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EDMUND G. BROWN JR.
Governor

State of California—Health and Human Services Agency
California Department of Public Health


AFL 24-06
January 17, 2024


TO:
General Acute Care Hospitals (GACH)
Special Hospitals (SH)
Skilled Nursing Facilities (SNF)
Congregate Living Health Facilities (CHLF)
Hospice Facilities (HOFA)
Home Health Agencies (HHAs)

SUBJECT:
Senate Bill (SB) 302 – Compassionate Access to Medical Cannabis Act

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AUTHORITY:     Health and Safety Code (HSC) sections 1649.1, 1649.2, 1649.3, and 1649.6



​Al​l Facilities Letter (AFL) Summary

​​This AFL notifies health care facilities of the chaptering of SB 302 (Chapter 484, Statutes of 2023), permitting medicinal cannabis use by patients over the age of 65 with a chronic disease in all SNFs, CLHFs, SHs, HOFAs, and HHAs and adding HHAs to the Compassionate Access to Medical Cannabis Act.  ​

​Patients Over 65 With a Chronic Disease

Effective January 1, 2024, a patient over the age of 65 who has received a physician's assessment declaring that they have a serious medical condition, as defined by Health and Safety Code (HSC) section 11362.7 (h), and that the use of medicinal cannabis is appropriate must be allowed use of medicinal cannabis by a SNF, CLHF, SH, HOFA, or HHA. Patients over 65 with a chronic disease and a physician's recommendation for medicinal cannabis use must provide the health care facility a copy of their medical marijuana card or written documentation of the physician's assessment and recommendation.

GACH patients over 65 with a chronic disease are excluded from the bill's medicinal cannabis authorization; however, terminally ill GACH patients may continue to use medicinal cannabis. No patient receiving emergency services and care may use medicinal cannabis.

Inclusion of HHA Patients

SB 302 adds HHAs to the Act's definition of health care facilities; therefore, they must allow both terminally ill patients and those over 65 with a chronic disease to use medicinal cannabis. This bill exempts HHA patients from the prohibition against smoking or vaping medicinal cannabis but requires each HHA to prohibit cannabis smoking or vaping immediately before or while HHA staff are present in the patient's residence.

The bill also exempts HHAs from the following Act requirements:

  • Secure storage of the medicinal cannabis. 
  • Development and dissemination of written guidelines for the use and disposal of medicinal cannabis.  
  • Removal and disposal of remaining medicinal cannabis by the health care facility after a patient's discharge.

Other New Provisions

SB 302 requires all health care facilities except HHAs to train their staff regarding the facility's written use and disposal guidelines for medicinal cannabis. 

The bill also requires all health care facilities to ensure that a patient is not denied admission, in whole or in part, because of their use of medicinal cannabis.

The bill also expands the grounds for a health care facility to suspend compliance with the Act to include a federal regulatory agency, the United States Department of Justice (US DOJ), or CMS making an inquiry about the health care facility's activities under the Act or the federal regulatory agency or the US DOJ issuing a notice to suspend funding.

CDPH's failure to expressly notify facilities of statutory or regulatory requirements does not relieve facilities of their responsibility for following all laws and regulations. Facilities should refer to the full text of all applicable sections of the Health and Safety Code and the California Code of Regulations to ensure compliance.

If you have any questions or concerns regarding this AFL, please contact the Center for Health Care Quality Pharmacy Consultants at LNC-PHARM-Consult@cdph.ca.gov.

Sincerely,

Original Signed by Cassie Dunham

Cassie Dunham

Deputy Director​



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