Amends TCA Title 4; Title 39, Chapter 17; Title 63; Title 67 and Title 68, Chapter 7.

Under present law, it is generally a criminal offense for a person to manufacture, deliver, or sell, or possess with the intent to manufacture, deliver, or sell, marijuana. The classification of the offense and authorized penalties depend on the amount of marijuana involved in the offense. Under present law, certain products that are derived from the cannabis plant (such as hemp, FDA-approved prescription medications, and products with limited amounts of THC that are used for clinical research or treatment of specific medical conditions) are excepted from the definition of marijuana and, therefore, not subject to criminal penalties. Effective upon this bill becoming a law, this bill condenses the present exceptions to marijuana for medicinal oils that contain THC into one exception for oil or other products containing less than 0.9 percent of delta-9 tetrahydrocannabinol. Present law establishes the medical cannabis commission to serve as a resource for the study of federal and state laws regarding medical cannabis and the preparation of legislation to establish an effective, patient-focused medical cannabis program in Tennessee upon the rescheduling or descheduling of marijuana from Schedule I of the federal Controlled Substances Act. This bill establishes the framework for a medical cannabis program to take effect July 1, 2023. The commission will continue to function as an advisory body but its legislative proposals will no longer be contingent on the rescheduling or descheduling of marijuana from Schedule I of the federal Controlled Substances Act. Under this bill, a Tennessee resident who has been diagnosed by a licensed physician as having a qualifying medical disease or condition may apply to the commission for a qualified patient identification card. Present law defines "qualifying medical disease or condition" to include diagnoses such as Alzheimer's disease, end-stage cancer, epilepsy, HIV, and sickle cell disease. This bill also authorizes a Tennessee resident who is at least 21 years of age and who has agreed to assist with a qualified patient's medical use of cannabis to apply to the commission for a designated caregiver identification card. The full text of this bill specifies various requirements for the issuance of either type of card, including application fees in the amount of $35.00 and, for designated caregivers, an issuance fee of $50.00. The issuance fee, if any, for a qualified patient identification card will be determined by the commission. Under this bill, a person establishes that the person has a qualifying medical disease or condition by providing a written certification to the commission. For purposes of this bill, a written certification is a document created by a licensed physician stating that in the physician's professional opinion, after having completed an assessment of the qualified patient's medical history, medication history, and a face-to-face assessment of the patient's current medical condition, made in the course of a bona fide practitioner-patient relationship, the qualified patient has a qualifying medical disease or condition. This bill specifies that written certification is not a medical prescription order. The full text of this bill specifies various contents that a written certification must include in order to be accepted for purposes of issuing a qualified patient identification card. This bill specifies that a licensed physician is not subject to criminal prosecution or disciplinary action by a licensing board solely for providing a written certification. This bill further specifies that it does not require physicians to issue written certifications. A qualified patient or designated caregiver in actual possession of a qualified patient identification card or designated caregiver identification card will not be subject to arrest, prosecution, or penalty in any manner or denied any right or privilege, including, without limitation, a civil penalty or disciplinary action by a business, occupational, or professional licensing board or bureau, for the medical use of cannabis in accordance with this bill if the qualified patient or designated caregiver possesses an amount of acceptable form of medical cannabis less than or equal to the following: (1) Three grams of concentrated product; or (2) Three thousand milligrams of infused products. For purposes of this bill, acceptable forms of medical cannabis are oils, tinctures, patches, sprays intended for sublingual or buccal administration, capsules, pills, suppositories, ointments, lotions, lozenges, liquids, and vapors; other portions of the cannabis plant; and any mixture or preparation thereof that is concealed in its manufacturer's original packaging and labeling from an approved state and that meets labeling and other specifications as determined by the commission in rule. Under this bill, dried leaves, flowers, seeds, roots, stems, stalks, or fan leaves are not acceptable forms of medical cannabis. Under this bill, Arkansas, Delaware, Missouri, Ohio, Oklahoma, Rhode Island, and Utah and any other state approved by the commission are "approved states". This bill creates a rebuttable presumption that a qualified patient or designated caregiver is lawfully engaged in the medical use of cannabis if such person is in actual possession of a qualified patient identification card or designated caregiver identification card and possesses an acceptable form of medical cannabis that does not exceed the amount allowed under this bill. Generally, this bill prohibits discrimination against a person in the areas of school admissions, housing, employment, and child custody/visitation based solely on that person being a qualified patient with a qualified patient identification card. This bill specifies that a person is not subject to criminal prosecution, a civil penalty, or professional discipline by a licensing board simply for being in the presence or vicinity of the medical use of cannabis as allowed under this bill or for directly assisting a qualified patient with the medical use of cannabis. This bill prohibits the use of information in the commission's database from being used to determine whether a person is permitted to purchase or possess firearms. This bill generally prohibits seizure and forfeiture of medical cannabis in forms and amounts authorized by this bill, medical cannabis paraphernalia, lawful property, or interest in lawful property, that is possessed, owned, or used exclusively in connection with the medical use of cannabis as allowed under this bill, or property incidental to such use, shall not be seized or forfeited. Unauthorized forms of medical cannabis or amounts in excess of possession limits may be seized and forfeited. Additionally, medical cannabis not contained in the manufacturer's original packaging and labeling may be seized and forfeited. This bill authorizes school personnel to possess medical cannabis in accordance with present law concerning self-administration of medications in schools, when obtained for medical use pursuant to this bill by a student who is a qualified patient. This bill specifies that it does not prohibit the medical use of cannabis or a designated caregiver assisting with the medical use of cannabis in a state-licensed nursing home facility, hospice facility, or assisted-care living facility, if the medical use of cannabis is permitted under federal law. This bill requires the commission to create and maintain a secure, online patient registry for qualified physicians, qualifying patients, and designated caregivers. The patient registry must be accessible to law enforcement agencies and qualified physicians to verify the authorization of a qualified patient or a designated caregiver to possess medical cannabis. The patient registry must also be accessible to practitioners licensed to prescribe prescription drugs to ensure proper care for patients before medications that may interact with the medical use of cannabis are prescribed and prevent an active registration of a qualified patient by multiple qualified physicians. The full text of this bill specifies procedures that the commission must follow for: (1) Confirmation of qualified patients, including residency; (2) Suspension or revocation of the registration of a qualified patient or designated caregiver; and (3) Issuance of replacement cards; This bill specifies that it does not permit a person to: (1) Undertake any task under the influence of medical cannabis when doing so would constitute negligence or professional malpractice; or (2) Control a vehicle while under the influence of medical cannabis. This bill specifies that it does not require: (1) A government medical assistance program or private health insurer to reimburse a person for costs associated with the medical use of cannabis unless federal law requires reimbursement; (2) An employer to accommodate the use of medical cannabis in a workplace or an employee working while under the influence of medical cannabis; (3) An individual or establishment in lawful possession of property to allow a visitor to use medical cannabis on or in that property; (4) An individual or establishment in lawful possession of property to admit a visitor who is impaired as a result of the person's medical use of cannabis; or (5) A public school to permit a qualified patient who is a student to be present on school grounds, to attend a school event, or to participate in extracurricular activities in violation of the public school's student discipline policies when a school office has a good faith belief that the behavior of such student is impaired from the use of medical cannabis. This bill makes it a Class A misdemeanor for: (1) A qualified physician to issue a written certification for a patient without a reasonable belief that the patient is suffering from a qualifying medical disease or condition; and (2) A person to fraudulently represent that the person has a qualified medical condition to a qualified physician for the purpose of being issued a written certification. A qualified patient or designated caregiver who possesses medical cannabis in an unauthorized form or in an amount beyond possession limits will be subject to applicable penalties concerning controlled substances under present law, regardless of patient registry status or the validity of a qualified patient identification card or designated caregiver identification card. A qualified patient or designated caregiver in possession of medical cannabis who fails or refuses to display a qualified patient identification card or designated caregiver identification card upon the request of a law enforcement officer commits a Class C misdemeanor, unless it can be determined through the patient registry that the person is authorized to be in possession of that medical cannabis. Possession of a blank, forged, stolen, fictitious, fraudulent, counterfeit, or otherwise unlawfully issued qualified patient identification card or designated caregiver identification card is a Class E felony. The manufacture of a blank, forged, stolen, fictitious, fraudulent, counterfeit, or otherwise unlawfully issued qualified patient identification card or designated caregiver identification card is a Class D felony. Unless otherwise specified, a violation of this part is: (1) A Class C misdemeanor for a first or second violation; and (2) A Class A misdemeanor for a third or subsequent violation.