Becoming a Patient in California
Patients with a written or verbal recommendation by a California physician may legally use, possess and cultivate medical cannabis in California. Patients may designate a primary caregiver to cultivate and possess medical cannabis on their behalf, and this individual may receive compensation for his or her services. County Health Departments issue an optional Medical Marijuana Identification Card (MMIC). This card is not mandatory for patients, but can be useful in a law enforcement encounter. Beginning November 9, 2016, patients holding a valid MMIC are exempt from state sales tax when buying medical cannabis.
California law currently protects not-for-profit cooperative and collective associations of patients and caregivers, which cultivate medical cannabis and provide it to their members. Theses associations may maintain storefront dispensaries to provide medicine to members. However, cities and counties can regulate or ban these associations, storefront dispensaries, delivery services and other medical cannabis activity. Cooperative and collective associations will eventually be replaced by licensed medical cannabis businesses.
The state legislature passed the Medical Cannabis Regulation and Safety Act (MCRSA) in 2015. This trio of bills created a statewide licensing and regulation program, which will become effective on January 1, 2018 (barring unforeseen delays). Cooperative and collective associations will loose their legal protection one year after the state begins to issue licenses for medical cannabis businesses that cultivate, manufacture, distribute, dispense, transport and test medical cannabis. Cities and counties will maintain the right to ban or further regulate medical cannabis businesses under the MCRSA.
Patients may cultivate 100 square feet or less of medical cannabis for their personal use without a license issued pursuant to the MCRSA. Primary caregivers cultivating medical cannabis for up to five patients may cultivate 500 square feet of medical cannabis or less for their patients without a state license. Cities and counties have the right to regulate or ban cultivation by patients or primary caregivers.
If you are on probation or parole, it is up to your probation or parole officer whether or not to allow you to use medical cannabis.
California voters approved Proposition 64, the Adult Use of Marijuana Act, on November 8, 2016. This law reduces or eliminates most penalties for using, cultivating or possessing cannabis for non-medical purposes for adults twenty one years old and older. Proposition 64 also creates a statewide licensing and regulation program for non-medical cannabis businesses, which is similar to the program created by the MCRSA. Proposition 64 leaves most of California's medical cannabis laws in place, but imposes a new statewide excise tax of 15% on cannabis and medical cannabis sales. Read more about Proposition 64 and medical cannabis on the ASA blog.
Under newly adopted state law, the Medical Cannabis Regulation and Safety Act (MCRSA), patients may cultivate 100 square feet or less of medical cannabis for their personal use without a state license issued pursuant to the MCRSA. Primary caregivers cultivating medical cannabis for up to five patients may cultivate 500 square feet of medical cannabis or less for their patients without a state license. Patients and primary caregivers cultivating who exceed these thresholds must obtain local and state licenses for cultivation and uphold all regulations. Fines for failing to obtain the required licenses are likely to be severe.
Cities and counties have the right to regulate or ban medical cannabis cultivation by patients or primary caregivers. However, Proposition 64 prohibits any city or county from banning the cultivation of up to six plants indoors at home by an adult who is at least twenty one years old. Patients and caregivers who live in cities or counties where medical cannabis cultivation is banned may cultivate up to six plants under this provision of law, provided that doing so is not prohibited under a lease.
Cities and counties cannot ban possession of medical cannabis by legal patients or caregivers. There is no numeric limit on how much medical cannabis a patient can possess, but his or her possession should be reasonably related to his or her medical need. The one-ounce possession limit imposed on non-medical cannabis users under Proposition 64 does not necessarily apply to legal medical cannabis patients or caregivers. However, ASA advises patients and caregivers to stay informed about changing laws and litigation on this topic.
Patients may continue to join not-for-profit cooperative and collective associations to cultivate or acquire medical cannabis for one year after the state begins to issue licenses for medical cannabis businesses under the MCRSA. Cooperative and collective associations will not be legal after this deadline.
Eligible conditions include: AIDS, anorexia, arthritis, cachexia, cancer, chronic pain, glaucoma, migraine, persistent muscle spasms, seizures, severe nausea, and any other serious chronic or persistent medical symptom for which cannabis provides relief.
Patients or their designated primary caregivers may cultivate medical cannabis. Patients and primary caregivers may join not-for-profit cooperative and collective associations to acquire medical cannabis for one year after the state begins to issue licenses for medical cannabis businesses under the MCRSA. After the MCRSA is implemented, patients and caregivers will be able to buy medical cannabis from storefront dispensaries licensed and regulated by local and state laws.
See CANORML's list of cooperative and collective associations. For more on dispensing collectives and cooperatives, read these FAQ. It is important to remember that cooperative and collective associations will not be legal after the MCRSA is implemented.
In general, legal patients can consume medical cannabis in any place it is not prohibited. Note that private property owners can and often do ban use of cannabis in stores, restaurants, bars, residences and many other places. State law does not authorize a legal patient to consume cannabis in any place or circumstances where it might endanger others. Driving while impaired by cannabis is illegal, and penalties may include jail time. Never smoke on a school bus, public transportation, etc. ASA strongly recommends that you do not consume cannabis while you drive. Do not use cannabis within 1,000 feet of a school, church or youth center.
The state law does not specifically address the legality of paraphernalia. Local laws regarding paraphernalia differ.
Your primary caregiver must be at least 18 years old and should consistently assume responsibility for your housing, health, or safety. They can be the primary caregiver of more than one patient only if the patients live in the same city or county as the primary caregiver.
Your doctor's written or verbal recommendation makes you a leal patient in California. County Health Departments are required to issue a Medical Marijuana Identification Card, which is optional for patients. Contact the California Department of Public Health at http://www.cdph.ca.gov/programs/MMP or 916-552-8600 to find out where and how to obtain a MMIC in your county.
Get a written recommendation from your doctor. Verbal recommendations are legal, but difficult to verify. Your recommendation must come from an "attending physician." State law defines an attending physician as a licensed physician "who has taken responsibility for an aspect of the medical care, treatment, diagnosis, counseling, or referral of a patient and who has conducted a medical examination of that patient before recording in the patient’s medical record the physician’s assessment of whether the patient has a serious medical condition and whether the medical use of marijuana is appropriate." The attending physician does not have to be your primary care physician.
Here is a sample doctor's recommendation, and here is the form used by San Francisco Department of Health Services. It's best to work with your primary care physician, but if they are unwilling or you do not have one, you can find a list of doctors familiar with medical cannabis at http://canorml.org.
California law and the US Supreme Court (Conant v. McCaffrey, 2000) say your doctor cannot be punished for recommending medical cannabis. However, state law does make the investigation of doctors who write excessive numbers of medical cannabis recommendations without good-faith prior exams one of many statutory priorities for investigation by the California Medical Board. The board cannot investigate patients (unless they are also physicians).
Your medical information is confidential and may be protected under Health Insurance Portability and Accountability Act of 1996 (HIPAA). You should consult with an attorney about the applicability of any state or federal laws or regulations related to privacy and medical information, based on your individual circumstances.
The MMIC issued by County Health Departments do not show your name, address, or other sensitive information; but they do have a photo. Police and government agents can verify the legitimacy of the card using a website or telephone number. Proposition 64, approved by voters in 2016, says that "No identification card application system or database… shall contain any personal information of any qualified patient, including but not limited to, the patient’s name, address, social security number, medical conditions, or the names of their primary caregivers.”
There is no statewide list of legal medical cannabis patients and primary caregivers that can be accessed by law enforcement, employers, licensing or accreditation bodies, etc. However, state law provides few protections fro discrimination in employment, housing or access to health care services for patients who test positive for cannabis use on a drug test.
Nothing in state law prevents a property owner from forbidding the use, possessions cultivation of medical cannabis on his or her property. Jails and other penal institutions do not necessarily have to accommodate your medical use of cannabis.
Employers may terminate an individual or deny employment based solely on a positive test for cannabis use, even if the employee or potential employee is a legal medical cannabis patient (see Ross v. Ragingwire, 2008). Furthermore, employers are not required to accommodate on-the-job consumption of medical cannabis.
Health insurance providers are not required to cover medical cannabis expenses.
Montana, Rhode Island, and Michigan should recognize your medical cannabis card issued by government entities.
For more information
If you have more specific questions, talk to a local attorney. You can also contact the California Department of Public Health: http://www.cdph.ca.gov/programs/MMP
California Department of Public Health
Office of County Health Services
Attention: Medical Marijuana Program Unit
P.O. Box 997377
Sacramento, CA 95899-7377