SALT LAKE CITY — The Utah Legislature passed changes to the state’s medical marijuana bill that will allow for 14 pharmacies — and more in the future — among other major changes. The decision sparked excitement for some and anxiety among others.

“I’m super happy. We’re super happy about what happened. I think that taking the central fill out was necessary, and then raising us from really seven dispensaries ... up to 14 before the regular session even starts is wonderful. And I think it just goes to show that we really all are working together,” said Desiree Hennessy, with the Utah Patients Coalition.

Hennessy believes the changes show that legislators are willing to work with the patients. But she expressed concern that those who live in rural areas, like her, might end up “struggling to get access” with only 14 pharmacies in the state.

“But really, I’m not worried. I feel like there’s light at the end of the tunnel with what we’ve created.”

The substitution bill passed unanimously in the House 66-0 and the Senate 27-0. In addition to increasing the number of pharmacies, it allows for the creation of an online central state portal for “patient safety and education,” and courier services to those homebound or in rural areas.

The changes also require the health department to issue no more than 10 licenses to between five and eight growers.

Setting up medical marijuana distribution has not always been a fast task in other states.

In August, Louisiana residents were able to receive medical cannabis four years after state lawmakers agreed to give patients access to it. Nine pharmacies are licensed to dispense medical marijuana as it joined more than 30 other states that allow medical marijuana in some form.

Hundreds of patients in Louisiana had been awaiting the start of the program after years of work by lawmakers, who created the framework in 2015 for dispensing the cannabis. State lawmakers faced regulatory disputes and other hurdles, according to the Associated Press

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After the bill passed, sponsor Senate Majority Leader Evan Vickers, R-Cedar City, said Utah will have medical cannabis in the hands of patients faster than many other states that passed similar laws.

“There’s some states that it’s taken significantly longer. Colorado took a long time to get theirs up and running after their initiatives passed,” he said. “It seems slow, because the patients are out there and they want something right now.”

A spokesman for The Church of Jesus Christ of Latter-day Saints — which was at the table in discussions involving a coalition of groups against medical marijuana last year — declined comment on the changes to the law.

Michelle McOmber, CEO of the Utah Medical Association, which had opposed medical cannabis, said the organization worked with Vickers on the bill “and we are comfortable with the changes.”

Ahead of the votes, tensions had simmered over the number of pharmacies the state will allow. Some legislators were advocating for the state to allow an unlimited number of pharmacies, while others wanted to limit the number to no more than 12.

“Why should we determine and set a statute on how many specific numbers there should be?” questioned House Majority Whip Mike Schultz, R-Hooper, speaking to the Deseret News. “Every one of us is just throwing a dart at a dart board when we try to pick a number.”

He said the numbers should be based off market demands.

“It’s certainly been a big issue that’s been raised,” Schultz said. However, “I think there’s broad consensus around ‘We need to get this figured out.’ So I don’t think it’ll unravel anything.”

Meanwhile, Rep. Norm Thurston, R-Provo, wanted to limit the number of pharmacies.

“Originally there were supposed to be seven plus the central fill. Sen. Vickers has proposed going from seven to 12, and now some people want more than that,” Thurston said.

“My concern is mostly about creating a number and a distribution that’s sustainable, because the last thing we want is to issue a bunch of permits, and everybody opens up and invests a bunch of money. And then within three months, they’re all closing their doors,” he said.

The substitute bill, sponsored by Vickers, will allow the state to issue 14 licenses to pharmacies and more if needed in the future. Under the proposal, the department could issue eight licenses to an initial group of pharmacies, and later six licenses to a second group of pharmacies.

Sen. Evan Vickers, R-Cedar City, bill sponsor of SB1002 Medical Cannabis Amendments, meets with members of the senate minority during a caucus meeting before a special legislative session at the Capitol in Salt Lake City on Monday, Sept. 16, 2019. | Kristin Murphy, Deseret News

Gov. Gary Herbert’s office in a statement said, “The bill will help provide safe and efficient access to an important medical option for patients while also taking public safety into consideration.”

Vickers said he has received assurance the governor will sign the bill into law.

After the bill passed, Gayle Ruzicka, president of the Utah Eagle Forum, expressed frustration at lawmakers backing away from previous compromises that included a central state fill.

“I’m concerned that they just keep changing. They made it, all sides came together and made a deal, or a compromise. And every time the legislature meets, they change that. And they just keep going more and more to (Proposition 2),” said Ruzicka.

Ruzicka also said she was angry legislators did not discuss restricting people under age 21 from vaping THC.

Utah voters approved the medical marijuana ballot initiative, Proposition 2, last November legalizing doctor-approved marijuana treatment for certain health conditions. State lawmakers the next month replaced the measure with a law they say puts tighter controls on the production, distribution and use of the drug.

But this year, some counties expressed concern about possibly facing federal retribution for being involved in Utah’s marijuana distribution system. Both Salt Lake and Davis counties’ top attorneys advised their county health departments against dispensing medical marijuana once the network is up and running.

State lawmakers have said they need to make “tweaks” to the law to make sure the program is up and running by the March 1 deadline. Some critics have expressed frustration at changes to the original ballot initiative, blaming the potential delay on those changes.

TRUCE founder Christine Stenquist told House Democrats in their caucus meeting before the special session the substitute bill was better, but still raised concerns about the state’s involvement in the dispensing process, taking issue with the state-led patient portal in place of a state-run central fill station.

“Why does the state need to be in the middle of this in that capacity?” Stenquist said.

Stenquist said cannabis, which is still an illegal substance under federal law, is “decades” away from being ready for a pharmacy model. 

“They (the state) still want their hands on this,” Stenquist said. “This is big government.” 

Still, Stenquist told House Democrats it’s “extremely beneficial” to remove a state-controlled central fill station. 

“I’m not advocating for a ‘no’ vote because we have to get rid of central fill,” Stenquist said. 

Like Hennessy, Stenquist’s concerns about the number of pharmacies remain, though, questioning whether cost of delivery from only 14 dispensaries from across the state would increase the cost of the product for patients. 

Connor Boyack, president of Libertas Institute, said, “We’re very gratified that the Legislature unanimously supported some important patient-centric changes we’ve been working with stakeholders on to improve the Utah Medical Cannabis Act.”

He said the “urgent fixes” will allow the program to “keep rolling out” before its March 2020 deadline. But like many lawmakers, he echoed that more changes will need to be considered during the Legislature’s general session in the spring.

”It’s a work in progress, I think,” House Minority Leader Brian King, D-Salt Lake City said, predicting future legislative sessions will be grappling with the medical marijuana law for years to come. 

The changes also remove a stipulation that those who live within a certain distance to a pharmacy could only receive 12-day supplies at a time. The changes will allow all patients to receive standard 30-day supplies, regardless of their distance to a pharmacy — unless a doctor specifically recommends a partial fill.

Monday’s bill also clarifies that regardless of municipality ordinances, pharmacies can use signage that includes the pharmacy’s name and hours of operation, and a green cross. Pharmacies can maintain websites with information about the establishment and employees but which do not advertise any products.

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Some have also emphasized the need for the law to require that judges treat people using prescribed medical cannabis the same as those using any prescribed opioid. The changes to the law approved Monday require officers and all state workers to treat patients who use legal medical marijuana no differently than those who use any prescribed substance, including in child custody matters.

Among other major changes, the bill prohibits legislators from having ownership or interest in any cannabis facility until after 2022, and allows growers to cultivate marijuana both indoors and outdoors, rather than one or the other.

When asked by reporters after the bill passed when a conversation on recreational marijuana might begin in the state, Vickers declared, “Not on my watch.”

Contributing: Katie McKellar, Lisa Riley Roche

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