Sec. 21a-408c. Physician, physician assistant or advanced practice registered nurse issuance of written certifications. Requirements. Not subject to arrest, prosecution or certain other penalties. Telehealth services. (a)(1) A physician, physician assistant or advanced practice registered nurse may issue a written certification to a qualifying patient that authorizes the palliative use of marijuana by the qualifying patient. Such written certification shall be in the form prescribed by the Department of Consumer Protection and shall include a statement signed and dated by the qualifying patient's physician, physician assistant or advanced practice registered nurse stating that, in such physician's, physician assistant's or advanced practice registered nurse's professional opinion, (A) the qualifying patient has a debilitating medical condition, and (B) the potential benefits of the palliative use of marijuana would likely outweigh the health risks of such use to the qualifying patient.
(2) Except as provided in subdivision (6) of this subsection, any written certification issued by a physician, physician assistant or advanced practice registered nurse pursuant to subdivision (1) of this subsection shall be valid for a period not to exceed one of the following durations, as determined by the physician, physician assistant or advanced practice registered nurse and beginning on the date on which such written certification is signed and dated by the physician, physician assistant or advanced practice registered nurse: (A) Six months; (B) one year; (C) eighteen months; or (D) two years.
(3) Except as provided in subdivision (6) of this subsection, not later than ten calendar days after the expiration of the period determined by the physician, physician assistant or advanced practice registered nurse under subdivision (2) of this subsection, or at any time before the expiration of such period should the qualifying patient no longer wish to possess marijuana for palliative use, the qualifying patient or the caregiver shall destroy all usable marijuana possessed by the qualifying patient and the caregiver for palliative use.
(4) A physician, physician assistant or advanced practice registered nurse shall not be subject to arrest or prosecution, penalized in any manner, including, but not limited to, being subject to any civil penalty, or denied any right or privilege, including, but not limited to, being subject to any disciplinary action by the Connecticut Medical Examining Board, the Connecticut State Board of Examiners for Nursing or other professional licensing board, for providing a written certification under subdivision (1) of subsection (a) of section 21a-408a if:
(A) The physician, physician assistant or advanced practice registered nurse has diagnosed the qualifying patient as having a debilitating medical condition;
(B) The physician, physician assistant or advanced practice registered nurse has explained the potential risks and benefits of the palliative use of marijuana to the qualifying patient and, if the qualifying patient lacks legal capacity, to a parent, guardian or person having legal custody of the qualifying patient, to the qualifying patient's caregiver or to a person legally authorized to make medical decisions on behalf of the qualifying patient;
(C) The written certification issued by the physician, physician assistant or advanced practice registered nurse is based upon the physician's, physician assistant's or advanced practice registered nurse's professional opinion after having completed a medically reasonable assessment of the qualifying patient's medical history and current medical condition made in the course of a bona fide health care professional-patient relationship; and
(D) The physician, physician assistant or advanced practice registered nurse has no financial interest in a cannabis establishment, except for retailers and delivery services, as such terms are defined in section 21a-420.
(5) A physician assistant or nurse shall not be subject to arrest or prosecution, penalized in any manner, including, but not limited to, being subject to any civil penalty, or denied any right or privilege, including, but not limited to, being subject to any disciplinary action by the Connecticut Medical Examining Board, Board of Examiners for Nursing or other professional licensing board, for administering marijuana to a qualifying patient or research program subject in a hospital or health care facility licensed by the Department of Public Health.
(6) A licensed dispensary, acting in the course of the licensed dispensary's employment on the premises of the dispensary facility or hybrid retailer that employs such licensed dispensary, may grant a temporary extension of a written certification issued by a physician, physician assistant or advanced practice registered nurse pursuant to subdivision (1) of this subsection for a period not to exceed ninety consecutive days following expiration of such written certification.
(b) (1) A licensed dispensary, acting in the course of the licensed dispensary's employment and on the premises of the dispensary facility or hybrid retailer that employs such licensed dispensary, may issue a temporary written certification to an individual that authorizes the individual to engage in the palliative use of marijuana as a qualifying patient for a period not to exceed ninety consecutive days, provided such licensed dispensary has:
(A) Reasonably determined, after reviewing such individual's medical history, that such individual is at least eighteen years of age and has a debilitating medical condition;
(B) Conducted an in-person assessment of such individual at the dispensary facility or on the premises of the hybrid retailer that employs the licensed dispensary; and
(C) Reviewed the electronic prescription drug monitoring program established pursuant to section 21a-254 and verified that no other licensed dispensary had prescribed or dispensed marijuana to such individual during the one-year period immediately preceding the date of such review.
(2) Each temporary written certification issued pursuant to subdivision (1) of this subsection shall be in a form prescribed by the Department of Consumer Protection and shall include a statement signed and dated by the licensed dispensary stating that, in such licensed dispensary's professional opinion, (A) the individual has provided sufficient proof that such individual has a debilitating medical condition, and (B) the potential benefits the individual would derive from the palliative use of marijuana likely outweigh the health risks that such use would pose to such individual.
(3) A licensed dispensary that issues a temporary written certification pursuant to subdivision (1) of this subsection, or the dispensary facility or hybrid retailer that employs such licensed dispensary, may impose a fee for such temporary written certification, which fee shall not exceed twenty-five dollars. Such licensed dispensary, dispensary facility or hybrid retailer shall not impose any other fee in connection with such temporary written certification.
(4) A licensed dispensary that issues a temporary written certification pursuant to subdivision (1) of this subsection shall maintain all patient assessment and eligibility documentation concerning such temporary written certification for a period of at least three years beginning on the date on which the licensed dispensary issued such temporary written certification. Such documentation shall be organized and maintained (A) in hard copy at the dispensary facility or hybrid retailer premises at which the licensed dispensary conducted an in-person assessment of the patient, or (B) electronically in a system readily accessible by the licensed dispensary.
(5) A licensed dispensary that issues a temporary written certification pursuant to subdivision (1) of this subsection shall ensure that all patient assessment and eligibility documentation maintained pursuant to subdivision (4) of this subsection is made readily available to the department, and shall submit any such documentation to the department, in a form and manner prescribed by the department, not later than forty-eight hours after the department requests such documentation.
(6) A licensed dispensary shall not be subject to arrest or prosecution, penalized in any manner, including, but not limited to, being subject to any civil penalty, or denied any right or privilege, including, but not limited to, being subject to any disciplinary action by the Commission of Pharmacy or any other professional licensing board, for providing a temporary written certification pursuant to subdivision (1) of this subsection if:
(A) The licensed dispensary has reasonably determined, after reviewing the individual's medical history, that the individual is eighteen years of age or older and has a debilitating medical condition; and
(B) The licensed dispensary has explained the potential risks and benefits of the palliative use of marijuana to the individual and, if the individual lacks legal capacity, to a parent, guardian or person having legal custody of the individual or to a person legally authorized to make medical decisions on behalf of the individual.
(c) Notwithstanding the provisions of this section, sections 21a-408 to 21a-408b, inclusive, and sections 21a-408d to 21a-408o, inclusive, a physician assistant or an advanced practice registered nurse shall not issue a written certification to a qualifying patient, and a licensed dispensary shall not issue a temporary written certification to an individual, when the qualifying patient's or individual's debilitating medical condition is glaucoma.
(d) Notwithstanding any provision of the general statutes or any regulation of Connecticut state agencies concerning the certification of qualifying patients through telehealth services, a physician, physician assistant or advanced practice registered nurse may issue a written certification to a qualifying patient and provide any follow-up care utilizing telehealth services, provided all other requirements for issuing such written certification to the qualifying patient, including, but not limited to, all recordkeeping requirements, are satisfied.
(P.A. 12-55, S. 4; P.A. 16-23, S. 4; 16-39, S. 49; June Sp. Sess. P.A. 21-1, S. 69; P.A. 22-103, S. 13; P.A. 23-52, S. 13; P.A. 25-101, S. 5.)
History: P.A. 16-23 added Subsec. (d) re nurse not subject to arrest, prosecution or other penalties for administering marijuana to qualifying patient or research program subject in a licensed hospital or health care facility; P.A. 16-39 added references to advanced practice registered nurse, amended Subsec. (c) by adding reference to Connecticut State Board of Examiners for Nursing and replacing “physician-patient relationship” with “health care professional-patient relationship” in Subdiv. (3), and added provision, codified by the Revisors as Subsec. (e), prohibiting advanced practice registered nurse from issuing certification when qualifying patient's debilitating medical condition is glaucoma, effective January 1, 2017; June Sp. Sess. P.A. 21-1 amended Subsec. (b) by replacing references to primary caregiver with caregiver and amended Subsec. (c)(4) by replacing a reference to licensed dispensaries and licensed producers with cannabis establishment and adding an exception for retailers and delivery services, effective July 1, 2021; P.A. 22-103 amended Subsecs. (a) to (e) by adding references to physician assistants, amended Subsec. (d) to add reference to Connecticut Medical Examining Board, and made technical and conforming changes, effective July 1, 2022; P.A. 23-52 added Subsec. (f) re written certification and provision of follow-up care by physicians, physician assistants and advanced practice registered nurses through telehealth, effective June 13, 2023; P.A. 25-101 substantially amended section including by redesignating existing Subsec. (a) as Subsec. (a)(1) and inserting Subpara. designators therein, redesignating existing Subsec. (b) as Subsec. (a)(2) and (3) and adding provisions therein re duration of written certification for period other than 1 year, redesignating existing Subsec. (c) as Subsec. (a)(4), existing Subsec. (c)(1) to (4) as Subsec. (a)(4)(A) to (D) and existing Subsec. (d) as Subsec. (a)(5), adding Subsec. (a)(6) re temporary extension of written certification, adding new Subsec. (b) re temporary written certification, redesignating existing Subsecs. (e) and (f) as Subsecs. (c) and (d), and making technical and conforming changes throughout, effective January 1, 2026.
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