TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH
SUBCHAPTER u: MISCELLANEOUS PROGRAMS AND SERVICES
PART 946 COMPASSIONATE USE OF MEDICAL CANNABIS PATIENT REGISTRY
SECTION 946.200 APPLICATION FOR REGISTRY IDENTIFICATION CARD FOR QUALIFYING PATIENTS AND DESIGNATED CAREGIVERS


 

Section 946.200  Application for Registry Identification Card for Qualifying Patients and Designated Caregivers

 

a)         A qualifying patient who has been issued a written certification who seeks to use medical cannabis for palliative or therapeutic benefit to treat or alleviate the symptoms associated with the patient's debilitating condition, and the qualifying patient's designated caregiver, when applicable, shall register with the Department on forms and in a manner prescribed by the Department.

 

b)         To qualify for a registry identification card, a qualifying patient shall:

 

1)         Be a resident of the State of Illinois, as defined in subsection (c), at the time of application and remain a resident during participation in the program;

 

2)         Have a qualifying medical condition for which the use of medical cannabis will provide help with treating or alleviating the pain, nausea and other symptoms associated with the condition or be diagnosed with a terminal illness;

 

3)         Have a signed, written certification meeting the requirements of this Part;

 

4)         Complete the fingerprint-based background check and not have been convicted of an offense specified under Section 65(b) of the Act, unless diagnosed with a terminal illness.

 

c)         Residency. For purposes of this Part, the qualifying patient and designated caregiver, if any, shall be a resident of the State of Illinois if the individual:

 

1)         Physically resides in the State of Illinois, or has taken verifiable actions to make Illinois his or her home indefinitely with no present intent to reside in another state.

 

2)         Provides proof of Illinois residency by submitting at least two of the following items with the application for a registry identification card.  The address on the documentation provided shall match the address on the application.  Persons who are homeless shall only be required to submit a Notarized Homeless Status Certification (available at https://www.cyberdriveillinois.com/publications/pdf_publications/

dsd_a230.pdf):

 

A)        Pay stub or electronic deposit receipt, issued less than 60 days prior to the application date, that shows evidence of the applicant's withholding for State income tax;

 

B)        Valid voter registration card with an address in Illinois;

 

C)        Valid, unexpired Illinois Driver's License, Illinois Temporary Visitor Driver's License, or other State identification card issued by the Illinois Secretary of State in the name of the applicant in accordance with the Illinois Identification Card Act or a current military identification card;

 

D)        Bank statement (dated less than 90 days prior to application) or credit card statement (dated less than 60 days prior to application);

 

E)        Deed/title, mortgage or rental/lease agreement; property tax bill;

 

F)         Insurance policy (current coverage for automobile, homeowner's, health or medical, or renter's);

 

G)        Medical claim or statement of benefits (from a hospital or health clinic or private insurance company or public (government) agency, dated less than 12 months prior to application);

 

H)        Persons enrolled in the federal Social Security Disability Income (SSDI) or Supplemental Security Income (SSI) disability program may submit a "Benefit Verification Letter" from the Social Security Administration; showing the individual's name and address and the type of benefits received.  The letter must be dated within the last year.  A copy of the letter may be obtained on-line at https://www.ssa.gov/myaccount/ or by contacting the Social Security Administration.  The annual cost of living increase letter mailed to recipients of social security benefits will not be accepted.

 

I)         Tuition invoice/official mail from college or university, dated less than the 12 months prior to application;

 

J)         Utility bill, including, but not limited to, those for electric, water, refuse, telephone land-line, cellular phone, cable or gas, issued less than 60 days prior to application; or

 

K)        W-2 form from the most recent tax year.

 

d)         To apply for a registry identification card, a qualifying patient shall submit a completed application to the Department on the required forms, which shall include, at a minimum, the following items:

 

1)         Written certification for the use of medical cannabis meeting the requirements of this Part issued by a physician who meets the requirements set forth in the Act and the Medical Practice Act of 1987 and dated less than 90 days prior to the application;

 

2)         Proof of Illinois residency of the qualifying patient, as specified in subsection (c);

 

3)         Proof of identity of the qualifying patient;

 

4)         Proof of the qualifying patient's age;

 

5)         Photograph of the qualifying patient and designated caregiver, if applicable, as follows:

 

A)        Current digital passport-size photograph, taken no more than 30 calendar days before the submission of the application;

 

B)        Taken against a plain background or backdrop;

 

C)        At least 2 inches by 2 inches in size;

 

D)        In natural color; and

 

E)        That provides an unobstructed front view of the full face. A full-faced photograph must be taken without any obstruction of the applicant's facial features or any items covering any portion of the face.  Prescription glasses and religious head coverings not covering any areas of the open face will be allowed. Head coverings for persons diagnosed and undergoing treatment for cancer will be allowed.

 

i)          A qualifying patient or designated caregiver will not be required to submit to a photograph if sufficient justification is provided by the qualifying patient or caregiver to establish that a photograph would be in violation of or contradictory to the qualifying patient's or designated caregiver's religious convictions. If a qualifying patient or designated caregiver declares that the use of a photograph is against his/her religious convictions, the qualifying patient or designated caregiver will be given an affidavit to be completed. This affidavit contains designated areas for a detailed written explanation of the reasons why a photograph is against the qualifying patient's or designated caregiver's religious convictions, a place for the qualifying patient's or designated caregiver's signature and date, the designation of the religious sect or denomination involved, space for a minister or other religious leader to apply his/her signature attesting to the explanation the qualifying patient or designated caregiver has offered, along with the date and official title of the minister or religious leader.

 

ii)         The affidavit shall be submitted to the Department.  The Director will appoint a committee of three Department employees to review each affidavit.  The committee shall submit a recommendation to the Director for his or her final decision.

 

iii)        If the qualifying patient or designated caregiver meets all other application requirements of this Part, the Department will issue a non-photo temporary registry identification card, not to exceed 90 days in duration, to allow for medical cannabis use privileges during the determination

 

iv)        Upon approval by the Department, a valid registry identification card without a photograph will be issued and can be renewed. The card will be mailed to the qualifying patient's home address.

 

6)         Designation of the medical cannabis dispensing organization where the qualifying patient will receive his or her medical cannabis.  Only one medical cannabis dispensing organization may be selected at any time, however, the patient is able to submit a request to change the selected dispensary by notifying the Department.

 

7)         Completion of the designated caregiver application if applicable.

 

8)         Payment of the applicable application fee (see Section 946.210) by check or money order.  If the qualifying patient or caregiver is applying on-line, the Department will accept credit card payments.

 

(Source:  Amended at 40 Ill. Reg. 16753, effective December 15, 2016)