H.F. 2097 Section 1. Section 124D.2, Code 2016, is amended by striking 1 the section and inserting in lieu thereof the following: 2 124D.2 Definitions. 3 As used in this chapter: 4 1. “Cannabidiol” means a nonpsychoactive cannabinoid found 5 in the plant Cannabis sativa L. or Cannabis indica or any 6 other preparation thereof that is essentially free from plant 7 material, and has a tetrahydrocannabinol level of no more than 8 three percent. 9 2. “Debilitating medical condition” means all of the 10 following: 11 a. Crohn’s disease. 12 b. Epilepsy. 13 c. Ulcerative colitis. 14 3. “Department” means the department of public health. 15 4. “Physician” means an individual licensed under the 16 provisions of chapter 148 to practice medicine and surgery or 17 osteopathic medicine and surgery. 18 5. “ Primary caregiver” means a person, at least eighteen 19 years of age, who has been designated by a patient’s physician 20 or by a person having custody of a patient, as being necessary 21 to take responsibility for managing the well-being of the 22 patient with respect to the medical use of cannabidiol pursuant 23 to the provisions of this chapter. 24 Sec. 2. Section 124D.3, Code 2016, is amended to read as 25 follows: 26 124D.3 Neurologist Physician recommendation —— medical use 27 of cannabidiol. 28 A neurologist physician who has examined and treated a 29 patient suffering from intractable epilepsy a debilitating 30 medical condition may provide but has no duty to provide 31 a written recommendation for the patient’s medical use of 32 cannabidiol to treat or alleviate symptoms of intractable 33 epilepsy the debilitating medical condition if no other 34 satisfactory alternative treatment options exist for the 35 -1- LSB 5294YH (4) 86 rh/rj 1/ 5

H.F. 2097 patient and all of the following conditions apply: 1 1. The patient is a permanent resident of this state. 2 2. A neurologist The physician has treated the patient for 3 intractable epilepsy the debilitating medical condition for 4 at least six months. For purposes of this treatment period, 5 and notwithstanding section 124D.2, subsection 4 , treatment 6 provided by a neurologist the physician may include treatment 7 by an out-of-state licensed neurologist physician in good 8 standing. 9 3. The neurologist physician has tried alternative 10 treatment options that have not alleviated the patient’s 11 symptoms. 12 4. The neurologist physician determines the risks of 13 recommending the medical use of cannabidiol are reasonable in 14 light of the potential benefit for the patient. 15 5. The neurologist physician maintains a patient treatment 16 plan. 17 Sec. 3. Section 124D.4, subsection 1, paragraph c, Code 18 2016, is amended to read as follows: 19 c. Requests the patient’s neurologist physician to submit 20 a written recommendation to the department signed by the 21 neurologist physician that the patient may benefit from the 22 medical use of cannabidiol pursuant to section 124D.3 . 23 Sec. 4. Section 124D.4, subsection 1, paragraph d, 24 subparagraph (3), Code 2016, is amended to read as follows: 25 (3) Full name, address, and telephone number of the 26 patient’s neurologist physician . 27 Sec. 5. Section 124D.4, subsection 3, paragraph b, Code 28 2016, is amended to read as follows: 29 b. Requests a patient’s neurologist physician to submit 30 a written recommendation to the department signed by the 31 neurologist physician that a patient in the primary caregiver’s 32 care may benefit from the medical use of cannabidiol pursuant 33 to section 124D.3 . 34 Sec. 6. Section 124D.4, subsection 3, paragraph c, 35 -2- LSB 5294YH (4) 86 rh/rj 2/ 5

H.F. 2097 subparagraph (4), Code 2016, is amended to read as follows: 1 (4) Full name, address, and telephone number of the 2 patient’s neurologist physician . 3 Sec. 7. Section 124D.6, subsections 1, 2, and 3, Code 2016, 4 are amended to read as follows: 5 1. a. A recommendation for the possession or use of 6 cannabidiol as authorized by this chapter shall be provided 7 exclusively by a neurologist physician for a patient who has 8 been diagnosed with intractable epilepsy a debilitating medical 9 condition . 10 b. Cannabidiol provided exclusively pursuant to the 11 recommendation of a neurologist physician shall be obtained 12 from an out-of-state source and shall only be recommended for 13 oral or transdermal administration. 14 c. A neurologist physician shall be the sole authorized 15 recommender as part of the treatment plan by the neurologist 16 physician of a patient diagnosed with intractable epilepsy 17 a debilitating medical condition . A neurologist physician 18 shall have the sole authority to recommend the use or amount 19 of cannabidiol, if any, in the treatment plan of a patient 20 diagnosed with intractable epilepsy a debilitating medical 21 condition . 22 2. A neurologist physician , including any authorized agent 23 thereof, shall not be subject to prosecution for the unlawful 24 recommendation, possession, or administration of marijuana 25 under the laws of this state for activities arising directly 26 out of or directly related to the recommendation or use of 27 cannabidiol in the treatment of a patient diagnosed with 28 intractable epilepsy a debilitating medical condition . 29 3. a. In a prosecution for the unlawful possession of 30 marijuana under the laws of this state, including but not 31 limited to chapters 124 and 453B , it is an affirmative and 32 complete defense to the prosecution that the patient has 33 been diagnosed with intractable epilepsy a debilitating 34 medical condition , used or possessed cannabidiol pursuant to 35 -3- LSB 5294YH (4) 86 rh/rj 3/ 5

H.F. 2097 a recommendation by a neurologist physician as authorized 1 under this chapter , and, for a patient eighteen years of age 2 or older, is in possession of a valid cannabidiol registration 3 card. 4 b. In a prosecution for the unlawful possession of 5 marijuana under the laws of this state, including but not 6 limited to chapters 124 and 453B , it is an affirmative and 7 complete defense to the prosecution that the person possessed 8 cannabidiol because the person is a primary caregiver of a 9 patient who has been diagnosed with intractable epilepsy a 10 debilitating medical condition and is in possession of a 11 valid cannabidiol registration card, and where the primary 12 caregiver’s possession of the cannabidiol is on behalf of the 13 patient and for the patient’s use only as authorized under this 14 chapter . 15 c. (1) The defenses afforded a patient under paragraph 16 “a” apply to a patient only if the quantity of cannabidiol oil 17 possessed by the patient does not exceed thirty-two ounces. 18 (2) The defenses afforded a primary caregiver under 19 paragraph “b” apply to a primary caregiver only if the quantity 20 of cannabidiol oil possessed by the primary caregiver does not 21 exceed thirty-two ounces per patient. 22 d. If a patient or primary caregiver is charged with 23 the commission of a crime and is not in possession of the 24 person’s cannabidiol registration card, any charge or charges 25 filed against the person shall be dismissed by the court if 26 the person produces to the court at the person’s trial a 27 cannabidiol registration card issued to that person and valid 28 at the time the person was charged. 29 EXPLANATION 30 The inclusion of this explanation does not constitute agreement with 31 the explanation’s substance by the members of the general assembly. 32 This bill relates to the medical use of cannabidiol for 33 certain debilitating medical conditions and makes penalties 34 applicable. 35 -4- LSB 5294YH (4) 86 rh/rj 4/ 5

H.F. 2097 Under current law in Code chapter 124D (Iowa’s medical 1 cannabidiol Act), a neurologist who has examined and treated 2 a person suffering from intractable epilepsy may provide, but 3 does not have a duty to provide, a written recommendation for 4 the patient’s medical use of cannabidiol to treat or alleviate 5 the symptoms of the person’s intractable epilepsy. The Code 6 chapter includes additional provisions relating to patients and 7 primary caregivers including cannabidiol registration cards, 8 confidentiality, and affirmative defenses and penalties. 9 This bill amends current law to provide that a licensed 10 physician who has examined and treated a patient suffering 11 from a debilitating medical condition (defined as Crohn’s 12 disease, epilepsy, or ulcerative colitis) may provide, but does 13 not have a duty to provide, a written recommendation for the 14 patient’s medical use of cannabidiol to treat or alleviate the 15 symptoms of the person’s debilitating medical condition. The 16 bill defines a “physician” as an individual licensed under the 17 provisions of Code chapter 148 to practice medicine and surgery 18 or osteopathic medicine and surgery; however, for purposes of 19 the treatment period, treatment provided by a physician may 20 include treatment by an out-of-state licensed physician in good 21 standing. 22 A person who knowingly or intentionally possesses or uses 23 cannabidiol in violation of the Code chapter is subject to the 24 penalties of Code chapters 124 (Controlled Substances Act) and 25 453B (Excise Tax on Unlawful Dealing in Certain Substances). 26 -5- LSB 5294YH (4) 86 rh/rj 5/ 5