Further Expansion of Texas’ Compassionate Use Program with H.B. 1535 in 2021

After establishing the Texas Compassionate Use Program in 2015 and augmenting it in 2019, Rep. Stephanie Klick (R) has once again initiated expanding the program with an incremental approach. With several beneficial provisions, this bill will potentially be the most effective and favorable legislation regarding medical marijuana reform in Texas. Although there are more comprehensive medical marijuana bills in other states, H.B. 1535 presents a significant opportunity for the Texas cannabis community. 

What is the Texas Compassionate Use Program?

In 2015, the Texas Compassionate Use Program (“TCUP”) was created pursuant to the Texas Compassionate Use Act (Senate Bill 339), which originally required the Texas Department of Public Safety (“DPS”) to create a secure registry of physicians to treat patients suffering from a limited list of medical conditions, such as intractable epilepsy and ALS, with low-THC cannabis (not more than 0.5% THC). In 2019, the Texas Compassionate Use Program was expanded to include additional conditions for which low-THC cannabis can be prescribed, such as incurable neurodegenerative diseases. Additionally, the Compassionate Use Registry of Texas (“CURT”) was updated to simplify the registration and prescription process for participating physicians. 

What Are the Main Provisions of H.B. 1535? 

Texas H.B. 1535 provides additional qualifying medical conditions to TCUP’s currently limited list for patients to be prescribed low-THC cannabis. Moreover, H.B. 1535 raises the low-THC cannabis 0.5% THC limit to a 5.0% THC limit. Additionally, the bill addresses the establishment of institutional review boards to evaluate and approve research programs to study the use of low-THC cannabis for medicinal use. These critical provisions of H.B. 1535 are discussed in more detail below.

Additional Qualifying Conditions

H.B. 1535 allows the Texas Department of State Health Services to designate new qualifying conditions through their administrative rule-making process. Notably, the bill includes the addition of cancer (not just terminal cancer), chronic pain, and post-traumatic stress disorder (“PTSD”) for veterans. The detailed text of the bill now outlines that a physician may prescribe low-THC cannabis if the patient is diagnosed with any of the following conditions:

“Epilepsy, a seizure disorder, multiple sclerosis, spasticity, amyotrophic lateral sclerosis, autism, cancer, an incurable neurodegenerative disease, a condition that causes acute or chronic pain [that would normally require] an opioid, PTSD and is a veteran, a medical condition that is approved for research under Subchapter F… or a debilitating medical condition designated by the Department of State Health Services under subchapter (b).” 

H.B. 1535 further requires physicians to determine the risk that the use of low-THC cannabis by the patient is reasonable in relation to the potential benefit. 

Raise in THC Percentage

Texas H.B. 1535 also amends the previous limitation on what is considered “Low-THC cannabis” by raising the permitted THC percentage from 0.5 percent to five percent. 

“Low-THC cannabis” means the plant Cannabis sativa L., and any part of that plant or any compound, manufacture, salt, derivative, mixture, preparation, resin, or oil of that plant that contains not more than five [0.5] percent by weight of tetrahydrocannabinols.”

Establishment of Research Review Boards 

Finally, Rep. Stephanie Klick’s H.B. 1535 encourages further research regarding medical cannabis and calls for the establishment of “Institutional Review Boards” to approve, facilitate, and help implement the findings. The bill mandates that these review boards must be affiliated with a licensed dispensary and either a medical school, hospital, or have a special accreditation. 


Even with the above-mentioned incremental additions to TCUP, innumerable patients in Texas are still omitted from accessibility to medical marijuana. Further, there are still no patient protections included in the legislation, and doctors still need to “prescribe” cannabis, which jeopardizes their DEA registration. Nonetheless, H.B. 1535 is a substantial leap forward, and with ample awareness and participation, the bill can receive the support it needs. 

Chelsie Spencer is an experienced cannabis lawyer and a founding member of Ritter Spencer Cheng PLLC, a law firm located in Dallas, Texas. With years of experience representing clients throughout all realms of the cannabis and marijuana industries, our experts are prepared to guide your legal marijuana business regarding the manufacturing, sale, and distribution of cannabis products. Contact Ritter Spencer Cheng or give us a call at 214.295.5070 for more information.