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<bill bill-stage="Introduced-in-House" dms-id="HE107211C3CFC4D50BC2DF16791F7CC8B" public-private="public" key="H" bill-type="olc">
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<dc:title>117 HR 6991 IH: To establish the policy of the Department of Veterans Affairs on medicinal cannabis, and for other purposes.</dc:title>
<dc:publisher>U.S. House of Representatives</dc:publisher>
<dc:date>2022-03-08</dc:date>
<dc:format>text/xml</dc:format>
<dc:language>EN</dc:language>
<dc:rights>Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.</dc:rights>
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<form>
<distribution-code display="yes">I</distribution-code>
<congress display="yes">117th CONGRESS</congress><session display="yes">2d Session</session>
<legis-num display="yes">H. R. 6991</legis-num>
<current-chamber>IN THE HOUSE OF REPRESENTATIVES</current-chamber>
<action display="yes">
<action-date date="20220308">March 8, 2022</action-date>
<action-desc><sponsor name-id="M001196">Mr. Moulton</sponsor> introduced the following bill; which was referred to the <committee-name committee-id="HVR00">Committee on Veterans' Affairs</committee-name></action-desc>
</action>
<legis-type>A BILL</legis-type>
<official-title display="yes">To establish the policy of the Department of Veterans Affairs on medicinal cannabis, and for other purposes.</official-title>
</form>
<legis-body id="H4EE041E833214245B01324F3937D2A4A" style="OLC"> 
<section id="H1E5B87D329B0484DBC199F3801C79E5A" section-type="section-one"><enum>1.</enum><header>Department of Veterans Affairs policy on medicinal cannabis</header> 
<subsection id="H7515A3DD202E48F58349BFCB78932329"><enum>(a)</enum><header>Policy</header><text display-inline="yes-display-inline">The policy of the Department of Veterans Affairs on medicinal cannabis is as follows:</text> <paragraph id="HA4D3BA7A3F9A483DB1008565561E87DD"><enum>(1)</enum><text display-inline="yes-display-inline">Veterans are encouraged to discuss their medicinal cannabis use with their health care providers without fear of negative repercussions.</text></paragraph> 
<paragraph id="H91D5411DA1184596B12294B0906091A2"><enum>(2)</enum><text display-inline="yes-display-inline">Veterans shall not be denied any benefit under the laws administered by the Secretary of Veterans Affairs by reason of cannabis use.</text></paragraph> <paragraph id="HBB02D9821B384E38B8AECF486C76A6C6"><enum>(3)</enum><text display-inline="yes-display-inline">The participation of a veteran in a State-legal marijuana program shall not affect the veteran’s eligibility for care and services furnished by the Department of Veterans Affairs.</text></paragraph> 
<paragraph id="H0E7D393FE86446DF80048FAA3F4A54D3"><enum>(4)</enum><text display-inline="yes-display-inline">The use or possession of cannabis is prohibited on all Department property and in all Department facilities pursuant to Federal law, which applies at such locations and not the laws of the State where the property or facility is located.</text></paragraph> <paragraph id="HE9FEB0F75FCF4693BCDBC850A7094925"><enum>(5)</enum><text>Department medical providers shall honor the desires of their patients to seek alternative forms of treatment.</text></paragraph> 
<paragraph id="H4DD60D7AF6484DCFBA4F52CA626A23F5"><enum>(6)</enum><text display-inline="yes-display-inline">The Department of Veterans Affairs acknowledges medicinal cannabis use may be a legitimate alternative treatment and a Department medical provider will not recommend a veteran for drug addiction treatment solely by reason of medicinal cannabis use.</text></paragraph> <paragraph id="H02DFD953A99B43D4AAB694779114DE00"><enum>(7)</enum><text display-inline="yes-display-inline">Department medical providers are permitted to discuss cannabis use as part of comprehensive care planning and may adjust treatment plans as necessary. Treatment adjustment should be relevant and a veteran should have the freedom to seek a second opinion if the veteran feels the change is not fair.</text></paragraph> 
<paragraph id="H016F28E828CD4228B77CED7D10506E6D"><enum>(8)</enum><text display-inline="yes-display-inline">Department medical providers will annotate a veteran’s cannabis use in the medical record of the veteran in order to have the information available in treatment planning. As with all clinical information, this is part of the confidential medical record and protected under patient privacy and confidentiality laws and regulations. Department medical providers will not record that a patient has a marijuana addiction problem in their medical record if the patient is responsibly using medicinal cannabis.</text></paragraph> <paragraph id="HC0C668618E5848E2BFE22C2E57C2E213"><enum>(9)</enum><text display-inline="yes-display-inline">Department clinicians shall follow Federal laws and regulations relating to medicinal cannabis.</text></paragraph> 
<paragraph id="HDC80F9E382BC44D587B0351784991D9E"><enum>(10)</enum><text display-inline="yes-display-inline">Department medical providers may not be fired nor have any other adverse personnel action taken against them for discussing cannabis use with their patients.</text></paragraph> <paragraph id="H68C16CC1908A4957B0C4A71E75D90115"><enum>(11)</enum><text display-inline="yes-display-inline">Department scientists may conduct research on cannabis benefits and risks under regulatory approval.</text></paragraph> 
<paragraph id="HF5D70B06B74C4F7281C281F07DF53A24"><enum>(12)</enum><text display-inline="yes-display-inline">Department medical providers may not dissuade participation in non-Department medicinal cannabis research.</text></paragraph></subsection> <subsection id="H28F01536D62C4C64AB48C50A4E50112F"><enum>(b)</enum><header>Dissemination of policy</header><text display-inline="yes-display-inline">The Secretary of Veterans Affairs shall disseminate the policy under subsection (a) widely, including by displaying such policy prominently in all Department of Veterans Affairs hospitals and clinics and online.</text></subsection> 
<subsection id="H86755A88F746462DB3E8B0770EC6985F"><enum>(c)</enum><header>Repeal in event of Federal legalization</header><text>If the use of medicinal cannabis becomes legal under Federal law, the requirement under subsection (a)(4) shall be repealed.</text></subsection></section> <section id="H170F5E018F7E40EBA3EBDAE21F4DFEE5" section-type="subsequent-section"><enum>2.</enum><header>Survey on cannabis use by veterans</header> <subsection id="H0D4BE8E6F2FA43D29BD8F31598A3D0A4"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">The Secretary of Veterans Affairs shall seek to enter into an agreement with a federally funded research and development center to conduct surveys nationwide to measure cannabis use by veterans.</text></subsection> 
<subsection id="HB8A3EF8FD34E4E16B71C424ED58A5813"><enum>(b)</enum><header>Selection</header><text display-inline="yes-display-inline">The Secretary shall select a federally funded research and development center under subsection (a) from among such centers that has—</text> <paragraph id="HA172F247D73744298FF01F02320A1609"><enum>(1)</enum><text display-inline="yes-display-inline">expertise and a record of independent, peer-reviewed publications with respect to—</text> 
<subparagraph id="H8C041B14A9534AF7AE47CCD374F6DA90"><enum>(A)</enum><text>behavioral health research; and</text></subparagraph> <subparagraph id="H4842A0C7A5AB42A486229E24C89AFDD2"><enum>(B)</enum><text>conducting independent evaluations of mental health programs using multidisciplinary methods; and</text></subparagraph></paragraph> 
<paragraph id="HF39B4BEDCD3C430D996D2836C32E432F"><enum>(2)</enum><text>an in-depth knowledge of all State medicinal marijuana programs and the ability to tailor the surveys under subsection (a) accordingly.</text></paragraph></subsection> <subsection id="HFBAA15E9730C4546ABD5D407DF48AF0D"><enum>(c)</enum><header>Conduct of surveys</header><text>The surveys conducted under subsection (a) shall meet the following criteria:</text> 
<paragraph id="HFE6443CFF0C049D78FB7A6D2AE348DCD"><enum>(1)</enum><text display-inline="yes-display-inline">One survey shall collect information from veterans who use cannabis, including both veterans enrolled in the health care system established under section 1705(a) of title 38, United States Code, and veterans who are not so enrolled.</text></paragraph> <paragraph id="HDE2EF45C73F44325879583CBE575A60F"><enum>(2)</enum><text>One survey shall collect information from health care providers of the Department of Veterans Affairs.</text></paragraph> 
<paragraph id="H2046B599E74A4B9995E8A13383E01DC2"><enum>(3)</enum><text>Each survey shall be conducted in a manner that ensures the anonymity of the individual being surveyed.</text></paragraph></subsection> <subsection id="HB00BD5C95B4942CEB098336C48541796"><enum>(d)</enum><header>Matters surveyed</header> <paragraph id="HEE2C10485570418F8A73E7B1B765C409"><enum>(1)</enum><header>Veterans</header><text display-inline="yes-display-inline">The survey described in subsection (c)(1) shall cover the following subjects:</text> 
<subparagraph id="H89CFD9298A494B0CBE784BE5BB6B7DC2"><enum>(A)</enum><text display-inline="yes-display-inline">The current medicinal cannabis use by the veteran, or the intent or desire by the veteran to use medicinal cannabis, and the reasons for such use, intent, or desire.</text></subparagraph> <subparagraph id="HA569BFD25F954F7C994CAA585ED61620"><enum>(B)</enum><text>The conditions, symptoms, or both, that the veteran uses cannabis to treat.</text></subparagraph> 
<subparagraph id="H92DA4C60F5CB42ABB893778DA446945E"><enum>(C)</enum><text display-inline="yes-display-inline">The types of cannabis and cannabis products used by the veteran, including with respect to—</text> <clause id="H432108BE35EF4C95A7903654E211661B"><enum>(i)</enum><text display-inline="yes-display-inline">tetrahydrocannabinol or can­na­bid­i­ol content;</text></clause> 
<clause id="H76011A169410441BA6A28DE19A62015E"><enum>(ii)</enum><text display-inline="yes-display-inline">indica, sativa, mixes, or hybrids; and</text></clause> <clause id="H97A815510BD84C638FD4C557F2325E3B"><enum>(iii)</enum><text display-inline="yes-display-inline">flower, oils, hash or kief, concentrates (wax, shatter, budder), edibles, drinks, tinctures, and topical ointments.</text></clause></subparagraph> 
<subparagraph id="H1B52FCF0E83945A2880F0CBC5F4EA794"><enum>(D)</enum><text display-inline="yes-display-inline">Other medications taken by the veteran concurrently with cannabis and any medications the veteran stopped using because of the use of cannabis.</text></subparagraph> <subparagraph id="H4833FBE6810F40C9AACCF8FAFA49DE0C"><enum>(E)</enum><text display-inline="yes-display-inline">How the veteran is self-administering medicinal cannabis, including—</text> 
<clause id="H50841165054044DE872B2B69024CDE4F"><enum>(i)</enum><text>the method;</text></clause> <clause id="H25394C45748A460BB5AC3372A7F3D04F"><enum>(ii)</enum><text>the typical times each day the veteran self-administers;</text></clause> 
<clause id="H490DFA5478DF45528CC1B31BB8505304"><enum>(iii)</enum><text>the frequency of different products per day and for what condition, symptom, or both; and</text></clause> <clause id="H4550457C9CC340DEB41262A6E88E97E0"><enum>(iv)</enum><text>the amounts per product.</text></clause></subparagraph> 
<subparagraph id="HB437254A34BF47899CC4CD5187F0FA27"><enum>(F)</enum><text display-inline="yes-display-inline">The ratings and descriptions of the effectiveness of using cannabis to treat conditions, symptoms, or both.</text></subparagraph> <subparagraph id="H62CA6E65DCFF44FF923DFE53770FE5D4"><enum>(G)</enum><text>Any experiences with side effects.</text></subparagraph> 
<subparagraph id="HDA71B20347A9412E9B06343BC716D831"><enum>(H)</enum><text display-inline="yes-display-inline">The number of different cannabis products tried before settling on the current product.</text></subparagraph> <subparagraph commented="no" id="H714AEA372B6F4280BF9438F8F7E6AAA8"><enum>(I)</enum><text display-inline="yes-display-inline">The typical source of medical cannabis (such as a single dispensary, multiple dispensaries, mail order, or other source), the typical purchase frequency, and the typical amount purchased.</text></subparagraph> 
<subparagraph id="H3E84C2D6B24D445AB7C08EBD90BEE37A"><enum>(J)</enum><text>The sources of information the veteran uses for products and dosages.</text></subparagraph> <subparagraph id="HA8E9DCF60853433598919B1A92CBDA66"><enum>(K)</enum><text display-inline="yes-display-inline">Factors that influence the choice of the veteran for using a chosen product (such as with respect to the levels of tet­ra­hy­dro­can­nab­i­nol or cannabidiol content, cost, availability, consistency, or strain).</text></subparagraph> 
<subparagraph id="HC42FBA53E6054F5A921B3103FF91EB93"><enum>(L)</enum><text>Any other matters determined appropriate.</text></subparagraph></paragraph> <paragraph id="HA9D3A86C3BDE47AD9D1ECAEC88BC49F2"><enum>(2)</enum><header>Health care providers</header><text display-inline="yes-display-inline">The survey described in subsection (c)(2) shall cover the following subjects:</text> 
<subparagraph id="H7AAB50F2C69C46CCA72182732F46E01F"><enum>(A)</enum><text display-inline="yes-display-inline">A description of the experience of the health care provider with respect to patents using medicinal cannabis.</text></subparagraph> <subparagraph id="H9CF2A0FEAC6C4A0F8AFB53E73B76AA07"><enum>(B)</enum><text display-inline="yes-display-inline">A description by the health care provider of how medicinal cannabis is changing patients.</text></subparagraph> 
<subparagraph id="HBB01FFF949014A648D4C647F6F1EDF8A"><enum>(C)</enum><text>A description of how treatment plans have been modified after a veteran discloses using cannabis.</text></subparagraph> <subparagraph id="HCD70016D6A7E445FAEE9DF7729E50F5D"><enum>(D)</enum><text>Any documentation of the products, dosages, or frequency of such cannabis use in the medical records of the veteran.</text></subparagraph> 
<subparagraph id="H4488A1F7AF2A462D870E288D1C2BD694"><enum>(E)</enum><text>Reporting of adverse events.</text></subparagraph> <subparagraph id="H01E0B1059C0E41768D80AF02335678B5"><enum>(F)</enum><text>The sources of information used by the health care provider with respect to cannabis products and the medical effectiveness of cannabis.</text></subparagraph> 
<subparagraph id="H4E1DDC57752749EA8722B5E5BB54C0C9"><enum>(G)</enum><text>Any other matters determined appropriate.</text></subparagraph></paragraph></subsection> <subsection id="H225FA8EF44E94B9699FCFB237EFA8EDB"><enum>(e)</enum><header>Report</header><text>Not later than one year after the date of the enactment of this Act, the Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and House of Representatives a report on the results of the surveys conducted under this section.</text></subsection></section> 
<section id="H468D4C12C67A4EDB87E3B825C3EC968E" section-type="subsequent-section"><enum>3.</enum><header>Training in use of medical cannabis for Department of Veterans Affairs primary care providers</header> 
<subsection id="H4557ADF4F1704660BB4B83151398D829"><enum>(a)</enum><header>Training</header><text display-inline="yes-display-inline">Not later than one year after the date of the enactment of this Act, the Secretary of Veterans Affairs shall provide for all primary care providers of the Department of Veterans Affairs an initial training in the use of medical cannabis. The Secretary shall provide supplemental training as necessary.</text></subsection> <subsection id="H194C587B662044859FD9C842E123CEF5"><enum>(b)</enum><header>Partnerships with medical schools</header><text>In developing and providing the training to be provided under subsection (a), the Secretary shall enter into partnerships with medical schools that have incorporated education on medical cannabis into their curricula.</text></subsection></section> 
</legis-body>
</bill> 

