Chapter 4.9Compassionate Access to Medical Cannabis Act or Ryan’s Law

Section § 1649

Explanation

This law is called the 'Compassionate Access to Medical Cannabis Act' or 'Ryan's Law.' It aims to allow terminally ill patients to use medicinal cannabis safely in certain healthcare facilities. This must be done in compliance with existing laws related to medical cannabis use established in 1996 and specific sections outlined in the legal code.

(a)CA Health and Safety Code § 1649(a) This chapter shall be known, and may be cited, as the “Compassionate Access to Medical Cannabis Act” or “Ryan’s Law.”
(b)CA Health and Safety Code § 1649(b) It is the intent of the Legislature in enacting this chapter to support the ability of a terminally ill patient to safely use medicinal cannabis within specified health care facilities in compliance with the Compassionate Use Act of 1996 and Article 2.5 (commencing with Section 11362.7) of Chapter 6 of Division 10.
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(Added by Stats. 2021, Ch. 384, Sec. 1. (SB 311) Effective January 1, 2022.)

Section § 1649.1

Explanation

This law defines key terms related to the use of medical cannabis in California. It explains that the 'Compassionate Use Act of 1996' is a voter-approved initiative for medical cannabis laws. A 'health care facility' generally covers specified types of health facilities and home health agencies, but excludes recovery hospitals, state hospitals, and emergency departments during emergency care. A 'home health agency' is any organization providing skilled nursing services at a person's residence. 'Medicinal cannabis' is cannabis used legally under California laws. A 'patient' is someone who is terminally ill or over 65 with a serious medical condition, as approved by a doctor. 'Terminally ill' describes a condition with a life expectancy of one year or less if untreated.

Unless the context requires otherwise, the following definitions shall apply for purposes of this chapter:
(a)CA Health and Safety Code § 1649.1(a) “Compassionate Use Act of 1996” means the initiative measure enacted by the approval of Proposition 215 at the November 5, 1996, statewide general election and found at Section 11362.5, and any amendments to that act.
(b)Copy CA Health and Safety Code § 1649.1(b)
(1)Copy CA Health and Safety Code § 1649.1(b)(1) Except as provided in paragraph (2), “health care facility” means a health facility specified in subdivision (a), (c), (f), (i), or (n) of Section 1250 or a home health agency licensed pursuant to Chapter 8 (commencing with Section 1725) of Division 2.
(2)CA Health and Safety Code § 1649.1(b)(2) The meaning of “health care facility” shall not include any of the following:
(A)CA Health and Safety Code § 1649.1(b)(2)(A) A chemical dependency recovery hospital.
(B)CA Health and Safety Code § 1649.1(b)(2)(B) A state hospital.
(C)CA Health and Safety Code § 1649.1(b)(2)(C) An emergency department of a health care facility, as specified in subdivision (a) of Section 1250, while the patient is receiving emergency services and care.
(c)CA Health and Safety Code § 1649.1(c) “Home health agency” means a private or public organization, including, but not limited to, any partnership, corporation, political subdivision of the state, or other government agency within the state, that provides, or arranges for the provision of, skilled nursing services, to persons in their temporary or permanent place of residence and is licensed pursuant to Chapter 8 (commencing with Section 1725) of Division 2.
(d)CA Health and Safety Code § 1649.1(d) “Medicinal cannabis” means cannabis or a cannabis product used in compliance with the Compassionate Use Act of 1996 and Article 2.5 (commencing with Section 11362.7) of Chapter 6 of Division 10.
(e)CA Health and Safety Code § 1649.1(e) “Patient” means an individual who meets one or both of the following criteria:
(1)CA Health and Safety Code § 1649.1(e)(1) Is terminally ill.
(2)CA Health and Safety Code § 1649.1(e)(2) Is over 65 years of age with a chronic disease for which the patient has received a physician’s assessment declaring that the patient has a serious medical condition, as defined by subdivision (h) of Section 11362.7 and that the use of medicinal cannabis is appropriate.
(f)CA Health and Safety Code § 1649.1(f) “Terminally ill” means a medical condition resulting in a prognosis of life of one year or less, if the disease follows its natural course.
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(Amended by Stats. 2023, Ch. 484, Sec. 1. (SB 302) Effective January 1, 2024.)

Section § 1649.2

Explanation

This law requires healthcare facilities to allow patients to use medicinal cannabis if recommended by their doctor and noted in their medical records, with some specific rules and exceptions. Home health agencies must prohibit smoking or vaping cannabis when staff are present, and other health facilities cannot allow smoking or vaping at all. Patients must provide ID or documentation for their cannabis use. They, or their caregivers, are responsible for handling the cannabis, which must be stored securely. Healthcare professionals and facility staff cannot administer or retrieve it from storage. Facilities must create and train staff on guidelines for using and disposing of medicinal cannabis. No patient should be denied entry because they use medicinal cannabis. However, general acute care hospitals can only allow its use for terminally ill patients, unless other conditions are met.

(a)CA Health and Safety Code § 1649.2(a) Except as provided in subdivision (b), a health care facility shall permit patient use of medicinal cannabis, as indicated by the attending physician, as defined by Section 11362.7, in the patient’s medical record and shall do all of the following:
(1)Copy CA Health and Safety Code § 1649.2(a)(1)
(A)Copy CA Health and Safety Code § 1649.2(a)(1)(A) A home health agency shall prohibit smoking or vaping immediately before or while home health agency staff are present in the residence.
(B)CA Health and Safety Code § 1649.2(a)(1)(A)(B) All other health facilities shall prohibit smoking or vaping as methods to use medicinal cannabis.
(2)CA Health and Safety Code § 1649.2(a)(2) Include the use of medicinal cannabis within the patient’s medical records.
(3)CA Health and Safety Code § 1649.2(a)(3) Require a patient to provide a copy of the patient’s valid identification card, as described in Section 11362.715, or a copy of that patient’s written documentation as defined in Section 11362.7.
(4)CA Health and Safety Code § 1649.2(a)(4) Require a patient or a primary caregiver, as defined in Section 11362.7, to be responsible for acquiring, retrieving, administering, and removing medicinal cannabis.
(5)CA Health and Safety Code § 1649.2(a)(5) Require medicinal cannabis to be stored securely at all times in a locked container in the patient’s room, other designated area, or with the patient’s primary caregiver. This requirement does not apply to a home health agency.
(6)CA Health and Safety Code § 1649.2(a)(6) Prohibit health care professionals, health care facility staff, and home health agency staff, including, but not limited to, physicians, nurses, and pharmacists, from administering medicinal cannabis or retrieving medicinal cannabis from storage.
(7)CA Health and Safety Code § 1649.2(a)(7) Develop, disseminate, and train health facility staff on the written guidelines developed by the facility for the use and disposal of medicinal cannabis within the health care facility pursuant to this chapter. This requirement does not apply to a home health agency.
(8)CA Health and Safety Code § 1649.2(a)(8) Ensure that a patient is not denied admission to the health care facility in whole or in part because of the patient’s use of medicinal cannabis.
(b)CA Health and Safety Code § 1649.2(b) Notwithstanding subdivision (a), a general acute care hospital specified in subdivision (a) of Section 1250 shall not permit a patient with a chronic disease to use medicinal cannabis unless the patient meets the definition of “terminally ill” in subdivision (f) of Section 1649.1.
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(Amended by Stats. 2024, Ch. 492, Sec. 5. (SB 1511) Effective January 1, 2025.)

Section § 1649.3

Explanation

When a patient is discharged from a health facility, they or their primary caregiver must take any remaining medicinal cannabis with them. If the patient can't do this and doesn't have a caregiver available, the facility must store the cannabis in a locked container until it can be disposed of properly according to the facility's rules. However, this requirement does not apply to home health agencies.

(a)CA Health and Safety Code § 1649.3(a) Upon discharge, all remaining medicinal cannabis shall be removed by the patient or patient’s primary caregiver. If a patient cannot remove the medicinal cannabis and does not have a primary caregiver that is available to remove the medicinal cannabis, the product shall be stored in a locked container until it is disposed of in accordance with the health facility policy and procedure governing medicinal cannabis.
(b)CA Health and Safety Code § 1649.3(b) Subdivision (a) does not apply to a home health agency licensed pursuant to Chapter 8 (commencing with Section 1725) of Division 2.
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(Amended by Stats. 2023, Ch. 484, Sec. 3. (SB 302) Effective January 1, 2024.)

Section § 1649.4

Explanation

This law says that health care facilities are not obligated to provide patients with recommendations for using medicinal cannabis or to include medicinal cannabis in their discharge plans.

This chapter does not require a health care facility to provide or furnish a patient with a recommendation to use medicinal cannabis in compliance with the Compassionate Use Act of 1996 and Article 2.5 (commencing with Section 11362.7) of Chapter 6 of Division 10 or include medicinal cannabis in a patient’s discharge plan.
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(Amended by Stats. 2022, Ch. 242, Sec. 5. (SB 988) Effective January 1, 2023.)

Section § 1649.5

Explanation

This law section states that the State Department of Public Health is responsible for enforcing this specific chapter. Health care facilities do not need to comply with this chapter as a requirement for their licensing. Additionally, it clarifies that this chapter does not change existing cannabis laws, such as those from Proposition 64, which govern the handling and use of marijuana.

(a)CA Health and Safety Code § 1649.5(a) This chapter shall be enforced by the State Department of Public Health.
(b)CA Health and Safety Code § 1649.5(b) Compliance with this chapter shall not be a condition for obtaining, retaining , or renewing a license as a health care facility.
(c)CA Health and Safety Code § 1649.5(c) This chapter does not reduce, expand, or otherwise modify the laws restricting the cultivation, possession, distribution, or use of cannabis that may be otherwise applicable, including, but not limited to, the Control, Regulate and Tax Adult Use of Marijuana Act, an initiative measure enacted by the approval of Proposition 64 at the November 8, 2016, statewide general election, and any amendments to that act.
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(Amended by Stats. 2022, Ch. 242, Sec. 6. (SB 988) Effective January 1, 2023.)

Section § 1649.6

Explanation

If federal agencies like the Department of Justice or Medicare and Medicaid step in with certain actions or questions about a health care facility allowing medical marijuana, the facility can pause its cannabis policy until given the green light again by these agencies. This includes actions like enforcement or funding threats, new rules, or specific bans on medical marijuana from these federal bodies. However, facilities can't stop patients from using medicinal cannabis just because it's considered a Schedule I drug or due to older existing federal rules against cannabis before this law was made.

(a)CA Health and Safety Code § 1649.6(a) If a federal regulatory agency, the United States Department of Justice (US DOJ), or the federal Centers for Medicare and Medicaid Services (CMS) takes one of the following actions, or makes an inquiry about the health care facility’s activities pursuant to Section 1649.2, a health care facility may suspend compliance with Section 1649.2 until the regulatory agency, the US DOJ, or CMS notifies the health care facility that it may resume permitting the use of medicinal cannabis within the facility:
(1)CA Health and Safety Code § 1649.6(a)(1) A federal regulatory agency or the US DOJ initiates enforcement action, including a notice to suspend funding, against a health care facility related to the facility’s compliance with a state-regulated medical marijuana program.
(2)CA Health and Safety Code § 1649.6(a)(2) A federal regulatory agency, the US DOJ, or CMS issues a rule, guidance, or otherwise provides notification to the health care facility that expressly prohibits the use of medical marijuana in health care facilities or otherwise prohibits compliance with a state-regulated medical marijuana program.
(b)CA Health and Safety Code § 1649.6(b) This section does not permit a health care facility to prohibit patient use of medicinal cannabis due solely to the fact that cannabis is a Schedule I drug pursuant to the federal Uniform Controlled Substances Act, or other federal constraints on the use of medicinal cannabis that were in existence prior to the enactment of this chapter.
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(Amended by Stats. 2023, Ch. 484, Sec. 4. (SB 302) Effective January 1, 2024.)