In 1996, California became the first medical cannabis state when voters approved Prop 215, the Compassionate Use Act. In 2003, the California legislature passed the Medical Marijuana Program Act, establishing a voluntary ID card program, protections for transporting cannabis, and a legal framework to protect not-for-profit dispensing collectives and cooperatives. These ID cards offered protection from arrest for patients and caregivers in possession of no more than eight ounces of cannabis or cultivating no more than six mature or 12 immature plants. Patients and designated caregivers without a state ID card, or those in possession of larger quantities, are afforded an affirmative defense. Over the years, adjustments continued to be made including the Adult Use of Marijuana Act (Proposition 64) in 2016, which expanded rights for patients by adding parental rights protections, enhancing patient privacy rules, prohibiting cities from banning personal cultivation, and exempting card-holding patients from sales tax. 

Cannabis is theoretically legal to all adults over 21 in California. Despite this, a byzantine regulatory structure has many counties and towns throughout the state with local restrictions keeping dispensaries from opening or producers from operating. Many of these local restrictions came with adult use cannabis and have unfortunately impacted access for medical cannabis patients by allowing localities to ban activities previously permitted to patients like growing at home or operating a dispensary. California falls short in supplying sufficient legal protections to their citizens by failing to protect against discrimination of patients in employment, housing, and in roadside sobriety tests. Though some Californians saw no improvements in the program between 2020 and 2021, others saw improved access thanks to expanded delivery services provided by emergency COVID measures. California does not recognize out of state medical cannabis cards however, visitors can apply for a Medical Marijuana ID card. Details on how these laws apply to patients and medical professionals can be found below.

In 2016, Prop 64 allowed individuals in California who had completed a sentence for a cannabis-related offense to have convictions “dismissed, sealed, resentenced, and/or redesignated from a felony misdemeanor” by petition. The petition application form is available online as a PDF. In 2018, Assembly Bill (AB) 1793 pushed the expungement process, requiring the courts to identify eligible cases by July 1, 2019.

Navigating California State Laws:

Patients and Caregivers: Enrolling and Accessing Medical Cannabis

Medical Professionals: Procedures for recommending Medical Cannabis

Policymakers and Advocates: Actions Needed to Improve Laws for Patients

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Here is a breakdown of how California fared in ASA’s Annual State of the States Report, which evaluates the effectiveness of each state cannabis program from a patient perspective and assigns a grade using a rubric that reflects the key issues affecting patient access. Medical cannabis laws are constantly changing, ASA’s policy recommendations for California can be found below. For policy updates sign up here.

Patient Rights and Civil Protections	70/100
Arrest Protection 25/25 Affirmative Defense 20/20 Parental Rights Protections 20/20 Employment Protections 0/20 DUI Protections 0/10 Explicit Privacy Standards 5/5
Access to Medicine	73/100
Authorizes Retail Access 10/10 Alternative Accessibility Methods 13/20 - Authorizes Delivery 8/10 - Authorizes Curbside Pickup 5/10 Personal Cultivation 15/15 Collective Gardening 0/5 Sufficient Number of Licensed Retailers 25/30 Reciprocity 10/20
Program Functionality	85/100
Legal Protections Within Reasonable Time Frame 20/20 Reasonable Possession Limits 10/10 Reasonable Purchase Limits 10/10 Telemedicine for Physician Certifications 15/15 Patient and Physician Representation in Program Decision Making 5/20 Reasonable Caregiver Standards 5/5 - Background Checks 2/2 - Number of Caregivers 3/3 Reasonable Physician Standards 5/5 Access to Administration Methods 10/10 - Allows Dried Flower 5/5 - Allows Edibles, Concentrates, and Other Forms 5/5 Provides Access to Minors on School Grounds 5/5
Affordability	40/100
Sales Tax Break for Patients and Caregivers 10/20 Covered by State Insurance or Health Aid 0/20 Reasonable Registration Fees 10/20 Financial Hardship Waivers or Discounts 20/20 Donation Program 0/10 Allows Multi-Year Registrations 0/10
Health and Social Equity	74/100
State Program Protections 25/25 Housing Protections 20/25 Access for Minors 10/10 Access in Underserved Areas 5/10 List of Qualifying Conditions is Exhaustive or All Inclusive 10/10 Allows Patients to Medicate Where they Choose 0/10 Organ Transplants 3/5 Ownership or Employment Restrictions 1/5
Consumer Protection and Product Safety	154/200
Cultivation Operations 34/50 Quality Management Systems 10/10 Staff Training 2/10 Standard Operating Procedures 3/8 - Facility and Equipment Sanitation 1/1 - Workplace Safety 0/1 - Storage 0/1 - Batch and Lot Tracking 0/1 - Security 0/1 - Waste Disposal 1/1 - Water Management 1/1 - Records Management 0/1 Pesticide Usage Limitations 2/2 Environmental Impact Regulations 2/2 Required Testing 7/8 - Cannabinoids 1/1 - Terpenes 0/1 - Microbials 1/1 - Aflatoxins 1/1 - Pesticides 1/1 - Heavy Metals 1/1 - Foreign Matter 1/1 - Moisture Content/ Water Activity 1/1 Packaging and Labeling 1/3 - Cannabinoids 1/1 - Terpenes 0/1 - Pesticides 0/1 Complaints, Adverse Event Reporting, and Recall Protocol 7/7 Manufacturing Operations 48/50 Quality Management Systems 10/10 Staff Training 10/10 Standard Operating Procedures 7/7 - Facility and Equipment Sanitation 1/1 - Workplace Safety 1/1 - Storage 1/1 - Batch and Lot Tracking 1/1 - Security 1/1 - Waste Disposal 1/1 - Records Management 1/1 Environmental Impact Regulations 3/3 Required Testing 9/10 - Cannabinoids 1/1 - Terpenes 0/1 - Microbials 1/1 - Aflatoxins 1/1 - Pesticides 1/1 - Heavy Metals 1/1 - Residual Solvents 1/1 - Homogeneity 1/1 - Foreign Matter 1/1 - Water Activity 1/1 Packaging and Labeling 4/5 - Cannabinoids 1/1 - Terpenes 0/1 - Ingredients 1/1 - Allergens 1/1 - Nutritional Content 1/1 Complaints, Adverse Event Reporting and Recall Protocol 5/5 Dispensary Operations 27/50 Staff Training 5/20 Standard Operating Procedures 4/7 - Facility Sanitation 1/1 - Workplace Safety 0/1 - Storage 0/1 - Batch and Lot Tracking 1/1 - Security 1/1 - Waste Disposal 1/1 - Records Management 0/1 Product Testing 5/10 - Product Meets Requirements Before Sale 5/5 - COA Disclosure 0/5 Complaints, Adverse Event Reporting and Recall Protocol 13/13 Laboratory Operations 45/50 Independent or Third-Party 0/5 Laboratory Sampling 5/5 Method Validation 4/4 Quality Management Systems 5/5 Staff Training 20/20 Standard Operating Procedures 7/7 - Facility and Equipment Sanitation 1/1 - Equipment and Instrument Calibration 1/1 - Workplace Safety 1/1 - Sample Tracking 1/1 - Security 1/1 - Waste Disposal 1/1 - Records Management 1/1 Result Reporting 4/4
Score Penalties	10/100
Gives Regulatory Preference to Adult Use 10/20 Classifies Cannabis as a Medicine of Last Resort 0/15 Administrative or Supply Problems 0/15 Requires Vertical Integration 0/10 Creates New Criminal Penalties for Patients 0/10 Limits Patients to a Single Retailer 0/10 No System for Adding Qualifying Conditions 0/10 Imposes Bans or Limits on THC 0/5 Imposes Bans or Limits on CBD 0/5
Excerpted from ASA's 2022 State of the States Report.