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A local ban on all medical cannabis cultivation stands after the California Supreme Court refused to hear an appeal on Wednesday in Maral v. Live Oak, an appellate decision permitting cities and counties to prevent patients from growing their own medicine, despite the fact that it is allowed under state law. The decision means that a ban on all cultivation adopted by the City of Live Oak in 2011 will be precedent for other cities and counties to follow.

The Maral decision is a second blow to patients’ rights in California. Last year, the state supreme court held in Riverside v. Inland Empire Patients Health and Wellness Center that local governments could ban distribution of legal medicine. Maral and Riverside are a one-two punch for California patients and providers. By allowing local governments to prevent any cultivation or distribution of medical cannabis, the courts are, in effect, authorizing jurisdictions to opt out of crucial parts of Proposition 215.

The decisions may create “access deserts” in some regions. Patients in southern and rural communities, where support for medical cannabis is less robust, are especially threatened. That was clearly not the voters’ intent when they approved the Compassionate Use Act to ensure “Californians have the right to obtain and use marijuana for medical purposes.” Nor is it what the California legislature intended when it enacted in 2003 the Medical Marijuana Program Act (SB 420) to “[p]romote uniform and consistent application of the act among the counties within the state.” And it is certainly not what is best for the most seriously ill patients who rely on cultivation or dispensaries for safe, consistent access to their medicine.

The obvious place to look for a solution to an unfair and unequal legal situation is the state legislature. Voters called on lawmakers “to implement a plan for the safe and affordable distribution of marijuana” when they adopted Proposition 215 in 1996. Unfortunately, state lawmakers have been slow to respond to the voters’ mandate. The Medical Marijuana Program Act recognized the right of patients and caregivers to grow collectively but gave little clarity to local governments about the scope of protection under the law.

State lawmakers are reluctant to buck local officials and constituents in their district when it comes to prohibiting local bans. Lobbyists for the League of California Cities and law enforcement have consistently opposed legislative efforts that would preempt local control. The stopped AB 2312 in 2012 and forced concessions for local control in AB 604 last year. This year, SB 1626 is sponsored by the League and law enforcement. That bill solidifies local control by requiring cities and counties to approve medical cannabis facilities before they are licensed by the state.

Even the most tenacious medical cannabis champions in the state legislature have conceded the right of cities and counties to ban medical cannabis distribution as the price of moving forward with statewide regulations and licensing. It is unlikely that a legislative effort to roll back Maral and Riverside will succeed in the short term. The only viable option for medical cannabis advocates this year is to create incentives for cities and counties to regulate distribution and cultivation.

So what can a patient or advocate do if his or her local government wants to ban cultivation or distribution and the state legislature is not likely to help? There are three routes to explore – and each takes time, effort, and money. One option is to launch local voter initiatives to allow cultivation and distribution. These are tough campaigns to fund and run, but they ultimately put power where it needs to be – in the hands of voters. Another option is to dig in your heels and mount a long and strategic campaign to change lawmakers’ minds. Lobbying a city council or county Board of Supervisors is hard work, and it requires more finesse today than it did a few years ago.

Finally, we need to build a bigger and more strategic grassroots voice in communities where cultivation and access are in jeopardy (or already banned). Former US Speaker Tip O’Neil famously said, “All politics is local,” and when it comes to medical cannabis in California right now, that is absolutely true. Whether we are building community support for a local ballot measure or grassroots support behind a local ordinance, it matters whether or not lawmakers are hearing from their constituents. Nothing will substitute for genuine grassroots power.

You may need help building the skills and coalition that will lead to success. Americans for Safe Access (ASA) cannot come to your community and do this work for you. That would not work, even if we had the resources to do it. Voters and lawmakers need to know that the push for an initiative or ordinance is coming straight from the community, from the people who will be directly affected by it. But ASA can help. Use our free online Medical Cannabis Advocates Training Center to make a strategic plan, learn advocacy skills, and build a coalition. Use the CA Weekly RoundUp to let others know about meetings and events (see below). And let me know in advance if you need more help with the campaign – honing messages, dealing with media, hosting organizing events, etc. I want to support your local effort as much as I can.

There is one last thing you can do to help out: Join ASA. No other organization is bringing the patients’ voices to the table in Sacramento and Washington, DC, the way we do. And no other national organization supports local advocacy like ASA does. We need your help to do even more right now. Thanks in advance for supporting us, while we support you!

Read more about the decision in Maral v. Live Oak here.

The CA Weekly Roundup is a once-a-week email for ASA Members and Friends that focuses on relevant news and important updates, action alerts, meetings and special events. It is a great place to post requests for court support. Send items for the California Weekly Roundup to [email protected] before 12:00 PM on Friday to be included in Monday's distribution.

Contact ASA CA Director Don Duncan at [email protected] or (916) 449-3975.