Senate File 2299 H-8294 Amend Senate File 2299, as amended, passed, and 1 reprinted by the Senate, as follows: 2 1. Page 1, before line 1 by inserting: 3 < DIVISION I 4 EARLY CHILDHOOD IOWA INITIATIVE > 5 2. Page 8, after line 4 by inserting: 6 < DIVISION ___ 7 MEDICAL CANNABIS 8 Sec. ___. Section 124.204, subsection 4, paragraphs 9 m and u, Code 2016, are amended by striking the 10 paragraphs. 11 Sec. ___. Section 124.204, subsection 7, Code 2016, 12 is amended by striking the subsection. 13 Sec. ___. Section 124.206, subsection 7, Code 2016, 14 is amended to read as follows: 15 7. Hallucinogenic substances. Unless specifically 16 excepted or unless listed in another schedule, any 17 material, compound, mixture, or preparation which 18 contains any quantity of the following substances , 19 or, for purposes of paragraphs “a” and “b” , which 20 contains any of its salts, isomers, or salts of isomers 21 whenever the existence of such salts, isomers, or salts 22 of isomers is possible within the specific chemical 23 designation (for purposes of this paragraph only, the 24 term “isomer” includes the optical, positional, and 25 geometric isomers) : 26 a. Marijuana when used for medicinal purposes 27 pursuant to rules of the board . 28 b. Tetrahydrocannabinols, meaning 29 tetrahydrocannabinols naturally contained in a 30 plant of the genus cannabis (cannabis plant) as well 31 as synthetic equivalents of the substances contained 32 in the cannabis plant, or in the resinous extractives 33 of such plant, and synthetic substances, derivatives, 34 and their isomers with similar chemical structure and 35 -1- SF2299.3871 (2) 86 rh/rj 1/ 22 #1. #2.

pharmacological activity to those substances contained 1 in the plant, such as the following: 2 (1) 1 cis or trans tetrahydrocannabinol, and their 3 optical isomers. 4 (2) 6 cis or trans tetrahydrocannabinol, and their 5 optical isomers. 6 (3) 3,4 cis or trans tetrahydrocannabinol, and 7 their optical isomers. (Since nomenclature of these 8 substances is not internationally standardized, 9 compounds of these structures, regardless of numerical 10 designation of atomic positions covered.) 11 b. c. Nabilone [another name for 12 nabilone: (+-) - 13 trans-3-(1,1-dimethylheptyl)-6,6a,7,8,10,10a-hexahydro-1-hydroxy-6,6- 14 dimethyl-9H-dibenzo[b,d]pyran-9-one]. 15 Sec. ___. Section 124.401, subsection 5, unnumbered 16 paragraph 3, Code 2016, is amended to read as follows: 17 A person may knowingly or intentionally recommend, 18 possess, use, dispense, deliver, transport, or 19 administer cannabidiol medical cannabis if the 20 recommendation, possession, use, dispensing, delivery, 21 transporting, or administering is in accordance with 22 the provisions of chapter 124D 124E . For purposes of 23 this paragraph, “cannabidiol” “medical cannabis” means 24 the same as defined in section 124D.2 124E.2 . 25 Sec. ___. NEW SECTION . 124E.1 Short title. 26 This chapter shall be known and may be cited as the 27 “Compassionate Use of Medical Cannabis Act” . 28 Sec. ___. NEW SECTION . 124E.2 Definitions. 29 As used in this chapter: 30 1. “Debilitating medical condition” means any of the 31 following: 32 a. Cancer, if the underlying condition or treatment 33 produces one or more of the following: 34 (1) Intractable pain. 35 -2- SF2299.3871 (2) 86 rh/rj 2/ 22

(2) Nausea or severe vomiting. 1 (3) Cachexia or severe wasting. 2 b. Multiple sclerosis. 3 c. Epilepsy or seizure disorders. 4 d. AIDS or HIV as defined in section 141A.1. 5 e. Crohn’s disease or ulcerative colitis. 6 f. Amyotrophic lateral sclerosis. 7 g. Intractable pain. 8 h. Glaucoma. 9 i. Any terminal illness, with a probable life 10 expectancy of under one year, if the illness or its 11 treatment produces one or more of the following: 12 (1) Intractable pain. 13 (2) Nausea or severe vomiting. 14 (3) Cachexia or severe wasting. 15 j. Any other chronic or debilitating disease or 16 medical condition or its medical treatment approved by 17 the department pursuant to rule. 18 2. “Department” means the department of public 19 health. 20 3. “Disqualifying felony offense” means a violation 21 under federal or state law of a felony offense, which 22 has as an element the possession, use, or distribution 23 of a controlled substance, as defined in 21 U.S.C. 24 §802(6). 25 4. “Enclosed, locked facility” means a closet, room, 26 greenhouse, or other enclosed area equipped with locks 27 or other security devices that permit access only by a 28 cardholder. 29 5. “Health care practitioner” means an individual 30 licensed under chapter 148 to practice medicine and 31 surgery or osteopathic medicine and surgery or an 32 individual licensed to prescribe medicine in any other 33 state and provides specialty care for an Iowa resident 34 for one or more of the debilitating medical conditions 35 -3- SF2299.3871 (2) 86 rh/rj 3/ 22

provided in this chapter. 1 6. “Intractable pain” means a pain in which the 2 cause of the pain cannot be removed or otherwise 3 treated with the consent of the patient and which, in 4 the generally accepted course of medical practice, no 5 relief or cure of the cause of the pain is possible, 6 or none has been found after reasonable efforts. 7 Reasonable efforts for relieving or curing the cause of 8 the pain may be determined on the basis of but are not 9 limited to any of the following: 10 a. When treating a nonterminally ill patient for 11 intractable pain, evaluation by the attending physician 12 and one or more physicians specializing in pain 13 medicine or the treatment of the area, system, or organ 14 of the body perceived as the source of the pain. 15 b. When treating a terminally ill patient, 16 evaluation by the attending physician who does so in 17 accordance with the level of care, skill, and treatment 18 that would be recognized by a reasonably prudent 19 physician under similar conditions and circumstances. 20 7. “Medical cannabis” means any species of the genus 21 cannabis plant, or any mixture or preparation of them, 22 including whole plant extracts and resins. 23 8. “Medical cannabis manufacturer” means an entity 24 licensed by the department to manufacture and to 25 possess, cultivate, transport, or supply medical 26 cannabis pursuant to the provisions of this chapter. 27 9. “Medical cannabis patient center” means an entity 28 licensed under section 124E.8 that acquires medical 29 cannabis from a medical cannabis manufacturer in this 30 state for the purpose of dispensing medical cannabis in 31 this state pursuant to this chapter. 32 10. “Primary caregiver” means a person, at least 33 eighteen years of age, who has been designated by a 34 patient’s health care practitioner or a person having 35 -4- SF2299.3871 (2) 86 rh/rj 4/ 22

custody of a patient, as a necessary caretaker taking 1 responsibility for managing the well-being of the 2 patient with respect to the use of medical cannabis 3 pursuant to the provisions of this chapter. 4 11. “Written certification” means a document signed 5 by a health care practitioner, with whom the patient 6 has established a patient-provider relationship, which 7 states that the patient has a debilitating medical 8 condition and identifies that condition and provides 9 any other relevant information. 10 Sec. ___. NEW SECTION . 124E.3 Health care 11 practitioner certification —— duties. 12 1. Prior to a patient’s submission of an 13 application for a medical cannabis registration card 14 pursuant to section 124E.4, a health care practitioner 15 shall do all of the following: 16 a. Determine, in the health care practitioner’s 17 medical judgment, whether the patient whom the health 18 care practitioner has examined and treated suffers from 19 a debilitating medical condition that qualifies for 20 the use of medical cannabis under this chapter, and 21 if so determined, provide the patient with a written 22 certification of that diagnosis. 23 b. Provide explanatory information as provided by 24 the department to the patient about the therapeutic use 25 of medical cannabis. 26 2. Determine, on an annual basis, if the patient 27 continues to suffer from a debilitating medical 28 condition and, if so, issue the patient a new 29 certification of that diagnosis. 30 3. Otherwise comply with all requirements 31 established by the department pursuant to rule. 32 4. A health care practitioner may provide, but has 33 no duty to provide, a written certification pursuant 34 to this section. 35 -5- SF2299.3871 (2) 86 rh/rj 5/ 22

Sec. ___. NEW SECTION . 124E.4 Medical cannabis 1 registration card. 2 1. Issuance to patient. The department may approve 3 the issuance of a medical cannabis registration card by 4 the department of transportation to a patient who: 5 a. Is at least eighteen years of age. 6 b. Is a permanent resident of this state. 7 c. Submits a written certification to the 8 department signed by the patient’s health care 9 practitioner that the patient is suffering from a 10 debilitating medical condition. 11 d. Submits an application to the department, on a 12 form created by the department, in consultation with 13 the department of transportation, that contains all of 14 the following: 15 (1) The patient’s full name, Iowa residence 16 address, date of birth, and telephone number. 17 (2) A copy of the patient’s valid photo 18 identification. 19 (3) Full name, address, and telephone number of the 20 patient’s health care practitioner. 21 (4) Full name, residence address, date of birth, 22 and telephone number of each primary caregiver of the 23 patient, if any. 24 (5) Any other information required by rule. 25 2. Patient card contents. A medical cannabis 26 registration card issued to a patient by the department 27 of transportation pursuant to subsection 1 shall 28 contain, at a minimum, all of the following: 29 a. The patient’s full name, Iowa residence address, 30 and date of birth. 31 b. The patient’s photograph. 32 c. The date of issuance and expiration date of the 33 registration card. 34 d. Any other information required by rule. 35 -6- SF2299.3871 (2) 86 rh/rj 6/ 22

3. Issuance to primary caregiver. For a patient in 1 a primary caregiver’s care, the department may approve 2 the issuance of a medical cannabis registration card 3 by the department of transportation to the primary 4 caregiver who: 5 a. Is at least eighteen years of age. 6 b. Submits a written certification to the 7 department signed by the patient’s health care 8 practitioner that the patient in the primary 9 caregiver’s care is suffering from a debilitating 10 medical condition. 11 c. Submits an application to the department, on a 12 form created by the department, in consultation with 13 the department of transportation, that contains all of 14 the following: 15 (1) The primary caregiver’s full name, residence 16 address, date of birth, and telephone number. 17 (2) The patient’s full name. 18 (3) A copy of the primary caregiver’s valid photo 19 identification. 20 (4) Full name, address, and telephone number of the 21 patient’s health care practitioner. 22 (5) Any other information required by rule. 23 4. Primary caregiver card contents. A medical 24 cannabis registration card issued by the department 25 of transportation to a primary caregiver pursuant to 26 subsection 3 shall contain, at a minimum, all of the 27 following: 28 a. The primary caregiver’s full name, residence 29 address, and date of birth. 30 b. The primary caregiver’s photograph. 31 c. The date of issuance and expiration date of the 32 registration card. 33 d. The registration card number of each patient 34 in the primary caregiver’s care. If the patient 35 -7- SF2299.3871 (2) 86 rh/rj 7/ 22

in the primary caregiver’s care is under the age of 1 eighteen, the full name of the patient’s parent or 2 legal guardian. 3 e. Any other information required by rule. 4 5. Expiration date of card. A medical cannabis 5 registration card issued pursuant to this section shall 6 expire one year after the date of issuance and may be 7 renewed. 8 6. Card issuance —— department of 9 transportation. The department may enter into 10 a chapter 28E agreement with the department of 11 transportation to facilitate the issuance of medical 12 cannabis registration cards pursuant to subsections 1 13 and 3. 14 Sec. ___. NEW SECTION . 124E.5 Medical advisory 15 board —— duties. 16 1. No later than August 15, 2016, the director 17 of public health shall establish a medical advisory 18 board consisting of nine practitioners representing the 19 fields of neurology, pain management, gastroenterology, 20 oncology, psychiatry, pediatrics, infectious disease, 21 family medicine, and pharmacy. The practitioners 22 shall be nationally board-certified in their area of 23 specialty and knowledgeable about the use of medical 24 cannabis. 25 2. A quorum of the advisory board shall consist of 26 five members. 27 3. The duties of the advisory board shall include 28 but not be limited to the following: 29 a. Reviewing and recommending to the department for 30 approval additional chronic or debilitating diseases or 31 medical conditions or their treatments as debilitating 32 medical conditions that qualify for the use of medical 33 cannabis under this chapter. 34 b. Accepting and reviewing petitions to add chronic 35 -8- SF2299.3871 (2) 86 rh/rj 8/ 22

or debilitating diseases or medical conditions or their 1 medical treatments to the list of debilitating medical 2 conditions that qualify for the use of medical cannabis 3 under this chapter. 4 c. Advising the department regarding the location 5 and number of necessary medical cannabis patient 6 centers throughout the state on a continuous basis, the 7 form and quantity of allowable medical cannabis to be 8 dispensed to a patient or primary caregiver, and the 9 general oversight of medical cannabis manufacturers and 10 medical cannabis patient centers in this state. 11 d. Convening at least twice per year to conduct 12 public hearings and to evaluate petitions, which 13 shall be maintained as confidential personal health 14 information, to add chronic or debilitating diseases or 15 medical conditions or their medical treatments to the 16 list of debilitating medical conditions that qualify 17 for the use of medical cannabis under this chapter. 18 Sec. ___. NEW SECTION . 124E.6 Medical cannabis 19 manufacturer licensure. 20 1. a. The department shall license up to two 21 medical cannabis manufacturers to manufacture 22 medical cannabis within this state consistent with 23 the provisions of this chapter by December 1, 2016. 24 The department shall license new medical cannabis 25 manufacturers or relicense the existing medical 26 cannabis manufacturers by December 1 of each year. 27 b. Information submitted during the application 28 process shall be confidential until the medical 29 cannabis manufacturer is licensed by the department 30 unless otherwise protected from disclosure under state 31 or federal law. 32 2. As a condition for licensure, a medical cannabis 33 manufacturer must agree to begin supplying medical 34 cannabis to medical cannabis patient centers in this 35 -9- SF2299.3871 (2) 86 rh/rj 9/ 22

state by July 1, 2017. 1 3. The department shall consider the following 2 factors in determining whether to license a medical 3 cannabis manufacturer: 4 a. The technical expertise of the medical cannabis 5 manufacturer in medical cannabis. 6 b. The qualifications of the medical cannabis 7 manufacturer’s employees. 8 c. The long-term financial stability of the medical 9 cannabis manufacturer. 10 d. The ability to provide appropriate security 11 measures on the premises of the medical cannabis 12 manufacturer. 13 e. Whether the medical cannabis manufacturer 14 has demonstrated an ability to meet certain medical 15 cannabis production needs for medical use regarding 16 the range of recommended dosages for each debilitating 17 medical condition, the range of chemical compositions 18 of any plant of the genus cannabis that will likely 19 be medically beneficial for each of the debilitating 20 medical conditions, and the form of the medical 21 cannabis in the manner determined by the department 22 pursuant to rule. 23 f. The medical cannabis manufacturer’s projection 24 of and ongoing assessment of fees on patients with 25 debilitating medical conditions. 26 4. The department shall require each medical 27 cannabis manufacturer to contract with the state 28 hygienic laboratory at the university of Iowa in Iowa 29 City to test the medical cannabis produced by the 30 manufacturer. The department shall require that the 31 laboratory report testing results to the manufacturer 32 in a manner determined by the department pursuant to 33 rule. 34 Sec. ___. NEW SECTION . 124E.7 Medical cannabis 35 -10- SF2299.3871 (2) 86 rh/rj 10/ 22

manufacturers. 1 1. A medical cannabis manufacturer shall contract 2 with the state hygienic laboratory at the university 3 of Iowa in Iowa City for purposes of testing the 4 medical cannabis manufactured by the medical cannabis 5 manufacturer as to content, contamination, and 6 consistency. The cost of all laboratory testing shall 7 be paid by the medical cannabis manufacturer. 8 2. The operating documents of a medical cannabis 9 manufacturer shall include all of the following: 10 a. Procedures for the oversight of the medical 11 cannabis manufacturer and procedures to ensure accurate 12 record keeping. 13 b. Procedures for the implementation of appropriate 14 security measures to deter and prevent the theft of 15 medical cannabis and unauthorized entrance into areas 16 containing medical cannabis. 17 3. A medical cannabis manufacturer shall implement 18 security requirements, including requirements for 19 protection of each location by a fully operational 20 security alarm system, facility access controls, 21 perimeter intrusion detection systems, and a personnel 22 identification system. 23 4. A medical cannabis manufacturer shall not share 24 office space with, refer patients to, or have any 25 financial relationship with a health care practitioner. 26 5. A medical cannabis manufacturer shall not permit 27 any person to consume medical cannabis on the property 28 of the medical cannabis manufacturer. 29 6. A medical cannabis manufacturer is subject to 30 reasonable inspection by the department. 31 7. A medical cannabis manufacturer shall not 32 employ a person under eighteen years of age or who has 33 been convicted of a disqualifying felony offense. An 34 employee of a medical cannabis manufacturer shall be 35 -11- SF2299.3871 (2) 86 rh/rj 11/ 22

subject to a background investigation conducted by the 1 division of criminal investigation of the department 2 of public safety and a national criminal history 3 background check. 4 8. A medical cannabis manufacturer shall not 5 operate in any location, whether for manufacturing, 6 cultivating, harvesting, packaging, or processing, 7 within one thousand feet of a public or private school 8 existing before the date of the medical cannabis 9 manufacturer’s licensure by the department. 10 9. A medical cannabis manufacturer shall comply 11 with reasonable restrictions set by the department 12 relating to signage, marketing, display, and 13 advertising of medical cannabis. 14 10. a. A medical cannabis manufacturer shall 15 provide a reliable and ongoing supply of medical 16 cannabis to medical cannabis patient centers pursuant 17 to this chapter. 18 b. All manufacturing, cultivating, harvesting, 19 packaging, and processing of medical cannabis shall 20 take place in an enclosed, locked facility at a 21 physical address provided to the department during the 22 licensure process. 23 c. A medical cannabis manufacturer shall not 24 manufacture edible medical cannabis products utilizing 25 food coloring. 26 d. A medical cannabis manufacturer shall 27 manufacture a reliable and ongoing supply of medical 28 cannabis to treat every debilitating medical condition 29 listed in this chapter. 30 Sec. ___. NEW SECTION . 124E.8 Medical cannabis 31 patient center licensure. 32 1. a. The department shall license by April 1, 33 2017, up to four medical cannabis patient centers to 34 dispense medical cannabis within this state consistent 35 -12- SF2299.3871 (2) 86 rh/rj 12/ 22

with the provisions of this chapter. The department 1 shall license new medical cannabis patient centers or 2 relicense the existing medical cannabis manufacturers 3 by December 1 of each year. 4 b. Information submitted during the application 5 process shall be confidential until the medical 6 cannabis patient center is licensed by the department 7 unless otherwise protected from disclosure under state 8 or federal law. 9 2. As a condition for licensure, a medical cannabis 10 patient center must agree to begin supplying medical 11 cannabis to patients by July 1, 2017. 12 3. The department shall consider the following 13 factors in determining whether to license a medical 14 cannabis patient center: 15 a. The technical expertise of the medical cannabis 16 patient center regarding medical cannabis. 17 b. The qualifications of the medical cannabis 18 patient center’s employees. 19 c. The long-term financial stability of the medical 20 cannabis patient center. 21 d. The ability to provide appropriate security 22 measures on the premises of the medical cannabis 23 patient center. 24 e. The medical cannabis patient center’s projection 25 and ongoing assessment of fees for the purchase of 26 medical cannabis on patients with debilitating medical 27 conditions. 28 Sec. ___. NEW SECTION . 124E.9 Medical cannabis 29 patient centers. 30 1. a. The medical cannabis patient centers shall 31 be located based on geographical need throughout the 32 state to improve patient access. 33 b. A medical cannabis patient center may dispense 34 medical cannabis pursuant to the provisions of this 35 -13- SF2299.3871 (2) 86 rh/rj 13/ 22

chapter but shall not dispense any medical cannabis 1 in a form or quantity other than the form or quantity 2 allowed by the department pursuant to rule. 3 2. The operating documents of a medical cannabis 4 patient center shall include all of the following: 5 a. Procedures for the oversight of the medical 6 cannabis patient center and procedures to ensure 7 accurate record keeping. 8 b. Procedures for the implementation of appropriate 9 security measures to deter and prevent the theft of 10 medical cannabis and unauthorized entrance into areas 11 containing medical cannabis. 12 3. A medical cannabis patient center shall 13 implement security requirements, including requirements 14 for protection by a fully operational security alarm 15 system, facility access controls, perimeter intrusion 16 detection systems, and a personnel identification 17 system. 18 4. A medical cannabis patient center shall not 19 share office space with, refer patients to, or have any 20 financial relationship with a health care practitioner. 21 5. A medical cannabis patient center shall not 22 permit any person to consume medical cannabis on the 23 property of the medical cannabis patient center. 24 6. A medical cannabis patient center is subject to 25 reasonable inspection by the department. 26 7. A medical cannabis patient center shall not 27 employ a person under eighteen years of age or who has 28 been convicted of a disqualifying felony offense. An 29 employee of a medical cannabis patient center shall be 30 subject to a background investigation conducted by the 31 division of criminal investigation of the department 32 of public safety and a national criminal history 33 background check. 34 8. A medical cannabis patient center shall not 35 -14- SF2299.3871 (2) 86 rh/rj 14/ 22

operate in any location within one thousand feet of a 1 public or private school existing before the date of 2 the medical cannabis patient center’s licensure by the 3 department. 4 9. A medical cannabis patient center shall 5 comply with reasonable restrictions set by the 6 department relating to signage, marketing, display, and 7 advertising of medical cannabis. 8 10. Prior to dispensing of any medical cannabis, 9 a medical cannabis patient center shall do all of the 10 following: 11 a. Verify that the medical cannabis patient center 12 has received a valid medical cannabis registration card 13 from a patient or a patient’s primary caregiver, if 14 applicable. 15 b. Assign a tracking number to any medical cannabis 16 dispensed from the medical cannabis patient center. 17 c. (1) Properly package medical cannabis in 18 compliance with federal law regarding child resistant 19 packaging and exemptions for packaging for elderly 20 patients, and label medical cannabis with a list of 21 all active ingredients and individually identifying 22 information, including all of the following: 23 (a) The name and date of birth of the patient and 24 the patient’s primary caregiver, if appropriate. 25 (b) The medical cannabis registration card numbers 26 of the patient and the patient’s primary caregiver, if 27 applicable. 28 (c) The chemical composition of the medical 29 cannabis. 30 (2) Proper packaging of medical cannabis shall 31 include but not be limited to all of the following: 32 (a) Warning labels regarding the use of medical 33 cannabis by a woman during pregnancy and while 34 breastfeeding. 35 -15- SF2299.3871 (2) 86 rh/rj 15/ 22

(b) Clearly labeled packaging indicating that 1 an edible medical cannabis product contains medical 2 cannabis and which packaging shall not imitate candy 3 products or in any way make the product marketable to 4 children. 5 11. A medical cannabis patient center shall employ 6 a pharmacist licensed pursuant to chapter 155A. 7 12. A medical cannabis patient center shall keep 8 a reliable and ongoing supply of medical cannabis to 9 treat every debilitating medical condition listed in 10 this chapter. 11 Sec. ___. NEW SECTION . 124E.10 Department duties 12 —— rules. 13 1. a. The department shall maintain a confidential 14 file of the names of each patient to or for whom the 15 department issues a medical cannabis registration 16 card, the name of each primary caregiver to whom the 17 department issues a medical cannabis registration card 18 under section 124E.4, and the names of each health care 19 practitioner who provides a written certification for 20 medical cannabis pursuant to this chapter. 21 b. Individual names contained in the file shall be 22 confidential and shall not be subject to disclosure, 23 except as provided in subparagraph (1). 24 (1) Information in the confidential file maintained 25 pursuant to paragraph “a” may be released on an 26 individual basis to the following persons under the 27 following circumstances: 28 (a) To authorized employees or agents of the 29 department and the department of transportation as 30 necessary to perform the duties of the department and 31 the department of transportation pursuant to this 32 chapter. 33 (b) To authorized employees of state or local 34 law enforcement agencies, but only for the purpose of 35 -16- SF2299.3871 (2) 86 rh/rj 16/ 22

verifying that a person is lawfully in possession of a 1 medical cannabis registration card issued pursuant to 2 this chapter. 3 (c) To authorized employees of a medical cannabis 4 patient center, but only for the purpose of verifying 5 that a person is lawfully in possession of a medical 6 cannabis registration card issued pursuant to this 7 chapter. 8 (2) Release of information pursuant to subparagraph 9 (1) shall be consistent with the federal Health 10 Insurance Portability and Accountability Act of 1996, 11 Pub. L. No. 104-191. 12 2. The department shall adopt rules pursuant to 13 chapter 17A to administer this chapter which shall 14 include but not be limited to rules to do all of the 15 following: 16 a. Govern the manner in which the department shall 17 consider applications for new and renewal medical 18 cannabis registration cards. 19 b. Identify criteria and set forth procedures for 20 including additional chronic or debilitating diseases 21 or medical conditions or their medical treatments 22 on the list of debilitating medical conditions that 23 qualify for the use of medical cannabis. Procedures 24 shall include a petition process and shall allow for 25 public comment and public hearings before the medical 26 advisory board. 27 c. Set forth additional chronic or debilitating 28 diseases or medical conditions or associated medical 29 treatments for inclusion on the list of debilitating 30 medical conditions that qualify for the use of medical 31 cannabis as recommended by the medical advisory board. 32 d. Establish the form and quantity of medical 33 cannabis allowed to be dispensed to a patient or 34 primary caregiver pursuant to this chapter. The 35 -17- SF2299.3871 (2) 86 rh/rj 17/ 22

form and quantity of medical cannabis shall be 1 appropriate to serve the medical needs of patients with 2 debilitating conditions. 3 e. Establish requirements for the licensure of 4 medical cannabis manufacturers and medical cannabis 5 patient centers and set forth procedures for medical 6 cannabis manufacturers and medical cannabis patient 7 centers to obtain licenses. 8 f. Develop a dispensing system for medical cannabis 9 within this state that provides for all of the 10 following: 11 (1) Medical cannabis patient centers within 12 this state housed on secured grounds and operated by 13 licensed medical cannabis patient centers. 14 (2) The dispensing of medical cannabis to patients 15 and their primary caregivers to occur at locations 16 designated by the department. 17 g. Specify and implement procedures that address 18 public safety including security procedures and product 19 quality including measures to ensure contaminant-free 20 cultivation of medical cannabis, safety, and labeling. 21 h. Establish and implement a real-time, statewide 22 medical cannabis registry management sale tracking 23 system that is available to medical cannabis patient 24 centers on a twenty-four-hour-day, seven-day-a-week 25 basis for the purpose of verifying that a person 26 is lawfully in possession of a medical cannabis 27 registration card issued pursuant to this chapter 28 and for tracking the date of the sale and quantity of 29 medical cannabis purchased by a patient or a primary 30 caregiver. 31 i. Establish and implement a medical cannabis 32 inventory and delivery tracking system to track 33 medical cannabis from production by a medical cannabis 34 manufacturer through dispensing at a medical cannabis 35 -18- SF2299.3871 (2) 86 rh/rj 18/ 22

patient center. 1 Sec. ___. NEW SECTION . 124E.11 Reciprocity. 2 A valid medical cannabis registration card, or its 3 equivalent, issued under the laws of another state 4 that allows an out-of-state patient to possess or 5 use medical cannabis in the jurisdiction of issuance 6 shall have the same force and effect as a valid 7 medical cannabis registration card issued pursuant to 8 this chapter, except that an out-of-state patient in 9 this state shall not obtain medical cannabis from a 10 medical cannabis patient center in this state and an 11 out-of-state patient shall not smoke medical cannabis. 12 Sec. ___. NEW SECTION . 124E.12 Use of medical 13 cannabis —— smoking prohibited. 14 A patient shall not consume medical cannabis 15 possessed or used as authorized by this chapter by 16 smoking medical cannabis. 17 Sec. ___. NEW SECTION . 124E.13 Use of medical 18 cannabis —— affirmative defenses. 19 1. A health care practitioner, including any 20 authorized agent or employee thereof, shall not be 21 subject to prosecution for the unlawful certification, 22 possession, or administration of marijuana under the 23 laws of this state for activities arising directly 24 out of or directly related to the certification or 25 use of medical cannabis in the treatment of a patient 26 diagnosed with a debilitating medical condition as 27 authorized by this chapter. 28 2. A medical cannabis manufacturer, including any 29 authorized agent or employee thereof, shall not be 30 subject to prosecution for manufacturing, possessing, 31 cultivating, harvesting, packaging, processing, 32 transporting, or supplying medical cannabis pursuant 33 to this chapter. 34 3. A medical cannabis patient center, including 35 -19- SF2299.3871 (2) 86 rh/rj 19/ 22

any authorized agent or employee thereof, shall not be 1 subject to prosecution for transporting, supplying, or 2 dispensing medical cannabis pursuant to this chapter. 3 a. In a prosecution for the unlawful possession 4 of marijuana under the laws of this state, including 5 but not limited to chapters 124 and 453B, it is an 6 affirmative and complete defense to the prosecution 7 that the patient has been diagnosed with a debilitating 8 medical condition, used or possessed medical 9 cannabis pursuant to a certification by a health care 10 practitioner as authorized under this chapter, and, 11 for a patient eighteen years of age or older, is in 12 possession of a valid medical cannabis registration 13 card. 14 b. In a prosecution for the unlawful possession 15 of marijuana under the laws of this state, including 16 but not limited to chapters 124 and 453B, it is an 17 affirmative and complete defense to the prosecution 18 that the person possessed medical cannabis because the 19 person is a primary caregiver of a patient who has been 20 diagnosed with a debilitating medical condition and is 21 in possession of a valid medical cannabis registration 22 card, and where the primary caregiver’s possession of 23 the medical cannabis is on behalf of the patient and 24 for the patient’s use only as authorized under this 25 chapter. 26 c. If a patient or primary caregiver is charged 27 with the commission of a crime and is not in possession 28 of the person’s medical cannabis registration card, 29 any charge or charges filed against the person shall 30 be dismissed by the court if the person produces to 31 the court prior to or at the person’s trial a medical 32 cannabis registration card issued to that person and 33 valid at the time the person was charged. 34 4. An agency of this state or a political 35 -20- SF2299.3871 (2) 86 rh/rj 20/ 22

subdivision thereof, including any law enforcement 1 agency, shall not remove or initiate proceedings to 2 remove a patient under the age of eighteen from the 3 home of a parent based solely upon the parent’s or 4 patient’s possession or use of medical cannabis as 5 authorized under this chapter. 6 Sec. ___. REPEAL. Chapter 124D, Code 2016, is 7 repealed. 8 Sec. ___. EMERGENCY RULES. The department may 9 adopt emergency rules under section 17A.4, subsection 10 3, and section 17A.5, subsection 2, paragraph “b”, 11 to implement the provisions of this division of this 12 Act and the rules shall be effective immediately upon 13 filing unless a later date is specified in the rules. 14 Any rules adopted in accordance with this section shall 15 also be published as a notice of intended action as 16 provided in section 17A.4. 17 Sec. ___. TRANSITION PROVISIONS. A medical 18 cannabis registration card issued under chapter 124D 19 prior to July 1, 2016, remains effective and continues 20 in effect as issued for the twelve-month period 21 following its issuance. This division of this Act does 22 not preclude the permit holder from seeking to renew 23 the permit under this division of this Act prior to the 24 expiration of the twelve-month period. > 25 3. Title page, by striking lines 1 and 2 and 26 inserting < An Act relating to state regulation of the 27 health and well-being of Iowa residents, including 28 children, and making penalties applicable. > 29 4. By renumbering, redesignating, and correcting 30 internal references as necessary. 31 ______________________________ FORBES of Polk -21- SF2299.3871 (2) 86 rh/rj 21/ 22 #3. #4.