Questions are showing a need for extensive information delivery.
Governor Greg Abbott silently signed HB 3703 expanding the Texas Compassionate Use Program (TCUP) into law June 14th shortly after 4 P.M. The bill will go into effect immediately as it did receive a supermajority in the house and senate. HB 3703 received a vote of 133-10 in the House and a unanimous vote of 31-0 in the Senate.
Some sites are claiming that the law takes effect September 1st, and are quickly changing the verbiage to state that it is effective immediately. Understand though that it does not mean that everything will magically be different today, tomorrow or even a week from now. It will even take time for the DPS site to be updated.
So, what changed as far as conditions go?
Several things were added, and the original condition was changed. The original qualifying condition of intractable epilepsy was changed to just epilepsy. No longer do you need to try two medications per the TCUP law Texas had beforehand. Medical cannabis an option in the formulary for epilepsy patients just like any other medication for epilepsy treatment.
Conditions added include autism, terminal cancer, incurable neurodegenerative diseases, ALS, multiple sclerosis, and spasticity. The term incurable neurodegenerative disease is defined as the following:
SECTION 1.Section 169.001, Occupations Code, is amended by adding Subdivisions (1-a) and (6) and amending Subdivision (3) to read as follows: (1-a)”Incurable neurodegenerative disease” means a disease designated as an incurable neurodegenerative disease by rule of the executive commissioner of the Health and Human Services Commission, adopted in consultation with the National Institutes of Health.
HB 3703 enrolled version
SECTION 4. Not later than December 1, 2019, the executive commissioner of the Health and Human Services Commission, in consultation with the National Institutes of Health, shall adopt rules designating diseases as incurable neurodegenerative diseases for which patients may be prescribed low-THC cannabis for medical use under Chapter 169, Occupations Code, as amended by this Act.
The citizens of Texans, lobby and activists groups may want to contact the executive commissioner of Health and Human Services Commission and request that they consider the neurodegenerative disease list found on the NIH website as the minimum list of diseases to be considered appropriate. This should be a starting point as there is no cure for any neurodegenerative disease.
Did the THC limit go up?
Unfortunately, the THC limit of 0.5% remains. This means that the total content of THC in the medicine cannot be more that 0.5% of the volume of the prescription. Think of it like the alcohol content one would see on the side of a beer or bottle of wine. As well, the CBD floor language was stricken from the bill on amending the definition of cannabis. It originally said that it could not less than 10% by weight of CBD, meaning that it could not less than 10% CBD by volume. Amongst activists and concerned consumers some are asking what the overall benefit is of having 0.2% more than what the current hemp law allows, which is 0.3% THC. The answer is that for a few that extra amount may help them, the legal benefit is the allowance of THC in a drug test performed by the state in instances where that could be typically be used in factoring a decision for a legal case. It will not be explicitly mentioned in this article but one can use their imagination on how this affects the black market.
Texas Health and Safety Code §481.111(e)(1) provides exemptions from state laws prohibiting possession of marijuana for patients (and their legal guardians) for whom low-THC cannabis is prescribed under a valid prescription from a dispensing organization. This provides an entrance to having protection in civil cases involving children as well. Usually the family cases are concerned because they a child may be getting their hands on an unknown tainted product or the drug is making the parent negligent to the child in their needs. Obviously if the criminal component is no longer a factor, it cannot be used as one in civil/family court. That does not mean that a DFPS worker cannot remove a child for that issue, but it will be much more difficult to use in a case as long as there is a valid entry into the Compassionate Use Registry of Texas (CURT). The biggest factor in those cases is the county you live in and the judge voted into office to oversee the cases.
With these new conditions, who can prescribe low-THC cannabis?
Sec. 169.002. PHYSICIAN QUALIFIED TO PRESCRIBE LOW-THC CANNABIS TO PATIENTS WITH CERTAIN MEDICAL CONDITIONS.
(a) Only a physician qualified with respect to a patient’s particular medical condition as provided by this section may prescribe low-THC cannabis in accordance with this chapter to treat the applicable medical condition.
HB 3703 enrolled version
(b) A physician is qualified to prescribe low-THC cannabis with respect to a patient’s particular medical condition [to a patient with intractable epilepsy] if the physician:
(1) is licensed under this subtitle;
(2) is board certified in a medical specialty relevant to the treatment of the patient’s particular medical condition by a specialty board approved by the American Board of Medical Specialties or the Bureau of Osteopathic Specialists; and
(3) dedicates a significant portion of clinical practice to the evaluation and treatment of the patient’s particular medical condition
All of this means that for the condition that a patient would qualify for under the TCUP law, the doctor prescribing low-THC cannabis must specialize in that area, and spend a good chunk of their time practicing that specialized area. This means your PCM cannot register with CURT to enter prescriptions. Perhaps one of the only conditions listed that will have two different providers available to prescribe will be the condition of Autism, which is treated both by neurologist and psychiatrists. As well, the language stating that two doctors need to sign off has been stricken from the law, and now patients will only need to see one qualifying doctor.
Was the finally language changed to say recommend instead of prescribe?
Unfortunately the language still says prescribe. The major upside is that the definition of prescribe when relating to the TCUP law was changed to now mean “an entry into the compassionate use program.”
About the TXDPS site, when is it expect that to be updated?
Really, there is no estimated date. But one thing can almost always be counted on: if they are asked enough, they will change it just to keep people from having to ask as many questions any more. And before you ask how you can do that, take a look at the image below and follow the link to their site to inquire about updating the site. You can even put in what Educating Texans wrote just to be quick and easy about it.
If you have any other questions concerning HB 3703 and the updates to TCUP, feel free to leave a comment or contact us directly.
