The proposal, which still must pass the more-conservative Senate, would allow doctors to prescribe cannabis to patients who suffer from cancer, autism, PTSD, severe pain and other conditions.

Christy and Mark Zartler consider cannabis to be their daughter’s “rescue medicine.” Kara, 19, has severe autism and cerebral palsy, and has hurt herself — smacking and punching her face and head repeatedly — for more than a decade. Nothing, including pharmaceutical drugs, worked to calm her, until the Zartlers began illegally using medical marijuana, which reduced her hits from more than 1,000 each day to as few as zero.

As the Zartlers lobbied lawmakers last session to legalize Kara’s treatment, they regularly provided her with cannabis vapor to stabilize her behavior. But something changed last year, Christy said, and the regimen they were using no longer worked to ease Kara’s biting and pinching. They stopped using the cannabis they had access to in January, but because the treatment is illegal in Texas, their options are limited. If they could access medical-grade CBD oil on a consistent basis, Christy said, “we might be able to stabilize her in a better way.”

“I can’t go to a dispensary or physician and ask if there’s a different concoction to try, like other families can do in other states,” she told the Observer on Monday. “Right now I’m just grasping at straws, and desperately trying to help her.”

On Monday night, the Texas House gave initial passage to a bill to legalize broader use of medical marijuana, for Kara and countless other Texans. House Bill 1365, by state Representative Eddie Lucio, D-Brownsville, would expand the state’s extremely narrow rules to allow doctors to prescribe low-THC cannabis to patients with cancer, autism, post-traumatic stress disorder, severe pain and nausea, muscular dystrophy, Alzheimer’s and a host of other conditions. The bipartisan passage, on a 121-23 vote, is noteworthy in a Legislature that has moved significantly slower than other states on marijuana reform. But it’s early for the Zartler family to celebrate: the bill still faces a major hurdle in the more-conservative Senate.

Introducing the bill, Lucio said he was there as a “voice for thousands of people in our state who are too sick to function or who live in constant debilitating pain.” Parents of kids with autism, veterans suffering from PTSD, patients battling cancer “really won my heart,” he said on Monday. The measure, which also includes a cannabis research component, overwhelmingly passed with no debate. It is the most comprehensive medical marijuana bill filed this session, and a top priority for advocates.

The Zartlers and other families and patients with debilitating illnesses have flooded committee hearings during the last few sessions, telling lawmakers that cannabis is the only thing that has worked to ease their pain or treat their ailments when pharmaceuticals failed or caused harmful side effects. Some were in the gallery watching the vote Monday night, Lucio said. But because it is illegal to prescribe to most patients in Texas, families have used cannabis in secret, fearing arrest, or left the state as “medical refugees.”

In 2015, lawmakers passed the “Compassionate Use Act,” authored by Fort Worth Republican Representative Stephanie Klick, which allows limited use of cannabis with low levels of THC for patients with intractable epilepsy who have not responded to other medication. The law has been restrictive and slow-moving, leaving out well over a million Texans who could benefit under HB 1365, according to Heather Fazio, director of Texans for Responsible Marijuana Policy. Meanwhile, access even for currently eligible patients is limited: only about 50 doctors are part of the Compassionate Use Program, along with three approved dispensaries, which opened last year.

Klick filed a new bill this session, which was postponed from a scheduled vote in the House on Monday, that would offer a more limited expansion of the 2015 law than Lucio’s. In total, about 20 bills related to medical marijuana were filed this session. Seven, including HB 1365, were considered in a House subcommittee hearing last month. But related measures have not taken off in the upper chamber, where Lieutenant Governor Dan Patrick last week declared a bill to reduce penalties for marijuana possession “dead in the Texas Senate.” While that measure focuses specifically on criminal justice reform, a spokesperson told the Texas Tribune recently that Patrick is “wary” of medical marijuana proposals that “could become a vehicle for expanding access to this drug.”

Thirty-four states and the District of Columbia have legalized medical marijuana, and 12, including Texas, allow limited use, according to the National Conference of State Legislatures.

“I can’t go to a dispensary or physician and ask if there’s a different concoction to try, like other families can do in other states.”

The Zartlers shared their story in the hope that seeing how cannabis helps Kara would sway the minds of conservative state leaders. In February 2017, they released a video, which went viral, that showed their daughter during one of her self-abusive episodes. When her father gave her vaporized cannabis, Kara stopped hitting herself within minutes. Less than three months later, Mark testified in favor of a similar bill from Lucio last session, which gained bipartisan momentum but never made it to the House floor for a vote.

In the midst of last session, someone reported Mark to Child Protective Services, which opened a child abuse investigation. The family was able to keep custody of Kara, but her father was added to an abuse and neglect registry. When Kara turned 18 and was no longer a minor, the family worried the CPS investigation would interfere with their case to remain her legal guardians. They were ultimately successful, but facing potential arrest and losing Kara for giving her medicinal cannabis remains a source of worry.

Medical marijuana advocates had reason to be optimistic going into this legislative session: the Texas GOP platform last year was amended to include expanding the Compassionate Use Act, and recent polling shows a vast majority of Texans support access to medical marijuana.

With limited time this session remaining, Lucio says he remains “fully committed” to getting his bill through the process, though he acknowledged it would take a “heavy lift” in the Senate. He told the Observer that he’s in talks with Senator Donna Campbell, a New Braunfels Republican who is an emergency room doctor, about carrying the bill, and said a House vote overwhelmingly supporting the measure will be a “great message to send the Senate and the Governor’s office.”

Meanwhile, each delay in a legislative solution is “heartbreaking,” said Christy, who describes a roller coaster of optimism and frustration around progress since last session. Her family has been in Texas for nine generations, and Mark has described himself as a lifelong Republican. But fighting for legal and safe access to their daughter’s treatment has changed their loyalties. “I’ve always loved Texas … now I’m not so proud,” Christy told the Observer. “I haven’t been able to really get over that some representatives tend be so uncaring.” She tries to stay optimistic too, but without action from lawmakers soon, “I’m not sure we’re going to be able to continue to live here and provide [Kara] an adequate life,” she said. The cover photo on Kara’s Facebook account, run by her parents, captures the sentiment: Governor Greg Abbott’s slogan “Anything is possible in Texas” is modified to add “except medical marijuana.”