (Suppliers will place at least two of their dispensaries in Tier 1 counties, a Department of Commerce designation for the state’s 40 most economically distressed counties.)
“We took some pieces of puzzles from other bills that we had seen in this legislature, and then really kind of put our own spin on it,” Lee told his fellow senators. “Because we really couldn’t pull anything from other states.”
Suppliers will pay a $50,000 license fee to NCDHHS, and a $10,000 annual renewal fee. NCDHHS also gets a 10% cut of all gross revenues.
The dispensaries will be subject to strict land-use and marketing reviews; no cartoonish imagery, attempts at humor, scintillating packaging or even depictions of marijuana leaves will be permitted. The goal is for the cannabis centers to blend into business districts.
There is a provision requiring five years experience in the legal medical cannabis world, meaning out-of-state consultants and businesses will be leaned on heavily at the outset.
“We’re on a crash course with federal legalization in my opinion,” said Axel Owen, the campaign manager for a New Jersey recreational cannabis ballot referendum overwhelmingly approved in November 2020. Vast swaths of the country put cannabis friendly laws on the books throughout the past two decades. Often there’s a trajectory, Owen said, in which states move from medicinal to recreational legalization. But in some cases medical-approved states sit idle without movement forward on the recreational cannabis front.
“We wanted to roll out the program that we wanted to see in New Jersey, and let New Jerseyites make that decision rather than having the federal government make that decision for everyone,” Owen said.
Owen said if states reform cannabis laws prior to federal action, they’ll be able to retain more control over their marketplaces and regulations when and if the federal move occurs.
“By North Carolina going earlier, it gives them the ability to set the parameters and the discussion of how this is going to be rolled out, rather than having the federal government come in and say ‘these are now your parameters,’” Owen said.
He added that he faced opposition from Smart Approaches to Marijuana, an anti-legalization advocacy group. During the committee hearing Wednesday, Lee said the same group had been active in opposing the Compassionate Care Act.
The Compassionate Care Act sat untouched in Rabon’s rules and operations committee for two months before a proposed committee substitute version earned the spotlight before the judiciary committee Wednesday in an informational hearing. If considered favorably at a future hearing, from there the bill would proceed to other committees, including finance, then healthcare, then back to Rabon’s rules and operations, before finally hitting the Senate floor.
“Bill is set to go through four committees. That’s as many as I’ve ever seen a bill go through,” Democrat Jeff Jackson tweeted. “That means this is being handled with extreme caution by the majority. Passage is by no means a foregone conclusion.”
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