RELATING TO COMPASSIONATE ACCESS TO MEDICAL CANNABIS.

HB1542

HOUSE OF REPRESENTATIVES

H.B. NO.

1542

THIRTY-THIRD LEGISLATURE, 2026

STATE OF HAWAII

A BILL FOR AN ACT

relating
to compassionate access to medical cannabis
.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

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SECTION
1.
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The Hawaii Revised Statutes is
amended by adding a new chapter to be appropriately designated and to read as
follows:

"
Chapter

compassionate access to medical cannabis Act
or ryan's law

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-1
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Short title; legislative intent.

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(a)
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This chapter shall be known, and may be cited, as the "Compassionate
Access to Medical Cannabis Act" or "Ryan's Law".

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(b)
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It is the intent of the legislature in
enacting this chapter to support the ability of terminally ill patients and
qualifying patients over sixty-five years of age with chronic diseases to
safely use medical cannabis within specified health care facilities in
compliance with part IX of chapter 329.

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-2
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Definitions.
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Unless the context requires otherwise, the
following definitions shall apply to this chapter:

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"Congregate
living health facility" means a residential health facility with a
noninstitutional, homelike environment that provides:

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(1)
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Inpatient care, including medical supervision,
twenty-four-hour skilled nursing and supportive care, pharmacy, dietary,
social, and recreational services, to residents whose primary need is the
availability of skilled nursing care on a recurring, intermittent, extended, or
continuous basis;

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(2)
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Care that is generally less intense than that
provided in general acute care hospitals but more intense than that provided in
skilled nursing facilities; and

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(3)
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At least one type of the following specialized
services:

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(A)
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Services
for persons who are mentally alert, persons with physical disabilities, or
persons who may be ventilator dependent;

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(B)
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Services
for persons who have a diagnosis of terminal illness, a diagnosis of a
life-threatening illness, or both, as stated in writing by the person's
attending physician or surgeon.
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For the
purposes of this definition, "life-threatening illness" means an
illness that can lead to a possibility of a termination of life within five
years or less; or

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(C)
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Services for persons who are catastrophically
and severely disabled, including, for catastrophically disabled persons,
speech, physical, and occupational therapy.
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For the purposes of this definition, "a person who is
catastrophically and severely disabled" means a person whose origin of
disability was acquired through trauma or nondegenerative neurologic illness,
for whom it has been determined that active rehabilitation would be beneficial,
and to whom these services are being provided.

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"Department"
means the department of health.

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"General
acute care hospital" means a health facility licensed by the department that
has a duly constituted governing body with overall administrative and
professional responsibility for the facility and an organized medical staff
that provides twenty-four-hour inpatient care, including the following basic
services:
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medical, nursing, surgical,
anesthesia, laboratory, radiology, pharmacy, and dietary services.
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"General acute care hospital"
includes a health facility that:

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(1)
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Has more than one physical plant maintained
and operated on separate premises; or

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(2)
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Exclusively provides acute medical
rehabilitation center services, including at least physical therapy,
occupational therapy, and speech therapy, and contracts for required surgical
and anesthesia services with another acute care hospital.

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"Health
care facility" means a congregate living health facility, general acute
care hospital, home health agency, hospice home, skilled nursing facility, or special
hospital.
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"Health care facility"
does not include a chemical dependency recovery hospital, a state hospital, or
an emergency department of a general acute care hospital while the patient is receiving
emergency services and care.

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"Home
health agency" means a private or public organization, including but not
limited to any partnership, corporation, political subdivision of the State, or
other government agency within the State, that provides, or arranges for the
provision of, skilled nursing services to persons in their temporary or
permanent place of residence and is licensed by the department.

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"Hospice
home" has the same meaning as defined in section 321-15.1.

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"Medical
cannabis" means cannabis or a cannabis product used in compliance with part
IX of chapter 329.

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"Patient"
means an individual who meets one or both of the following criteria:

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(1)
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Is terminally ill; or

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(2)
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Is over sixty-five years of age with a chronic
disease for which the patient has received a written certification from the
patient's physician or advanced practice registered nurse pursuant to part IX
of chapter 329.

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"Primary
caregiver" has the same meaning as defined in section 329-121.

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"Skilled
nursing facility" means a skilled nursing facility licensed pursuant to
section 321-571 that provides skilled nursing care and supportive care to
patients whose primary need is for availability of skilled nursing care on an
extended basis.

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"Special
hospital" means a health facility that has a duly constituted governing
body with overall administrative and professional responsibility for the
facility and an organized medical or dental staff that provides inpatient or
outpatient care in maternity or dentistry.

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"Terminally
ill" means a medical condition resulting in a prognosis of life of one
year or less if the disease follows its natural course.

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-3
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Health care facilities; duties regarding
permitted use of medical cannabis.
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(a)
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Except as provided in subsection (b), a
health care facility shall permit patient use of medical cannabis, as authorized
by the patient's physician or advanced practice registered nurse pursuant to
part IX of chapter 329 and indicated in the patient's medical record, and shall
do all of the following:

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(1)
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Prohibit smoking or vaping as methods to use
medical cannabis; provided that a home health agency shall only prohibit
smoking or vaping immediately before or while home health agency staff are
present in the residence;

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(2)
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Include the use of medical cannabis within the
patient's medical records;

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(3)
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Require a patient to provide a copy of the
patient's valid medical cannabis registry card or certificate issued pursuant
to part IX of chapter 329, or a copy of the patient's written certification as
defined under section 329-121;

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(4)
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Require a patient or primary caregiver to be
responsible for acquiring, retrieving, administering, and removing medical
cannabis;

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(5)
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Require medical cannabis to be stored securely
at all times in a locked container in the patient's room, other designated
area, or with the patient's primary caregiver; provided that this requirement shall
not apply to a home health agency;

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(6)
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Prohibit health care professionals, health
care facility staff, and home health agency staff, including but not limited to
physicians, nurses, and pharmacists, from administering medical cannabis or
retrieving medical cannabis from storage;

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(7)
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Develop, disseminate, and train health care
facility staff on written guidelines developed by the health care facility for
the use and disposal of medical cannabis within the health care facility
pursuant to this chapter; provided that this requirement shall not apply to a
home health agency; and

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(8)
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Ensure that a patient is not denied admission
to the health care facility in whole or in part because of the patient's use of
medical cannabis.

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(b)
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Notwithstanding subsection (a), a general
acute care hospital shall not permit a patient with a chronic disease to use
medical cannabis unless the patient is terminally ill.

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Removal of medical cannabis from health care
facility upon discharge of patient.

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(a)
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Upon discharge, all remaining medical
cannabis shall be removed by the patient or the patient's primary
caregiver.
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If a patient cannot remove
the medical cannabis and does not have a primary caregiver that is available to
remove the medical cannabis, the medical cannabis shall be stored in a locked
container until it is disposed of in accordance with the health care facility's
policy and procedure governing medical cannabis.

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(b)
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Subsection (a) shall not apply to a home
health agency.

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-5
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Medical cannabis recommendation not required.

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This chapter shall not require a health
care facility to provide or furnish a patient with a recommendation to use medical
cannabis in compliance with part IX of chapter 329 or include medical cannabis
in a patient's discharge plan.

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Enforcement; compliance with chapter not
required for licensing; construction of chapter with other laws.

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(a)
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This chapter shall be enforced by the department.

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(b)
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Compliance with this chapter shall not be a
condition for obtaining, retaining, or renewing a license as a health care
facility.

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(c)
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This chapter does not reduce, expand, or
otherwise modify the laws restricting the cultivation, possession,
distribution, or use of cannabis that may be otherwise applicable.

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-7
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Actions permitting noncompliance.

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(a)
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If
a federal regulatory agency, the United States Department of Justice, or the
federal Centers for Medicare and Medicaid Services takes one of the following
actions, or makes an inquiry about the health care facility's activities
pursuant to section -3, a health care facility may suspend
compliance with section -3 until the regulatory agency, the
United States Department of Justice, or the federal Centers for Medicare and
Medicaid Services notifies the health care facility that it may resume
permitting the use of medical cannabis within the facility:

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(1)
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A federal regulatory agency or the United
States Department of Justice initiates enforcement action, including a notice
to suspend funding, against a health care facility related to the health care facility's
compliance with a state-regulated medical cannabis program; or

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(2)
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A federal regulatory agency, the United States
Department of Justice, or the federal Centers for Medicare and Medicaid
Services issues a rule, guidance, or otherwise provides notification to the
health care facility that expressly prohibits the use of medical cannabis in
health care facilities or otherwise prohibits compliance with a state-regulated
medical cannabis program.

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(b)
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This section shall not permit a health care
facility to prohibit patient use of medical cannabis due solely to the fact
that cannabis is a Schedule I drug pursuant to the federal Uniform Controlled
Substances Act, or other federal constraints on the use of medical cannabis
that were in existence before the enactment of this chapter."

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SECTION
2
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Section 329-122, Hawaii Revised Statutes, is
amended by amending subsection (e) to read as follows:

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"(e)
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[
The
]
Except as permitted under
chapter , the
authorization for the medical use of
cannabis in this section shall not apply to:

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(1)
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The medical use of
cannabis that endangers the health or well-being of another person;

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(2)
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The medical use of
cannabis:

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(A)
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In a school bus,
public bus, or any moving vehicle;

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(B)
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In the workplace
of one's employment;

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(C)
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On any school
grounds;

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(D)
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At any public
park, public beach, public recreation center, recreation or youth center; or

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(E)
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At any other place
open to the public; provided that a qualifying patient, primary caregiver,
qualifying out-of-state patient, caregiver of a qualifying out-of-state
patient, or an owner or employee of a medical cannabis dispensary licensed
under chapter 329D shall not be prohibited from transporting cannabis or any
manufactured cannabis product, as that term is defined in section 329D-1, in
any public place; provided further that the cannabis or manufactured cannabis
product shall be transported in a sealed container, not be visible to the
public, and shall not be removed from its sealed container or consumed or used
in any way while it is in the public place; and

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(3)
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The use of
cannabis by a qualifying patient, parent, primary caregiver, qualifying
out-of-state patient, or caregiver of a qualifying out-of-state patient, for
purposes other than medical use permitted by this part."

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SECTION 3.
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This Act shall take effect upon its approval.

INTRODUCED BY:

_____________________________

Report Title:

DOH; Medical
Cannabis; Health Care Facilities; Access

Description:

Allows
terminally ill patients and qualifying patients over sixty-five years of age
with chronic diseases to use medical cannabis within specified health care
facilities under certain conditions.
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Requires enforcement by the Department of Health.

The summary description
of legislation appearing on this page is for informational purposes only and is
not legislation or evidence of legislative intent.