Editor's Note: The electronic version of this article was updated following the legislative vote held on June 20, 2019. It contains changes not reflected in the newspaper of June 24, 2019, which had already gone to print. 

On his final day in office on Jan. 18, 2010, New Jersey Governor Jon Corzine signed Senate Bill 119 into law. Known as the New Jersey Compassionate Use Medical Marijuana Act (CUMMA), the new law created New Jersey's medicinal marijuana program (MMP), permitting the use of medicinal cannabis to treat certain debilitating medical conditions set forth in the provisions of CUMMA. Under the subsequent administration of Governor Chris Christie, six New Jersey non-profit corporate entities were granted permits by the New Jersey Department of Health (NJDOH) to operate alternative treatment centers (ATCs), also known as medicinal marijuana dispensaries. Two dispensaries would be permitted in each region of the State: North, Central and South New Jersey.

By 2015, 5,540 patients were registered in New Jersey's MMP, and 335 caregivers had been authorized to purchase medicinal marijuana on behalf of those registered. In 2017, the number of registered patients had grown to 11,659 statewide, and continues to grow rapidly. This dramatic growth created concerns that the six existing ATCs would not be sufficient to satisfy the increase in demand for medicinal marijuana, and concerns about the restrictiveness of the list of debilitating medical conditions that the state determined medicinal marijuana would be permitted to treat became a focus for revision. In response, Governor Phil Murphy signed an Executive Order on Jan. 23, 2018, directing the New Jersey Department of Health and the New Jersey Board of Medical Examiners (NJBME) to review the state's existing medicinal marijuana program in order to remove what had become access barriers for patients suffering from illnesses that could be treated with medicinal marijuana.

Since the signing of that Executive Order, the NJDOH and the NJBME have evaluated the rules, regulations, operations and siting of dispensaries and cultivation facilities and analyzed the list of debilitating medical conditions for which medical marijuana may be authorized by a physician. Based on these evaluations and analysis, in March 2018, the NJDOH added five additional medical conditions to the list of conditions available for treatment with medical marijuana, and, in January 2019, the NJDOH added one additional condition. Since the addition of these conditions, the number of patients has significantly increased, bringing the total count of registered patients with the MMP to over 47,500 as of June 3, 2019.

In response to the significant expansion of the patient population served by the MMP, on May 21, 2018, the New Jersey Legislature introduced Senate bill S-10, which is also referred to as the Jake Honig Compassionate Use Medical Marijuana Act. The bill expands the MMP by revising requirements to authorize and access medical cannabis, establishes a Cannabis Regulatory Commission, and revises requirements for ATC operations and permitting.

Simultaneously with the proposal of S-10, the New Jersey Legislature proposed legalizing recreational/adult use cannabis through Senate bill S-2703, which created four classes of licenses: Class 1 Cannabis Grower License, Class 2 Cannabis Processor License, Class 3 Cannabis Wholesaler License, and Class 4 Cannabis Retail License. Bills S-10 and S-2703 were to move through Senate and the Assembly simultaneously. However, S-2703 did not garner the appropriate number of votes in the Senate and Assembly to move forward. As a consequence, S-10 has moved forward without S-2703.

While S-10 makes its way through the legislative process, Governor Phil Murphy determined that immediate action needed to be taken to respond to the significant expansion of the patient population served by the MMP. On June 3, 2019, the NJDOH released a notice of a Request for Applications (RFA) for up to 108 additional (non-vertical) ATCs to operate in New Jersey. Specifically, the NJDOH will seek up to 24 cultivation endorsements, up to 30 manufacturing endorsements, and up to 54 dispensary endorsements. These applications will be available to the public on July 1, 2019, at https:www.nj.gov/health/medicalmarijuana, and the deadline for submission is Aug. 15, 2019, at 3:00 p.m.

On June 10, 2019, the New Jersey Assembly was scheduled to vote on the Senate amendments to S-10. The expectation was for S-10 to be approved by the Assembly and thereafter the bill would go to Governor Phil Murphy for signature. However, shortly before the assembly session began on June 10, 2019, Speaker Craig Coughlin announced that the vote on S-10 would be postponed, and the bill is being held to foster a spirit of cooperation between Governor Phil Murphy and the Senate President, Stephen Sweeney. Shortly thereafter, further amendments were proposed to S-10 (which, as of the date of this publication, is also referred to as A-20 (collectively, the "Bill")). On June 20, 2019, both the Senate and the Assembly approved the amendments made to the Bill, and the Bill will go to Governor Phil Murphy for signature.

Should the Bill become law, a number of significant changes shall occur to the MMP, including, but not limited to, the following:

• The creation of three new medical cannabis permit classes: (i) Medical Cannabis Cultivator Permit; (ii) Medical Cannabis Dispensary Permit; and (iii) Medical Cannabis Manufacturer Permit. As a result, ATCs will no longer be required to conduct all the operations from seed to sale, such as cultivation, processing and dispensing.
• The creation of a Cannabis Regulatory Commission (the "Commission") to regulate the MMP, rather than the NJDOH. The Commission will issue permits in accordance with rules and regulations which it will establish.
• The term "debilitating condition" will be modified to "qualifying medical condition" and defined as: seizure disorder, including epilepsy; intractable skeletal muscular spasticity; post-traumatic stress disorder; glaucoma; positive status for human immunodeficiency virus; acquired immune deficiency syndrome; cancer; amyotrophic lateral sclerosis; multiple sclerosis; muscular dystrophy; inflammatory bowel disease, including Crohn's disease; terminal illnesses, if the patient has a prognosis of less than 12 months of life; anxiety; migraine; Tourette's syndrome; dysmenorrhea; chronic pain; opioid use disorder; or any other medical condition or its treatment that is approved by the Commission.
• The maximum amount of usable cannabis that a patient may be dispensed, in weight, in a 30-day period, shall be increased to three ounces, as opposed to the current two ounce maximum. The three ounces maximum limit shall not apply to patients who are terminally ill or who are currently receiving hospice care through a licensed hospice, which patients may be dispensed an unlimited amount of medical cannabis.
• The term "primary caregiver" will be modified to "designated caregiver," and the patient registry will record each designated caregiver for the patient, if applicable, and establish a means of identifying and verifying the registration status of patients and designated caregivers who are registered with the Commission.
• Each registered patient will be permitted to concurrently have up to two designated caregivers.
• Health care facilities, defined as "institutional caregivers," will be permitted to possess medical cannabis and administer the medical cannabis to treat their patients.
• In addition to physicians, licensed nurses and physician assistants will be permitted, under certain circumstances, to authorize patients to use medicinal marijuana.
• A physician will not be required to enroll in any medical cannabis practitioner registry or undergo any additional registration process as a condition of authorizing patients for the medical use of cannabis.
• An individual, who is registered as a qualifying patient in another state or jurisdiction within the United States that authorizes the medical use of cannabis, will be considered a registered patient in New Jersey for a period of up to six months, provided that the individual possess both proof of registration in, and a valid photo identification card issued by, the other state or jurisdiction. However, medical cannabis will not be dispensed to the individual unless a health care practitioner licensed in New Jersey issues written instructions for the individual, pursuant to the requirement of the Bill.
• If an ATC was issued a permit prior to the effective date of the Bill becoming law, the ATC will be deemed to concurrently hold a Medical Cannabis Cultivator Permit, a Medical Cannabis Dispensary Permit, and a Medical Cannabis Manufacturer Permit, and will be authorized to engage in any conduct in relation to the cultivation, manufacturing, and dispensing of medical cannabis.
• For a period of 18 months after the effective date, there will be no more than 23 active medical cannabis cultivator permits in New Jersey, including the six operational and the six ATCs approved by the NJDOH on Dec. 17, 2018.

The above changes are just some of the changes that would be effectuated by the passing of the Bill in its current form.

Despite the constant political movement surrounding the MMP, New Jersey can certainly expect a change in the landscape of the MMP that will provide increased access to the patient population served by the MMP. Legalization in New Jersey of recreational/adult use cannabis will have to wait for either a referendum on the November 2020 ballot or a bill that New Jersey politicians can support and move forward with. Only time will tell.

Michael F. Schaff is a shareholder and co-chair of the Cannabis Law, Health Law and Corporate teams at Wilentz, Goldman & Spitzer, in Woodbridge. He is a trustee of the NJSBA and serves as co-chair of the its Cannabis Law Committee. Lisa Gora is a corporate and health law attorney at Wilentz, Goldman & Spitzer, and a member of the firm's Cannabis Law team. She also serves as secretary of the NJSBA's Cannabis Law Committee and is on the board of the Health Law Section.