Expansion of Medical Cannabis Bill to Impact Senior Housing Communities and Other Georgia Post-Acute Providers

During its most recent session, the Georgia legislature passed SB16, expanding Georgia’s Medical Cannabis Bill, “Haleigh’s Hope Act” (the “Act”), which legalized the possession of low THC oil for individuals with certain medical illnesses and their caregivers. The Act established the Low THC Oil Patient Registry (the “Registry”) within the Department of Public Health (“DPH”). Individuals on the Registry are exempt from prosecution for legal possession of twenty fluid ounces or less of low THC oil, defined as “an oil that contains an amount of cannabidiol and not more than 5 percent by weight of tetrahydrocannabinol, tetrahydrocannabinolic acid, or a combination of tetrahydrocannabinol and tetrahydrocannabinolic acid which does not contain plant material exhibiting the external morphological features of the plant of the genus Cannabis.” Under the new amendments, the low THC oil must be contained in a pharmaceutical container labeled by the manufacturer indicating the percentage of tetrahydrocannabinol.

Prior to SB16, eight conditions qualified an individual for the Registry: (1) cancer when qualified as end stage or treatment produces related wasting illness, recalcitrant nausea and vomiting; (2) severe or end stage amyotrophic lateral sclerosis; (3) seizure disorders related to epilepsy or traumatic head injuries; (4) severe or end stage multiple sclerosis; (5) Crohn’s disease; (6) mitochondrial disease; (7) severe or end stage Parkinson’s disease; and (8) severe or end stage sickle cell disease. SB16 expands the definition of “condition,” adding six additional conditions to the list. These conditions include: (1) Tourette’s syndrome when it is diagnosed as severe; (2) Autism Spectrum disorder when diagnosed for a patient who is at least 18 years old, or severe autism when diagnosed for a patient who is less than 18 years old; (3) Epidermolysis Bullosa; (4) Alzheimer’s disease when diagnosed as severe or end stage; (5) Acquired Immune Deficiency Syndrome when diagnosed as severe or end stage; and (6) Peripheral Neuropathy when diagnosed as severe or end stage.

Individuals become eligible for the Registry if a physician certifies that he or she diagnosed the individual with one of the specified conditions. The individual and physician must have a doctor-patient relationship. These prerequisites to eligibility are required for patient access to the Registry and are the primary mode of physician involvement in the legislative scheme, an involvement that is otherwise limited because providers cannot become involved with helping users acquire or store medical marijuana. With that being said, the addition of Alzheimer’s as a qualifying condition will have a substantial impact on senior housing communities and other Georgia post-acute providers designed to meet the memory care and dementia care needs of seniors in Georgia. As patients, caregivers, and physicians continue to seek ways in which to relieve some of the day-to-day symptoms associated with Alzheimer’s and other forms of dementia, assisted living communities and other senior housing communities may expect to see an increase in resident eligibility for the Registry. Because patients consider the ALC to be their home/residence, expanded cannabis use in ALCs may cause special and nuanced issues, such as whether to allow residents who handle their own medication to also store it in their “residence,” while potentially prohibiting storage by patients who require assistance to take medication. In addition, an ALC with a resident and registered user of medical marijuana who requests assistance with the administration or storage of the drug should be extremely cautious, as any assistance would likely be legally problematic.

Senior housing communities, and in particular assisted living communities, should be aware of certain requirements for compliance. Requirements under the Act include physician reporting obligations, which require physicians to provide certain information pertaining to patients certified for the Registry. This information includes, but is not limited to, dosages recommended for a particular condition, clinical responses, compliance, responses to treatment, side effects, and drug interactions. SB16 updates the physician reporting requirements, adding that physicians must report on levels of tetrahydrocannabinol or tetrahydrocannabinolic acid present in test results. Providers should be aware of these updates and ensure that reporting is in compliance with these new standards. In addition to Georgia requirements, multi-state providers should remain aware of the varying requirements in other states in which they provide services. All providers should also remain vigilant of federal law, which still classifies marijuana as a Schedule I drug, defined to mean a dangerous drug that has no accepted medical uses. Federal law also bans interstate transportation of any form of marijuana, so providers should be wary of any role they might play in assisting with acquisition of the drug.

The bill is currently on Governor Nathan Deal’s desk. Representative Allen Peake, who led the expansion effort in the House, says he has “every expectation” that the governor will sign the bill.

Disclaimer: Federal law is, at best, inconsistent in the area of medical marijuana. Because marijuana remains classified as a Schedule I controlled substance by the United States Drug Enforcement Agency, it is a crime under federal law to cultivate, distribute, sell or use marijuana. Any content contained herein is not intended to provide legal advice in connection with the violation of any state or federal law. It is incumbent on those seeking and those providing legal advice to be aware of their respective state’s requirements.

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