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Full Opinion
Opinion
The Compassionate Use Act of 1996 (Act; Health & Saf. Code, § 11362.5, added by voter initiative, Prop. 215, Gen. Elec. (Nov. 5, 1996)) provides partial immunity for the possession and cultivation of marijuana to two groups of people; qualified medical marijuana patients and their primary caregivers. We consider here who may qualify as a primary caregiver. We hold that a defendant whose caregiving consisted principally of
Factual and Procedural Background
In 2003, Roger William Mentch was arrested and charged with the cultivation of marijuana (Health & Saf. Code, § 11358)
Prosecution Evidence
Heidi Roth, a teller at Monterey Bay Bank, testified that she became familiar with Mentch over the period of February to April 2003. Mentch came to the bank on several occasions and made large deposits of cash in small bills, each deposit totaling over $2,000. Roth noticed that some of the money Mentch deposited smelled so strongly of marijuana that the smell filled the bank, and the bank had to remove the money from circulation. The total amount Mentch deposited with the bank over a two-month period was $10,750. On April 15, 2003, Roth filed a suspicious activity report with the Santa Cruz County Sheriffâs Office, relating the questionable nature of Mentchâs deposits.
After further investigation, the sheriffâs office obtained a warrant to search Mentchâs house for marijuana. On June 6, 2003, Mark Yanez, a narcotics investigator, and four deputies went to Mentchâs house to serve the warrant. When Mentch opened the door, Yanez told him they had a warrant to search his house for marijuana. Mentch told Yanez that he had a medical recommendation for marijuana. A search of Mentchâs person turned up $253 in cash and a small vial of hash oil, or concentrated cannabis. Yanez advised Mentch of his rights and interviewed him in a police vehicle parked outside Mentchâs residence.
A search of Mentchâs residence revealed several elaborate marijuana growing setups. In various rooms of the house, the deputies found 82 marijuana plants in the flowering or budding stage, 57 âcloneâ marijuana plants, 48 marijuana plants in the growing or vegetative stage, and three âmotherâ plants, which Yanez opined were likely the female plants from which clippings were taken to make the clone plants. Considering the evidence seized from Mentchâs bank and residence, as well as his statement to Yanez, Yanez opined that while Mentch may have personally consumed some of the marijuana he grew, his operation was primarily a for-profit commercial venture.
Defense Evidence
Leland Besson testified that he had known Mentch for two years. In June 2003, Besson was on disability and had a medical marijuana recommendation for a bad back, neck, and joints. At the time, he was smoking approximately two to three grams of marijuana a day. For about one year before Mentch was arrested, Besson purchased his marijuana exclusively from Mentch, who knew about Bessonâs medical marijuana recommendation. Mentch supplied medical marijuana through his business, the Hemporium. Besson gave Mentch $150 to $200 in cash every month for one and one-half ounces of marijuana, the amount Besson usually consumed in a month.
Laura Eldridge testified she had known Mentch for about three years. In June 2003, she was working as a caretaker for Besson, cooking and cleaning for him, driving him to the grocery store, and driving him to medical appointments and to pick up his medications. Eldridge also drove Besson to Mentchâs house to get him his marijuana. The only time Besson saw Mentch was when Eldridge took him to Mentchâs house to get marijuana.
At the time, Eldridge herself had a medical marijuana recommendation for migraine headaches and posttraumatic stress disorder. She was smoking about five or six marijuana cigarettes a day and consuming about one ounce of marijuana a month. Eldridge obtained marijuana exclusively from Mentch for approximately one and one-half years before his arrest. Mentch provided the marijuana through his medical marijuana business, the Hemporium. Eldridge obtained the marijuana from Mentch every month, paying him $200 to $250
Eldridge was at Mentchâs house getting her daughter ready for school on the morning of Mentchâs arrest. At the time, she and Mentch were not living together but were seeing each other romantically, and Eldridge had stayed over at Mentchâs house the night before the search warrant was served.
Mentch took the stand in his own defense. In 2002, he obtained a medical marijuana recommendation and began growing marijuana. He learned how to grow marijuana from reading books, searching the Internet, and talking to people. He kept marijuana plants in all three stages of growth so that he was in a constant cycle of marijuana production, which produced a yield of four harvests a year. Mentchâs medical marijuana recommendation was still current on the day the police searched his home. At that time, he smoked four to six marijuana cigarettes a day (approximately one-sixteenth of an ounce) and consumed between one and one-half to two ounces of marijuana a month.
Mentch opened the Hemporium, a caregiving and consultancy business, in March 2003. The purpose of the Hemporium was to give people safe access to medical marijuana. Mentch regularly provided marijuana to five other individuals, including Besson, Eldridge, and a man named Mike Manstock. Sometimes he did not charge them. All five individuals had valid medical marijuana recommendations. Mentch did not provide marijuana to anyone who did not have a medical marijuana recommendation. Occasionally, he took any extra marijuana he had to two different cannabis clubs, The Third Floor and another unnamed place. Although a majority of the marijuana plants in Mentchâs home belonged to him, some belonged to Manstock. In addition, Mentch let Besson and Eldridge grow one or two plants.
Mentch provided marijuana to Besson about once every month and to Eldridge about once or twice every month. On average, they each gave him $150 to $200 for an ounce and a half of marijuana a month. Mentch considered his marijuana âhigh-gradeâ and provided it to Besson and Eldridge for less than street value. He used the money they paid him to pay for ânutrients, utilities, part of the rent.â Mentch did not profit from his sales of marijuana, and sometimes he did not even recover his costs of growing it. Mentch counseled his patients/customers about the best strains of marijuana to grow for their ailments and the cleanest way to use the marijuana. He took a âcouple of themâ to medical appointments on a âsporadicâ basis.
Although Mentch asked all five patients to come to court and testify on his behalf, only Besson and Eldridge showed up. He did not subpoena the others
The Primary Caregiver Defense
Before trial, the prosecutor filed a motion in limine to exclude any references by counsel during voir dire, testimony, or closing argument to Mentchâs being a âprimary caregiverâ for Eldridge or Besson.
After Eldridge and Besson testified, the com! concluded the evidence was insufficient to show that Mentch had provided primary caregiver services. Mentch argued in a brief to the court that a person could qualify as a patientâs primary caregiver whenever he or she consistently assumed responsibility for a patientâs health by providing medical marijuana upon a doctorâs recommendation or approval. The trial court rejected the argument.
During the subsequent discussion of jury instructions after the close of evidence, Mentch requested the standard jury instruction for affirmative defenses under the Act (CALJIC No. 12.24.1) on the theory that he was both a qualified patient entitled to cultivate marijuana for himself and a primary caregiver entitled to cultivate marijuana and possess it for sale to others. The trial court agreed to give the instruction insofar as it articulated a qualified patient defense but, consistent with its prior rulings, omitted the optional portion of the instruction relating to the primary caregiver defense.
So instructed, the jury convicted Mentch of both cultivation and possession for sale. (§§ 11358, 11359.) The trial court suspended imposition of sentence and imposed three yearsâ probation.
The Court of Appeal reversed Mentchâs convictions. It concluded: âWhere, as here, [Mentch] presented evidence that he not only grew medical marijuana for several qualified patients, but also counseled them on the best varieties to grow and use for their ailments and accompanied them to medical appointments, albeit on a sporadic basis, there was enough evidence to present to the jury.â Because there was sufficient evidence to support an instruction on the primary caregiver defense, the trial court erred by redacting all references to it in CALJIC No. 12.24.1. (See People v. Michaels (2002) 28 Cal.4th 486, 529 [122 Cal.Rptr.2d 285, 49 P.3d 1032] [defendant has a right to have the trial court give a jury instruction on any affirmative defense for which the record contains substantial evidence].)
We granted review to address the meaning of âprimary caregiverâ under the Act.
Discussion
I. The Primary Caregiver Defense
A. The Meaning of âPrimary Caregiverâ
We interpret voter initiatives using the same principles that govern construction of legislative enactments. (Professional Engineers in California Government v. Kempton (2007) 40 Cal.4th 1016, 1037 [56 Cal.Rptr.3d 814, 155 P.3d 226].) Thus, we begin with the text as the first and best indicator of intent. (Ibid.; Elsner v. Uveges (2004) 34 Cal.4th 915, 927 [22 Cal.Rptr.3d 530, 102 P.3d 915].) If the text is ambiguous and supports multiple interpretations, we may then turn to extrinsic sources such as ballot summaries and arguments for insight into the votersâ intent. (Professional Engineers, at
Section 11362.5, subdivision (d) provides: âSection 11357, relating to the possession of marijuana, and Section 11358, relating to the cultivation of marijuana, shall not apply to a patient, or to a patientâs primary caregiver, who possesses or cultivates marijuana for the personal medical purposes of the patient upon the written or oral recommendation or approval of a physician.â In turn, section 11362.5, subdivision (e) defines âprimary caregiverâ as âthe individual designated by the person exempted under this section who has consistently assumed responsibility for the housing, health, or safety of that person.â
This statutory definition has two parts: (1) a primary caregiver must have been designated as such by the medicinal marijuana patient; and (2) he or she must be a person âwho has consistently assumed responsibility for the housing, health, or safety ofâ the patient. It is clear from the structure of subdivision (e) of section 11362.5 that this latter part of the definition has additional restrictive power, or else the subdivision would have ended with the phrase âby the person exempted under this section,â thereby allowing every patient to designate one person without limitation. Thus, to qualify for exemption under this subdivision, a person must satisfy both halvesâthe âdesigneeâ clause and the âresponsibilityâ clause. (See People v. Mower (2002) 28 Cal.4th 457, 475 [122 Cal.Rptr.2d 326, 49 P.3d 1067] [âFor a person to be a qualified primary caregiver, he or she must be âdesignatedâ as such by a qualified patient, and must have âconsistently assumed responsibilityâ for the qualified patientâs âhousing, health, or safety.â â (Italics added.)].) Designation is necessary, but not sufficient. (People v. Urziceanu (2005) 132 Cal.App.4th 747, 773 [33 Cal.Rptr.3d 859]; People ex rel. Lungren v. Peron (1997) 59 Cal.App.4th 1383, 1397 [70 Cal.Rptr.2d 20].)
Three aspects of the structure of the responsibility clause are noteworthy. From these aspects, as we shall explain, we conclude a defendant asserting primary caregiver status must prove at a minimum that he or she (1) consistently provided caregiving, (2) independent of any assistance in taking medical marijuana, (3) at or before the time he or she assumed responsibility for assisting with medical marijuana.
First, the text requires that the primary caregiver have âconsistentlyâ assumed responsibility for the patientâs care. âConsistentlyâ suggests an ongoing relationship marked by regular and repeated actions over time. In People ex rel. Lungren v. Peron, supra, 59 Cal.App.4th 1383, for example, the many customers of a marijuana club, the Cannabis Buyersâ Club,
Second, the definition of a primary caregiver is written using a past participleâ-âhas consistently assumed.â (§ 11362.5, subd. (e).) This reinforces the inference arising from the use of the word âconsistentlyâ that primary caregiver status requires an existing, established relationship. In some situations, the formation of a bona fide caregiving relationship and the onset of assistance in taking medical marijuana may be contemporaneous, as with a cancer patient entering chemotherapy who has a recommendation for medical marijuana use and has a live-in or home-visit nurse to assist with all aspects of his or her health care, including marijuana consumption. (See § 11362.7, subd. (d)(1) [primary caregiver may include employees of hospice or home health agency].) Even in this scenario, however, the caregiving relationship will arise at or before the onset of assistance in the administration of marijuana. What is not permitted is for an individual to establish an after-the-fact caregiving relationship in an effort to thereby immunize from prosecution previous cultivation or possession for sale. (Cf. People v. Rigo (1999) 69 Cal.App.4th 409, 412-415 [81 Cal.Rptr.2d 624] [doctor may not give postarrest recommendation to bless prior use].)
Third, from these two aspects of the text, as well as logic, we draw a further inference: a primary caregiver must establish he or she satisfies the responsibility clause based on evidence independent of the administration of medical marijuana. Under the Act, a primary caregiver relationship is a necessary antecedent, a predicate for being permitted under state law to possess or cultivate medical marijuana. The possession or cultivation of marijuana for medical purposes cannot serve as the basis for making lawful
We thus agree with the Court of Appeal in People v. Frazier (2005) 128 Cal.App.4th 807, 823 [27 Cal.Rptr.3d 336], which rejected the argument that âa âprimary caregiverâ is a person who âconsistently grows and supplies physician approved marijuana for a medical marijuana patient to serve the health needs of that patientâ . . . .â The Frazier court concluded that, while if one were already qualified as a primary caregiver one could consistently grow and supply medical marijuana to a patient, the consistent growth and supply of medical marijuana would not by itself place one in the class of primary caregivers. (Ibid..; see also People v. Windus (2008) 165 Cal.App.4th 634, 644 [81 Cal.Rptr.3d 227] [âCase law is clear that one who merely supplies a patient with marijuana has no defense under the [Act].â].)
The trial court accurately assessed the law when, in denying Mentchâs request for a primary caregiver instruction, it explained: âIâm satisfied that simply providing marijuana, in and of itself to these folks does notâyou donât bootstrap yourself to becoming the primary caregiver because youâre providing [marijuana]â and âyou have to be a caregiver before you can provide the marijuana.â (Italics added.) Later, in denying Mentchâs motion for a judgment of acquittal (Pen. Code, § 1118.1), the trial court reiterated the point: âThere has to be something more to be a caregiver than simply providing marijuana. Otherwise, there would be no reason to have the definition of a caregiver, because anybody who would be providing marijuana and related services would qualify as a caregiver[,] therefore giving them a defense to the very activity thatâs otherwise illegal, and I donât think that makes any sense in terms of statutory construction, nor do I think it was intended by the people or the Legislature.â
Mentch himself highlights the dog-chasing-its-tail absurdity of allowing the administration of medical marijuana to patients to form the basis for authorizing the administration of medical marijuana to patients in his attempts to
Nothing in the text or in the supporting ballot arguments suggests this is what the voters intended. The words the statute usesâhousing, health, safetyâimply a caretaking relationship directed at the core survival needs of a seriously ill patient, not just one single pharmaceutical need. The ballot arguments in support suggest a patient is generally personally responsible for noncommercially supplying his or her own marijuana: âProposition 215 allows patients to cultivate their own marijuana simply because federal laws prevent the sale of marijuana, and a state initiative cannot overrule those laws.â (Ballot Pamp., Gen. Elec. (Nov. 5, 1996) argument in favor of Prop. 215, p. 60.) But as the focus is on the âseriously and terminally illâ (ibid.), logically the Act must offer some alternative for those unable to act in their own behalf; accordingly, the Act allows â âprimary caregiver[s]â the same authority to act on behalf of those too ill or bedridden to do soâ (People ex rel. Lungren v. Peron, supra, 59 Cal.App.4th at p. 1394). To exercise that authority, however, one must be a âprimaryââprincipal, lead, centralâ âcaregiverââone responsible for rendering assistance in the provision of daily life necessitiesâfor a qualifying seriously or terminally ill patient.
We note in passing that some other states in adopting their own medical marijuana compassionate use acts have adopted substantially different and manifestly broader language in defining their primary caregiver exceptions. In New Mexico, for example, a primary caregiver is âa resident of New Mexico
We have no doubt our interpretation of the statute will pose no obstacle for those bona fide primary caregivers whose ministrations to their patients the Act was actually intended to shield from prosecution. The spouse or domestic partner caring for his or her ailing companion, the child caring for his or her ailing parent, the hospice nurse caring for his or her ailing patientâeach can point to the many ways in which they, medical marijuana aside, attend to and assume responsibility for the core survival needs of their dependents. The Act allows them, insofar as state criminal law is concerned, to add the provision of marijuana, where medically recommended or approved, as one more arrow in their caregiving quiver. It simply does not provide similar protection where the provision of marijuana is itself the substance of the relationship.
B. Sufficiency of the Evidence to Support an Instruction on the Primary Caregiver Affirmative Defense
We turn to the merits of Mentchâs request for a primary caregiver instruction in light of the evidence he adduced and the evidence he sought to adduce.
Mentch relies on three strands of evidence: his alleged provision of shelter to one patient, his taking of other patients to medical appointments, and his ongoing provision of both marijuana and marijuana advice and counseling to all his patients. Even crediting this evidence, as we must for purposes of deciding whether he was entitled to an instruction, we discern a series of interrelated shortcomings. Some of Mentchâs caregiving was independent of providing marijuana, but was not provided at or before the time he began providing marijuana. Some of it may have been at or before the time he began providing marijuana, but was not consistent. And some of it was consistent, but was not independent of providing marijuana. But none of the evidence demonstrated satisfaction of each of the three aspects of the responsibility clause we have identified; none of it was sufficient to raise a reasonable doubt as to whether Mentch had provided his patients consistent caregiving, independent of providing them marijuana, at or before the time he began providing them marijuana.
First, Mentch argues Eldridge moved in shortly before the June 6, 2003, search. Unfortunately for Mentchâs argument, the record directly contradicts this assertion. Eldridge testified she lived elsewhere at the time, and Mentch did not testify to the contrary. Even if the record supported it, however, the argument would not address the lack of any evidence of a primary caregiving relationship during the preceding year and a half during which Mentch was, by his own admission, selling Eldridge marijuana; it would not retroactively bless Mentchâs prior cultivation of marijuana and sale of marijuana to her.
Second, Mentch testified he took âa coupleâ patients to medical appointments âsporadically.â A sporadic assumption of responsibility is the antithesis of a consistent assumption of responsibility; it cannot satisfy the responsibility clause.
There is a final overarching problem with the evidence. Mentch testified to providing marijuana to five patients and also to occasionally growing too much and providing the excess to marijuana clubs. But where, as here, Mentch was charged with single counts of possession and cultivation, primary caregiver status would provide Mentch a defense only if it extended to all the marijuana he possessed or cultivated. Consider, for example, a defendant who testified that he (1) grew marijuana, (2) gave half to his critically ill daughter, a qualified patient for whom he was the designated primary caregiver and by whom he was reimbursed for growing expenses, and (3) sold the other half on the street. However much the primary caregiver defense might protect his actions toward his daughter, it would have no bearing on his case because a portion of his distribution of marijuana for money would be unprotected from state prosecution. Similarly, Mentchâs testimony that he âsporadicallyâ took âa coupleâ of the five patients to medical appointments, and his assertion (unsupported by the record) that he provided Eldridge shelter, would, even if believed, do nothing to insulate from prosecution his cultivation of and sale of marijuana to those for whom he did not provide shelter or nonmarijuana-based health care. (See People v. Urziceanu, supra, 132 Cal.App.4th at p. 773 [rejecting primary caregiver defense because the defendant failed to adduce evidence he was âthe primary caregiver for all of the patients who patronized his cooperativeâ (italics added)].) Nor would it protect him from prosecution for cultivating marijuana and providing it to cannabis clubs. (See People v. Galambos, supra, 104 Cal.App.4th at pp. 1165-1167 [the primary caregiver defense does not extend to supplying marijuana to a cooperative]; People v. Trippet, supra, 56 Cal.App.4th at p. 1546 [noting with approval a ballot pamphlet argument that the Act was not intended to protect â âanyone who grows too much, or tries to sell itâ â]; Ballot Pamp., Gen. Elec. (Nov. 5, 1996) rebuttal to argument against Prop. 215, p. 61.)
II. Defenses Under the Medical Marijuana Program
Before us, Mentch contends in the alternative that the 2003 enactment of the Medical Marijuana Program (Program; § 11362.7 et seq.) provides a defense to cultivation and possession for sale charges for those who give assistance to patients and primary caregivers in (1) administering medical marijuana, and (2) acquiring the skills necessary to cultivate or administer medical marijuana (§ 11362.765, subds. (a), (b)(3)). Accordingly, he argues the trial court breached its duty to give sua sponte instructions on any affirmative defense supported by the evidence. (See People v. Salas, supra, 37 Cal.4th at p. 982.) As Mentch misinterprets the scope and effect of the Program, we conclude the trial court committed no error in failing to instruct on any defense arising from it.
The Program was passed in part to address issues not included in the Act, so as to promote the fair and orderly implementation of the Act and to â[c]larify the scope of the application of the [A]ct.â (Stats. 2003, ch. 875, § 1; see People v. Wright (2006) 40 Cal.4th 81, 93 [51 Cal.Rptr.3d 80, 146 P.3d 531].) As part of its effort to clarify and smooth implementation of the Act, the Program immunizes from prosecution a range of conduct ancillary to the provision of medical marijuana to qualified patients. (§ 11362.765.)
Having closely analyzed the text of section 11362.765, however, we conclude it does not do what Mentch says it does. While the Program does convey additional immunities against cultivation and possession for sale charges to specific groups of people, it does so only for specific actions; it does not provide globally that the specified groups of people may never be charged with cultivation or possession for sale. That is, the immunities conveyed by section 11362.765 have three defining characteristics: (1) they each apply only to a specific group of people; (2) they each apply only to a specific range of conduct; and (3) they each apply only against a specific set of laws. Subdivision (a) provides in relevant part: âSubject to the requirements of this article, the individuals specified in subdivision (b) shall not be
For example, subdivision (b)(1) grants immunity to a âqualified patient or a person with [a Program] identification cardâ who âtransports or processes marijuana for his or her own personal medical use.â (§ 11362.765, subd. (b)(1).) As we explained in People v. Wright, supra, 40 Cal.4th 81, this means a specified groupâqualified patients and Program identification card holdersâmay not be prosecuted under particular state laws for specific conductâtransportation or processing for personal useâthat otherwise might have been criminal. (Id. at p. 94; see id. at p. 92 [recognizing that the Program supersedes statement in People v. Young (2001) 92 Cal.App.4th 229, 237 [111 Cal.Rptr.2d 726], that the Act does not immunize marijuana transportation].)
The same is true of subdivision (b)(2) of section 11362.765, which likewise extends to a specific groupâprimary caregiversâstate immunity for particular conductâtransportation, processing, administration, delivery, or donationâthat might otherwise fall afoul of state law. (See People v. Trippet, supra, 56 Cal.App.4th at p. 1550 [acknowledging that the plain language of the Act, if literally applied, might fail to protect primary caregivers transporting marijuana down a hallway to their patients].)
Finally, as relevant here, subdivision (b)(3) of section 11362.765 grants immunity to a specific group of individualsâthose who assist in administering medical marijuana or acquiring the skills necessary to cultivate itâfor specific conduct, namely, assistance in the administration of, or teaching how to cultivate, medical marijuana.*
Disposition
For the foregoing reasons, we reverse the Court of Appealâs judgment.
George, C. J., Kennard, J., Baxter, J., Chin, J., Moreno, I., and Corrigan, J., concurred.
All further unlabeled statutory references are to the Health and Safety Code.
Mentch was also charged with manufacturing and possessing concentrated cannabis (also known as hash oil) (§§ 11357, subd. (a), 11379.6, subd. (a)), possessing psilocybin mushrooms (§ 11377, subd. (a)), and firearm enhancements for the marijuana and hash oil counts (Pen. Code, § 12022, subd. (a)(1)), but these additional counts have no bearing on the issues in this appeal, and we do not address them further.
The Act extends limited immunity from state prosecution for cultivation or possession to both qualified patients and their designated âprimary caregiver[s].â (§ 11362.5, subd. (d).)
At the time of trial, CALJIC No. 12.24.1 provided: âThe [possession] [or] [cultivation] [or] [transportation] of marijuana is not unlawful when the acts of [defendant] [a primary caregiver] are authorized by law for compassionate use. The [possession] [or] [cultivation] [or] [transportation] of marijuana is lawful (1) where its medical use is deemed appropriate and has been recommended or approved, orally or in writing, by a physician; (2) the physician has determined that the personâs health would benefit from the use of marijuana in the treatment of cancer, anorexia, AIDS, chronic pain, spasticity, glaucoma, arthritis, migraine, or any other illness for which marijuana provides relief; [and] (3) the marijuana [possessed] [cultivated] [transported] was for the personal medical use of [the patient] [_][.] [; and (4) the quantity of marijuana [[possessed] [or] [cultivated], and the form in which it was possessed were reasonably related to the [patientâs] [_] then current medical needs[.]] [transported, and the method, timing and distance of the transportation were reasonably related to the [patientâs] [_] then current medical needs.] [][] [A âprimary caregiverâ is an individual designated by [the person exempted] [ (name) ] who has consistently assumed responsibility for the housing, health, or safety of that person.] [1] [âRecommendationâ and âapprovalâ have different meanings. To ârecommendâ something is to present it as worthy of acceptance or trial. To
In holding that the assumption of primary caregiver responsibilities cannot apply retroactively to immunize prior cultivation or possession of marijuana, we do not suggest it would not apply prospectively. Defendants who show they satisfied all other prerequisites for primary caregiver status for a given patient at some point after the onset of providing marijuana may avail themselves of the defense going forward, even if they remain subject to prosecution for actions taken prior to assumption of a primary caregi