On September 28, 2021, Governor Gavin Newsom signed SB 311, also known as “Ryan’s Law”, requiring healthcare facilities to allow the use of medical cannabis on their premises for terminally ill patients with a valid Medical Marijuana Identification Card (MMIC) or/ recommendation from an attending physician. The law was passed the legislature with support from a diverse group of organizations including Americans for Safe Access (ASA). The law goes into effect January 1, 2022, and applies to all CA health care facilities including acute care hospitals, special hospitals, skilled nursing facilities, congregate living health facilities, or hospice providers (excluding to the emergency department of a health care facility, chemical dependency recovery hospitals and state hospitals).
Ryan’s law was passed in honor of Ryan Bartell who was diagnosed with Stage 4 pancreatic cancer at the age of 41. As his condition progressed, he was admitted to the palliative wing of a hospital where he spent his first four and a half weeks on fentanyl to treat his pain. Unfortunately, the first hospital could not allow Ryan to use cannabis in their facility. He stayed on this medication until his family could locate and move Ryan to a hospital that would allow him to use cannabis. As a result of using medical cannabis, he spent his last two and half weeks lucid and pain-free with his family and friends. Following this experience, Ryan’s father Jim Bartell made it his mission to ensure that no other family would have to navigate this choice for palliative care, losing precious time with their loved one.
Ryan’s Law builds on the rights granted to patients through the voter initiative Proposition 215 in 1996, also known as the Compassionate Use Act. The law exempts patients and their designated caregivers from criminal penalties relating to the use, possession, and cultivation cannabis with an oral or written recommendation or approval from a physician. In 2003, the California legislature passed the Medical Marijuana Program Act expanding rights for patients and establishing a voluntary ID card program that exempts patients from arrests.
The US Supreme Court confirmed in 2004 that medical professionals have a legal right to recommend cannabis as a treatment in any state due to protections afforded by the First Amendment to the US Constitution. The court upheld an earlier ruling in Conant v. Walters in which the Nineth Circuit Court of Appeals ruled that the federal government could neither punish nor threaten a doctor merely for recommending the use of cannabis to a patient.
Physicians with terminally ill patients need only to provide written recommendation to their patients for the patients to utilize the rights created in SB 311. This is the same recommendation that is written for qualification of The Compassionate Use Act. The following is a quick guide to the law and offers recourses for physicians and their patients. If patients have issues with health care facilities refusing to comply, please report immediately at [email protected] and/or fill out this quick report.
II. Ryan's Law Summary
On September 28, 2021, Governor Gavin Newsom signed SB 311, also known as “Ryan’s Law”, requiring healthcare facilities to allow the use of medical cannabis on their premises for terminally ill patients with a valid Medical Marijuana Identification Card (MMIC) or/ recommendation from an attending physician. The law goes into effect on January 1, 2022.
SB 311 defines “terminally ill patient” as a patient with a medical condition resulting in a prognosis of life of one year or less, if the disease follows its natural course. The bill defines “health care facility” as a licensed general acute care hospital, special hospital, skilled nursing facility, congregate living health facility, or hospice provider while excluding a chemical dependency recovery hospital or a state hospital.
SB 311 requires health care facilities to do ALL of the following:
- Refrain from Interfering or Prohibiting a terminally ill patient from using medical cannabis within the health care facility,
- Prohibit smoking or vaping methods on premises,
- Include the use of medical cannabis within the patient’s medical records,
- Require patient to provide a copy of patient’s medical cannabis physician’s recommendation or a copy of their valid MMIC,
- Develop and disseminate written guidelines for the use of medical cannabis within the health care facility, and
- Reasonably restrict the manner in which a patient stores his/her medical cannabis, including the use of a locked container.
III. Tools for Physicians
IV. Tools for Patients