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When Gov. Josh Green issued  on Dec. 30, 2024, it appeared that a medical cannabis patient crisis had been averted. However, a closer look at the details reveals a very different picture.

The impetus for this order  prohibiting primary caregivers from cultivating for medical cannabis patients on islands with a dispensary that went into effect on Jan. 1, 2025.

The Legislature recognized last session that prohibiting primary caregiver cultivation would adversely affect patient access to medical cannabis and tried to correct this error with , which, in its final form, would have allowed primary caregiver cultivation to continue on any island and ten patients to cultivate on the same property.

Unfortunately,  at the very last minute in conference because the House conference co-chair could not get release from the chair of the House Finance Committee, for reasons that are still unknown. 

With primary caregiver cultivation for certain patients set to disappear on Dec. 31, a request for an emergency proclamation  to the governor’s office on June 14. This request never received a response.

Then, on Nov. 29, Hawaii News Now , in which two key state lawmakers acknowledged that the Legislature made a mistake when it failed to pass House Bill 2443 last session, and that the pending prohibition of primary caregiver cultivation was a crisis for medical cannabis patients.

So, when the governor unexpectedly issued Executive Order No. 24-06 on Dec. 30, there was initial relief among patients and primary caregivers. In fact, many people mistook this for an emergency proclamation, which created even more confusion, especially with how Executive Order No. 24-06 directs the Hawaii Department of Health to overlook certain violations of primary caregiver cultivation.

It was only after a deep dive into the substance of this order that the practical implications started to emerge.

Two Categories Of Patients

Back in June 2024, DOH estimated that about 1,440 medical cannabis patients were using a primary caregiver for assistance with cultivation. This number was expected to drop over the following months as patients removed their primary caregiver grow site from their registration in preparation for the Dec. 31 deadline.

However, it is entirely possible that patients still have a primary caregiver grow site listed on their registration if these were not automatically removed on Jan. 1.

If this is the case, then Executive Order No. 24-06 created two groups of medical cannabis patients on islands with a dispensary that need assistance with cultivation: One group that retained a primary caregiver grow site in violation  that will now be allowed to continue cultivation under the new policy of non-enforcement, and a second group that already removed their primary caregiver grow site from their registration prior to the deadline that will not be allowed to add it back. 

 that “Patients submitting new or renewal application to OMCCR will be unable to officially designate a primary caregiver to cultivate cannabis on their behalf beginning January 1, 2025.”

In addition, Executive Order No. 24-06 says that “after January 1, 2025, a primary caregiver acting in accordance with the law in effect prior to January 1, 2025, is not committing a significant violation of part lX of chapter 329, HRS”, which apparently will not benefit patients who already removed their primary caregiver grow site prior to the new law going into effect because acting in accordance with the law prior to Jan. 1, required that be registered with DOH. 

Releasing this Executive Order less than 48 hours before the deadline made it impossible for patients to add a primary caregiver grow site back to their registration, which has caused considerable frustration and desperation for medical cannabis patients who thought they were doing the right thing by removing their primary caregiver grow site before the deadline.

Furthermore, Executive Order No. 24-06 does not apply to local law enforcement. Without executive orders being issued by all the county police chiefs that similarly make primary caregiver cultivation a lowest law enforcement priority, local law enforcement will inevitably encounter primary caregiver grow sites on islands with a dispensary, registered or not, that are now illegal under the new law. 

Medical cannabis patients and their primary caregivers require and deserve explicit protection under state law when it comes to the cultivation of medical cannabis, and law enforcement needs the kind of clear guidance that an emergency proclamation would provide.

It is understandable that the governor’s legal counsel recommended a policy of non-enforcement to deal with the current primary caregiver cultivation crisis, since Hawaiʻi’s entire medical cannabis program unnecessarily depends upon the non-enforcement of federal drug law.

However, we need to recognize that a policy of non-enforcement is not consistent with public health and safety, especially when dealing with a controlled substance. Just look at the devastating consequences our medical cannabis patients are suffering under the federal situation with cannabis and the unlawful behavior this policy promotes. 

It’s still not too late for the governor to fix the primary caregiver cultivation crisis with a temporary emergency proclamation. But perhaps even more importantly, this administration needs to reevaluate its approach to the state-authorized use of cannabis before another big mistake is made.