Compassionate Use Medical Cannabis Pilot Program: IL Industry, Law Summary

Illinois medical marijuana law is a comprehensive system whose effects reach across many aspects of society. The law creates an licensing framework of 21 cultivation centers and 60 dispensaries for regulating the intrastate production and sale of cannabis and derived products. The law also sets rules for debilitating medical conditions, physician certification, and patient registration. Additional rules reinforce safe use and possession of medical cannabis and protect card holders from discrimination in school, work, and housing.

The Compassionate Use of Medical Cannabis Pilot Program Act was enacted in 2013. Former Democratic Governor Patrick Quinn embraced and encouraged the medical cannabis pilot program. Quinn’s agencies oversaw the first year of the law’s implementation, which included the drafting and promulgation of regulations. Following Quinn’s election defeat in 2014, implementation was taken over by the agency heads appointed by Republican Governor Bruce Rauner. While the Republican governor does allow the pilot program to persist, he has denied many opportunities to help it expand or thrive.

Legalization History

2013-14: Former Governor Pat Quinn (D) signed the Compassionate Use marijuana law on Aug. 1, 2013. Quinn’s administration carried out the first year of implementation, adopting regulations through three state departments and conducting a competitive application process to award licenses to the best qualified applicants.

2015-2017: Taking office in January 2015, Republican Governor Bruce Rauner’s actions (or lack thereof) have largely chilled the Pilot Program’s ability to adapt. He vetoed legislation that would recognize additional debilitating medical conditions that qualify for medical use. Rauner’s Public Health Department also controversially refused on multiple occasions to acknowledge recommendations of the government’s own Medical Cannabis Advisory Board, which has advised adding autism, chronic pain, migraines, and more.

June 2016: Governor Rauner finally signed medical marijuana legislation improving Illinois Medical Cannabis Pilot Program (SB 10). The amendments make a series of changes to the law: PTSD was added as a debilitating medical condition, the Physician’s written certification requirement was adjusted, and the Pilot Program’s termination date was extended to Dec. 31, 2020.

governor veto marijuana legislation
Governor Bruce Rauner- Why no love for cannabis, man?

Regulation of Production

Illinois Department of Agriculture regulates cultivation centers and the independent laboratories who perform chemical analysis testing of marijuana products. Cultivation centers grow cannabis plants, manufacture concentrates, edibles, extracts, and infused products, and perform final packaging and labeling of all products. Law creates one cultivation center license in each of the 21 Illinois State Police Districts.

Regulation of Sale (Retail)

IL Department of Financial and Professional Regulation (DFPR) regulates dispensaries’ sale of medical cannabis products to registered patients.  Retail sale of medical cannabis products to registered patients occurs at licensed dispensaries. The law permits 60 dispensaries, allocated by population density, so that most are clustered around Chicago.

Regulation of Physicians, Patients

IL Department of Public Health regulates physician certification and patient registration.

A patient may register for an Illinois medical card only after an Illinois doctor certifies that the patient suffers from a specific debilitating medical condition listed in the law. The Physician must be a Doctor of Medicine or Osteopathy licensed under Illinois Medical Practice Act (225 ILCS 60/). It can’t be a nurse, dentist, or chiropractor. The physician must have a license in good standing under Illinois Controlled Substances Act (720 ILCS 57)).

Scope of relationship: The physician must have a bona fide (good faith) relationship with the patient, defined by Health Dept regulations as one with “ongoing responsibility for the assessment, care, and treatment…” of the patient’s condition. The physician must physically examine the patient in person and assess the patient’s medical history and relevant records. Remote examination is not sufficient.

Certification is not Recommendation: In the eyes of Illinois law, a physician who certifies a patient as having a debilitating medical condition does not necessarily recommend the use of medical cannabis or otherwise state a professional opinion about the potential effectiveness of medical cannabis for relieving the patient’s condition. This extraordinary provision was enacted into law in June 2016 (see above), presumably in response to lower than expected patient registrations. Physician reluctance to certify patients has been a common theme of newspaper coverage in the state.

Debilitating Medical Conditions

Illinois law is distinctive for having a rigid list of very specific medical conditions which provide little flexibility for doctor’s discretion. However, the legislation has already acted to add additional conditions (seizures, PTSD). The law also provides a Medical Cannabis Advisory Board as a means to expand the list of conditions, but Governor Rauner’s administration seems unwilling to use it.

The list of recognized conditions appears in Illinois law at 410 ILCS 130/10(h):

cancer, glaucoma, positive status for human immunodeficiency virus, acquired immune deficiency syndrome, hepatitis C, amyotrophic lateral sclerosis, Crohn’s disease, agitation of Alzheimer’s disease, cachexia/wasting syndrome, muscular dystrophy, severe fibromyalgia, spinal cord disease, including but not limited to arachnoiditis, Tarlov cysts, hydromyelia, syringomyelia, Rheumatoid arthritis, fibrous dysplasia, spinal cord injury, traumatic brain injury and post-concussion syndrome, Multiple Sclerosis, Arnold-Chiari malformation and Syringomyelia, Spinocerebellar Ataxia (SCA), Parkinson’s, Tourette’s, Myoclonus, Dystonia, Reflex Sympathetic Dystrophy, RSD (Complex Regional Pain Syndromes Type I), Causalgia, CRPS (Complex Regional Pain Syndromes Type II), Neurofibromatosis, Chronic Inflammatory Demyelinating Polyneuropathy, Sjogren’s syndrome, Lupus, Interstitial Cystitis, Myasthenia Gravis, Hydrocephalus, nail-patella syndrome, residual limb pain, seizures (including those characteristic of epilepsy), post-traumatic stress disorder (PTSD), or the treatment of these conditions… terminal illness…