Senate File 506 - Reprinted SENATE FILE 506 BY COMMITTEE ON APPROPRIATIONS (SUCCESSOR TO SSB 1190) (As Amended and Passed by the Senate April 17, 2017 ) A BILL FOR An Act concerning the compassionate use of medical 1 cannabis Act, reclassifying marijuana, including 2 tetrahydrocannabinols, from a schedule I controlled 3 substance to a schedule II controlled substance, providing 4 for civil and criminal penalties and fees, and including 5 effective date provisions. 6 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 7 SF 506 (2) 87 rh/rj/jh

S.F. 506 Section 1. Section 124.204, subsection 4, paragraphs m and 1 u, Code 2017, are amended by striking the paragraphs. 2 Sec. 2. Section 124.204, subsection 7, Code 2017, is amended 3 by striking the subsection. 4 Sec. 3. Section 124.206, subsection 7, Code 2017, is amended 5 to read as follows: 6 7. Hallucinogenic substances. Unless specifically excepted 7 or unless listed in another schedule, any material, compound, 8 mixture, or preparation which contains any quantity of the 9 following substances , or, for purposes of paragraphs “a” and 10 “b” , which contains any of its salts, isomers, or salts of 11 isomers whenever the existence of such salts, isomers, or salts 12 of isomers is possible within the specific chemical designation 13 (for purposes of this paragraph only, the term “isomer” 14 includes the optical, positional, and geometric isomers) : 15 a. Marijuana when used for medicinal purposes pursuant to 16 rules of the board . 17 b. Tetrahydrocannabinols, meaning tetrahydrocannabinols 18 naturally contained in a plant of the genus cannabis (cannabis 19 plant) as well as synthetic equivalents of the substances 20 contained in the cannabis plant, or in the resinous extractives 21 of such plant, and synthetic substances, derivatives, and their 22 isomers with similar chemical structure and pharmacological 23 activity to those substances contained in the plant, such as 24 the following: 25 (1) 1 cis or trans tetrahydrocannabinol, and their optical 26 isomers. 27 (2) 6 cis or trans tetrahydrocannabinol, and their optical 28 isomers. 29 (3) 3,4 cis or trans tetrahydrocannabinol, and their 30 optical isomers. (Since nomenclature of these substances 31 is not internationally standardized, compounds of these 32 structures, regardless of numerical designation of atomic 33 positions covered.) 34 b. c. Nabilone [another name for nabilone: (+-) - 35 -1- SF 506 (2) 87 rh/rj/jh 1/ 21

S.F. 506 trans-3-(1,1-dimethylheptyl)-6,6a,7,8,10,10a-hexahydro-1- 1 hydroxy-6,6-dimethyl-9H-dibenzo[b,d]pyran-9-one]. 2 Sec. 4. Section 124.401, subsection 5, unnumbered paragraph 3 3, Code 2017, is amended to read as follows: 4 A person may knowingly or intentionally recommend, possess, 5 use, dispense, deliver, transport, or administer cannabidiol 6 medical cannabis if the recommendation, possession, use, 7 dispensing, delivery, transporting, or administering is in 8 accordance with the provisions of chapter 124D 124E . For 9 purposes of this paragraph, “cannabidiol” ”medical cannabis” 10 means the same as defined in section 124D.2 124E.2 . 11 Sec. 5. NEW SECTION . 124E.1 Short title. 12 This chapter shall be known and may be cited as the 13 “Compassionate Use of Medical Cannabis Act” . 14 Sec. 6. NEW SECTION . 124E.2 Definitions. 15 As used in this chapter: 16 1. “Debilitating medical condition” means any of the 17 following: 18 a. Cancer, if the underlying condition or treatment produces 19 one or more of the following: 20 (1) Intractable pain. 21 (2) Nausea or severe vomiting. 22 (3) Cachexia or severe wasting. 23 b. Multiple sclerosis. 24 c. Epilepsy or seizure disorders. 25 d. AIDS or HIV as defined in section 141A.1. 26 e. Glaucoma. 27 f. Hepatitis C. 28 g. Crohn’s disease or ulcerative colitis. 29 h. Amyotrophic lateral sclerosis. 30 i. Ehlers-Danlos syndrome. 31 j. Post-traumatic stress disorder. 32 k. Tourette’s syndrome. 33 l. Any terminal illness, with a probable life expectancy of 34 under one year, if the illness or its treatment produces one or 35 -2- SF 506 (2) 87 rh/rj/jh 2/ 21

S.F. 506 more of the following: 1 (1) Intractable pain. 2 (2) Nausea or severe vomiting. 3 (3) Cachexia or severe wasting. 4 m. Intractable pain. 5 n. Parkinson’s disease. 6 o. Muscular dystrophy. 7 p. Huntington’s disease. 8 q. Alzheimer’s disease. 9 r. Complex regional pain syndrome, type I and II. 10 s. Rheumatoid arthritis. 11 t. Polyarteritis nodosa. 12 u. Any other chronic or debilitating disease or medical 13 condition or its medical treatment approved by the department 14 pursuant to rule. 15 2. “Department” means the department of public health. 16 3. “Disqualifying felony offense” means a violation under 17 federal or state law of a felony offense, which has as an 18 element the possession, use, or distribution of a controlled 19 substance, as defined in 21 U.S.C. §802(6). 20 4. “Enclosed, locked facility” means a closet, room, 21 greenhouse, or other enclosed area equipped with locks or 22 other security devices that permit access only by authorized 23 personnel. 24 5. “Health care practitioner” means an individual licensed 25 under chapter 148 to practice medicine and surgery or 26 osteopathic medicine and surgery or an individual licensed to 27 practice medicine in any other state who provides specialty 28 care for an Iowa resident for one or more of the debilitating 29 medical conditions provided in this chapter. 30 6. “Intractable pain” means a pain in which the cause of the 31 pain cannot be removed or otherwise treated with the consent 32 of the patient and which, in the generally accepted course of 33 medical practice, no relief or cure of the cause of the pain 34 is possible, or none has been found after reasonable efforts. 35 -3- SF 506 (2) 87 rh/rj/jh 3/ 21

S.F. 506 Reasonable efforts for relieving or curing the cause of the 1 pain may be determined on the basis of but are not limited to 2 any of the following: 3 a. When treating a nonterminally ill patient for intractable 4 pain, evaluation by the attending physician and one or more 5 physicians specializing in pain medicine or the treatment of 6 the area, system, or organ of the body perceived as the source 7 of the pain. 8 b. When treating a terminally ill patient, evaluation by 9 the attending physician who does so in accordance with the 10 level of care, skill, and treatment that would be recognized 11 by a reasonably prudent physician under similar conditions and 12 circumstances. 13 7. “Medical cannabis” means any species of the genus 14 cannabis plant, or any mixture or preparation of them, 15 including whole plant extracts and resins. 16 8. “Medical cannabis dispensary” means an entity licensed 17 under section 124E.8 that acquires medical cannabis from a 18 medical cannabis manufacturer in this state for the purpose 19 of dispensing medical cannabis in this state pursuant to this 20 chapter. 21 9. “Medical cannabis manufacturer” means an entity licensed 22 under section 124E.6 to manufacture and to possess, cultivate, 23 transport, or supply medical cannabis pursuant to the 24 provisions of this chapter. 25 10. “Primary caregiver” means a person, at least eighteen 26 years of age, who has been designated by a patient’s health 27 care practitioner or a person having custody of a patient, as 28 a necessary caretaker taking responsibility for managing the 29 well-being of the patient with respect to the use of medical 30 cannabis pursuant to the provisions of this chapter. 31 11. “Written certification” means a document signed by a 32 health care practitioner, with whom the patient has established 33 a patient-provider relationship, which states that the patient 34 has a debilitating medical condition and identifies that 35 -4- SF 506 (2) 87 rh/rj/jh 4/ 21

S.F. 506 condition and provides any other relevant information. 1 Sec. 7. NEW SECTION . 124E.3 Health care practitioner 2 certification —— duties. 3 1. Prior to a patient’s submission of an application for a 4 medical cannabis registration card pursuant to section 124E.4, 5 a health care practitioner shall do all of the following: 6 a. Determine, in the health care practitioner’s medical 7 judgment, whether the patient whom the health care practitioner 8 has examined and treated suffers from a debilitating medical 9 condition that qualifies for the use of medical cannabis under 10 this chapter, and if so determined, provide the patient with a 11 written certification of that diagnosis. 12 b. Provide explanatory information as provided by the 13 department to the patient about the therapeutic use of medical 14 cannabis. 15 c. Determine, on an annual basis, if the patient continues 16 to suffer from a debilitating medical condition and, if so, 17 issue the patient a new certification of that diagnosis. This 18 paragraph shall not apply if the patient is suffering from an 19 incurable debilitating medical condition. 20 d. Otherwise comply with all requirements established by the 21 department pursuant to rule. 22 2. A health care practitioner may provide, but has no duty 23 to provide, a written certification pursuant to this section. 24 Sec. 8. NEW SECTION . 124E.4 Medical cannabis registration 25 card. 26 1. Issuance to patient. The department may approve the 27 issuance of a medical cannabis registration card by the 28 department of transportation to a patient who: 29 a. Is at least eighteen years of age. 30 b. Is a permanent resident of this state. 31 c. Submits a written certification to the department signed 32 by the patient’s health care practitioner that the patient is 33 suffering from a debilitating medical condition. 34 d. Submits an application to the department, on a form 35 -5- SF 506 (2) 87 rh/rj/jh 5/ 21

S.F. 506 created by the department, in consultation with the department 1 of transportation, that contains all of the following: 2 (1) The patient’s full name, Iowa residence address, date 3 of birth, and telephone number. 4 (2) A copy of the patient’s valid photograph 5 identification. 6 (3) Full name, address, and telephone number of the 7 patient’s health care practitioner. 8 (4) Full name, residence address, date of birth, and 9 telephone number of each primary caregiver of the patient, if 10 any. 11 (5) Any other information required by rule. 12 e. Submits a medical cannabis registration card fee of one 13 hundred dollars to the department. If the patient attests to 14 receiving social security disability benefits, supplemental 15 security insurance payments, or being enrolled in the medical 16 assistance program, the fee shall be twenty-five dollars. 17 2. Patient card contents. A medical cannabis registration 18 card issued to a patient by the department of transportation 19 pursuant to subsection 1 shall contain, at a minimum, all of 20 the following: 21 a. The patient’s full name, Iowa residence address, and date 22 of birth. 23 b. The patient’s photograph. 24 c. The date of issuance and expiration of the registration 25 card. 26 d. Any other information required by rule. 27 3. Issuance to primary caregiver. For a patient in a 28 primary caregiver’s care, the department may approve the 29 issuance of a medical cannabis registration card by the 30 department of transportation to the primary caregiver who: 31 a. Submits a written certification to the department signed 32 by the patient’s health care practitioner that the patient in 33 the primary caregiver’s care is suffering from a debilitating 34 medical condition. 35 -6- SF 506 (2) 87 rh/rj/jh 6/ 21

S.F. 506 b. Submits an application to the department, on a form 1 created by the department, in consultation with the department 2 of transportation, that contains all of the following: 3 (1) The primary caregiver’s full name, residence address, 4 date of birth, and telephone number. 5 (2) The patient’s full name. 6 (3) A copy of the primary caregiver’s valid photograph 7 identification. 8 (4) Full name, address, and telephone number of the 9 patient’s health care practitioner. 10 (5) Any other information required by rule. 11 c. Submits a medical cannabis registration card fee of 12 twenty-five dollars to the department. 13 4. Primary caregiver card contents. A medical cannabis 14 registration card issued by the department of transportation to 15 a primary caregiver pursuant to subsection 3 shall contain, at 16 a minimum, all of the following: 17 a. The primary caregiver’s full name, residence address, and 18 date of birth. 19 b. The primary caregiver’s photograph. 20 c. The date of issuance and expiration of the registration 21 card. 22 d. The registration card number of each patient in the 23 primary caregiver’s care. If the patient in the primary 24 caregiver’s care is under the age of eighteen, the full name of 25 the patient’s parent or legal guardian. 26 e. Any other information required by rule. 27 5. Expiration date of card. A medical cannabis registration 28 card issued pursuant to this section shall expire one year 29 after the date of issuance and may be renewed. 30 6. Card issuance —— department of transportation. 31 a. The department may enter into a chapter 28E agreement 32 with the department of transportation to facilitate the 33 issuance of medical cannabis registration cards pursuant to 34 subsections 1 and 3. 35 -7- SF 506 (2) 87 rh/rj/jh 7/ 21

S.F. 506 b. The department of transportation may issue renewal 1 medical cannabis registration cards through an online or 2 in-person process. 3 Sec. 9. NEW SECTION . 124E.5 Medical advisory board —— 4 duties. 5 1. No later than August 15, 2017, the director of public 6 health shall establish a medical advisory board consisting of 7 nine practitioners representing the fields of neurology, pain 8 management, gastroenterology, oncology, psychiatry, pediatrics, 9 infectious disease, family medicine, and pharmacy, and three 10 patients or primary caregivers with valid medical cannabis 11 registration cards. The practitioners shall be nationally 12 board-certified in their area of specialty and knowledgeable 13 about the use of medical cannabis. 14 2. A quorum of the advisory board shall consist of seven 15 members. 16 3. The duties of the advisory board shall include but not be 17 limited to the following: 18 a. Reviewing and recommending to the department for 19 approval additional chronic or debilitating diseases or 20 medical conditions or their treatments as debilitating medical 21 conditions that qualify for the use of medical cannabis under 22 this chapter. 23 b. Accepting and reviewing petitions to add chronic or 24 debilitating diseases or medical conditions or their medical 25 treatments to the list of debilitating medical conditions that 26 qualify for the use of medical cannabis under this chapter. 27 c. Working with the department regarding the requirements 28 for the licensure of medical cannabis manufacturers and medical 29 cannabis dispensaries, including licensure procedures. 30 d. Advising the department regarding the location of 31 medical cannabis dispensaries throughout the state, the form 32 and quantity of allowable medical cannabis to be dispensed 33 to a patient or primary caregiver, and the general oversight 34 of medical cannabis manufacturers and medical cannabis 35 -8- SF 506 (2) 87 rh/rj/jh 8/ 21

S.F. 506 dispensaries in this state. 1 e. Convening at least twice per year to conduct public 2 hearings and to review and recommend for approval petitions, 3 which shall be maintained as confidential personal health 4 information, to add chronic or debilitating diseases or 5 medical conditions or their medical treatments to the list of 6 debilitating medical conditions that qualify for the use of 7 medical cannabis under this chapter. 8 f. Recommending improvements relating to the effectiveness 9 of the provisions of this chapter. 10 g. In making recommendations pursuant to this section, 11 consideration of the economic and financial impacts on patients 12 and the medical cannabis industry, and making recommendations 13 that minimize the extent of such impacts to the greatest extent 14 practicable. 15 Sec. 10. NEW SECTION . 124E.6 Medical cannabis manufacturer 16 licensure. 17 1. a. The department shall license up to four medical 18 cannabis manufacturers to manufacture medical cannabis within 19 this state consistent with the provisions of this chapter by 20 December 1, 2017. The department shall license new medical 21 cannabis manufacturers or relicense the existing medical 22 cannabis manufacturers by December 1 of each year. 23 b. Information submitted during the application process 24 shall be confidential until the medical cannabis manufacturer 25 is licensed by the department unless otherwise protected from 26 disclosure under state or federal law. 27 2. As a condition for licensure, a medical cannabis 28 manufacturer must agree to begin supplying medical cannabis to 29 medical cannabis dispensaries in this state by July 2, 2018. 30 3. The department shall consider the following factors in 31 determining whether to license a medical cannabis manufacturer: 32 a. The technical expertise of the medical cannabis 33 manufacturer regarding medical cannabis. 34 b. The qualifications of the medical cannabis manufacturer’s 35 -9- SF 506 (2) 87 rh/rj/jh 9/ 21

S.F. 506 ownership and management team. 1 c. The long-term financial stability of the medical cannabis 2 manufacturer. 3 d. The ability to provide appropriate security measures on 4 the premises of the medical cannabis manufacturer. 5 e. Whether the medical cannabis manufacturer has 6 demonstrated an ability to meet certain medical cannabis 7 production needs for medical use regarding the range of 8 recommended dosages for each debilitating medical condition, 9 the range of chemical compositions of any plant of the genus 10 cannabis that will likely be medically beneficial for each 11 of the debilitating medical conditions, and the form of the 12 medical cannabis in the manner determined by the department 13 pursuant to rule. 14 f. The medical cannabis manufacturer’s projection of and 15 ongoing assessment of fees on patients with debilitating 16 medical conditions. 17 g. The medical cannabis manufacturer’s experience in medical 18 cannabis production, plant extraction, and pharmaceutical 19 formulations. 20 4. The department shall require each medical cannabis 21 manufacturer to contract with a laboratory approved by the 22 department to test the medical cannabis produced by the 23 manufacturer. The department shall require that the laboratory 24 report testing results to the manufacturer in a manner 25 determined by the department pursuant to rule. 26 5. Each entity submitting an application for licensure 27 as a medical cannabis manufacturer shall pay a nonrefundable 28 application fee of fifteen thousand dollars to the department. 29 Sec. 11. NEW SECTION . 124E.7 Medical cannabis 30 manufacturers. 31 1. A medical cannabis manufacturer shall contract with a 32 laboratory approved by the department for purposes of testing 33 the medical cannabis manufactured by the medical cannabis 34 manufacturer as to content, contamination, and consistency. 35 -10- SF 506 (2) 87 rh/rj/jh 10/ 21

S.F. 506 The cost of all laboratory testing shall be paid by the medical 1 cannabis manufacturer. 2 2. The operating documents of a medical cannabis 3 manufacturer shall include all of the following: 4 a. Procedures for the oversight of the medical cannabis 5 manufacturer and procedures to ensure accurate recordkeeping. 6 b. Procedures for the implementation of appropriate security 7 measures to deter and prevent the theft of medical cannabis and 8 unauthorized entrance into areas containing medical cannabis. 9 3. A medical cannabis manufacturer shall implement security 10 requirements, including requirements for protection of each 11 location by a fully operational security alarm system, facility 12 access controls, perimeter intrusion detection systems, and a 13 personnel identification system. 14 4. A medical cannabis manufacturer shall not share 15 office space with, refer patients to, or have any financial 16 relationship with a health care practitioner. 17 5. A medical cannabis manufacturer shall not permit any 18 person to consume medical cannabis on the property of the 19 medical cannabis manufacturer. 20 6. A medical cannabis manufacturer is subject to reasonable 21 inspection by the department. 22 7. A medical cannabis manufacturer shall not employ a 23 person who is under eighteen years of age or who has been 24 convicted of a disqualifying felony offense. An employee 25 of a medical cannabis manufacturer shall be subject to a 26 background investigation conducted by the division of criminal 27 investigation of the department of public safety and a national 28 criminal history background check. 29 8. A medical cannabis manufacturer shall not operate in any 30 location, whether for manufacturing, cultivating, harvesting, 31 packaging, or processing, within one thousand feet of a public 32 or private school existing before the date of the medical 33 cannabis manufacturer’s licensure by the department. 34 9. A medical cannabis manufacturer shall comply with 35 -11- SF 506 (2) 87 rh/rj/jh 11/ 21

S.F. 506 reasonable restrictions set by the department relating to 1 signage, marketing, display, and advertising of medical 2 cannabis. 3 10. a. A medical cannabis manufacturer shall provide a 4 reliable and ongoing supply of medical cannabis to medical 5 cannabis dispensaries pursuant to this chapter. 6 b. All manufacturing, cultivating, harvesting, packaging, 7 and processing of medical cannabis shall take place in an 8 enclosed, locked facility at a physical address provided to the 9 department during the licensure process. 10 c. A medical cannabis manufacturer shall not manufacture 11 edible medical cannabis products utilizing food coloring. 12 d. A medical cannabis manufacturer shall manufacture a 13 reliable and ongoing supply of medical cannabis to treat every 14 debilitating medical condition listed in this chapter. 15 11. The department shall establish and collect an annual 16 fee from a medical cannabis manufacturer not to exceed the cost 17 of regulating and inspecting the manufacturer in the calendar 18 year. 19 Sec. 12. NEW SECTION . 124E.8 Medical cannabis dispensary 20 licensure. 21 1. a. The department shall license by April 2, 2018, twelve 22 medical cannabis dispensaries to dispense medical cannabis 23 within this state consistent with the provisions of this 24 chapter. The department shall license new medical cannabis 25 dispensaries or relicense the existing medical cannabis 26 dispensaries by December 1 of each year. 27 b. Information submitted during the application process 28 shall be confidential until the medical cannabis dispensary 29 is licensed by the department unless otherwise protected from 30 disclosure under state or federal law. 31 2. As a condition for licensure, a medical cannabis 32 dispensary must agree to begin supplying medical cannabis to 33 patients by July 16, 2018. 34 3. The department shall consider the following factors in 35 -12- SF 506 (2) 87 rh/rj/jh 12/ 21

S.F. 506 determining whether to license a medical cannabis dispensary: 1 a. The technical expertise of the medical cannabis 2 dispensary regarding medical cannabis. 3 b. The qualifications of the medical cannabis dispensary’s 4 owners and management team. 5 c. The long-term financial stability of the medical cannabis 6 dispensary. 7 d. The ability to provide appropriate security measures on 8 the premises of the medical cannabis dispensary. 9 e. The medical cannabis dispensary’s projection and ongoing 10 assessment of fees for the purchase of medical cannabis on 11 patients with debilitating medical conditions. 12 4. Each entity submitting an application for licensure 13 as a medical cannabis dispensary shall pay a nonrefundable 14 application fee of fifteen thousand dollars to the department. 15 Sec. 13. NEW SECTION . 124E.9 Medical cannabis dispensaries. 16 1. a. Medical cannabis dispensaries shall be located based 17 on geographical need throughout the state to improve patient 18 access. 19 b. A medical cannabis dispensary may dispense medical 20 cannabis pursuant to the provisions of this chapter but shall 21 not dispense any medical cannabis in a form or quantity other 22 than the form or quantity allowed by the department pursuant 23 to rule. 24 2. The operating documents of a medical cannabis dispensary 25 shall include all of the following: 26 a. Procedures for the oversight of the medical cannabis 27 dispensary and procedures to ensure accurate recordkeeping. 28 b. Procedures for the implementation of appropriate security 29 measures to deter and prevent the theft of medical cannabis and 30 unauthorized entrance into areas containing medical cannabis. 31 3. A medical cannabis dispensary shall implement security 32 requirements, including requirements for protection by a fully 33 operational security alarm system, facility access controls, 34 perimeter intrusion detection systems, and a personnel 35 -13- SF 506 (2) 87 rh/rj/jh 13/ 21

S.F. 506 identification system. 1 4. A medical cannabis dispensary shall not share office 2 space with, refer patients to, or have any financial 3 relationship with a health care practitioner. 4 5. A medical cannabis dispensary shall not permit any person 5 to consume medical cannabis on the property of the medical 6 cannabis dispensary. 7 6. A medical cannabis dispensary is subject to reasonable 8 inspection by the department. 9 7. A medical cannabis dispensary shall not employ a 10 person who is under eighteen years of age or who has been 11 convicted of a disqualifying felony offense. An employee 12 of a medical cannabis dispensary shall be subject to a 13 background investigation conducted by the division of criminal 14 investigation of the department of public safety and a national 15 criminal history background check. 16 8. A medical cannabis dispensary shall not operate in any 17 location within one thousand feet of a public or private school 18 existing before the date of the medical cannabis dispensary’s 19 licensure by the department. 20 9. A medical cannabis dispensary shall comply with 21 reasonable restrictions set by the department relating to 22 signage, marketing, display, and advertising of medical 23 cannabis. 24 10. Prior to dispensing of any medical cannabis, a medical 25 cannabis dispensary shall do all of the following: 26 a. Verify that the medical cannabis dispensary has received 27 a valid medical cannabis registration card from a patient or a 28 patient’s primary caregiver, if applicable. 29 b. Assign a tracking number to any medical cannabis 30 dispensed from the medical cannabis dispensary. 31 c. (1) Properly package medical cannabis in compliance with 32 federal law regarding child resistant packaging and exemptions 33 for packaging for elderly patients, and label medical cannabis 34 with a list of all active ingredients and individually 35 -14- SF 506 (2) 87 rh/rj/jh 14/ 21

S.F. 506 identifying information, including all of the following: 1 (a) The name and date of birth of the patient and the 2 patient’s primary caregiver, if appropriate. 3 (b) The medical cannabis registration card numbers of the 4 patient and the patient’s primary caregiver, if applicable. 5 (c) The chemical composition of the medical cannabis. 6 (2) Proper packaging of medical cannabis shall include but 7 not be limited to all of the following: 8 (a) Warning labels regarding the use of medical cannabis by 9 a woman during pregnancy and while breastfeeding. 10 (b) Clearly labeled packaging indicating that an edible 11 medical cannabis product contains medical cannabis and which 12 packaging shall not imitate candy products or in any way make 13 the product marketable to children. 14 Sec. 14. NEW SECTION . 124E.10 Fees. 15 Medical cannabis registration card fees and medical cannabis 16 manufacturer and medical cannabis dispensary application 17 and annual fees collected by the department pursuant to 18 this chapter shall be retained by the department, shall be 19 considered repayment receipts as defined in section 8.2, and 20 shall be used for the purpose of regulating medical cannabis 21 manufacturers and medical cannabis dispensaries and for other 22 expenses necessary for the administration of this chapter. 23 Sec. 15. NEW SECTION . 124E.11 Department duties —— rules. 24 1. a. The department shall maintain a confidential file of 25 the names of each patient to or for whom the department issues 26 a medical cannabis registration card, the name of each primary 27 caregiver to whom the department issues a medical cannabis 28 registration card under section 124E.4, and the names of each 29 health care practitioner who provides a written certification 30 for medical cannabis pursuant to this chapter. 31 b. Individual names contained in the file shall be 32 confidential and shall not be subject to disclosure, except as 33 provided in subparagraph (1). 34 (1) Information in the confidential file maintained 35 -15- SF 506 (2) 87 rh/rj/jh 15/ 21

S.F. 506 pursuant to paragraph “a” may be released on an individual basis 1 to the following persons under the following circumstances: 2 (a) To authorized employees or agents of the department and 3 the department of transportation as necessary to perform the 4 duties of the department and the department of transportation 5 pursuant to this chapter. 6 (b) To authorized employees of state or local law 7 enforcement agencies, but only for the purpose of verifying 8 that a person is lawfully in possession of a medical cannabis 9 registration card issued pursuant to this chapter. 10 (c) To authorized employees of a medical cannabis 11 dispensary, but only for the purpose of verifying that a person 12 is lawfully in possession of a medical cannabis registration 13 card issued pursuant to this chapter. 14 (d) To any other authorized persons recognized by the 15 department by rule, but only for the purpose of verifying 16 that a person is lawfully in possession of a medical cannabis 17 registration card issued pursuant to this chapter. 18 (2) Release of information pursuant to subparagraph 19 (1) shall be consistent with the federal Health Insurance 20 Portability and Accountability Act of 1996, Pub. L. No. 21 104-191. 22 2. The department shall adopt rules pursuant to chapter 23 17A to administer this chapter which shall include but not be 24 limited to rules to do all of the following: 25 a. Govern the manner in which the department shall consider 26 applications for new and renewal medical cannabis registration 27 cards. 28 b. Identify criteria and set forth procedures for 29 including additional chronic or debilitating diseases or 30 medical conditions or their medical treatments on the list of 31 debilitating medical conditions that qualify for the use of 32 medical cannabis. Procedures shall include a petition process 33 and shall allow for public comment and public hearings before 34 the medical advisory board. 35 -16- SF 506 (2) 87 rh/rj/jh 16/ 21

S.F. 506 c. Set forth additional chronic or debilitating diseases 1 or medical conditions or associated medical treatments for 2 inclusion on the list of debilitating medical conditions that 3 qualify for the use of medical cannabis as recommended by the 4 medical advisory board. 5 d. Establish, in consultation with medical cannabis 6 manufacturers and medical cannabis dispensaries, the form and 7 quantity of medical cannabis allowed to be dispensed to a 8 patient or primary caregiver pursuant to this chapter. The 9 form and quantity of medical cannabis shall be appropriate to 10 serve the medical needs of patients with debilitating medical 11 conditions. 12 e. Establish, in conjunction with the medical advisory 13 board, requirements for the licensure of medical cannabis 14 manufacturers and medical cannabis dispensaries and set forth 15 procedures for medical cannabis manufacturers and medical 16 cannabis dispensaries to obtain licenses. 17 f. Develop a dispensing system for medical cannabis within 18 this state that provides for all of the following: 19 (1) Medical cannabis dispensaries within this state housed 20 on secured grounds and operated by licensed medical cannabis 21 dispensaries. 22 (2) The dispensing of medical cannabis to patients and 23 their primary caregivers to occur at locations designated by 24 the department. 25 g. Establish and collect annual fees from medical cannabis 26 manufacturers and medical cannabis dispensaries to cover 27 the costs associated with regulating and inspecting medical 28 cannabis manufacturers and medical cannabis dispensaries. 29 h. Specify and implement procedures that address public 30 safety including security procedures and product quality 31 including measures to ensure contaminant-free cultivation of 32 medical cannabis, safety, and labeling. 33 i. Establish and implement a medical cannabis inventory 34 and delivery tracking system to track medical cannabis 35 -17- SF 506 (2) 87 rh/rj/jh 17/ 21

S.F. 506 from production by a medical cannabis manufacturer through 1 dispensing at a medical cannabis dispensary. 2 Sec. 16. NEW SECTION . 124E.12 Reciprocity. 3 A valid medical cannabis registration card, or its 4 equivalent, issued under the laws of another state that allows 5 an out-of-state patient to possess or use medical cannabis in 6 the jurisdiction of issuance shall have the same force and 7 effect as a valid medical cannabis registration card issued 8 pursuant to this chapter, except that an out-of-state patient 9 in this state shall not obtain medical cannabis from a medical 10 cannabis dispensary in this state and an out-of-state patient 11 shall not smoke medical cannabis. 12 Sec. 17. NEW SECTION . 124E.13 Use of medical cannabis —— 13 affirmative defenses. 14 1. A health care practitioner, including any authorized 15 agent or employee thereof, shall not be subject to 16 prosecution for the unlawful certification, possession, or 17 administration of marijuana under the laws of this state for 18 activities arising directly out of or directly related to the 19 certification or use of medical cannabis in the treatment of 20 a patient diagnosed with a debilitating medical condition as 21 authorized by this chapter. 22 2. A medical cannabis manufacturer, including any 23 authorized agent or employee thereof, shall not be subject 24 to prosecution for manufacturing, possessing, cultivating, 25 harvesting, packaging, processing, transporting, or supplying 26 medical cannabis pursuant to this chapter. 27 3. A medical cannabis dispensary, including any authorized 28 agent or employee thereof, shall not be subject to prosecution 29 for transporting, supplying, or dispensing medical cannabis 30 pursuant to this chapter. 31 a. In a prosecution for the unlawful possession of marijuana 32 under the laws of this state, including but not limited to 33 chapters 124 and 453B, it is an affirmative and complete 34 defense to the prosecution that the patient has been diagnosed 35 -18- SF 506 (2) 87 rh/rj/jh 18/ 21

S.F. 506 with a debilitating medical condition, used or possessed 1 medical cannabis pursuant to a certification by a health care 2 practitioner as authorized under this chapter, and, for a 3 patient eighteen years of age or older, is in possession of a 4 valid medical cannabis registration card. 5 b. In a prosecution for the unlawful possession of marijuana 6 under the laws of this state, including but not limited to 7 chapters 124 and 453B, it is an affirmative and complete 8 defense to the prosecution that the person possessed medical 9 cannabis because the person is a primary caregiver of a patient 10 who has been diagnosed with a debilitating medical condition 11 and is in possession of a valid medical cannabis registration 12 card, and where the primary caregiver’s possession of the 13 medical cannabis is on behalf of the patient and for the 14 patient’s use only as authorized under this chapter. 15 c. If a patient or primary caregiver is charged with the 16 commission of a crime and is not in possession of the person’s 17 medical cannabis registration card, any charge or charges filed 18 against the person shall be dismissed by the court if the 19 person produces to the court prior to or at the person’s trial 20 a medical cannabis registration card issued to that person and 21 valid at the time the person was charged. 22 4. An agency of this state or a political subdivision 23 thereof, including any law enforcement agency, shall not remove 24 or initiate proceedings to remove a patient under the age 25 of eighteen from the home of a parent based solely upon the 26 parent’s or patient’s possession or use of medical cannabis as 27 authorized under this chapter. 28 Sec. 18. NEW SECTION . 124E.14 Penalties. 29 1. A person who knowingly or intentionally possesses or 30 uses medical cannabis in violation of the requirements of this 31 chapter is subject to the penalties provided under chapters 124 32 and 453B. 33 2. A medical cannabis manufacturer or a medical cannabis 34 dispensary shall be assessed a civil penalty of up to one 35 -19- SF 506 (2) 87 rh/rj/jh 19/ 21

S.F. 506 thousand dollars per violation for any violation of this 1 chapter in addition to any other applicable penalties. 2 Sec. 19. NEW SECTION . 124E.15 Use of medical cannabis —— 3 smoking prohibited. 4 A patient shall not consume medical cannabis possessed 5 or used as authorized under this chapter by smoking medical 6 cannabis. 7 Sec. 20. NEW SECTION . 124E.16 Employment. 8 1. An employer in this state may retain, create, reinstate, 9 or enforce a written zero tolerance policy prohibiting the 10 possession or use of medical cannabis or any derivative 11 thereof including cannabidiol by an employee in the employer’s 12 workplace, including but not limited to a policy prohibiting 13 an employee from having any detectable amount of medical 14 cannabis or any derivative thereof including cannabidiol in the 15 employee’s body while at work. 16 2. An employer’s prohibition of the possession or use 17 of medical cannabis or any derivative thereof including 18 cannabidiol under this section shall not be considered to be 19 an unfair or discriminatory employment practice under section 20 216.6. 21 Sec. 21. Section 730.5, subsection 11, Code 2017, is amended 22 by adding the following new paragraph: 23 NEW PARAGRAPH . f. Testing or taking action against an 24 individual with a confirmed positive test result due to the 25 individual’s use of medical cannabis as authorized under 26 chapter 124E. 27 Sec. 22. REPEAL. Chapter 124D, Code 2017, is repealed. 28 Sec. 23. EMERGENCY RULES. The department may adopt 29 emergency rules under section 17A.4, subsection 3, and section 30 17A.5, subsection 2, paragraph “b”, to implement the provisions 31 of this Act and the rules shall be effective immediately upon 32 filing unless a later date is specified in the rules. Any 33 rules adopted in accordance with this section shall also be 34 published as a notice of intended action as provided in section 35 -20- SF 506 (2) 87 rh/rj/jh 20/ 21