A Special Condition: Medical Marijuana in SLC States
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THE SOUTHERN OFFICE OF THE COUNCIL OF STATE GOVERNMENTS PO Box 98129 | Atlanta, Georgia 30359 ph: 404/633-1866 | fx: 404/633-4896 | www.slcatlanta.org SERVING THE SOUTH SOUTHERN LEGISLATIVE CONFERENCE OF THE COUNCIL OF STATE GOVERNMENTS © Copyright March 2014 Lauren Greer Policy Analyst Southern Legislative Conference March 2014 A SPECIAL CONDITION: MEDICAL MARIJUANA IN SLC STATES A REGIONAL RESOURCE FROM THE SLC Photo courtesy of flickr user Brian Stalter via Creative Commons License Introduction Gaining traction in a number of state legislatures of The Council of State Governments (CSG), Southern Legisla- tive Conference (SLC) member states, is the legalization of marijuana for medical use. Many SLC lawmakers cite sto- ries of families with children suffering from severe seizure disorders that failed to respond to the more conventional treatments as the impetus for the push toward its legaliza- tion; some of these families have even considered moving to a state that does allow for the medicinal or recreational use of marijuana. Prior to the start of the 2014 legislative session, 21 states and the District of Columbia had legalized marijuana for medical purposes. 1,2 Additionally, in 2012, voters in Colorado and Washington approved the recre- ational use of marijuana within their states. Mirroring the rise in states legalizing or decriminalizing marijuana, public support for legalization also is on the rise. A 2010 national survey conducted by the Pew Research Center found that only 41 percent of Americans supported legalizing mari- juana. 3 Only three years later, the same Pew survey found that 52 percent of Americans favor legalization. 4 Previously Enacted Legislation Georgia, Louisiana, South Carolina, and Virginia already have laws from the 1970s and 1980s that allow for some use of cannabis or cannabis derivatives for medical purposes. However, all of these programs have remained mostly dor- mant since their enactment, mainly due to lack of funding or regulations for implementation. In previous and cur- rent legislation, the terms marijuana and cannabis often are used interchangeably. Current Legislation As of February 2014, 10 of the 15 SLC member states have introduced legislation for the 2014 session that would al- low for the medical use of marijuana to some extent. Although North Carolina does not reconvene until May, legislation filed in 2013 technically is still available, de- spite an unfavorable committee vote. Oklahoma also introduced medical marijuana legislation in 2013. No leg- islation has been introduced to allow medical marijuana in Arkansas, Texas, or Virginia in the last two years. How- ever, it should be noted that Arkansas only has a short budget session in 2014, and Texas will not reconvene for their next biennial legislative session until 2015. In ad- dition to medical marijuana legislation, some states also have seen legislation that would allow for the recreation- al use of marijuana. Despite the prevalence of marijuana-related legislation being filed across the Southern states, only a few bills are expected to make their way through the legislative process to achieve enactment. However, as the topic moves further from theoretical and closer to reality, there are some com- mon trends emerging in legislation across the SLC region. This Regional Resource reviews the similarities among these 12 legislative proposals and two ballot proposals. * The anal- ysis was conducted on the February 28, 2014, version of the proposals in SLC member states listed on Table 1. * One Arkansas ballot proposal and the Florida ballot proposal have been included in the comparisons. The Missouri proposals were not included in the analysis because they propose constitutional amend- ments to legalize marijuana for recreational uses.
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Gaining traction in a number of state legislatures of The Council of State Governments (CSG), Southern Legislative Conference (SLC) member states, is the legalization of marijuana for medical use. Despite the prevalence of marijuana-related legislation being filed across the Southern states, only a few bills are expected to make their way through the legislative process to achieve enactment. However, as the topic moves further from theoretical and closer to reality, there are some common trends emerging in legislation across the SLC region. This Regional Resource reviews the similarities among these 12 legislative proposals and two ballot proposals.
Transcript of A Special Condition: Medical Marijuana in SLC States
THE SOUTHERN OFFICE OF THE COUNCIL OF STATE GOVERNMENTSPO Box 98129 | Atlanta, Georgia 30359 ph: 404/633-1866 | fx: 404/633-4896 | www.slcatlanta.orgSERVING THE SOUTHSOUTHERN LEGISLATIVE CONFERENCEOFTHE COUNCIL OF STATE GOVERNMENTS Copyright March 2014Lauren Greer Policy AnalystSouthern Legislative ConferenceMarch 2014A SPECIAL CONDITION:MEDICAL MARIJUANA IN SLC STATESA REGIONAL RESOURCE FROM THE SLCPhoto courtesy of fickr user Brian Stalter via Creative Commons LicenseIntroductionGainingtractioninanumberofstatelegislaturesofThe CouncilofStateGovernments(CSG),SouthernLegisla-tive Conference (SLC) member states, is the legalization of marijuana for medical use.Many SLC lawmakers cite sto-ries of families with children suffering from severe seizure disordersthatfailedtorespondtothemoreconventional treatments as the impetus for the push toward its legaliza-tion; some of these families have even considered moving to a state that does allow for the medicinal or recreational useofmarijuana.Priortothestartofthe2014legislative session, 21 states and the District of Columbia had legalized marijuanaformedicalpurposes.1,2Additionally,in2012, votersinColoradoandWashingtonapprovedtherecre-ational use of marijuana within their states.Mirroring the rise in states legalizing or decriminalizing marijuana, public support for legalization also is on the rise.A 2010 national surveyconductedbythePewResearchCenterfoundthat only41percentofAmericanssupportedlegalizingmari-juana.3Only three years later, the same Pew survey found that 52 percent of Americans favor legalization.4Previously Enacted Legislation Georgia,Louisiana,SouthCarolina,andVirginiaalready have laws from the 1970s and 1980s that allow for some use ofcannabisorcannabisderivativesformedicalpurposes. However, all of these programs have remained mostly dor-mant since their enactment, mainly due to lack of funding orregulationsforimplementation.Inpreviousandcur-rentlegislation,thetermsmarijuanaandcannabisoften are used interchangeably.Current Legislation As of February 2014, 10 of the 15 SLC member states have introducedlegislationforthe2014sessionthatwouldal-lowforthemedicaluseofmarijuanatosomeextent. AlthoughNorthCarolinadoesnotreconveneuntilMay, legislationfiledin2013technicallyisstillavailable,de-spiteanunfavorablecommitteevote.Oklahomaalso introduced medical marijuana legislation in 2013.No leg-islation has been introduced to allow medical marijuana in Arkansas, Texas, or Virginia in the last two years.How-ever,itshouldbenotedthatArkansasonlyhasashort budgetsessionin2014,andTexaswillnotreconvenefor theirnextbienniallegislativesessionuntil2015.Inad-ditiontomedicalmarijuanalegislation,somestatesalso have seen legislation that would allow for the recreation-al use of marijuana.Despitetheprevalenceofmarijuana-relatedlegislation beingfiledacrosstheSouthernstates,onlyafewbillsare expected to make their way through the legislative process to achieve enactment.However, as the topic moves further from theoretical and closer to reality, there are some com-montrendsemerginginlegislationacrosstheSLCregion. This Regional Resource reviews the similarities among these 12 legislative proposals and two ballot proposals.* The anal-ysis was conducted on the February 28, 2014, version of the proposals in SLC member states listed on Table 1.* One Arkansas ballot proposal and the Florida ballot proposal have been included in the comparisons.The Missouri proposals were not included in the analysis because they propose constitutional amend-ments to legalize marijuana for recreational uses.2 A SPECIAL CONDITION: MEDICAL MARIJUANA IN SLC STATESNationally,10ofthe21statesthatalreadyhavelegalized medical marijuana in some form have done so through tra-ditional legislative means.In 2000, Hawaii became the first statetoenactlegislationlegalizingmarijuanaformedical use.Between Hawaii in 2000, and most recently Illinois and New Hampshire in 2013, Connecticut, Delaware, New Jer-sey, New Mexico, Rhode Island, and Vermont have enacted similarlegislation.In2013,Marylandenactedlegislation that legalized marijuana only for medical research by aca-demic medical centers; however, no regulations have been established to implement the program.Public Vote Somestatesofferanothermeansofdecidingwhethermari-juana will be allowed public vote.Ballot language has been approved in Arkansas, Florida, and Missouri that will appear on the respective 2014 ballot if petitioners can collect the req-uisite number of signatures before the deadline in each state.Despite voters rejecting a proposal to legalize medical mar-ijuana in 2012, the Arkansas attorney general has approved two statutory proposals for the ballot in 2014.The largest distinctionbetweenTheArkansasMedicalCannabisAct andTheArkansasMedicalMarijuanaActisthatthelat-ter would not allow for home cultivation.Petitioners have until July 2014 to collect signatures.InFlorida,therequirednumberofsignatureshasbeen obtained to put the constitutional question of medical mar-ijuanalegalizationbeforevotersin2014.Althoughthe language was challenged for being too vague and mislead-ing,itwasnarrowlyapprovedbytheFloridaSupreme Court in January of this year.In Missouri, the secretary of state has approved 13 separate petitions for amending the states constitution to allow for theuseofmarijuana.PetitionershaveuntilMaytocol-lect the requisite number of signatures to have the petitions placed on the 2014 ballot.The petitions propose a range of amendmentsfromallowingtherecreationaluseofmari-juanaforanyone21yearsofageorolder,toallowingfor themedicaluseofmarijuana,toallowingthestatetotax and regulate marijuana.Some petitions also call for chang-ing the criminal provisions for marijuana-related offenses andtheexpunctionoftheseoffensesfromexistingcrimi-nal records.Legislation has also been filed in 2014 to enact statutoryprovisionssimilartothoseintheconstitutional ballot proposals.Morethanhalfofthestatesthatcurrentlyallowforthe medicaluseofmarijuanahavelegalizeditthroughpub-lic vote.California became the first state in the nation to approveaballotmeasuretoallowmedicalmarijuanain 1996.Between1996inCaliforniaandmostrecentlyAr-izonain2010,Alaska,Colorado,Maine,Massachusetts, Michigan,Montana,Nevada,Oregon,andWashington approvedmedicalmarijuanaballotmeasures.TheDis-trict of Colombia approved a ballot measure in 1998, but it Table 1 Analyzed Medical Marijuana ProposalsAlabamaSB 174 (2014) Carlys LawArkansas Statutory (2014) - The Arkansas Medical Cannabis ActFlorida Constitutional (2014) - 2014 Ballot Amendment 2HB 859 (2014) Cathy Jordan Medical Cannabis ActGeorgia HB 885 (2014) Haleighs Hope ActKentuckySB 43 (2014) Cannabis Compassion ActLouisiana SB 541 (2014) Louisiana Therapeutic Use of Marijuana ActMississippi SB 2763 (2014) No title Missouri HB 1324 (2014) Compassionate Use of Medical Cannabis Pilot Program ActNorth Carolina HB 84 (2013) North Carolina Medical Cannabis ActOklahoma SB 710 (2013) Compassionate Use Act of 2013South Carolina SB 1035 (2014) South Carolina Medical Cannabis Therapeutic Treatment Research ActTennesseeHB 1385 (2014) Koozer-Kuhn Medical Cannabis ActTexas NoneVirginia NoneWest Virginia HB 4264 (2014) The Compassionate Use Act for Medical CannabisNote: This is not an exhaustive list of medical marijuana proposals in each state.A SPECIAL CONDITION: MEDICAL MARIJUANA IN SLC STATES 3was not implemented until District Council members ap-proved legislation in 2010, which the U.S.Congress then allowed to become law.Drugs Approved for Medical UseProposalsinSLCmemberstatesvaryontheformof marijuanabeingapprovedformedicaluse.Mostofthe proposals would allow all forms of cannabis or marijuana, whilethreeproposalsonlywouldallowlimitedcannabis derivatives or extracts. The Alabama proposal is limited to nonpsychoactive can-nabidiol (CBD) with a tetrahydrocannabinol (THC) level of no more than 3 percent. The Georgia and South Carolina proposals are limited to medicalcannabis,whichiscannabisextractsandcom-poundsofcannabis,including,butnotlimitedto,CBD anonpsychoactivecannabinoid,thatisdeliveredtopa-tients in a nonsmoking delivery system.Required Medical ConditionAlloftheproposalsrequireanindividualtohaveanexist-ing medical condition before being considered as a potential patientwhoqualifiesfortheuseofmedicalmarijuanaasa THCisthechemicalinmarijuanathatisresponsibleformost of its psychological effects.Comparatively, some of the most po-tent products derived from cannabis can have THC levels as high as 30 percent.form of treatment.In order to receive a registry identifica-tioncard,mostoftheproposalswouldrequireapatientto havesometypeofwrittencertificationrecommendingthe use of marijuana for medical purposes from a doctor in their statewithwhomtheyhaveabonafidephysician-patient relationship.However, the proposals vary widely on what classifies as a qualifying or debilitating medical condition. South Carolina provides the narrowest qualification by only allowing patients who suffer from seizures to participate in the research-only program.Similarly, Georgia only would allow patients who suffer from severe side effects of cancer treatment, nonresponsive glaucoma, or seizure disorders to participate in its research-only program.Themostcommonconditionsfoundamongthemedical conditionproposalsareseizures,cancer,glaucoma,HIV/AIDS, and Crohns Disease.Table 2 provides a more com-prehensivelistofsomeofthemorecommonandunique conditionsincludedintheproposalsasaqualifyingor debilitatingmedicalcondition;however,itisnotanex-haustive list of the proposed conditions: The proposals in Florida (ballot and legislation), Alabama, NorthCarolina,Oklahoma,andTennesseewouldallow doctors some discretion in recommending the use of med-icalmarijuanaforadditionalqualifyingconditionsnot listedinlaw.Likewise,theproposalsinArkansas,Ken-tucky,Mississippi,Missouri,andWestVirginiawould Figure 1 Legalization of Marijuana by State and MethodLegislationPublic VoteIllegal4 A SPECIAL CONDITION: MEDICAL MARIJUANA IN SLC STATESTable 2Most Common and Unique Qualifying Medical Conditions Proposed for Medical Marijuana TreatmentAlabamaSB 174ArkansasBallotFloridaBallotFloridaHB 859GerogiaHB 885KentuckySB 43LouisianaSB 541MississippiSB 2763MissouriHB 1324North CarolinaHB 84OklahomaSB 710South CaorlinaSB 1035TennesseeHB 1385West VirginiaHB 4264Alzheimers Amyotrophic Lateral Sclerosis Anorexia Autism Cachexia or Wasting Syndrome Cancer Celiac Disease Chronic Pain Crohns Disease Depression or Anxiety Diabetes Fibromyalgia Glaucoma Hepatitis C HIV/AIDS Hypertension Incontinence Lupus Multiple Sclerosis Muscle Spasms Narcolepsy Opiate Addiction Organ Transplantation Osteoporosis Post-Traumatic Stress Disorder Rheumatoid Arthritis Seizures, including Epilepsy Severe Migraines Severe Nausea Sleep Apnea A SPECIAL CONDITION: MEDICAL MARIJUANA IN SLC STATES 5allowtheregulatingdepartmenttoaddadditionalquali-fyingconditionsafterpublicpetitionandcomment.The LouisianaproposalwouldallowtheTherapeuticMari-juanaUtilizationReviewBoard,anewentitycreatedby theproposalwithinthestatesDepartmentofHealthand Hospitals, to review and recommend additional qualifying medical conditions.Research Beyond staying apprised of research on the medical uses of marijuana, seven states specifically have included research provisions in their legislation. GeorgiaandSouthCarolinaonlywouldallowforthe medical use of cannabis by patients enrolled in a research program conducted by academic medical centers and ap-proved pediatric neurologists. NorthCarolinawoulddirecttheUniversityofNorth CarolinaSystemtoundertakeresearchregardingthe efficacyandsafetyofadministeringcannabisaspartof medical treatment. Kentucky and West Virginia would allow registered safety compliancecenterstoconductresearchrelatedtomedi-cal marijuana, but patients are not required to participate. However, the application for qualifying patients shall ask whether the patient would like to be notified of any clini-cal studies conducted in the Unites States needing human subjects for research on the medical use of marijuana. Florida legislation would direct the Department of Busi-nessandProfessionalRegulation(DBPR)tospecify persons who will be exempt from possession laws for the purposes of teaching, research, or testing, but it does not set any specifications for the research to be conducted. OklahomawoulddirecttheStateBoardofHealthto promulgaterulestoauthorizeandlicensemedicalcan-nabislaboratoriestoanalyzedried,extracted,cured, food-based,oranyotherformsofcannabis.Testing would be voluntary and may include the analysis of con-taminants and chemical composition and other methods ofinvestigationintendedtoadvancetheunderstanding of the therapeutic benefits of cannabis.Cultivation Language in six of the proposed laws would allow a qualifying patient or his or her designated caregiver to cultivate cannabis. Arkansaswouldrequirethepatientorcaregivertoob-tainaHardshipCultivationCertificate,butonlyifitis determinedthatthepatientlacksaccesstoanonprof-it dispensary.The certificate only would be issued if the patient,basedonphysicalincapacity,lacksreasonable transportation to a dispensary, a caregiver with access to reasonable transportation, or a dispensary that will deliv-er to the patients residence. Oklahomawouldrequireapatientorcaregivertoei-therobtainapatientgrowerslicense,whichisseparate fromtheidentificationcard,orrequiremembershipin alicensedcollective,whichmayhavenomorethan75 members. ThelegislationinFlorida,Kentucky,Mississippi,and WestVirginiaexplicitlywouldallowpatientsorcare-givers to cultivate their own cannabis.Tenoftheproposalswouldrequireanentitytoregister orbelicensedforthepurposeofgrowingmedicalcanna-bis; however, only the legislation in West Virginia and the ballotproposalsinArkansasandFloridawouldallowthe cultivatortoselldirectlytothepatientorcaregiver.The other proposals that would require a license for cultivation includethelegislationinFlorida,Kentucky,Louisiana, Missouri,NorthCarolina,Oklahoma,Tennessee,and West Virginia.In most cases, being registered or licensed asacultivationcenteronlyallowsforselling,processing, or delivering the cultivated cannabis to a separate licensed entity for dispensing.One of the more unique cultivator-related provisions is in the Florida legislation, which would allow medical canna-bis farms permitted by the DBPR to cultivate, manufacture, sell,deliver,andpossesswiththeintenttosell,cannabis, cannabis-based products, and cannabis plants for wholesale toalicenseddispensary.Beforeapplyingforthepermit, all of the necessary agricultural classifications must be ob-tained to indicate that the land on which the farm is located is primarily for bona fide agricultural purposes.Somestates,likeNorthCarolinaandOklahoma,would requireaseparatelicensetoproducemarijuana-related products or paraphernalia.Dispensing Mostoftheproposalswouldrequireaseparatelicenseor registrationfordispensaries,whichserveastheinterme-diary between the cultivator and qualifying patient.Some proposals require a chain of three or four licensed entities before the product would reach the patient. InLouisiana,alicensetodispensetherapeuticmarijua-naonlywouldbeissuedtopharmacistswhoareeither employedbyortheownerofatherapeuticmarijua-natreatmentcenter.Alicensetooperateatherapeutic marijuana treatment facility only will be granted to phar-6 A SPECIAL CONDITION: MEDICAL MARIJUANA IN SLC STATESmacies that employ a pharmacist who holds a therapeutic marijuana dispensing license. In Oklahoma, medical cannabis dispensing centers would havetobelicensedtodispensecannabisandcannabis productsthroughastorefrontformedicalusetomem-ber patients and caregivers.A separate license is required foramedicalcannabisdeliveryserviceforcannabisand cannabisproductstopatients,designatedcaregivers, cannabislaboratories,manufacturers,cultivators,and dispensing centers. In Tennessee, a licensed producer would be able to possess, cultivate,harvest,anddelivercannabisorrelatedprod-ucts to a licensed processor.A licensed processor would beabletopossess,process,package,anddelivercanna-bis and related products to participating pharmacies and regulateddispensaries,whichthenwoulddistributethe cannabis or products to program participants.TheproposalsinGeorgiaandSouthCarolinaonlywould allowtheacademicmedicalcentersconductingthere-searchtoactasdispensaries.TheAlabamalegislationis silent regarding the source of the drug.Limitations on Amount in Possession Nineoftheproposalswouldlimittheamountofmedical cannabisapatientorcaregivercouldpossessatonetime. Thecaregiverpossessionlimitationsgenerallyarecollec-tiveorinlieuofpatientpossession.Table3providesthe patient and caregiver possession limits for each proposal. Caregivers and Assistance LimitsWith one exception, all of the proposals would extend the protectionsprovidedtoaqualifyingpatienttohisorher designated caregiver.Like patients, caregivers also would berequiredtohavearegistryidentificationcardprovid-edbytheregulatingagency.Sevenoftheproposalslimit the number of patients a caregiver may assist at one time. The numbers range from one patient in Missouri,two pa-tientsinNorthCarolina,threepatientsundertheFlorida legislation,andfivepatientsinArkansas,Kentucky,and West Virginia.The largest number of patients allowed is in Oklahoma, in which a single caregiver could assist up to 25qualifyingpatientssimultaneously;however,thelimit is reduced to 10 patients if operating within 1,000 feet of a Patient Possession Limit Caregiver Possession LimitUsable Cannabis Plants Usable Cannabis PlantsArkansas 2.5 ounces6 marijuana plants - only 3 may be more than 12 inches in height or diameter 2.5 ounces, per patient6 marijuana plants per patient, not to exceed 30 plants totalFlorida Legislation250 grams 8 mature plants and 8 immature plants250 grams, per patient8 mature plants and 8 immature plants, per patientKentucky12 ounces at the site where cultivated or 3 ounces elsewhere12 mature plants and 12 seedlings at the site where cultivated12 ounces at site where cultivated or 3 ounces elsewhere, per patient12 mature plants and 12 seedlings at the site where cultivated, per patientMississippi 30 grams per mature plant3 mature plants and 4 immature plants30 grams per mature plant collectively with patient3 mature plants and 4 immature plants collectively with patientMissouri2.5 ounces during a 14-day periodNone 2.5 ouncesNoneNorth CarolinaVaries by recommended delivery methodVaries by recommended delivery methodOklahoma 8 ounces 12 plants 8 ounces, per patient 12 plants, per patientTennessee 1 month supply None 1 month supply NoneWest Virginia 6 ounces12 mature plants and 12 seedlings, if no caregiver designated for cultivation6 ounces, per patient12 mature plants and 12 seedlings, per patientTable 3 Maximum Possession AmountsA SPECIAL CONDITION: MEDICAL MARIJUANA IN SLC STATES 7jail, correctional facility, public or private primary school, church, or daycare facility.Louisiana has the only propos-al that does not mention patient caregivers.Other Notable Provisions Someoftheproposalsincludeabreakdownofhowthe funds collected from the sale of medical cannabis should be distributed. UndertheArkansasproposal,anysalestaxreve-nueremainingaftercoveringthestateDepartment ofHealthscostofadministeringtheprogramwould bedistributedasfollows:50percentfortheNewborn UmbilicalCordBloodInitiativeFundand50percent fordrugeducationprogramsadministeredbytheDe-partment of Human Services. UndertheOklahomaproposal,salestaxwouldbere-mittedtothestatesgeneralfundandlicensefeeswould bedistributedasfollows:30percentforthedepartment whereoperationalexpenseswereincurred;30percent forgeneralstate,county,andcitytaxfunds;20percent fordrugrehabilitationandpreventionprogramsspon-soredororganizedbytheOklahomaDepartmentof MentalHealthandSubstanceAbuse;10percentforthe Oklahoma Department of Agriculture, Food, and Forest-ry; and 10 percent for law enforcement entities.References1)Medical marijuana gains traction in the Deep South, The Atlanta Journal-Constitution, February 9, 2014. http://www.ajc.com/ap/ap/legislative/medical-marijuana-gains-traction-in-the-deep-south/ndJGG/.2)Medical marijuana still beyond reach in Maryland, The Baltimore Sun, January 28, 2014. http://articles.baltimoresun.com/2014-01-28/health/bs-md-medical-marijuana-20140118_1_medical-marijuana-morhaim-biker-bar.3)Majority Now Supports Legalizing Marijuana, Pew Research Center, April 4, 2013. http://www.people-press.org/2013/04/04/majority-now-supports-legalizing-marijuana/.4)Ibid. UndertheLouisianaproposal,aphysicianwouldbere-quiredtohaveaseparatelicensetoprescribetherapeutic marijuana.However,onlycertifiedneurologists,oncolo-gists, and ophthalmologists would be eligible for the license. Tennesseehasoneofonlytwoproposalsthatwouldin-cludeexistingpharmaciesinanycontext(Louisianahas the other).Under the proposed Tennessee Safe Access pro-gram, patients and caregivers would have to enroll in a Safe Accessprogramataparticipatingpharmacyorregulated dispensarytoreceivetheiridentificationcardinorderto obtain cannabis for medical use from these sources.ConclusionWhilethelegalizationordecriminalizationofmarijuana use for medicinal or recreational purposes has been on the legislative agenda in many states outside the SLC region for a number of years, it is only within the past few years that Southern state legislatures have begun to grapple with the complexities of this issue.ForanumberofSouthernstates,craftinglegislationthat addressestheuseofmedicalmarijuanahasbeenthefocal pointinthismostlyunchartedarea.Tothatend,asthe possibilityoflegalizingmedicalmarijuanabecomesmore plausible, there are many issues policymakers will need to address,including,butnotlimitedto:determiningwhich departmentwillregulateitscultivation,distribution,and use;issuinglicensestocultivatorsanddistributors;regis-teringqualifyingpatients;determiningwhetherapatient mustdesignatecaregivers;establishingataxstructureto determinewhichproductswillbetaxedandatwhatrate theywillbetaxed;determiningthecostofmedicalmari-juana and its related products; setting limitations on where medicalmarijuanacanbeconsumed(i.e.workorschool); and determining whether insurance will cover the cost of medical marijuana.Although it is not an exhaustive analysis of medical mari-juana-related proposals in the SLC states, as of February 28, 2014, this SLC Regional Resource demonstrates that the idea of legalization is spreading in the Southern region.Table 4Maximum Number of Patients Assisted by a CaregiverStateMaximum Number of PatientsArkansas 5Florida3Kentucky 5Missouri 1North Carolina 2Oklahoma 10 or 25West Virginia 5THE SOUTHERN OFFICE OF THE COUNCIL OF STATE GOVERNMENTSPO Box 98129 | Atlanta, Georgia 30359 ph: 404/633-1866 | fx: 404/633-4896 | www.slcatlanta.orgSERVING THE SOUTHTHE SOUTHERN OFFICE OF THE COUNCIL OF STATE GOVERNMENTSREGIONAL VIEW NATIONAL REACHThisreportwaspreparedbyPolicyAnalyst Lauren Greer for the Human Services & Public SafetyCommitteeoftheSouthernLegislative Conference (SLC) of The Council of State Gov-ernments (CSG), under the chairmanship of state Senator Emmett W. Hanger, Jr. of VirginiaThemissionofTheCouncilofStateGovernments SouthernLegislativeConferenceistofosteranden-courageintergovernmentalcooperationamongits 15-memberstates.Inlargemeasure,thisisachieved throughtheongoingworkoftheConferencessix standingcommitteesandsupportinggroups.Through memberoutreachinstatecapitols,policyresearch, memberdelegationstopointsofinterest,meetingsand fly-ins, staff support state policymakers in their work to build a stronger region.Foundedin1947,theSouthernLegislativeConferenceisa member-driven organization and the largest of four region-allegislativegroupsoperatingunderTheCouncilofState GovernmentsandcomprisesthestatesofAlabama,Ar-kansas,Florida,Georgia,Kentucky,Louisiana,Mississippi, Missouri, North Carolina, Oklahoma, South Carolina, Ten-nessee, Texas, Virginia and West Virginia.The SLCs six standing committees provide a forum which allows policymakers to share knowledge in their area of ex-pertise with colleagues from across the South. By working togetherwithintheSLCandparticipatingonitscommit-tees, Southern state legislative leaders are able to speak in a distinctive, unified voice while addressing issues that affect their states and the entire region.TheSouthernOfficewasopenedinAtlantain1959.Ini-tiallychargedwithservingallthreebranchesofstate government, the duties of the Office have evolved to pro-viding services primarily to the more than 2,400 legislative members and staff of its 15-state region. SLC members are appointed by the leadership of the 30 legislative chambers intheSouth.TheSLCAnnualMeetinghasgrowntobe-comethelargestregionalgatheringofstatelegislatorsin the country and attracts the largest audience of any of the CSG regional conferences.
