Sen. Don Harmon

Filed: 1/24/2018





10000SB0336sam001LRB100 05118 MJP 33190 a


2    AMENDMENT NO. ______. Amend Senate Bill 336 by replacing
3everything after the enacting clause with the following:
4    "Section 1. This Act may be referred to as the Alternatives
5to Opioids Act of 2018.
6    Section 5. The Compassionate Use of Medical Cannabis Pilot
7Program Act is amended by changing Sections 5, 10, 60, and 160
8as follows:
9    (410 ILCS 130/5)
10    (Section scheduled to be repealed on July 1, 2020)
11    Sec. 5. Findings.
12    (a) The recorded use of cannabis as a medicine goes back
13nearly 5,000 years. Modern medical research has confirmed the
14beneficial uses of cannabis in treating or alleviating the
15pain, nausea, and other symptoms associated with a variety of



10000SB0336sam001- 2 -LRB100 05118 MJP 33190 a

1debilitating medical conditions, including cancer, multiple
2sclerosis, and HIV/AIDS, as found by the National Academy of
3Sciences' Institute of Medicine in March 1999.
4    (b) Studies published since the 1999 Institute of Medicine
5report continue to show the therapeutic value of cannabis in
6treating a wide array of debilitating medical conditions. These
7include relief of the neuropathic pain caused by multiple
8sclerosis, HIV/AIDS, and other illnesses that often fail to
9respond to conventional treatments and relief of nausea,
10vomiting, and other side effects of drugs used to treat
11HIV/AIDS and hepatitis C, increasing the chances of patients
12continuing on life-saving treatment regimens.
13    (c) Cannabis has many currently accepted medical uses in
14the United States, having been recommended by thousands of
15licensed physicians to at least 600,000 patients in states with
16medical cannabis laws. The medical utility of cannabis is
17recognized by a wide range of medical and public health
18organizations, including the American Academy of HIV Medicine,
19the American College of Physicians, the American Nurses
20Association, the American Public Health Association, the
21Leukemia & Lymphoma Society, and many others.
22    (d) Data from the Federal Bureau of Investigation's Uniform
23Crime Reports and the Compendium of Federal Justice Statistics
24show that approximately 99 out of every 100 cannabis arrests in
25the U.S. are made under state law, rather than under federal
26law. Consequently, changing State law will have the practical



10000SB0336sam001- 3 -LRB100 05118 MJP 33190 a

1effect of protecting from arrest the vast majority of seriously
2ill patients who have a medical need to use cannabis.
3    (d-5) In 2014, the Task Force on Veterans' Suicide was
4created by the Illinois General Assembly to gather data on
5veterans' suicide prevention. Data from a U.S. Department of
6Veterans Affairs study indicates that 22 veterans commit
7suicide each day.
8    (d-10) According to the State of Illinois Opioid Action
9Plan released in September 2017, "The opioid epidemic is the
10most significant public health and public safety crisis facing
12    According to the Action Plan, "Fueled by the growing opioid
13epidemic, drug overdoses have now become the leading cause of
14death nationwide for people under the age of 50. In Illinois,
15opioid overdoses have killed nearly 11,000 people since 2008.
16Just last year, nearly 1,900 people died of overdoses—almost
17twice the number of fatal car accidents. Beyond these deaths
18are thousands of emergency department visits, hospital stays,
19as well as the pain suffered by individuals, families, and
21    According to the Action Plan, "At the current rate, the
22opioid epidemic will claim the lives of more than 2,700
23Illinoisans in 2020."
24    Further, the Action Plan states, "Physical tolerance to
25opioids can begin to develop as early as two to three days
26following the continuous use of opioids, which is a large



10000SB0336sam001- 4 -LRB100 05118 MJP 33190 a

1factor that contributes to their addictive potential."
2    The 2017 State of Illinois Opioid Action Plan also states,
3"The increase in OUD [opioid use disorder] and opioid overdose
4deaths is largely due to the dramatic rise in the rate and
5amount of opioids prescribed for pain over the past decades."
6    Further, according to the Action Plan, "In the absence of
7alternative treatments, reducing the supply of prescription
8opioids too abruptly may drive more people to switch to using
9illicit drugs (including heroin), thus increasing the risk of
11    According to the Action Plan, "Medication-assisted
12treatment (MAT) is the use of medications in combination with
13counseling, behavioral therapies, and other recovery support
14services for the treatment of SUDs [substance use disorders]."
15    Finally, the Action Plan states, "The World Health
16Organization (WHO), CDC, National Institutes of Health (NIH),
17and other experts all agree that MAT is essential to treating
18those with OUD and helping them recover."
19    (e) Alaska, Arizona, California, Colorado, Connecticut,
20Delaware, Hawaii, Maine, Massachusetts, Michigan, Montana,
21Nevada, New Jersey, New Mexico, Oregon, Rhode Island, Vermont,
22Washington, and Washington, D.C. have removed state-level
23criminal penalties from the medical use and cultivation of
24cannabis. Illinois joins in this effort for the health and
25welfare of its citizens.
26    (f) States are not required to enforce federal law or



10000SB0336sam001- 5 -LRB100 05118 MJP 33190 a

1prosecute people for engaging in activities prohibited by
2federal law. Therefore, compliance with this Act does not put
3the State of Illinois in violation of federal law.
4    (g) State law should make a distinction between the medical
5and non-medical uses of cannabis. Hence, the purpose of this
6Act is to protect patients with debilitating medical
7conditions, as well as their physicians and providers, from
8arrest and prosecution, criminal and other penalties, and
9property forfeiture if the patients engage in the medical use
10of cannabis.
11(Source: P.A. 98-122, eff. 1-1-14; 99-519, eff. 6-30-16.)
12    (410 ILCS 130/10)
13    (Section scheduled to be repealed on July 1, 2020)
14    Sec. 10. Definitions. The following terms, as used in this
15Act, shall have the meanings set forth in this Section:
16    (a) "Adequate supply" means:
17        (1) 2.5 ounces of usable cannabis during a period of 14
18    days and that is derived solely from an intrastate source.
19        (2) Subject to the rules of the Department of Public
20    Health, a patient may apply for a waiver where a physician
21    provides a substantial medical basis in a signed, written
22    statement asserting that, based on the patient's medical
23    history, in the physician's professional judgment, 2.5
24    ounces is an insufficient adequate supply for a 14-day
25    period to properly alleviate the patient's debilitating



10000SB0336sam001- 6 -LRB100 05118 MJP 33190 a

1    medical condition or symptoms associated with the
2    debilitating medical condition.
3        (3) This subsection may not be construed to authorize
4    the possession of more than 2.5 ounces at any time without
5    authority from the Department of Public Health.
6        (4) The pre-mixed weight of medical cannabis used in
7    making a cannabis infused product shall apply toward the
8    limit on the total amount of medical cannabis a registered
9    qualifying patient may possess at any one time.
10    (b) "Cannabis" has the meaning given that term in Section 3
11of the Cannabis Control Act.
12    (c) "Cannabis plant monitoring system" means a system that
13includes, but is not limited to, testing and data collection
14established and maintained by the registered cultivation
15center and available to the Department for the purposes of
16documenting each cannabis plant and for monitoring plant
17development throughout the life cycle of a cannabis plant
18cultivated for the intended use by a qualifying patient from
19seed planting to final packaging.
20    (d) "Cardholder" means a qualifying patient or a designated
21caregiver who has been issued and possesses a valid registry
22identification card by the Department of Public Health.
23    (e) "Cultivation center" means a facility operated by an
24organization or business that is registered by the Department
25of Agriculture to perform necessary activities to provide only
26registered medical cannabis dispensing organizations with



10000SB0336sam001- 7 -LRB100 05118 MJP 33190 a

1usable medical cannabis.
2    (f) "Cultivation center agent" means a principal officer,
3board member, employee, or agent of a registered cultivation
4center who is 21 years of age or older and has not been
5convicted of an excluded offense.
6    (g) "Cultivation center agent identification card" means a
7document issued by the Department of Agriculture that
8identifies a person as a cultivation center agent.
9    (h) "Debilitating medical condition" means one or more of
10the following:
11        (1) cancer, glaucoma, positive status for human
12    immunodeficiency virus, acquired immune deficiency
13    syndrome, hepatitis C, amyotrophic lateral sclerosis,
14    Crohn's disease, agitation of Alzheimer's disease,
15    cachexia/wasting syndrome, muscular dystrophy, severe
16    fibromyalgia, spinal cord disease, including but not
17    limited to arachnoiditis, Tarlov cysts, hydromyelia,
18    syringomyelia, Rheumatoid arthritis, fibrous dysplasia,
19    spinal cord injury, traumatic brain injury and
20    post-concussion syndrome, Multiple Sclerosis,
21    Arnold-Chiari malformation and Syringomyelia,
22    Spinocerebellar Ataxia (SCA), Parkinson's, Tourette's,
23    Myoclonus, Dystonia, Reflex Sympathetic Dystrophy, RSD
24    (Complex Regional Pain Syndromes Type I), Causalgia, CRPS
25    (Complex Regional Pain Syndromes Type II),
26    Neurofibromatosis, Chronic Inflammatory Demyelinating



10000SB0336sam001- 8 -LRB100 05118 MJP 33190 a

1    Polyneuropathy, Sjogren's syndrome, Lupus, Interstitial
2    Cystitis, Myasthenia Gravis, Hydrocephalus, nail-patella
3    syndrome, residual limb pain, seizures (including those
4    characteristic of epilepsy), post-traumatic stress
5    disorder (PTSD), or the treatment of these conditions;
6        (1.5) terminal illness with a diagnosis of 6 months or
7    less; if the terminal illness is not one of the qualifying
8    debilitating medical conditions, then the physician shall
9    on the certification form identify the cause of the
10    terminal illness; or
11        (2) any other debilitating medical condition or its
12    treatment that is added by the Department of Public Health
13    by rule as provided in Section 45.
14    Through June 30, 2020, "debilitating medical condition"
15includes any other medical condition for which an opioid has
16been or could be prescribed by a physician based on generally
17accepted standards of care.
18    (i) "Designated caregiver" means a person who: (1) is at
19least 21 years of age; (2) has agreed to assist with a
20patient's medical use of cannabis; (3) has not been convicted
21of an excluded offense; and (4) assists no more than one
22registered qualifying patient with his or her medical use of
24    (j) "Dispensing organization agent identification card"
25means a document issued by the Department of Financial and
26Professional Regulation that identifies a person as a medical



10000SB0336sam001- 9 -LRB100 05118 MJP 33190 a

1cannabis dispensing organization agent.
2    (k) "Enclosed, locked facility" means a room, greenhouse,
3building, or other enclosed area equipped with locks or other
4security devices that permit access only by a cultivation
5center's agents or a dispensing organization's agent working
6for the registered cultivation center or the registered
7dispensing organization to cultivate, store, and distribute
8cannabis for registered qualifying patients.
9    (l) "Excluded offense" for cultivation center agents and
10dispensing organizations means:
11        (1) a violent crime defined in Section 3 of the Rights
12    of Crime Victims and Witnesses Act or a substantially
13    similar offense that was classified as a felony in the
14    jurisdiction where the person was convicted; or
15        (2) a violation of a state or federal controlled
16    substance law, the Cannabis Control Act, or the
17    Methamphetamine Control and Community Protection Act that
18    was classified as a felony in the jurisdiction where the
19    person was convicted, except that the registering
20    Department may waive this restriction if the person
21    demonstrates to the registering Department's satisfaction
22    that his or her conviction was: (A) for the possession,
23    cultivation, transfer, or delivery of a reasonable amount
24    of cannabis intended for medical use; or (B) a result of
25    opioid addiction or dependence. This exception does not
26    apply if the conviction was under state law and involved a



10000SB0336sam001- 10 -LRB100 05118 MJP 33190 a

1    violation of an existing medical cannabis law.
2    For purposes of this subsection, the Department of Public
3Health shall determine by emergency rule within 30 days after
4the effective date of this amendatory Act of the 99th General
5Assembly what constitutes a "reasonable amount".
6    (l-5) "Excluded offense" for a qualifying patient or
7designated caregiver means a violation of state or federal
8controlled substance law, the Cannabis Control Act, or the
9Methamphetamine and Community Protection Act that was
10classified as a felony in the jurisdiction where the person was
11convicted, except that the registering Department may waive
12this restriction if the person demonstrates to the registering
13Department's satisfaction that his or her conviction was: (1)
14for the possession, cultivation, transfer, or delivery of a
15reasonable amount of cannabis intended for medical use; or (2)
16a result of opioid addiction or dependence. This exception does
17not apply if the conviction was under state law and involved a
18violation of an existing medical cannabis law. For purposes of
19this subsection, the Department of Public Health shall
20determine by emergency rule within 30 days after the effective
21date of this amendatory Act of the 99th General Assembly what
22constitutes a "reasonable amount".
23    (m) "Medical cannabis cultivation center registration"
24means a registration issued by the Department of Agriculture.
25    (n) "Medical cannabis container" means a sealed,
26traceable, food compliant, tamper resistant, tamper evident



10000SB0336sam001- 11 -LRB100 05118 MJP 33190 a

1container, or package used for the purpose of containment of
2medical cannabis from a cultivation center to a dispensing
4    (o) "Medical cannabis dispensing organization", or
5"dispensing organization", or "dispensary organization" means
6a facility operated by an organization or business that is
7registered by the Department of Financial and Professional
8Regulation to acquire medical cannabis from a registered
9cultivation center for the purpose of dispensing cannabis,
10paraphernalia, or related supplies and educational materials
11to registered qualifying patients.
12    (p) "Medical cannabis dispensing organization agent" or
13"dispensing organization agent" means a principal officer,
14board member, employee, or agent of a registered medical
15cannabis dispensing organization who is 21 years of age or
16older and has not been convicted of an excluded offense.
17    (q) "Medical cannabis infused product" means food, oils,
18ointments, or other products containing usable cannabis that
19are not smoked.
20    (r) "Medical use" means the acquisition; administration;
21delivery; possession; transfer; transportation; or use of
22cannabis to treat or alleviate a registered qualifying
23patient's debilitating medical condition or symptoms
24associated with the patient's debilitating medical condition.
25    (r-5) "Opioid" means a narcotic drug or substance that is a
26Schedule II controlled substance under paragraph (1), (2), (3),



10000SB0336sam001- 12 -LRB100 05118 MJP 33190 a

1or (5) of subsection (b) or under subsection (c) of Section 206
2of the Illinois Controlled Substances Act.
3    (s) "Physician" means a doctor of medicine or doctor of
4osteopathy licensed under the Medical Practice Act of 1987 to
5practice medicine and who has a controlled substances license
6under Article III of the Illinois Controlled Substances Act. It
7does not include a licensed practitioner under any other Act
8including but not limited to the Illinois Dental Practice Act.
9    (t) "Qualifying patient" means a person who has been
10diagnosed by a physician as having a debilitating medical
12    (u) "Registered" means licensed, permitted, or otherwise
13certified by the Department of Agriculture, Department of
14Public Health, or Department of Financial and Professional
16    (v) "Registry identification card" means a document issued
17by the Department of Public Health that identifies a person as
18a registered qualifying patient or registered designated
20    (w) "Usable cannabis" means the seeds, leaves, buds, and
21flowers of the cannabis plant and any mixture or preparation
22thereof, but does not include the stalks, and roots of the
23plant. It does not include the weight of any non-cannabis
24ingredients combined with cannabis, such as ingredients added
25to prepare a topical administration, food, or drink.
26    (x) "Verification system" means a Web-based system



10000SB0336sam001- 13 -LRB100 05118 MJP 33190 a

1established and maintained by the Department of Public Health
2that is available to the Department of Agriculture, the
3Department of Financial and Professional Regulation, law
4enforcement personnel, and registered medical cannabis
5dispensing organization agents on a 24-hour basis for the
6verification of registry identification cards, the tracking of
7delivery of medical cannabis to medical cannabis dispensing
8organizations, and the tracking of the date of sale, amount,
9and price of medical cannabis purchased by a registered
10qualifying patient.
11    (y) "Written certification" means a document dated and
12signed by a physician, stating (1) that the qualifying patient
13has a debilitating medical condition and specifying the
14debilitating medical condition the qualifying patient has; and
15(2) that the physician is treating or managing treatment of the
16patient's debilitating medical condition. A written
17certification shall be made only in the course of a bona fide
18physician-patient relationship, after the physician has
19completed an assessment of the qualifying patient's medical
20history, reviewed relevant records related to the patient's
21debilitating condition, and conducted a physical examination.
22    A veteran who has received treatment at a VA hospital shall
23be deemed to have a bona fide physician-patient relationship
24with a VA physician if the patient has been seen for his or her
25debilitating medical condition at the VA Hospital in accordance
26with VA Hospital protocols.



10000SB0336sam001- 14 -LRB100 05118 MJP 33190 a

1    A bona fide physician-patient relationship under this
2subsection is a privileged communication within the meaning of
3Section 8-802 of the Code of Civil Procedure.
4(Source: P.A. 98-122, eff. 1-1-14; 98-775, eff. 1-1-15; 99-519,
5eff. 6-30-16.)
6    (410 ILCS 130/60)
7    (Section scheduled to be repealed on July 1, 2020)
8    Sec. 60. Issuance of registry identification cards.
9    (a) Except as provided in subsection (b), the Department of
10Public Health shall:
11        (1) verify the information contained in an application
12    or renewal for a registry identification card submitted
13    under this Act, and approve or deny an application or
14    renewal, within 30 days of receiving a completed
15    application or renewal application and all supporting
16    documentation specified in Section 55;
17        (2) issue registry identification cards to a
18    qualifying patient and his or her designated caregiver, if
19    any, within 15 business days of approving the application
20    or renewal;
21        (3) enter the registry identification number of the
22    registered dispensing organization the patient designates
23    into the verification system; and
24        (4) allow for an electronic application process, and
25    provide a confirmation by electronic or other methods that



10000SB0336sam001- 15 -LRB100 05118 MJP 33190 a

1    an application has been submitted.
2    (b) The Department of Public Health may not issue a
3registry identification card to a qualifying patient who is
4under 18 years of age, unless that patient suffers from
5seizures, including those characteristic of epilepsy, or as
6provided by administrative rule. The Department of Public
7Health shall adopt rules for the issuance of a registry
8identification card for qualifying patients who are under 18
9years of age and suffering from seizures, including those
10characteristic of epilepsy. The Department of Public Health may
11adopt rules to allow other individuals under 18 years of age to
12become registered qualifying patients under this Act with the
13consent of a parent or legal guardian. Registered qualifying
14patients under 18 years of age shall be prohibited from
15consuming forms of cannabis other than medical cannabis infused
16products and purchasing any usable cannabis.
17    (c) A veteran who has received treatment at a VA hospital
18is deemed to have a bona fide physician-patient relationship
19with a VA physician if the patient has been seen for his or her
20debilitating medical condition at the VA hospital in accordance
21with VA hospital protocols. All reasonable inferences
22regarding the existence of a bona fide physician-patient
23relationship shall be drawn in favor of an applicant who is a
24veteran and has undergone treatment at a VA hospital.
25    (c-10) An individual who submits an application as someone
26who is terminally ill shall have all fees and fingerprinting



10000SB0336sam001- 16 -LRB100 05118 MJP 33190 a

1requirements waived. The Department of Public Health shall
2within 30 days after this amendatory Act of the 99th General
3Assembly adopt emergency rules to expedite approval for
4terminally ill individuals. These rules shall include, but not
5be limited to, rules that provide that applications by
6individuals with terminal illnesses shall be approved or denied
7within 14 days of their submission.
8    (c-15) An individual whose initial application is
9submitted as an alternative to opioid treatment shall have all
10provisions of subsection (f) of Section 60 of this Act relating
11to fingerprints and background checks waived. An individual
12issued a registry card under this subsection who is seeking
13renewal of the registry card must follow the renewal
14requirements under subsection (c) of Section 70 of this Act.
15Within 30 days after the effective date of this amendatory Act
16of the 100th General Assembly, the Department of Public Health
17shall adopt emergency rules to expedite approval for
18individuals who submit an application under this subsection.
19The rules shall include, but are not be limited to, rules that
20provide that:
21        (1) an application by an individual whose application
22    is submitted as an alternative to opioid treatment shall be
23    approved or denied within 14 days after submission; and
24        (2) a registry card issued under this subsection and
25    the rules applicable to the card shall be valid for 12
26    months.



10000SB0336sam001- 17 -LRB100 05118 MJP 33190 a

1    (c-20) The provisions of subsection (c-15) are inoperative
2on and after July 1, 2020.
3    (d) Upon the approval of the registration and issuance of a
4registry card under this Section, the Department of Public
5Health shall forward the designated caregiver or registered
6qualified patient's driver's registration number to the
7Secretary of State and certify that the individual is permitted
8to engage in the medical use of cannabis. For the purposes of
9law enforcement, the Secretary of State shall make a notation
10on the person's driving record stating the person is a
11registered qualifying patient who is entitled to the lawful
12medical use of cannabis. If the person no longer holds a valid
13registry card, the Department shall notify the Secretary of
14State and the Secretary of State shall remove the notation from
15the person's driving record. The Department and the Secretary
16of State may establish a system by which the information may be
17shared electronically.
18    (e) Upon the approval of the registration and issuance of a
19registry card under this Section, the Department of Public
20Health shall electronically forward the registered qualifying
21patient's identification card information to the Prescription
22Monitoring Program established under the Illinois Controlled
23Substances Act and certify that the individual is permitted to
24engage in the medical use of cannabis. For the purposes of
25patient care, the Prescription Monitoring Program shall make a
26notation on the person's prescription record stating that the



10000SB0336sam001- 18 -LRB100 05118 MJP 33190 a

1person is a registered qualifying patient who is entitled to
2the lawful medical use of cannabis. If the person no longer
3holds a valid registry card, the Department of Public Health
4shall notify the Prescription Monitoring Program and
5Department of Human Services to remove the notation from the
6person's record. The Department of Human Services and the
7Prescription Monitoring Program shall establish a system by
8which the information may be shared electronically. This
9confidential list may not be combined or linked in any manner
10with any other list or database except as provided in this
12    (f) All applicants for a registry card shall be
13fingerprinted as part of the application process if they are a
14first-time applicant, if their registry card has already
15expired, or if they previously have had their registry card
16revoked or otherwise denied. At renewal, cardholders whose
17registry cards have not yet expired, been revoked, or otherwise
18denied shall not be subject to fingerprinting. Registry cards
19shall be revoked by the Department of Public Health if the
20Department of Public Health is notified by the Secretary of
21State that a cardholder has been convicted of an excluded
22offense. For purposes of enforcing this subsection, the
23Department of Public Health and Secretary of State shall
24establish a system by which violations reported to the
25Secretary of State under paragraph 18 of subsection (a) of
26Section 6-205 of the Illinois Vehicle Code shall be shared with



10000SB0336sam001- 19 -LRB100 05118 MJP 33190 a

1the Department of Public Health.
2(Source: P.A. 98-122, eff. 1-1-14; 98-775, eff. 1-1-15; 99-519,
3eff. 6-30-16.)
4    (410 ILCS 130/160)
5    (Section scheduled to be repealed on July 1, 2020)
6    Sec. 160. Annual reports. (a) The Department of Public
7Health shall submit to the General Assembly a report, by
8September 30 of each year, that does not disclose any
9identifying information about registered qualifying patients,
10registered caregivers, or physicians, but does contain, at a
11minimum, all of the following information based on the fiscal
12year for reporting purposes:
13        (1) the number of applications and renewals filed for
14    registry identification cards or registrations;
15        (2) the number of qualifying patients and designated
16    caregivers served by each dispensary during the report
17    year;
18        (3) the nature of the debilitating medical conditions
19    of the qualifying patients;
20        (4) the number of registry identification cards or
21    registrations revoked for misconduct;
22        (5) the number of physicians providing written
23    certifications for qualifying patients; and
24        (6) the number of registered medical cannabis
25    cultivation centers or registered dispensing



10000SB0336sam001- 20 -LRB100 05118 MJP 33190 a

1    organizations; .
2        (7) the number of applications received from
3    applicants seeking an alternative to opioid treatment;
4        (8) the nature of the conditions of the applicants
5    seeking an alternative to opioid treatment; and
6        (9) the number of applications approved and denied from
7    applicants seeking an alternative to opioid treatment.
8(Source: P.A. 98-122, eff. 1-1-14; revised 11-8-17.)".