House File 573 H-1070 Amend House File 573 as follows: 1 1. By striking everything after the enacting clause 2 and inserting: 3 < Section 1. Section 124.401, subsection 5, 4 unnumbered paragraph 3, Code 2015, is amended to read 5 as follows: 6 A person may knowingly or intentionally recommend, 7 possess, use, dispense, deliver, transport, or 8 administer cannabidiol medical cannabis if the 9 recommendation, possession, use, dispensing, delivery, 10 transporting, or administering is in accordance with 11 the provisions of chapter 124D 124E . For purposes of 12 this paragraph, “cannabidiol” “medical cannabis” means 13 the same as defined in section 124D.2 124E.2 . 14 Sec. 2. NEW SECTION . 124E.1 Short title. 15 This chapter shall be known and may be cited as the 16 “Medical Cannabis Act” . 17 Sec. 3. NEW SECTION . 124E.2 Definitions. 18 As used in this chapter: 19 1. “Debilitating medical condition” means any of the 20 following: 21 a. Cancer. 22 b. Multiple sclerosis. 23 c. Epilepsy. 24 d. AIDS or HIV as defined in section 141A.1. 25 e. Glaucoma. 26 f. Hepatitis C. 27 g. Crohn’s disease or ulcerative colitis. 28 h. Amyotrophic lateral sclerosis. 29 i. Ehlers-danlos syndrome. 30 j. Post-traumatic stress syndrome. 31 k. Any other chronic or debilitating disease or 32 medical condition or its medical treatment approved by 33 the department pursuant to rule. 34 2. “Department” means the department of public 35 health. 36 3. “Disqualifying felony offense” means a violation 37 under federal or state law of a felony offense, which 38 has as an element the possession, use, or distribution 39 of a controlled substance, as defined in 21 U.S.C. 40 §802(6). 41 4. “Enclosed, locked facility” means a closet, room, 42 greenhouse, or other enclosed area equipped with locks 43 or other security devices that permit access only by a 44 cardholder. 45 5. “Health care practitioner” means an individual 46 licensed under chapter 148 to practice medicine 47 and surgery or osteopathic medicine and surgery, a 48 physician assistant licensed under chapter 148C, or 49 an advanced registered nurse practitioner licensed 50 -1- HF573.828 (3) 86 pf/nh 1/ 12 #1.

pursuant to chapter 152 or 152E. 1 6. “Medical cannabis” means any species of the genus 2 cannabis plant, or any mixture or preparation of them, 3 including whole plant extracts and resins. 4 7. “Medical cannabis dispensary” means an entity 5 licensed under section 124E.6 that dispenses and 6 acquires, possesses, cultivates, or manufactures 7 medical cannabis pursuant to this chapter. 8 8. “Medical cannabis manufacturer” means an entity 9 licensed by the department to manufacture and to 10 possess, cultivate, transport, supply, or dispense 11 medical cannabis pursuant to the provisions of this 12 chapter. 13 9. “Primary caregiver” means a person, at least 14 eighteen years of age, who has been designated by a 15 patient’s health care practitioner or a person having 16 custody of a patient, as a necessary caretaker taking 17 responsibility for managing the well-being of the 18 patient with respect to the use of medical cannabis 19 pursuant to the provisions of this chapter. 20 10. “Written certification” means a document signed 21 by a health care practitioner, with whom the patient 22 has established a patient-provider relationship, which 23 states that the patient has a debilitating medical 24 condition and identifies that condition and provides 25 any other relevant information. 26 Sec. 4. NEW SECTION . 124E.3 Health care 27 practitioner certification —— duties. 28 1. Prior to a patient’s submission of an 29 application for a medical cannabis card pursuant to 30 section 124E.4, a health care practitioner shall do all 31 of the following: 32 a. Determine, in the health care practitioner’s 33 medical judgment, whether the patient whom the health 34 care practitioner has examined and treated suffers from 35 a debilitating medical condition that qualifies for 36 the use of medical cannabis under this chapter, and 37 if so determined, provide the patient with a written 38 certification of that diagnosis. 39 b. Provide explanatory information as provided by 40 the department to the patient about the therapeutic use 41 of medical cannabis. 42 2. Determine, on an annual basis, if the patient 43 continues to suffer from a debilitating medical 44 condition and, if so, issue the patient a new 45 certification of that diagnosis. 46 3. Otherwise comply with all requirements 47 established by the department pursuant to rule. 48 4. A health care practitioner may provide, but has 49 no duty to provide, a written certification pursuant 50 -2- HF573.828 (3) 86 pf/nh 2/ 12

to this section. 1 Sec. 5. NEW SECTION . 124E.4 Medical cannabis 2 registration card. 3 1. Issuance to patient. The department may approve 4 the issuance of a medical cannabis registration card by 5 the department of transportation to a patient who: 6 a. Is at least eighteen years of age. 7 b. Is a permanent resident of this state. 8 c. Submits a written certification to the 9 department signed by the patient’s health care 10 practitioner that the patient is suffering from a 11 debilitating medical condition. 12 d. Submits an application to the department, on a 13 form created by the department, in consultation with 14 the department of transportation, that contains all of 15 the following: 16 (1) The patient’s full name, Iowa residence 17 address, date of birth, and telephone number. 18 (2) A copy of the patient’s valid photo 19 identification. 20 (3) Full name, address, and telephone number of the 21 patient’s health care practitioner. 22 (4) Full name, residence address, date of birth, 23 and telephone number of each primary caregiver of the 24 patient, if any. 25 (5) Any other information required by rule. 26 2. Patient card contents. A medical cannabis 27 registration card issued to a patient by the department 28 of transportation pursuant to subsection 1 shall 29 contain, at a minimum, all of the following: 30 a. The patient’s full name, Iowa residence address, 31 and date of birth. 32 b. The patient’s photo. 33 c. The date of issuance and expiration date of the 34 registration card. 35 d. Any other information required by rule. 36 3. Issuance to primary caregiver. For a patient in 37 a primary caregiver’s care, the department may approve 38 the issuance of a medical cannabis registration card 39 by the department of transportation to the primary 40 caregiver who: 41 a. Is at least eighteen years of age. 42 b. Submits a written certification to the 43 department signed by the patient’s health care 44 practitioner that the patient in the primary 45 caregiver’s care is suffering from a debilitating 46 medical condition. 47 c. Submits an application to the department, on a 48 form created by the department, in consultation with 49 the department of transportation, that contains all of 50 -3- HF573.828 (3) 86 pf/nh 3/ 12

the following: 1 (1) The primary caregiver’s full name, residence 2 address, date of birth, and telephone number. 3 (2) The patient’s full name. 4 (3) A copy of the primary caregiver’s valid photo 5 identification. 6 (4) Full name, address, and telephone number of the 7 patient’s health care practitioner. 8 (5) Any other information required by rule. 9 4. Primary caregiver card contents. A medical 10 cannabis registration card issued by the department 11 of transportation to a primary caregiver pursuant to 12 subsection 3 shall contain, at a minimum, all of the 13 following: 14 a. The primary caregiver’s full name, residence 15 address, and date of birth. 16 b. The primary caregiver’s photo. 17 c. The date of issuance and expiration date of the 18 registration card. 19 d. The full name of each patient in the primary 20 caregiver’s care. 21 e. Any other information required by rule. 22 5. Expiration date of card. A medical cannabis 23 registration card issued pursuant to this section shall 24 expire one year after the date of issuance and may be 25 renewed. 26 6. Card issuance —— department of 27 transportation. The department may enter into 28 a chapter 28E agreement with the department of 29 transportation to facilitate the issuance of medical 30 cannabis registration cards pursuant to subsections 1 31 and 3. 32 Sec. 6. NEW SECTION . 124E.5 Medical advisory board 33 —— duties. 34 1. No later than August 15, 2015, the director 35 of public health shall establish a medical advisory 36 board consisting of nine practitioners representing the 37 fields of neurology, pain management, gastroenterology, 38 oncology, psychiatry, infectious disease, family 39 medicine, gynecology, and pharmacy. The practitioners 40 shall be nationally board-certified in their area of 41 specialty and knowledgeable about the use of medical 42 cannabis. 43 2. A quorum of the advisory board shall consist of 44 five members. 45 3. The duties of the advisory board shall include 46 but not be limited to the following: 47 a. Reviewing and recommending to the department for 48 approval additional chronic or debilitating diseases or 49 medical conditions or their treatments as debilitating 50 -4- HF573.828 (3) 86 pf/nh 4/ 12

medical conditions that qualify for the use of medical 1 cannabis under this chapter. 2 b. Accepting and reviewing petitions to add chronic 3 or debilitating diseases or medical conditions or their 4 medical treatments to the list of debilitating medical 5 conditions that qualify for the use of medical cannabis 6 under this chapter. 7 c. Advising the department regarding the location 8 of medical cannabis dispensaries throughout the state, 9 the form and quantity of allowable medical cannabis to 10 be dispensed to a patient or primary caregiver, and the 11 general oversight of medical cannabis manufacturers and 12 medical cannabis dispensaries in this state. 13 d. Convening at least twice per year to conduct 14 public hearings and to evaluate petitions, which 15 shall be maintained as confidential personal health 16 information, to add chronic or debilitating diseases or 17 medical conditions or their medical treatments to the 18 list of debilitating medical conditions that qualify 19 for the use of medical cannabis under this chapter. 20 Sec. 7. NEW SECTION . 124E.6 Medical cannabis 21 manufacturer licensure. 22 1. a. The department shall license four medical 23 cannabis manufacturers to manufacture medical cannabis 24 within this state consistent with the provisions of 25 this chapter by December 1, 2015. The department shall 26 license new medical cannabis manufacturers or relicense 27 the existing medical cannabis manufacturers by December 28 1 of each year. 29 b. Information submitted during the application 30 process shall be confidential until the medical 31 cannabis manufacturer is licensed by the department 32 unless otherwise protected from disclosure under state 33 or federal law. 34 2. As a condition for licensure, a medical cannabis 35 manufacturer must agree to begin supplying medical 36 cannabis to patients by July 1, 2016. 37 3. The department shall consider the following 38 factors in determining whether to license a medical 39 cannabis manufacturer: 40 a. The technical expertise of the medical cannabis 41 manufacturer in medical cannabis. 42 b. The qualifications of the medical cannabis 43 manufacturer’s employees. 44 c. The long-term financial stability of the medical 45 cannabis manufacturer. 46 d. The ability to provide appropriate security 47 measures on the premises of the medical cannabis 48 manufacturer. 49 e. Whether the medical cannabis manufacturer 50 -5- HF573.828 (3) 86 pf/nh 5/ 12

has demonstrated an ability to meet certain medical 1 cannabis production needs for medical use in the manner 2 determined by the department pursuant to rule. 3 f. The medical cannabis manufacturer’s projection 4 and ongoing assessment of fees on patients with 5 debilitating medical conditions. 6 4. The department shall require each medical 7 cannabis manufacturer to contract with the state 8 hygienic laboratory at the university of Iowa in Iowa 9 City to test the medical cannabis produced by the 10 manufacturer. The department shall require that the 11 laboratory report testing results to the manufacturer 12 in a manner determined by the department pursuant to 13 rule. 14 5. Each entity submitting an application for 15 licensure as a medical cannabis manufacturer shall 16 pay an application fee of seven thousand five hundred 17 dollars to the department. 18 Sec. 8. NEW SECTION . 124E.7 Medical cannabis 19 manufacturers —— medical cannabis dispensaries. 20 1. a. A medical cannabis manufacturer shall 21 operate three medical cannabis dispensaries, which may 22 include the medical cannabis manufacturer’s single 23 location for manufacturing and cultivating, harvesting, 24 packaging, or processing. 25 b. A medical cannabis manufacturer shall begin 26 dispensing medical cannabis from at least one medical 27 cannabis dispensary by July 1, 2016. 28 c. The medical cannabis dispensaries shall be 29 located based on geographical need throughout the state 30 to improve patient access. 31 d. A medical cannabis manufacturer shall disclose 32 the proposed locations for the medical cannabis 33 dispensaries to the department during the licensure 34 process. 35 e. A medical cannabis manufacturer shall operate 36 only one location where all manufacturing and 37 cultivating, harvesting, packaging, or processing 38 shall be conducted. The other medical cannabis 39 dispensaries may dispense medical cannabis pursuant to 40 the provisions of this chapter but shall not dispense 41 any medical cannabis in a form or quantity other than 42 the form or quantity allowed by the department pursuant 43 to rule. 44 2. A medical cannabis manufacturer shall contract 45 with the state hygienic laboratory at the university 46 of Iowa in Iowa City for purposes of testing the 47 medical cannabis manufactured by the medical cannabis 48 manufacturer as to content, contamination, and 49 consistency. The cost of all laboratory testing shall 50 -6- HF573.828 (3) 86 pf/nh 6/ 12

be paid by the medical cannabis manufacturer. 1 3. The operating documents of a medical cannabis 2 manufacturer shall include all of the following: 3 a. Procedures for the oversight of the medical 4 cannabis manufacturer and procedures to ensure accurate 5 record keeping. 6 b. Procedures for the implementation of appropriate 7 security measures to deter and prevent the theft of 8 medical cannabis and unauthorized entrance into areas 9 containing medical cannabis. 10 4. A medical cannabis manufacturer shall implement 11 security requirements, including requirements for 12 protection of each location by a fully operational 13 security alarm system, facility access controls, 14 perimeter intrusion detection systems, and a personnel 15 identification system. 16 5. A medical cannabis manufacturer shall not share 17 office space with, refer patients to, or have any 18 financial relationship with a health care practitioner. 19 6. A medical cannabis manufacturer shall not permit 20 any person to consume medical cannabis on the property 21 of the medical cannabis manufacturer. 22 7. A medical cannabis manufacturer is subject to 23 reasonable inspection by the department. 24 8. A medical cannabis manufacturer shall not employ 25 a person under twenty-one years of age or who has 26 been convicted of a disqualifying felony offense. An 27 employee of a medical cannabis manufacturer shall be 28 subject to a background investigation conducted by the 29 division of criminal investigation of the department 30 of public safety and a national criminal history 31 background check. 32 9. A medical cannabis manufacturer shall not 33 operate in any location, whether for dispensing or for 34 manufacturing, cultivating, harvesting, packaging, or 35 processing, within one thousand feet of a public or 36 private school existing before the date of the medical 37 cannabis manufacturer’s licensure by the department. 38 10. A medical cannabis manufacturer shall comply 39 with reasonable restrictions set by the department 40 relating to signage, marketing, display, and 41 advertising of medical cannabis. 42 Sec. 9. NEW SECTION . 124E.8 Medical cannabis 43 manufacturer —— production and dispensation. 44 1. Production. 45 a. A medical cannabis manufacturer shall provide a 46 reliable and ongoing supply of medical cannabis for all 47 patients served pursuant to this chapter. 48 b. All manufacturing, cultivating, harvesting, 49 manufacturing, packaging, and processing of medical 50 -7- HF573.828 (3) 86 pf/nh 7/ 12

cannabis shall take place in an enclosed, locked 1 facility at a physical address provided to the 2 department during the licensure process. 3 2. Dispensation. Prior to dispensing of any 4 medical cannabis, the medical cannabis manufacturer 5 shall do all of the following: 6 a. Verify that the medical cannabis manufacturer 7 has received a valid medical cannabis registration card 8 from a patient or a patient’s primary caregiver, if 9 applicable. 10 b. Assign a tracking number to any medical cannabis 11 dispensed from the manufacturer. 12 c. Properly package medical cannabis in compliance 13 with federal law regarding child resistant packaging 14 and exemptions for packaging for elderly patients, 15 and label medical cannabis with a list of all active 16 ingredients and individually identifying information, 17 including all of the following: 18 (1) The name and date of birth of the patient and 19 the patient’s primary caregiver, if appropriate. 20 (2) The medical cannabis registration card numbers 21 of the patient and the patient’s primary caregiver, if 22 applicable. 23 (3) The chemical composition of the medical 24 cannabis. 25 Sec. 10. NEW SECTION . 124E.9 Department duties —— 26 rules. 27 1. a. The department shall maintain a confidential 28 file of the names of each patient to or for whom the 29 department issues a medical cannabis registration card 30 and the name of each primary caregiver to whom the 31 department issues a medical cannabis registration card 32 under section 124E.4. 33 b. Individual names contained in the file shall be 34 confidential and shall not be subject to disclosure, 35 except as provided in subparagraph (1). 36 (1) Information in the confidential file maintained 37 pursuant to paragraph “a” may be released on an 38 individual basis to the following persons under the 39 following circumstances: 40 (a) To authorized employees or agents of the 41 department and the department of transportation as 42 necessary to perform the duties of the department and 43 the department of transportation pursuant to this 44 chapter. 45 (b) To authorized employees of state or local 46 law enforcement agencies, but only for the purpose of 47 verifying that a person is lawfully in possession of a 48 medical cannabis registration card issued pursuant to 49 this chapter. 50 -8- HF573.828 (3) 86 pf/nh 8/ 12

(c) To authorized employees of a medical cannabis 1 manufacturer, but only for the purpose of verifying 2 that a person is lawfully in possession of a medical 3 cannabis registration card issued pursuant to this 4 chapter. 5 (2) Release of information pursuant to subparagraph 6 (1) shall be consistent with the federal Health 7 Insurance Portability and Accountability Act of 1996, 8 Pub. L. No. 104-191. 9 2. The department shall adopt rules pursuant to 10 chapter 17A to administer this chapter which shall 11 include but not be limited to rules to do all of the 12 following: 13 a. Govern the manner in which the department shall 14 consider applications for new and renewal medical 15 cannabis registration cards. 16 b. Identify criteria and set forth procedures for 17 including additional chronic or debilitating diseases 18 or medical conditions or their medical treatments 19 on the list of debilitating medical conditions that 20 qualify for the use of medical cannabis. Procedures 21 shall include a petition process and shall allow for 22 public comment and public hearings before the medical 23 advisory board. 24 c. Set forth additional chronic or debilitating 25 diseases or medical conditions or their medical 26 treatments for inclusion on the list of debilitating 27 medical conditions that qualify for the use of medical 28 cannabis as recommended by the medical advisory board. 29 d. Establish the form and quantity of medical 30 cannabis allowed to be dispensed to a patient or 31 primary caregiver pursuant to this chapter. The 32 form and quantity of medical cannabis shall be 33 appropriate to serve the medical needs of patients with 34 debilitating conditions. 35 e. Establish requirements for the licensure of 36 medical cannabis manufacturers and set forth procedures 37 for medical cannabis manufacturers to obtain licenses. 38 f. Develop a dispensing system for medical cannabis 39 within this state that provides for all of the 40 following: 41 (1) Medical cannabis manufacturing facilities 42 within this state housed on secured grounds and 43 operated by licensed medical cannabis manufacturers. 44 (2) The dispensing of medical cannabis to patients 45 and their primary caregivers to occur at locations 46 designated by the department. 47 g. Establish medical cannabis registration card 48 application and renewal fees. 49 h. Specify and implement procedures that address 50 -9- HF573.828 (3) 86 pf/nh 9/ 12

public safety including security procedures and product 1 quality including measures to ensure contaminant-free 2 cultivation of medical cannabis, safety, and labeling. 3 Sec. 11. NEW SECTION . 124E.10 Reciprocity. 4 A valid medical cannabis registration card, or its 5 equivalent, issued under the laws of another state 6 that allows an out-of-state patient to possess or use 7 medical cannabis in the jurisdiction of issuance shall 8 have the same force and effect as a valid medical 9 cannabis registration card issued pursuant to this 10 chapter, except that an out-of-state patient in this 11 state shall not obtain medical cannabis from a medical 12 cannabis dispensary in this state. 13 Sec. 12. NEW SECTION . 124E.11 Use of medical 14 cannabis —— smoking prohibited. 15 A patient shall not consume medical cannabis 16 possessed or used as authorized by this chapter by 17 smoking medical cannabis. 18 Sec. 13. NEW SECTION . 124E.12 Use of medical 19 cannabis —— affirmative defenses. 20 1. A health care practitioner, including any 21 authorized agent or employee thereof, shall not be 22 subject to prosecution for the unlawful certification, 23 possession, or administration of marijuana under the 24 laws of this state for activities arising directly 25 out of or directly related to the certification or 26 use of medical cannabis in the treatment of a patient 27 diagnosed with a debilitating medical condition as 28 authorized by this chapter. 29 2. A medical cannabis manufacturer, including any 30 authorized agent or employee thereof, shall not be 31 subject to prosecution for manufacturing, possessing, 32 cultivating, harvesting, packaging, or processing, or 33 transporting, supplying, or dispensing medical cannabis 34 pursuant to this chapter. 35 3. A medical cannabis dispensary, including any 36 authorized agent or employee thereof, shall not be 37 subject to prosecution for transporting, supplying, or 38 dispensing medical cannabis pursuant to this chapter. 39 a. In a prosecution for the unlawful possession 40 of marijuana under the laws of this state, including 41 but not limited to chapters 124 and 453B, it is an 42 affirmative and complete defense to the prosecution 43 that the patient has been diagnosed with a debilitating 44 medical condition, used or possessed medical 45 cannabis pursuant to a certification by a health care 46 practitioner as authorized under this chapter, and, 47 for a patient eighteen years of age or older, is in 48 possession of a valid medical cannabis registration 49 card. 50 -10- HF573.828 (3) 86 pf/nh 10/ 12

b. In a prosecution for the unlawful possession 1 of marijuana under the laws of this state, including 2 but not limited to chapters 124 and 453B, it is an 3 affirmative and complete defense to the prosecution 4 that the person possessed medical cannabis because the 5 person is a primary caregiver of a patient who has been 6 diagnosed with a debilitating medical condition and is 7 in possession of a valid medical cannabis registration 8 card, and where the primary caregiver’s possession of 9 the medical cannabis is on behalf of the patient and 10 for the patient’s use only as authorized under this 11 chapter. 12 c. If a patient or primary caregiver is charged 13 with the commission of a crime and is not in possession 14 of the person’s medical cannabis registration card, 15 any charge or charges filed against the person shall 16 be dismissed by the court if the person produces to 17 the court prior to or at the person’s trial a medical 18 cannabis registration card issued to that person and 19 valid at the time the person was charged. 20 4. An agency of this state or a political 21 subdivision thereof, including any law enforcement 22 agency, shall not remove or initiate proceedings to 23 remove a patient under the age of eighteen from the 24 home of a parent based solely upon the parent’s or 25 patient’s possession or use of medical cannabis as 26 authorized under this chapter. 27 Sec. 14. NEW SECTION . 124E.13 Penalties. 28 1. A person who knowingly or intentionally 29 possesses or uses medical cannabis in violation of 30 the requirements of this chapter is subject to the 31 penalties provided under chapters 124 and 453B. 32 2. A medical cannabis manufacturer shall be 33 assessed a civil penalty of up to one thousand dollars 34 per violation for any violation of this chapter in 35 addition to any other applicable penalties. 36 Sec. 15. EMERGENCY RULES. The department may 37 adopt emergency rules under section 17A.4, subsection 38 3, and section 17A.5, subsection 2, paragraph “b”, to 39 implement the provisions of this Act and the rules 40 shall be effective immediately upon filing unless 41 a later date is specified in the rules. Any rules 42 adopted in accordance with this section shall also be 43 published as a notice of intended action as provided 44 in section 17A.4. 45 Sec. 16. TRANSITION PROVISIONS. A medical cannabis 46 registration card issued under chapter 124D prior to 47 July 1, 2015, remains effective and continues in effect 48 as issued for the twelve-month period following its 49 issuance. This Act does not preclude the permit holder 50 -11- HF573.828 (3) 86 pf/nh 11/ 12

from seeking to renew the permit under this Act prior 1 to the expiration of the twelve-month period. 2 Sec. 17. REPORTS. The university of Iowa Carver 3 college of medicine and college of pharmacy shall, 4 on or before July 1 of each year, beginning July 5 1, 2016, submit a report detailing the scientific 6 literature, studies, and clinical trials regarding the 7 use of medical cannabis on patients diagnosed with 8 debilitating medical conditions as defined in this Act 9 to the department of public health and the general 10 assembly. 11 Sec. 18. REPEAL. Chapter 124D, Code 2015, is 12 repealed. > 13 2. Title page, by striking lines 1 and 2 and 14 inserting < An Act creating the medical cannabis Act and 15 provides for civil and criminal penalties and fees. > 16 ______________________________ LENSING of Johnson -12- HF573.828 (3) 86 pf/nh 12/ 12 #2.