Senate Study Bill 1176 - Introduced SENATE FILE _____ BY (PROPOSED COMMITTEE ON JUDICIARY BILL BY CHAIRPERSON ZAUN) A BILL FOR An Act creating the compassionate use of medical cannabis 1 preparations 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 TLSB 2562XC (7) 87 rh/rj

S.F. _____ 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- LSB 2562XC (7) 87 rh/rj 1/ 28

S.F. _____ 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” means “medical 10 cannabis” and “medical cannabis preparation” mean the same as 11 defined in section 124D.2 124E.2 . 12 Sec. 5. NEW SECTION . 124E.1 Short title. 13 This chapter shall be known and may be cited as the 14 “Compassionate Use of Medical Cannabis Preparations Act” . 15 Sec. 6. NEW SECTION . 124E.2 Definitions. 16 As used in this chapter: 17 1. “Debilitating medical condition” means any of the 18 following: 19 a. Cancer. 20 b. Multiple sclerosis. 21 c. Epilepsy or seizure disorders. 22 d. AIDS or HIV as defined in section 141A.1. 23 e. Glaucoma. 24 f. Hepatitis C. 25 g. Crohn’s disease or ulcerative colitis. 26 h. Amyotrophic lateral sclerosis. 27 i. Ehlers-danlos syndrome. 28 j. Post-traumatic stress disorder. 29 k. Tourette’s syndrome. 30 l. Any terminal illness. 31 m. Intractable pain. 32 n. Any other chronic or debilitating disease or medical 33 condition or its medical treatment approved by the department 34 pursuant to rule. 35 -2- LSB 2562XC (7) 87 rh/rj 2/ 28

S.F. _____ 2. “Department” means the department of public health. 1 3. “Enclosed, locked facility” means a closet, room, 2 greenhouse, or other enclosed area equipped with locks or other 3 security devices that permit access only by a cardholder. 4 4. “Health care practitioner” means an individual licensed 5 under chapter 148 to practice medicine and surgery or 6 osteopathic medicine and surgery or an individual licensed to 7 prescribe medicine in any other state who provides specialty 8 care for an Iowa resident for one or more of the debilitating 9 medical conditions provided in this chapter. 10 5. “Intractable pain” means a pain in which the cause of the 11 pain cannot be removed or otherwise treated with the consent 12 of the patient and which, in the generally accepted course of 13 medical practice, no relief or cure of the cause of the pain 14 is possible, or none has been found after reasonable efforts. 15 Reasonable efforts for relieving or curing the cause of the 16 pain may be determined on the basis of but are not limited to 17 any of the following: 18 a. When treating a nonterminally ill patient for intractable 19 pain, evaluation by the attending physician and one or more 20 physicians specializing in pain medicine or the treatment of 21 the area, system, or organ of the body perceived as the source 22 of the pain. 23 b. When treating a terminally ill patient, evaluation by 24 the attending physician who does so in accordance with the 25 level of care, skill, and treatment that would be recognized 26 by a reasonably prudent physician under similar conditions and 27 circumstances. 28 6. “Medical cannabis” means any species of the genus 29 cannabis plant, or any mixture or preparation of them, 30 including whole plant extracts and resins grown only by a 31 medical cannabis preparation manufacturer licensed under this 32 chapter. 33 7. “Medical cannabis preparation” means any of the 34 following: 35 -3- LSB 2562XC (7) 87 rh/rj 3/ 28

S.F. _____ a. Cannabis flowers, leaves, or other plant material 1 that includes cannabidiol and is no more than ten percent 2 tetrahydrocannabinol by weight and dispensed by a medical 3 cannabis preparation dispensary licensed under this chapter. 4 b. An extract, mixture, or preparation of cannabis that 5 includes cannabidiol and contains no more than ten percent 6 tetrahydrocannabinol by weight and dispensed by a medical 7 cannabis preparation dispensary licensed under this chapter. 8 8. “Medical cannabis preparation dispensary” means an entity 9 licensed under section 124E.8 that acquires a medical cannabis 10 preparation from a medical cannabis preparation manufacturer 11 in this state for the purpose of dispensing a medical cannabis 12 preparation in this state pursuant to this chapter. 13 9. “Medical cannabis preparation manufacturer” means an 14 entity licensed under section 124E.6 to manufacture, possess, 15 cultivate, transport, or supply medical cannabis and a medical 16 cannabis preparation pursuant to the provisions of this 17 chapter. 18 10. “Primary caregiver” means a person, at least eighteen 19 years of age, who has been designated by a patient’s health 20 care practitioner or a person having custody of a patient, 21 as a necessary caretaker taking responsibility for managing 22 the well-being of the patient with respect to the use of a 23 medical cannabis preparation pursuant to the provisions of this 24 chapter. 25 11. “Written certification” means a document signed by a 26 health care practitioner, with whom the patient has established 27 a patient-provider relationship, which states that the patient 28 has a debilitating medical condition and identifies that 29 condition and provides any other relevant information. 30 Sec. 7. NEW SECTION . 124E.3 Health care practitioner 31 certification —— duties. 32 1. Prior to a patient’s submission of an application for 33 a medical cannabis preparation registration card pursuant to 34 section 124E.4, a health care practitioner shall do all of the 35 -4- LSB 2562XC (7) 87 rh/rj 4/ 28

S.F. _____ following: 1 a. Determine, in the health care practitioner’s medical 2 judgment, whether the patient whom the health care practitioner 3 has examined and treated suffers from a debilitating medical 4 condition that qualifies for the use of a medical cannabis 5 preparation under this chapter, and if so determined, provide 6 the patient with a written certification of that diagnosis. 7 b. Provide explanatory information as provided by the 8 department to the patient about the therapeutic use of a 9 medical cannabis preparation. 10 c. Determine, on an annual basis, if the patient continues 11 to suffer from a debilitating medical condition and, if so, 12 issue the patient a new certification of that diagnosis. 13 d. Otherwise comply with all requirements established by the 14 department pursuant to rule. 15 2. A health care practitioner may provide, but has no duty 16 to provide, a written certification pursuant to this section. 17 Sec. 8. NEW SECTION . 124E.4 Medical cannabis preparation 18 registration card. 19 1. Issuance to patient. The department may approve the 20 issuance of a medical cannabis preparation registration card by 21 the department of transportation to a patient who: 22 a. Is at least eighteen years of age. 23 b. Is a permanent resident of this state. 24 c. Submits a written certification to the department signed 25 by the patient’s health care practitioner that the patient is 26 suffering from a debilitating medical condition. 27 d. Submits an application to the department, on a form 28 created by the department, in consultation with the department 29 of transportation, that contains all of the following: 30 (1) The patient’s full name, Iowa residence address, date 31 of birth, and telephone number. 32 (2) A copy of the patient’s valid photograph 33 identification. 34 (3) Full name, address, and telephone number of the 35 -5- LSB 2562XC (7) 87 rh/rj 5/ 28

S.F. _____ patient’s health care practitioner. 1 (4) Full name, residence address, date of birth, and 2 telephone number of each primary caregiver of the patient, if 3 any. 4 (5) Any other information required by rule. 5 e. Submits a medical cannabis preparation registration card 6 fee of one hundred dollars to the department. If the patient 7 attests to receiving social security disability benefits, 8 supplemental security insurance payments, or being enrolled in 9 the medical assistance program, the fee shall be twenty-five 10 dollars. 11 2. Patient card contents. A medical cannabis preparation 12 registration card issued to a patient by the department of 13 transportation pursuant to subsection 1 shall contain, at a 14 minimum, all of the following: 15 a. The patient’s full name, Iowa residence address, and date 16 of birth. 17 b. The patient’s photograph. 18 c. The date of issuance and expiration of the registration 19 card. 20 d. Any other information required by rule. 21 3. Issuance to primary caregiver. For a patient in a 22 primary caregiver’s care, the department may approve the 23 issuance of a medical cannabis preparation registration card by 24 the department of transportation to the primary caregiver who: 25 a. Is at least eighteen years of age. 26 b. Submits a written certification to the department signed 27 by the patient’s health care practitioner that the patient in 28 the primary caregiver’s care is suffering from a debilitating 29 medical condition. 30 c. Submits an application to the department, on a form 31 created by the department, in consultation with the department 32 of transportation, that contains all of the following: 33 (1) The primary caregiver’s full name, residence address, 34 date of birth, and telephone number. 35 -6- LSB 2562XC (7) 87 rh/rj 6/ 28

S.F. _____ (2) The patient’s full name. 1 (3) A copy of the primary caregiver’s valid photograph 2 identification. 3 (4) Full name, address, and telephone number of the 4 patient’s health care practitioner. 5 (5) Any other information required by rule. 6 d. Submits a medical cannabis preparation registration card 7 fee of twenty-five dollars to the department. 8 4. Primary caregiver card contents. A medical cannabis 9 preparation registration card issued by the department of 10 transportation to a primary caregiver pursuant to subsection 3 11 shall contain, at a minimum, all of the following: 12 a. The primary caregiver’s full name, residence address, and 13 date of birth. 14 b. The primary caregiver’s photograph. 15 c. The date of issuance and expiration of the registration 16 card. 17 d. The registration card number of each patient in the 18 primary caregiver’s care. If the patient in the primary 19 caregiver’s care is under the age of eighteen, the full name of 20 the patient’s parent or legal guardian. 21 e. Any other information required by rule. 22 5. Expiration date of card. A medical cannabis preparation 23 registration card issued pursuant to this section shall expire 24 one year after the date of issuance and may be renewed. 25 6. Card issuance —— department of transportation. The 26 department may enter into a chapter 28E agreement with the 27 department of transportation to facilitate the issuance of 28 medical cannabis preparation registration cards pursuant to 29 subsections 1 and 3. 30 Sec. 9. NEW SECTION . 124E.5 Medical advisory board —— 31 duties. 32 1. No later than August 15, 2017, the director of public 33 health shall establish a medical advisory board consisting of 34 nine practitioners representing the fields of neurology, pain 35 -7- LSB 2562XC (7) 87 rh/rj 7/ 28

S.F. _____ management, gastroenterology, oncology, psychiatry, pediatrics, 1 infectious disease, family medicine, and pharmacy, and three 2 patients or primary caregivers with valid medical cannabis 3 preparation registration cards. The practitioners shall be 4 nationally board-certified in their area of specialty and 5 knowledgeable about the use of medical cannabis preparations. 6 2. A quorum of the advisory board shall consist of seven 7 members. 8 3. The duties of the advisory board shall include but not be 9 limited to the following: 10 a. Reviewing and recommending to the department for 11 approval additional chronic or debilitating diseases or 12 medical conditions or their treatments as debilitating medical 13 conditions that qualify for the use of a medical cannabis 14 preparation under this chapter. 15 b. Accepting and reviewing petitions to add chronic or 16 debilitating diseases or medical conditions or their medical 17 treatments to the list of debilitating medical conditions that 18 qualify for the use of a medical cannabis preparation under 19 this chapter. 20 c. Advising the department regarding the location and number 21 of medical cannabis preparation dispensaries throughout the 22 state, the form and quantity of allowable medical cannabis 23 preparations to be dispensed to a patient or primary caregiver, 24 and the general oversight of medical cannabis preparation 25 manufacturers and medical cannabis preparation dispensaries in 26 this state. 27 d. Convening at least twice per year to conduct public 28 hearings and to review and recommend for approval petitions, 29 which shall be maintained as confidential personal health 30 information, to add chronic or debilitating diseases or 31 medical conditions or their medical treatments to the list of 32 debilitating medical conditions that qualify for the use of a 33 medical cannabis preparation under this chapter. 34 Sec. 10. NEW SECTION . 124E.6 Medical cannabis preparation 35 -8- LSB 2562XC (7) 87 rh/rj 8/ 28

S.F. _____ manufacturer licensure. 1 1. a. The department shall license up to four medical 2 cannabis preparation manufacturers to manufacture medical 3 cannabis preparations within this state consistent with the 4 provisions of this chapter by December 1, 2017. The department 5 shall license new medical cannabis preparation manufacturers 6 or relicense the existing medical cannabis preparation 7 manufacturers by December 1 of each year. 8 b. Information submitted during the application process 9 shall be confidential until the medical cannabis preparation 10 manufacturer is licensed by the department unless otherwise 11 protected from disclosure under state or federal law. 12 2. As a condition for licensure, a medical cannabis 13 preparation manufacturer must agree to begin supplying 14 medical cannabis preparations to medical cannabis preparation 15 dispensaries in this state by July 1, 2018. 16 3. The department shall consider the following factors in 17 determining whether to license a medical cannabis preparation 18 manufacturer: 19 a. The technical expertise of the medical cannabis 20 preparation manufacturer regarding medical cannabis and medical 21 cannabis preparations. 22 b. The qualifications of the medical cannabis preparation 23 manufacturer’s employees. 24 c. The long-term financial stability of the medical cannabis 25 preparation manufacturer. 26 d. The ability to provide appropriate security measures on 27 the premises of the medical cannabis preparation manufacturer. 28 e. Whether the medical cannabis preparation manufacturer 29 has demonstrated an ability to meet certain medical cannabis 30 and medical cannabis preparation production needs for 31 medical use regarding the range of recommended dosages for 32 each debilitating medical condition, the range of chemical 33 compositions of any plant of the genus cannabis that will 34 likely be medically beneficial for each of the debilitating 35 -9- LSB 2562XC (7) 87 rh/rj 9/ 28

S.F. _____ medical conditions, and the form of the medical cannabis 1 preparation in the manner determined by the department pursuant 2 to rule. 3 f. The medical cannabis preparation manufacturer’s 4 projection of and ongoing assessment of fees on patients with 5 debilitating medical conditions. 6 4. The department shall require each medical cannabis 7 preparation manufacturer to contract with the state hygienic 8 laboratory at the university of Iowa in Iowa City to test 9 the medical cannabis and the medical cannabis preparations 10 produced by the manufacturer as provided in section 124E.7. 11 The department shall require that the laboratory report testing 12 results to the manufacturer in a manner determined by the 13 department pursuant to rule. 14 5. Each entity submitting an application for licensure 15 as a medical cannabis preparation manufacturer shall pay a 16 nonrefundable application fee of fifteen thousand five hundred 17 dollars to the department. 18 Sec. 11. NEW SECTION . 124E.7 Medical cannabis preparation 19 manufacturers. 20 1. A medical cannabis preparation manufacturer shall 21 contract with the state hygienic laboratory at the university 22 of Iowa in Iowa City for purposes of testing the medical 23 cannabis and the medical cannabis preparations manufactured by 24 the medical cannabis preparation manufacturer as to content, 25 contamination, and consistency. The cost of all laboratory 26 testing shall be paid by the medical cannabis preparation 27 manufacturer. 28 2. The operating documents of a medical cannabis 29 preparation manufacturer shall include all of the following: 30 a. Procedures for the oversight of the medical cannabis 31 preparation manufacturer and procedures to ensure accurate 32 recordkeeping. 33 b. Procedures for the implementation of appropriate security 34 measures to deter and prevent the theft of medical cannabis 35 -10- LSB 2562XC (7) 87 rh/rj 10/ 28

S.F. _____ and medical cannabis preparations and unauthorized entrance 1 into areas containing medical cannabis and medical cannabis 2 preparations. 3 3. A medical cannabis preparation manufacturer shall 4 implement security requirements, including requirements for 5 protection of each location by a fully operational security 6 alarm system, facility access controls, perimeter intrusion 7 detection systems, and a personnel identification system. 8 4. A medical cannabis preparation manufacturer shall 9 not share office space with, refer patients to, or have any 10 financial relationship with a health care practitioner. 11 5. A medical cannabis preparation manufacturer shall not 12 permit any person to consume medical cannabis or a medical 13 cannabis preparation on the property of the medical cannabis 14 preparation manufacturer. 15 6. A medical cannabis preparation manufacturer is subject 16 to reasonable inspection by the department. 17 7. A medical cannabis preparation manufacturer shall 18 not employ a person who is under eighteen years of age. An 19 employee of a medical cannabis preparation manufacturer shall 20 be subject to a background investigation conducted by the 21 division of criminal investigation of the department of public 22 safety and a national criminal history background check. 23 8. A medical cannabis preparation manufacturer shall 24 not operate in any location, whether for manufacturing, 25 cultivating, harvesting, packaging, or processing, within one 26 thousand feet of a public or private school existing before 27 the date of the medical cannabis preparation manufacturer’s 28 licensure by the department. 29 9. A medical cannabis preparation manufacturer shall comply 30 with reasonable restrictions set by the department relating 31 to signage, marketing, display, and advertising of medical 32 cannabis preparations. 33 10. a. A medical cannabis preparation manufacturer shall 34 provide a reliable and ongoing supply of medical cannabis 35 -11- LSB 2562XC (7) 87 rh/rj 11/ 28

S.F. _____ preparations to medical cannabis preparation dispensaries 1 pursuant to this chapter. 2 b. All manufacturing, cultivating, harvesting, packaging, 3 and processing of medical cannabis preparation shall take place 4 in an enclosed, locked facility at a physical address provided 5 to the department during the licensure process. 6 c. A medical cannabis preparation manufacturer shall 7 manufacture a reliable and ongoing supply of medical cannabis 8 preparations to treat every debilitating medical condition 9 listed in this chapter. 10 11. The department shall establish and collect an annual 11 fee from a medical cannabis preparation manufacturer equal to 12 the cost of regulating and inspecting the manufacturer in a 13 calendar year. 14 Sec. 12. NEW SECTION . 124E.8 Medical cannabis preparation 15 dispensary licensure. 16 1. a. The department shall license by April 1, 2018, up to 17 twelve medical cannabis preparation dispensaries to dispense 18 medical cannabis preparations within this state consistent with 19 the provisions of this chapter. The department shall license 20 new medical cannabis preparation dispensaries or relicense the 21 existing medical cannabis preparation dispensaries by December 22 1 of each year. 23 b. Information submitted during the application process 24 shall be confidential until the medical cannabis preparation 25 dispensary is licensed by the department unless otherwise 26 protected from disclosure under state or federal law. 27 2. As a condition for licensure, a medical cannabis 28 preparation dispensary must agree to begin supplying medical 29 cannabis preparations to patients by July 15, 2018. 30 3. The department shall consider the following factors in 31 determining whether to license a medical cannabis preparation 32 dispensary: 33 a. The technical expertise of the medical cannabis 34 preparation dispensary regarding medical cannabis preparations. 35 -12- LSB 2562XC (7) 87 rh/rj 12/ 28

S.F. _____ b. The qualifications of the medical cannabis preparation 1 dispensary’s employees. 2 c. The long-term financial stability of the medical cannabis 3 preparation dispensary. 4 d. The ability to provide appropriate security measures on 5 the premises of the medical cannabis preparation dispensary. 6 e. The medical cannabis preparation dispensary’s projection 7 and ongoing assessment of fees for the purchase of medical 8 cannabis preparations on patients with debilitating medical 9 conditions. 10 4. Each entity submitting an application for licensure 11 as a medical cannabis preparation dispensary shall pay a 12 nonrefundable application fee of fifteen thousand dollars to 13 the department. 14 5. The department shall establish and collect an annual 15 fee from a medical cannabis preparation dispensary equal to 16 the cost of regulating and inspecting the medical cannabis 17 preparation manufacturer during a calendar year. 18 Sec. 13. NEW SECTION . 124E.9 Medical cannabis preparation 19 dispensaries. 20 1. a. Medical cannabis preparation dispensaries shall be 21 located based on geographical need throughout the state to 22 improve patient access. 23 b. A medical cannabis preparations dispensary may dispense 24 medical cannabis preparations pursuant to the provisions 25 of this chapter but shall not dispense medical cannabis 26 preparations in any form or quantity other than the form or 27 quantity allowed by the department pursuant to rule. 28 2. The operating documents of a medical cannabis 29 preparation dispensary shall include all of the following: 30 a. Procedures for the oversight of the medical cannabis 31 preparation dispensary and procedures to ensure accurate 32 recordkeeping. 33 b. Procedures for the implementation of appropriate security 34 measures to deter and prevent the theft of medical cannabis 35 -13- LSB 2562XC (7) 87 rh/rj 13/ 28

S.F. _____ preparations and unauthorized entrance into areas containing 1 medical cannabis preparations. 2 3. A medical cannabis preparation dispensary shall 3 implement security requirements, including requirements for 4 protection by a fully operational security alarm system, 5 facility access controls, perimeter intrusion detection 6 systems, and a personnel identification system. 7 4. A medical cannabis preparation dispensary shall not 8 share office space with, refer patients to, or have any 9 financial relationship with a health care practitioner. 10 5. A medical cannabis preparation dispensary shall not 11 permit any person to consume medical cannabis preparations on 12 the property of the medical cannabis preparation dispensary. 13 6. A medical cannabis preparation dispensary is subject to 14 reasonable inspection by the department. 15 7. A medical cannabis preparation dispensary shall not 16 employ a person who is under eighteen years of age. An 17 employee of a medical cannabis preparation dispensary shall be 18 subject to a background investigation conducted by the division 19 of criminal investigation of the department of public safety 20 and a national criminal history background check. 21 8. A medical cannabis preparation dispensary shall not 22 operate in any location within one thousand feet of a public or 23 private school existing before the date of the medical cannabis 24 preparation dispensary’s licensure by the department. 25 9. A medical cannabis preparation dispensary shall comply 26 with reasonable restrictions set by the department relating 27 to signage, marketing, display, and advertising of medical 28 cannabis preparation. 29 10. Prior to dispensing of a medical cannabis preparation, 30 a medical cannabis preparation dispensary shall do all of the 31 following: 32 a. Verify that the medical cannabis preparation dispensary 33 has received a valid medical cannabis preparation registration 34 card from a patient or a patient’s primary caregiver, if 35 -14- LSB 2562XC (7) 87 rh/rj 14/ 28

S.F. _____ applicable. 1 b. Assign a tracking number to the medical cannabis 2 preparation dispensed from the medical cannabis preparation 3 dispensary. 4 c. (1) Properly package the medical cannabis preparation in 5 compliance with federal law regarding child resistant packaging 6 and exemptions for packaging for elderly patients, and label 7 the medical cannabis preparation with a list of all active 8 ingredients and individually identifying information, including 9 all of the following: 10 (a) The name and date of birth of the patient and the 11 patient’s primary caregiver, if appropriate. 12 (b) The medical cannabis preparation registration card 13 numbers of the patient and the patient’s primary caregiver, if 14 applicable. 15 (c) The chemical composition of the medical cannabis 16 preparation. 17 (2) Proper packaging of the medical cannabis preparation 18 shall include but not be limited to all of the following: 19 (a) Warning labels regarding the use of the medical 20 cannabis preparation by a woman during pregnancy and while 21 breastfeeding. 22 (b) Clearly labeled packaging indicating that an edible 23 medical cannabis preparation product contains a medical 24 cannabis preparation, which packaging shall not imitate candy 25 products or in any way make the product marketable to children. 26 Sec. 14. NEW SECTION . 124E.10 Fees. 27 Medical cannabis preparation registration card fees and 28 medical cannabis preparation manufacturer and medical cannabis 29 preparation dispensary application and annual fees collected 30 by the department pursuant to this chapter shall be retained 31 by the department, shall be considered repayment receipts as 32 defined in section 8.2, and shall be used for the purpose 33 of regulating medical cannabis preparation manufacturers 34 and medical cannabis preparation dispensaries and for other 35 -15- LSB 2562XC (7) 87 rh/rj 15/ 28

S.F. _____ expenses necessary for the administration of this chapter. 1 Notwithstanding section 8.33, moneys retained by the department 2 that remain unencumbered or unobligated at the end of the 3 fiscal year shall not revert to the general fund of the state. 4 Sec. 15. NEW SECTION . 124E.11 Department duties —— rules. 5 1. a. The department shall maintain a confidential file 6 of the names of each patient to or for whom the department 7 issues a medical cannabis preparation registration card and the 8 name of each primary caregiver to whom the department issues a 9 medical cannabis preparation registration card under section 10 124E.4. 11 b. Individual names contained in the file shall be 12 confidential and shall not be subject to disclosure, except as 13 provided in subparagraph (1). 14 (1) Information in the confidential file maintained 15 pursuant to paragraph “a” may be released on an individual basis 16 to the following persons under the following circumstances: 17 (a) To authorized employees or agents of the department and 18 the department of transportation as necessary to perform the 19 duties of the department and the department of transportation 20 pursuant to this chapter. 21 (b) To authorized employees of state or local law 22 enforcement agencies, but only for the purpose of verifying 23 that a person is lawfully in possession of a medical cannabis 24 preparation registration card issued pursuant to this chapter. 25 (c) To authorized employees of a medical cannabis 26 preparation dispensary, but only for the purpose of verifying 27 that a person is lawfully in possession of a medical cannabis 28 preparation registration card issued pursuant to this chapter. 29 (2) Release of information pursuant to subparagraph 30 (1) shall be consistent with the federal Health Insurance 31 Portability and Accountability Act of 1996, Pub. L. No. 32 104-191. 33 2. The department shall adopt rules pursuant to chapter 34 17A to administer this chapter which shall include but not be 35 -16- LSB 2562XC (7) 87 rh/rj 16/ 28

S.F. _____ limited to rules to do all of the following: 1 a. Govern the manner in which the department shall consider 2 applications for new and renewal medical cannabis preparation 3 registration cards. 4 b. Identify criteria and set forth procedures for 5 including additional chronic or debilitating diseases or 6 medical conditions or their medical treatments on the list of 7 debilitating medical conditions that qualify for the use of 8 a medical cannabis preparation. Procedures shall include a 9 petition process and shall allow for public comment and public 10 hearings before the medical advisory board. 11 c. Set forth additional chronic or debilitating diseases 12 or medical conditions or associated medical treatments for 13 inclusion on the list of debilitating medical conditions that 14 qualify for the use of a medical cannabis preparation as 15 recommended by the medical advisory board. 16 d. Establish the form and quantity of medical cannabis 17 preparations allowed to be dispensed to a patient or primary 18 caregiver pursuant to this chapter. The form and quantity of 19 medical cannabis preparations shall be appropriate to serve the 20 medical needs of patients with debilitating medical conditions. 21 e. Establish requirements for the licensure of medical 22 cannabis preparation manufacturers and medical cannabis 23 preparation dispensaries and set forth procedures for medical 24 cannabis preparation manufacturers and medical cannabis 25 preparation dispensaries to obtain licenses. 26 f. Develop a dispensing system for medical cannabis 27 preparations within this state that provides for all of the 28 following: 29 (1) Medical cannabis preparation dispensaries within this 30 state housed on secured grounds and operated by licensed 31 medical cannabis preparation dispensaries. 32 (2) The dispensing of medical cannabis preparations to 33 patients and their primary caregivers to occur at locations 34 designated by the department. 35 -17- LSB 2562XC (7) 87 rh/rj 17/ 28

S.F. _____ g. Specify and implement procedures that address public 1 safety including security procedures and product quality 2 including measures to ensure contaminant-free cultivation of 3 medical cannabis, and measures to ensure safety, and proper 4 labeling of medical cannabis preparations. 5 h. Establish and implement a medical cannabis and medical 6 cannabis preparation inventory and delivery tracking system 7 to track medical cannabis and medical cannabis preparations 8 from production by a medical cannabis preparation manufacturer 9 through dispensing at a medical cannabis preparation 10 dispensary. 11 Sec. 16. NEW SECTION . 124E.12 Reciprocity. 12 A valid medical cannabis preparation registration card, or 13 its equivalent, issued under the laws of another state that 14 allows an out-of-state patient to possess or use a medical 15 cannabis preparation in the jurisdiction of issuance shall 16 have the same force and effect as a valid medical cannabis 17 preparation registration card issued pursuant to this chapter, 18 except that an out-of-state patient in this state shall not 19 obtain medical cannabis preparations from a medical cannabis 20 preparation dispensary in this state and an out-of-state 21 patient shall not smoke medical cannabis preparations in this 22 state. 23 Sec. 17. NEW SECTION . 124E.13 Use of medical cannabis 24 preparation —— smoking prohibited. 25 A patient shall not consume a medical cannabis preparation 26 possessed or used as authorized by this chapter by smoking the 27 medical cannabis preparation. 28 Sec. 18. NEW SECTION . 124E.14 Use of medical cannabis 29 preparation —— affirmative defenses. 30 1. A health care practitioner, including any authorized 31 agent or employee thereof, shall not be subject to 32 prosecution for the unlawful certification, possession, or 33 administration of marijuana under the laws of this state for 34 activities arising directly out of or directly related to the 35 -18- LSB 2562XC (7) 87 rh/rj 18/ 28

S.F. _____ certification or use of a medical cannabis preparation in the 1 treatment of a patient diagnosed with a debilitating medical 2 condition as authorized by this chapter. 3 2. A medical cannabis preparation manufacturer, including 4 any authorized agent or employee thereof, shall not be subject 5 to prosecution for manufacturing, possessing, cultivating, 6 harvesting, packaging, processing, transporting, or supplying 7 medical cannabis or medical cannabis preparations pursuant to 8 this chapter. 9 3. A medical cannabis preparation dispensary, including any 10 authorized agent or employee thereof, shall not be subject to 11 prosecution for transporting, supplying, or dispensing medical 12 cannabis preparations pursuant to this chapter. 13 a. In a prosecution for the unlawful possession of marijuana 14 under the laws of this state, including but not limited to 15 chapters 124 and 453B, it is an affirmative and complete 16 defense to the prosecution that the patient has been diagnosed 17 with a debilitating medical condition, used or possessed a 18 medical cannabis preparation pursuant to a certification by a 19 health care practitioner as authorized under this chapter, and, 20 for a patient eighteen years of age or older, is in possession 21 of a valid medical cannabis preparation registration card. 22 b. In a prosecution for the unlawful possession of marijuana 23 under the laws of this state, including but not limited to 24 chapters 124 and 453B, it is an affirmative and complete 25 defense to the prosecution that the person possessed a medical 26 cannabis preparation because the person is a primary caregiver 27 of a patient who has been diagnosed with a debilitating 28 medical condition and is in possession of a valid medical 29 cannabis preparation registration card, and where the primary 30 caregiver’s possession of the medical cannabis preparation is 31 on behalf of the patient and for the patient’s use only as 32 authorized under this chapter. 33 c. If a patient or primary caregiver is charged with the 34 commission of a crime and is not in possession of the person’s 35 -19- LSB 2562XC (7) 87 rh/rj 19/ 28

S.F. _____ medical cannabis preparation registration card, any charge or 1 charges filed against the person shall be dismissed by the 2 court if the person produces to the court prior to or at the 3 person’s trial a medical cannabis preparation registration card 4 issued to that person and valid at the time the person was 5 charged. 6 4. An agency of this state or a political subdivision 7 thereof, including any law enforcement agency, shall not remove 8 or initiate proceedings to remove a patient under the age 9 of eighteen from the home of a parent based solely upon the 10 parent’s or patient’s possession or use of a medical cannabis 11 preparation as authorized under this chapter. 12 Sec. 19. NEW SECTION . 124E.15 Penalties. 13 1. A person who knowingly or intentionally possesses or uses 14 medical cannabis or a medical cannabis preparation in violation 15 of the requirements of this chapter is subject to the penalties 16 provided under chapters 124 and 453B. 17 2. A medical cannabis preparation manufacturer or a medical 18 cannabis preparation dispensary shall be assessed a civil 19 penalty of up to one thousand dollars per violation for any 20 violation of this chapter in addition to any other applicable 21 penalties. 22 Sec. 20. REPEAL. Chapter 124D, Code 2017, is repealed. 23 Sec. 21. TRANSITION PROVISIONS. A cannabidiol registration 24 card issued under chapter 124D prior to the effective date of 25 this Act, remains effective and continues in effect as issued 26 for the twelve-month period following its issuance. This Act 27 does not preclude the cannabidiol registration card holder 28 from seeking to renew the card under this Act prior to the 29 expiration of the twelve-month period. 30 Sec. 22. EFFECTIVE UPON ENACTMENT. This Act, being deemed 31 of immediate importance, takes effect upon enactment. 32 EXPLANATION 33 The inclusion of this explanation does not constitute agreement with 34 the explanation’s substance by the members of the general assembly. 35 -20- LSB 2562XC (7) 87 rh/rj 20/ 28

S.F. _____ This bill creates the compassionate use of medical 1 cannabis preparations Act, reclassifies marijuana, including 2 tetrahydrocannabinols, from a schedule I controlled substance 3 to a schedule II controlled substance, and provides for civil 4 and criminal penalties and fees. 5 OVERVIEW. The bill allows a patient with a debilitating 6 medical condition (as defined in the bill) who receives 7 a written certification from the patient’s health care 8 practitioner that the patient has a debilitating medical 9 condition and who submits the written certification along with 10 an application to the department of public health (department) 11 for a medical cannabis preparation registration card to allow 12 for the lawful use of a medical cannabis preparation to treat 13 the patient’s debilitating medical condition. A patient who is 14 issued a medical cannabis preparation registration card will be 15 able to receive a medical cannabis preparation directly from a 16 medical cannabis preparation dispensary operated and licensed 17 in this state. 18 RECLASSIFICATION. The bill reclassifies marijuana, 19 including tetrahydrocannabinols as a schedule II controlled 20 substance instead of a schedule I controlled substance and 21 strikes references to the authority of the board of pharmacy to 22 adopt rules for the use of marijuana or tetrahydrocannabinols 23 for medicinal purposes. 24 A schedule I controlled substance is a highly addictive 25 substance that has no accepted medical use in the United States 26 and a schedule II controlled substance is a highly addictive 27 substance that has an accepted medical use in the United 28 States. The reclassification of marijuana from a schedule I 29 controlled substance to a schedule II controlled substance 30 would allow a physician to issue a prescription for marijuana 31 under state law. However, federal regulations may prohibit 32 such prescriptions. 33 The penalties remain unchanged for violations involving 34 marijuana under the bill. The penalties under Code section 35 -21- LSB 2562XC (7) 87 rh/rj 21/ 28