SALT LAKE CITY — The Utah Legislature on Monday signaled overwhelming support for a sweeping medical marijuana compromise bill fraught with complexity and political risk, but which nonetheless enjoyed broad support among key groups both for and against Proposition 2.

During a special legislative session lawmakers spent weeks preparing for, both the Utah Senate and House of Representatives voted by large margins to pass a wide-ranging medical marijuana bill replacing the ballot initiative voters approved Nov. 6.

Following about two hours of debate on the House floor, the bill was approved by a 60-13 vote. Just one Republican, Rep. Michael Kennedy of Alpine, voted against the bill, while every Democrat present voted against it.

After more than 90 minutes of consideration on the Senate floor, the bill sailed through with a 22 to 4 vote. Sen. Gene Davis, D-Salt Lake City, expressed some concerns with the compromise but voted for it. Besides him, all Democrats present opposed the bill while Republicans broke uniformly in favor of it.

Passing with more than two-thirds support allows the new bill to go into effect immediately, said Senate President Wayne Niederhauser. Gov. Gary Herbert announced Monday evening he had signed the bill, saying Utah "now has the best-designed medical cannabis program in the country."

"Working with trained medical professionals, qualified patients in Utah will be able to receive quality-controlled cannabis products from a licensed pharmacist in medical dosage form. And this will be done in a way that prevents diversion of product into a black market.

"This is an example of how collaboration makes Utah the best-managed state in the nation. Proponents and opponents came together to honor the voice of Utah voters who compassionately stood up for Utah patients. They provided for access to medical cannabis, while closing loopholes that have created significant problems in other states that have legalized medical cannabis."

Utah House Speaker Greg Hughes believes Monday's votes make Utah's medical marijuana program "structurally stronger and politically stronger" than it would have otherwise been.

"I think what you've seen here is extraordinary, and I think it's needed, frankly," Hughes told the Deseret News. "If we're going to get it done right you can't put your head in the sand and wait for the consequences to come."

The decisive votes Monday come about two months after major players for and against Proposition 2 announced an agreement to support the core contents of a sweeping compromise bill that would essentially replace the initiative. At the same time, Herbert announced he would call a special session to get the compromise legislation passed.

The consensus was reached after dozens of hours of private negotiations convened by Hughes, R-Draper. The groups in those talks were the Proposition 2 campaign itself, called the Utah Patients Coalition; Libertas Institute, which had supported the initiative; and influential anti-Proposition 2 groups the Utah Medical Association and The Church of Jesus Christ of Latter-day Saints.

In a statement Monday evening, Marty Stephens, director of community and government relations for the church, said, "The Church of Jesus Christ of Latter-day Saints welcomed the opportunity to participate in a broad community effort to alleviate pain and suffering.

"Today the passage of the Utah Medical Cannabis Act once again shows how organizations with diverse interests can come together to resolve difficult issues for the benefit of those who suffer while simultaneously protecting our children. We thank the leadership of the state, the medical professionals, patients advocates, law enforcement and the many others who made this effort possible."

Hughes told his fellow lawmakers he is proud of the efforts that brought together opposing sides and crafted a bill that each could hold up as worth supporting. He said he also stands by the process of refining the compromise, which involved multiple, lengthy public hearings, as well as private meetings between legislators.

"The bill you have before you today is a product in large part of the ongoing public input," Hughes said on the House floor.

Sen. Evan Vickers, R-Cedar City, who co-sponsored the bill in the Senate, said it "allows for medical professionals to be dealing with the patient all the way through."

"I think this (bill) does that," Vickers said on the senate floor. "It's just time to move forward, and let's get it done."

Utah patients group Together for Responsible Use and Cannabis Education promised it wasn't giving up its fight to preserve Proposition 2 as much as possible, with founder Christine Stenquist saying she will be "moving forward" with a lawsuit on the issue.

Stenquist said the lawsuit could be filed as soon as Tuesday through attorney Rocky Anderson, a former Salt Lake City mayor, who has already served notice to sue.

"The citizens of Utah jumped through the hoops that they needed to jump through to pass an initiative and the first business day (that it is in effect) you undermine and you remove our voice. That's a problem," Stenquist told reporters at the state Capitol.

Together for Responsible Use and Cannabis Education, along with the Epilepsy Association of Utah, have argued the compromise bill makes patient access to medical marijuana significantly more difficult.

Proposition 2, which became law Saturday and made medical marijuana available to patients with certain qualifying illnesses, passed with support from nearly 53 percent of Utah voters.

The compromise bill sponsored by Hughes proposes significant changes to how medical marijuana could legally be recommended, sold and consumed. It removes a hotly contested provision allowing patients living a certain distance from a dispensary to grow up to six marijuana plants.

It also narrows a controversial provision that gives a person an "affirmative defense" to marijuana use or possession charges if they can prove their medical need despite not possessing a medical cannabis card.

Floor debate

In the debate over Hughes' bill, Democrats' main refrain Monday was that doing so would be disrespectful to the ballot initiative process that made Proposition 2 the law in Utah.

Rep. Rebecca Chavez-Houck, D-Salt Lake City, said she would ask for "the members of this body to stay in our lane. The voters have spoken."

"We don't need to hyper regulate the lives of patients and providers," Chavez-Houck said.

Sen. Jim Dabakis, D-Salt Lake City, said voting for a bill to supersede Proposition 2 shows "a level of arrogance we ought not to display to the rest of the state."

"This body has its own opinion and I respect that, but I ask that this body respect the will of the voters (from) where we get our power," Dabakis said.

However, a pair of bills Dabakis presented as substitutes to Hughes' bill — one of them making only technical changes — were handily defeated. So was a proposed bill substitute introduced by Chavez-Houck.

Rep. Merrill Nelson, R-Grantsville, pushed back at the notion that a ballot initiative is incontrovertible once passed. Just like the people have lawmaking powers, so do the legislators they elect, Nelson said.

"We have the right to override what the people do by initiative. Now, we don't do that willy-nilly. The only reason we're here today is we see errors in the initiative passed by the people — we see (excesses)," Nelson said.

Sen. Lyle Hillyard was among a handful of legislators to say he didn't feel compelled to preserve a ballot initiative that most of the people in his jurisdiction voted against.

"I … could be justified on (my constituents') vote to vote to repeal Proposition 2, period," Hillyard said, though he was quick to add that was never something he planned to do.

Hillyard also said he was skeptical of arguments made by some Proposition 2 supporters that the process for drafting the compromise bill was secretive.

"I don't know how many here sat through the drafting of Proposition 2," Hillyard said.

Amendments fail

The majority of legislators resisted multiple attempts to materially amend the bill.

In the House, Rep. Brian Greene, R-American Fork, wanted to remove a provision requiring patients ages 18 to 20 who wish to get a medical cannabis card to get additional approval — beyond that of their doctor — from the state-appointed Compassionate Use Board.

Greene said requiring governmental approval of what amounts to a prescription inappropriately gets between adult patients and their doctor.

"This is a terrible precedent to set where we're going to require the approval of a the governmental board in … what our doctor has prescribed to us," Greene said.

However, Hughes and others pushed back saying the extra requirement was put in place as a precaution in light of research showing THC, marijuana's active ingredient, can be harmful to young people's developing brains.

Greene's amendment failed to gain enough support.

In the Senate, Sen. Luz Escamilla, D-Salt Lake City, pushed to get an amendment requiring members of the state-appointed Compassionate Use Board be subject to senators' confirmation.

"This will be a critical group of individuals," Escamilla said.

But her proposed amendment fell short, too, even though Vickers and others said they could support the idea in the general legislative session.

Implications for patients

So, when may Utahns legally use medical cannabis?

"Right now," Hughes said. "It is no longer illegal in the eyes of the state to access medical cannabis."

A resident, though, must be under the supervision of a doctor who recommended medical marijuana and the drug must be taken in dosage form. That means eligible patients under could go to neighboring Colorado or Nevada and bring medical marijuana into the state without violating Utah law.

Hughes said police might cite people for marijuana possession even under those circumstances, but if they can prove they were meeting the requirements, "you are not committing a crime."

"We like our system better than that system, so that's kind of the race to get the state system up and running," Hughes said.

Setting up the state central fill dispensary system and establishing state-licensed cannabis pharmacies are still down the road.

Changes made

Some of the other significant adjustments the compromise bill makes compared to Proposition 2 are as follows:

• Removes Proposition 2 language permitting anyone with "an autoimmune disorder" to qualify for a medical cannabis card.

• Requires businesses selling medical marijuana to employ a licensed pharmacist, changes the name from dispensaries to pharmacies, and allows fewer such businesses to operate in the state.

• Limits the authorized forms of medical marijuana consumption to a capsule, chewable or dissolvable gelatin cube, concentrated oil, liquid suspension, skin patch, sublingual pill, or in limited circumstances, a resin or wax.

• Removes a restriction on landlords prohibiting them from refusing to rent to a person on the sole basis that they are a medical cannabis cardholder.