Proposals to allow medical marijuana patients to use cannabis in hospitals and to authorize unannounced state inspections of sites where licensed caregivers grow the drug will be introduced in public hearings Monday before the Legislature’s Health and Human Services Committee.

The proposals are among a dozen bills, sponsored by a mix of Republicans and Democrats, that would amend the state’s 16-year-old medical marijuana law in various ways to expand production or access to the drug for patients and strengthen oversight by state officials. Lawmakers say the tweaks are necessary to ensure the program continues to operate responsibly and keeps patients safe.

“Since medical marijuana became legalized, there’s always been a need to refine the law,” said Sen. Eric Brakey, R-Auburn, co-chairman of the Health and Human Services Committee. “It’s still relatively new to our state.”

Maine voters first legalized the limited use of medical marijuana in 1999 and significantly expanded the law a decade later. A 2009 ballot initiative ordered the state to set up a regulated system of dispensaries and caregivers to supply patients with the drug.

After hearing from parents of children with epilepsy and other seizure disorders who rely on medical marijuana, Brakey became the lead sponsor of L.D. 35, which would allow patients to use a tincture or other smokeless form of medical marijuana in hospitals. The bill faces opposition from hospital officials, who say they are prohibited by federal law from allowing the drug’s use.

“We’re talking about young children who have upwards of 200 seizures a day and who could not live a normal life until a doctor recommended medical marijuana for them,” Brakey said. “Suddenly, because of prohibitions when they are in the hospital, they are separated from the only medicine they have found that works for them and they go back to having 200 seizures a day.”

CAUGHT IN THE MIDDLE

Rep. Diane Russell, D-Portland, a sponsor or co-sponsor of several of the bills, said she supports Brakey’s proposal because the ban on medicinal marijuana in hospitals is difficult for both patients and health care providers.

Russell said she hears from parents who say they’ve had mixed experiences in Maine hospitals, with some doctors refusing to allow the parents to administer the treatment and others who avoid the issue by not addressing it with the parents. The parents are hesitant to talk openly about which hospitals don’t hassle them because they don’t want to get the doctors in trouble, she said.

“Some hospitals in the state will quietly look the other way so parents can do what they need to do,” she said. “The hospitals are stuck between a rock and a hard place.”

Brian Marden, senior director of pharmacy at Maine Medical Center in Portland, said the hospital would lose its U.S. Drug Enforcement Administration license to dispense many medications if it permitted marijuana use in its facilities, because the drug is illegal under federal laws. That also would be the case if Brakey’s bill passes, he said, noting that even the hospital’s state license requires it to follow both state and federal drug laws as one of its conditions.

Both MMC and Eastern Maine Medical Center in Bangor dispense marinol, which is a synthetic form of marijuana, said Marden and Andy Soucier, a spokesman for EMMC, although Marden said it’s not clear whether it’s as effective as medical marijuana.

Soucier said EMMC also permits the use of — but doesn’t dispense — cannabidiol oil, which is derived from the hemp plant, a variety of cannabis. Relatives of patients or marijuana caregivers would be allowed to dispense that oil to a patient, he said. Marden said MMC doesn’t allow the use of any of the products of cannibis plants.

Jeff Austin, a lobbyist for the Maine Hospital Association, said the organization opposes allowing medical marijuana use in hospitals, although members sympathize with patients whose medical conditions best respond to marijuana. He said the bill could “create a conflict for hospitals that would be quite difficult to navigate.” Because marijuana is illegal under federal law and hospitals are licensed by the federal government, they could risk being found in violation of their license, lose funding and face penalties.

However, Austin said, the bigger concern among members of the association is that medical marijuana is not approved by the Food and Drug Administration, which means clinicians are prohibited from providing the drug in a hospital.

“Everybody understands where the families are coming from. Most people look at the situation and say, ‘I’d do the same thing for my kid,'” Austin said. “The challenge is we live in a regulated world.”

ADDRESSING INSPECTIONS

A bill sponsored by Sen. Tom Saviello, R-Wilton, would give the Department of Health and Human Services permission to do random inspections of the grow sites of Maine’s 1,700 licensed caregivers, who can cultivate up to six plants each for five patients but must do so under secure conditions detailed in state regulations.

Caregivers reacted with alarm this month when they learned that DHHS had contracted with the Maine Sheriffs’ Association to investigate complaints against caregivers. DHHS defended the practice, saying it regularly hires vendors to perform those types of services and only was responding to complaints about specific growing operations.

State law already permits DHHS to do random inspections of registered medical marijuana dispensaries, and Saviello’s bill, L.D. 726, clarifies that caregivers are also subject to the same unscheduled compliance checks.

“If you’re growing a drug to help somebody, that person needs to know it’s being grown under the proper conditions,” Saviello said, adding that he believes most caregivers already operate within the law.

A similar bill, L.D. 1258, sponsored by Rep. Deb Sanderson, R-Chelsea, also would allow DHHS to make on-site inspections of caregivers for three or more patients to ensure compliance with state law.

Catherine Lewis, director of education for the Medical Marijuana Caregivers of Maine, said caregivers are not opposed to inspections with prior notice, but they think it is unfair to subject them to surprise inspections when other businesses are not.

“Why do they treat caregivers any different? If the purpose is to make sure everyone is compliant and they’re doing everything safely, why be sneaky and assume they’re doing something wrong?” she said.

OTHER BILLS

Russell, the Portland legislator, has proposed bills that would remove the limit on the number of patients caregivers can sell marijuana to and remove the list of qualifying conditions. Caregivers currently can have up to five patients at a time. Those patients can be prescribed marijuana by doctors only if they have certain debilitating conditions, including cancer, epilepsy, AIDS and post-traumatic stress disorder.

Those conditions that qualify have been defined by the Legislature, which Russell says is inappropriate.

“We need to get politicians out of the doctor’s office,” she said.

Two other bills, sponsored by Sanderson and Rep. Dick Farnsworth, D-Portland, would authorize the establishment of marijuana testing laboratories, allow them to possess quantities of marijuana for testing and require the state to set rules for who can own and operate the facilities.

Concerns about protecting patient privacy are the focus of other bills, including one from Russell that would require DHHS to assign unique identifying numbers to patients and use that number, rather than a patient’s name, in agency programs that monitor marijuana sales and consumption.

Portland Press Herald staff writer Edward D. Murphy contributed to this report.