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New Law Allows Cannabis for Terminally Ill Patients

As of January 1, 2022, the Compassionate Access to Medical Cannabis Act—also known as “Ryan’s law”— came into effect in California. Ryan’s law allows terminally ill patients to use cannabis in GACHs, SHs, SNFs, CLHFs, and HOFAs (except for chemical dependency recovery hospitals and state hospitals). A similar bill was actually sent to Governor Newsom in 2019, but Newsom vetoed that bill. At the time, Newsom said that, although he supported the use of medicinal cannabis in hospital facilities, the bill would “create significant conflicts between federal and state law that cannot be taken lightly.” The difference between the 2019 bill and Ryan’s law is that the federal government has since changed its position on the use of medical marijuana in hospital facilities and now doesn’t oppose such use.

Terminally ill patients are defined for purposes of the bill as those who have “a medical condition resulting in a prognosis of life of one year or less, if the disease follows its natural course.” Ryan’s law is supported by evidence that cannabis can alleviate chronic pain and nausea caused by certain serious illnesses or by treatments for such illnesses. Cannabis has also been found to alleviate anxiety and other psychological conditions.

Under Ryan’s law, terminally ill patients need to give the healthcare facility a copy of their medical marijuana card or written documentation that medicinal cannabis use has been recommended by their doctor. However, the use of cannabis for terminally ill patients in the above-mentioned healthcare facilities must still comply with the Compassionate Use Act of 1996, the law which saw California become the first state in the country to enact a voter-approved law permitting cannabis use for medical purposes.

The final subsection of Ryan’s law drives home the point that the law is designed to preclude certain healthcare facilities from prohibiting terminally ill patients from using medicinal cannabis on grounds that cannabis is a Schedule I drug pursuant to the federal Uniform Controlled Substances Act. In other words, the law makes clear that California permits use for terminally ill patients even though federal law explicitly prohibits it.

An AFL was released on January 22, 2022 to notify healthcare facilities about Ryan’s law and can be found using Clearpol’s website here. The AFL says that the specified healthcare facilities must develop and disseminate written guidelines for the use of medicinal cannabis within the health care facility, and that such guidelines must ensure the safety of individuals at the facility and ensure compliance with other state laws. In doing so, Ryan’s law provides that healthcare facilities may continue to restrict the manner in which a patient stores and uses medicinal cannabis.

Ryan’s law also makes it clear that compliance with the law is “not a condition for obtaining, retaining, or renewing a license as a health care facility.” The law further states that the specified healthcare facilities must record the use of medicinal cannabis on the patient's medical record.

Finally, the AFL notes that Ryan’s law has a provision which says that healthcare facilities may suspend patient use of medicinal cannabis if a federal regulatory agency, the United States Department of Justice, or CMS initiates or takes formal enforcement actions against the facility for complying with Ryan’s law.

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