Medical Cannabis Policy Update
The State House adjourned on Friday, May 12, 2023, and with it came the passage of Bill H.270, now Act 65 (2023), a miscellaneous cannabis bill that Green Mountain Patients Alliance worked on throughout the session, alongside the Vermont Cannabis Equity Coalition, including some long-held policy changes to the Vermont medical cannabis program, and on August 8, 2023, the Cannabis Control Board began work on a legislative report on improvements to the medical program by kicking-off series of public Medical Cannabis Committee meetings.
On June 14, 2023, Governor Scott allowed Bill H.270, now called Act 65 (2023), An act relating to miscellaneous amendments to the adult-use and medical cannabis programs, to become law without his signature, and delivered with that enactment a statement on the branches of power and ensuring that the Cannabis Control Board “be accountable to the governor as part of the Executive Branch.”
Placing aside the Governor’s political philosophical sentiment, and the 30 different adult-use market policies found in Act 65, there are long-standing medical cannabis policy changes that are welcomed by the medical cannabis community and we review them below.
Removes the counseling requirement for acceptance of PTSD as a qualifying medical condition for purposes of the Medical Cannabis Registry.
Post-traumatic stress disorder, an anxiety disorder that can come from a traumatic event, was a qualifying condition under the Vermont Medical Program (previously called the Vermont Marijuana Registry) that required the applicant to verify they are undergoing psychotherapy or counseling with a Vermont-licensed mental health care provider. This unreasonable burden is not only socio-economically discriminatory in practice, not everyone can afford nor has access to health care, but it places an undo strain on the applicant through the application process to prove they're in talk therapy, which amounts to additional paperwork and risks reliving trauma. Act 65 has lifted the excessive and potentially stigmatizing requirement for PTSD applicants seeking to use cannabis for medical use.
Increases the maximum amount of cannabis that may be cultivated by a registered patient or caregiver to six mature plants and 12 immature plants.
Registered medical cannabis patients and caregivers in Vermont have been struggling with some of the lowest and least effective home-grow plant count numbers in the country. In 2007, lawmakers designated medical cannabis home grow allowances for 2 mature and 7 immature plants, and it has remained at that impractically low number for over 15 years. One of the most significant policies in Act 65 (2023) is the increase in plant count for registered medical cannabis patients and caregivers to 6 mature and 12 immature plants. Note, home grow for non-medical remains at 2 mature and 4 immature plants – Act 65 only increases plant counts for registered medical cannabis patients and caregivers. We advocated for 12 mature plants and no limitation on immature plants, so 6 mature plants is a start, and we continue the fight.
Allows caregivers to care for up to two people at a time.
Many state medical cannabis programs, such as Maine, have long allowed caregivers to grow for multiple patients. The allowance for caregivers to grow for multiple patients is seen as increasing accessibility, it helps to ensure care is not interrupted and is considered standard patient-focused public policy in state medical cannabis programs. Vermont is behind in accessibility but is beginning to slowly catch up by introducing value back into its program. Act 65 now allows a registered caregiver to designate two patients to grow for, effectively increasing that caregiver's plant count from 6 mature and 12 immature plants to 12 mature and 24 immature plants. Note, a patient is allowed to be a caregiver for one other patient, this means a patient may also grow up to 12 mature and 24 immature plants if they grow for themselves, and another patient.
Changes background check requirements for caregivers .
The enabling statute for Vermont's adult-use industry, Act 164 (2020) is considered status quo cannabis law and includes some policies that made the medical cannabis market even less accessible by mandating fingerprinting for caregivers.
This past year we led an effort to remove the fingerprints from the application process for caregivers by giving the Cannabis Control Board discretion over the application process and to determine what is needed for that process. Despite our best efforts, the policy that shook out of Act 65 is that the CCB shall perform a Vermont criminal background check, and obtain information from the Child Protection Registry maintained by the Department for Children and Families and from the Vulnerable Adult Abuse, Neglect, and Exploitation Registry maintained by the Department of Disabilities, Aging, and Independent Living (collectively, the Registries) for any person who applies to be a caregiver.
Allows registered patients with qualifying conditions that are not chronic pain to renew their registration every three years instead of annually.
A majority of the eligible conditions for the Vermont Medical Program (previously called the Vermont Marijuana Registry) are common chronic illnesses that likely will not ever go away – Cancer, Multiple sclerosis, HIV or AIDS, Glaucoma, Crohn's disease, Parkinson's disease – in these cases, the annual renewal fee becomes another expense for those already dealing with the challenging reality of living with a chronic condition. Act 65 now allows registered patients who are not in chronic pain to be reviewed every three years instead of each year. We hope to include chronic pain in this category, as well. It is important to highlight there is no medical professional making these determinations for patient eligibility and in determining which illnesses receive an annual or 3-year renewal and urge policymakers to revisit this issue.
Directes the CCB to work with the Vermont Academic Detailing Program, Registry patients and caregivers, licensed medical cannabis dispensaries, and medical professional stakeholders to review the Medical Cannabis Registry and to provide recommendations for improvement on or before January 15, 2024.
Lastly, in an effort to continue the conversation around improvements to the Medical Cannabis Program between various state agencies, lawmakers in the State House, and program stakeholders, Act 65 includes a directive for the Cannabis Control Board to work with the Vermont Academic Detailing Program to form a Medical Program Study Committee and deliver a report on the Medical Cannabis Program to lawmakers by the 2024 legislative session. The directive in the statute includes the following criteria for the report.
An assessment of the illnesses or symptoms most appropriately treated by cannabis;
The strains of cannabis recommended for such treatment;
The doses of active chemicals recommended for treatment;
Appropriate treatment protocols for patients, including whether ongoing medical oversight such as counseling or other services is needed for each condition being treated;
How the use of cannabis is communicated to patients and patients’ providers; and
Any other issues that will improve the Registry.
To learn more about the Medical Program Study Committee and its legislative report, including how to participate in the stakeholder process, visit the CCB's website. This upcoming Friday, September 15, 2023, at 7 PM we will be holding a medical cannabis roundtable Zoom event – RSVP to attend!
