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Another North Carolina Senate committee has approved a bill to legalize marijuana, getting the measure one step closer to the floor.

Members of the Senate Health Care Committee on Thursday advanced the legislation in a voice vote. This comes two days after the Judiciary Committee cleared the bill, which followed a meeting of the panel where members accepted changes.

An earlier version of the reform legislation cleared Judiciary and the Finance Committee last month, but it was rereferred back to the former panel for this week’s revisions. The measure must still pass the Senate Rules and Operations Committee—which is chaired by bill sponsor Sen. Bill Rabon (R)—in order to reach the floor before potentially heading to the House of Representatives and then to the governor’s desk.

“The reason that we’re doing this is to provide access to those who really need it,” Sen. Michael Lee (R), who presented the bill on Thursday, said before the vote. “This is not a legalization of cannabis. What this is is an availability of a particular product—you can call it a medicine, you can call it a remedy, you can call it whatever you want—but the folks that I’ve spoken to that have the debilitating conditions that are outlined in the bill really, really know it works for them, and improves their quality of life.”

Under the proposal, patients would be allowed to access cannabis if they have a “debilitating medical condition” such as cancer, epilepsy, HIV/AIDS, Parkinson’s disease, multiple sclerosis and post-traumatic stress disorder. The committee substitute adopted earlier this week by Judiciary changes the list somewhat to allow patients with terminal illnesses and have six months to live, as well as those with conditions resulting in hospice care, to also qualify for cannabis.

Patients could possess up to one and a half ounces of marijuana, but home cultivation would not be permitted.

The definition of what constitutes a “cannabis-infused” product was also changed in the latest substitute version. Such products include “a tablet, a capsule, a concentrated liquid or viscous oil, a liquid suspension, a topical preparation, a transdermal preparation, a sublingual preparation, a gelatinous cube, gelatinous rectangular cuboid, lozenge in a cube or rectangular cuboid shape, a resin or wax.”

Smoking and vaping would also be allowed, but doctors would need to prescribe a specific method of delivery and dosages for patients under the revised legislation. And they would need to reevaluate patients’ eligibility for the program at least once a year.

Lee offered four amendment in committee on Thursday that the panel accepted with voice votes.

One would modify the membership of the cannabis advisory board, stipulate that physicians must be in good standing with the federal Drug Enforcement Administration to recommend marijuana and outline requirements for continuing education for doctors, as well as require that they be located in the state of North Carolina.

Another amendment changes the membership of the regulatory body that would oversee the program and directs officials to set certain rules on an expedited basis. It also specifies requirements for the seed-to-sale tracking system and adds conflicts of interest provisions, as well as performance and reporting requirements for licensees.

A third amendment adds requirements for businesses on location, hours of operation, visibility and advertising. It further adds minimum standards on testing.

Finally, the panel approved a revision to modify annual report requirements and protect researchers from criminal liability for possessing cannabis for studies.

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The bill provides for up to 10 medical marijuana suppliers who control the cultivation and sale of cannabis. Each supplier can operate up to four dispensaries.

But advocates have taken issue with provisions on who would be eligible for such licenses, as the measure stipulates that applicants must provide documentation showing they have at least five years of experience “in cultivation, production, extraction, product development, quality control, and inventory management of medical cannabis in a state-licensed medical or adult use cannabis operation.”

That would effectively mean that the licenses and dispensaries would be exclusively operated by established, out-of-state marijuana businesses—a major issue for advocates who feel this unfairly alienates small, in-state businesses.

Under the bill, a Compassionate Use Advisory Board would be established, and it could add new qualifying medical conditions.

Separately, a Medical Cannabis Production Commission would be created to ensure that there’s an adequate supply of cannabis for patients, oversee licensing and generate enough revenue to regulate the program.

Advocates are still hoping to see further revisions to expand the proposed program and promote social equity.

The measure would further create a North Carolina Cannabis Research Program to “undertake objective, scientific research regarding the administration of cannabis or cannabis-infused products as part of medical treatment.”

There are also protections for patients included in the latest version. It stipulates that employees and agents of the state must treat possession of cannabis for qualified patients the same as any other prescribed controlled substance.

Further, the bill includes limitations on where marijuana can be smoked or vaped, and includes restrictions on the locations and hours of operation for medical cannabis businesses. It also allows regulators to place a “limitation on the number of written certifications a physician may issue at any given time.”

A majority of North Carolina adults support legalizing marijuana for recreational use—and three in four say it should be legal for medical purposes—according to a poll released in February.

A separate medical cannabis bill, adult-use marijuana legalization measures and several pieces of cannabis decriminalization legislation have also been introduced in recent months—though they would likely face an uphill battle in the GOP-controlled legislature.

While advocates have their doubts about broad reform being enacted in North Carolina this session, Senate President Pro Tempore Phil Berger (R) recently acknowledged that opinions are shifting when it comes to marijuana in the state, and he said that Rabon specifically “for a long time has looked at the issue.”

“I do sense that public opinion is changing on marijuana—both medical and recreational,” Rabon said previously. “I don’t know where the members of the General Assembly are at this time in terms of support for the bill, but it’s something we’ll look at and we’ll see how things move along.”

Pressure to end criminalization is also building regionally.

Neighboring Virginia became the first state in the south to legalize marijuana for recreational use in April and that law took effect in July, for example. And the sponsor of a South Carolina medical cannabis legalization bill said he’s received assurances from a top Senate leader that his measure will be taken up as the first order of business at the beginning of next year.

A task force convened by North Carolina Gov. Roy Cooper (D) backed decriminalization as part of a series of policy recommendations on racial equity that were released late last year. The group also said prior cannabis convictions should be expunged and the state should consider whether to more broadly legalize marijuana.

Under current law, possessing more than half an ounce up to 1.5 ounces of cannabis is a class 1 misdemeanor, subject to up to 45 days imprisonment and a $200 fine. In 2019, there were 3,422 such charges and 1,909 convictions, with 70 percent of those convicted being nonwhite.

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