Medical Marijuana Card: California Requirements

In California, those suffering from certain medical conditions may legally use marijuana to get relief from symptoms. With a county-issued Medical Marijuana Identification Card (MMIC), patients and their designated primary caregivers can possess, transport, grow and buy marijuana for personal medical use. In order to get an MMIC, the applicant must submit an application, provide accompanying documentation and pay a fee.

In California, medical use of marijuana has been legal since 1996 with the passage of Proposition 215, the Compassionate Use Act. The Compassionate Use Act allows people and their primary caregivers, with the recommendation of a physician, to possess and cultivate marijuana for medical purposes. In 2016, the passage of Proposition 64, the Adult Use of Marijuana Act, legalized recreational use of marijuana in California.

While Propositions 215 and 64 have legalized marijuana within California, it's important to note that marijuana is still considered an illegal substance under federal law. This means that while the California propositions protect patients and their caregivers from California criminal prosecution or sanction, it doesn't protect them from federal prosecution or federal seizures of marijuana.

California has a Medical Marijuana Identification Card Program that processes MMIC applications. The program also maintains a registry database of qualified patients and their primary caregivers. While it is not required that patients and their caregivers have an MMIC, it may be useful to have one since those with cards may grow and have marijuana in larger quantities than recreational users.

An MMIC also allows those under 21 to purchase marijuana and marijuana products from marijuana dispensaries, and those who present a valid MMIC may not have to pay sales and use tax when buying medical cannabis, edible medical cannabis products or topical cannabis from marijuana dispensaries.

Read More: California Medical Marijuana Laws: Uses, Regulations & Card Rules

In order to qualify for an MMIC, the patient must have written documentation from her doctor that she suffers from one or more of the qualifying medical conditions and that marijuana is appropriate to use for alleviating the symptoms of that medical condition. Some qualifying medical conditions are:

• Acquired Immune Deficiency Syndrome (AIDS).
• Anorexia.
• Arthritis.
  
• Cachexia.
  
• Cancer.
• Chronic pain.
• Glaucoma.
• Migraines.
• Persistent muscle spasms.
  
• Seizures.
• Severe nausea.

The MMIC application also provides a catch-all qualification. Per the application form, an MMIC can also be issued for any other chronic or persistent medical symptom that either substantially limits the ability of the person to conduct one or more major life activities as defined in the Americans with Disabilities Act of 1990 or for chronic or persistent symptoms that, if not alleviated, may cause serious harm to the patient's safety, physical or mental health.

The patient or her legal representative may apply for an MMIC for herself, her primary caregiver or for both. If the patient is under 18 years of age, a parent, a legal guardian or other person with legal authority to make medical decisions must fill out the application unless the minor is lawfully emancipated.

If the applicant is unable to make his own medical decisions, then someone with legal authority can complete the application on his behalf. The legal representative can be a conservator with authority to make medical decisions, an attorney-in-fact with a durable power of attorney for health care, a surrogate decision-maker authorized under a health care directive or someone otherwise authorized by law to make medical decisions for the applicant.

When applying for a primary caregiver MMIC, the designated primary caregiver must provide her personal information on the application. She must also list her caregiver duties, making sure to detail how she regularly provides care, including housing, health and safety, for the patient. The caregiver must not be a designated primary caregiver for another patient in another county.

In addition to individuals who have been designated as primary caregivers, parents of the patient and persons legally entitled to make medical decisions on behalf of the patient can apply for a primary caregiver MMIC. Owners/operators of health clinics and employees of a clinic, facility, hospice or home health agency who have been designated by the owner/operator to serve as the patient's primary caregiver can also apply for a primary caregiver MMIC.

In order to get an MMIC, the patient or primary caregiver must apply through the program of the county in which he lives. The California Department of Public Health has a database listing all county programs, their contact information and their business hours. Some county programs have established business hours and accept walk-ins, while other programs are open by appointment only.

Applicants need to fill out and bring the Medical Marijuana Program Application/Renewal form to their county program. The application/renewal form can be downloaded online from the California Department of Health's website.

Along with the application/renewal form, applicants must also provide a copy of their physician's medical recommendation, proof of identity and proof of residency in the county. Proof of identity can be a valid California driver's license or identification card or some other valid government-issued photo ID card. Proof of residency can be a lease or a mortgage agreement, a utility bill or a California Department of Motor Vehicles registration letter.

Some counties require additional forms. Los Angeles County, for example, requires a physician attestation form from a doctor and an acknowledgement form from the applicant. A legal representative applying on behalf of a patient may also need to provide proof of his legal representation of the patient, such as a court-issued conservator document, a living will, an advanced health care directive or a power of attorney for health care.

In San Diego County, emancipated minors must bring proof of their legal emancipation or be accompanied by their parents or legal guardians. To get a primary caregiver MMIC, the primary caregiver must go to the office with the patient.

Once the applicant provides all of the required forms and documentation to his county's program office and pays the fee, he and/or his caregiver will have his photo taken. This photo will be printed on the MMIC.

The county has 30 days to verify the application or to contact the applicant regarding any missing information. If approved, the county then has five days to provide the applicant with his MMIC. This means that it can take up to 35 days for an applicant to receive his MMIC, provided that everything is complete.

The fee to apply for, replace or renew an MMIC varies by county and is nonrefundable. While each county program can set its own fees, fees cannot be more than $100 per card. This means that if an applicant is applying for both a patient card and a primary caregiver card, the total fee for both cards may be upwards of $200.

County programs must give a 50 percent discount to Medi-Cal eligible applicants, which means a fee of no more than $50 per card, and waive fees completely for applicants who are in the County Medical Services program. Applicants who are part of such medical programs should be ready to show their program card and/or submit a copy of it in order to get the reduced MMIC application fee.

Depending on the county, the application fee may be paid by cash, check or credit card.

One of the most important pieces of information that must be completed on the application form is the patient's physician's name, contact information and California medical license. The doctor must have a license in good standing with the Medical Board of California, the Osteopathic Medical Board of California or the California Board of Podiatric Medicine to practice medicine, osteopathy or podiatry.

The doctor may use a standard form, called the Written Documentation of Patient’s Medical Records form, to fulfill the application's medical documentation requirement. The form is available from the county program offices, as well as from the California Department of Public Health website.

The doctor must also have the patient sign an authorized medical release of information and provide the patient with a copy of her medical condition. Otherwise, the county program may not have access to the medical information needed to process the application. As in the case of Los Angeles County requiring a physician attestation form, individual counties may also require additional forms that doctors must submit in order for their patients to get an MMIC.

If a county denies an applicant's application, she has the right to appeal the decision. She will have to fill out the denial appeals application, also available on the California Department of Public Health's website, and submit it within 30 days of the denial. On the form, the applicant has the chance to explain why she disagrees with the county's denial. She will then mail the appeals application, along with a copy of her denied application, to an appeals office in Sacramento.

If an application has been denied, and there has been no appeal, then the applicant may be barred from reapplying for six months.

Once an MMIC is issued, it is valid for up to one year, after which time the applicant will have to fill out another application/renewal form and provide the necessary documentation. A new MMIC with a unique nine-digit user identification number is issued with each renewal.

If the MMIC is a primary caregiver card, then it expires when the patient's card expires, even if it is less than one year. If the patient changes her primary caregiver, the previous caregiver must return his MMIC to the county program.

Since the MMIC program is a statewide program, a card issued by one county is valid in all California counties.

The MMIC contains cardholder identity information, namely the cardholder's photo, the cardholder's nine-digit user identification number and whether the cardholder is the patient or a primary caregiver. The MMIC also lists the card's expiration date, the name and telephone number of the county program that approved the MMIC and the internet address where the MMIC's validity can be verified.

Law enforcement and dispensers can verify cardholders' nine-digit user identification numbers via the California Department of Public Health MMIC verification website.