Senate File 492 H-8297 Amend the amendment, H-8293, to Senate File 492, as 1 passed by the Senate, as follows: 2 1. By striking page 1, line 1, through page 21, 3 line 31, and inserting: 4 < Amend Senate File 492, as passed by the Senate, as 5 follows: 6 1. Page 1, before line 1 by inserting: 7 < DIVISION I 8 DISASTER CASE MANAGEMENT GRANT FUND AND PROGRAM > 9 2. Page 3, after line 22 by inserting: 10 < DIVISION ___ 11 MEDICAL CANNABIS 12 Sec. ___. Section 124.204, subsection 4, paragraphs 13 m and u, Code 2016, are amended by striking the 14 paragraphs. 15 Sec. ___. Section 124.204, subsection 7, Code 2016, 16 is amended by striking the subsection. 17 Sec. ___. Section 124.206, subsection 7, Code 2016, 18 is amended to read as follows: 19 7. Hallucinogenic substances. Unless specifically 20 excepted or unless listed in another schedule, any 21 material, compound, mixture, or preparation which 22 contains any quantity of the following substances , 23 or, for purposes of paragraphs “a” and “b” , which 24 contains any of its salts, isomers, or salts of isomers 25 whenever the existence of such salts, isomers, or salts 26 of isomers is possible within the specific chemical 27 designation (for purposes of this paragraph only, the 28 term “isomer” includes the optical, positional, and 29 geometric isomers) : 30 a. Marijuana when used for medicinal purposes 31 pursuant to rules of the board . 32 b. Tetrahydrocannabinols, meaning 33 tetrahydrocannabinols naturally contained in a 34 plant of the genus cannabis (cannabis plant) as well 35 -1- H8293.3874 (2) 86 rh/rj 1/ 22 #1.

as synthetic equivalents of the substances contained 1 in the cannabis plant, or in the resinous extractives 2 of such plant, and synthetic substances, derivatives, 3 and their isomers with similar chemical structure and 4 pharmacological activity to those substances contained 5 in the plant, such as the following: 6 (1) 1 cis or trans tetrahydrocannabinol, and their 7 optical isomers. 8 (2) 6 cis or trans tetrahydrocannabinol, and their 9 optical isomers. 10 (3) 3,4 cis or trans tetrahydrocannabinol, and 11 their optical isomers. (Since nomenclature of these 12 substances is not internationally standardized, 13 compounds of these structures, regardless of numerical 14 designation of atomic positions covered.) 15 b. c. Nabilone [another name for 16 nabilone: (+-) - 17 trans-3-(1,1-dimethylheptyl)-6,6a,7,8,10,10a-hexahydro-1-hydroxy-6,6- 18 dimethyl-9H-dibenzo[b,d]pyran-9-one]. 19 Sec. ___. Section 124.401, subsection 5, unnumbered 20 paragraph 3, Code 2016, is amended to read as follows: 21 A person may knowingly or intentionally recommend, 22 possess, use, dispense, deliver, transport, or 23 administer cannabidiol medical cannabis if the 24 recommendation, possession, use, dispensing, delivery, 25 transporting, or administering is in accordance with 26 the provisions of chapter 124D 124E . For purposes of 27 this paragraph, “cannabidiol” “medical cannabis” means 28 the same as defined in section 124D.2 124E.2 . 29 Sec. ___. NEW SECTION . 124E.1 Short title. 30 This chapter shall be known and may be cited as the 31 “Compassionate Use of Medical Cannabis Act” . 32 Sec. ___. NEW SECTION . 124E.2 Definitions. 33 As used in this chapter: 34 1. “Debilitating medical condition” means any of the 35 -2- H8293.3874 (2) 86 rh/rj 2/ 22

following: 1 a. Cancer, if the underlying condition or treatment 2 produces one or more of the following: 3 (1) Intractable pain. 4 (2) Nausea or severe vomiting. 5 (3) Cachexia or severe wasting. 6 b. Multiple sclerosis. 7 c. Epilepsy or seizure disorders. 8 d. AIDS or HIV as defined in section 141A.1. 9 e. Crohn’s disease or ulcerative colitis. 10 f. Amyotrophic lateral sclerosis. 11 g. Intractable pain. 12 h. Glaucoma. 13 i. Any terminal illness, with a probable life 14 expectancy of under one year, if the illness or its 15 treatment produces one or more of the following: 16 (1) Intractable pain. 17 (2) Nausea or severe vomiting. 18 (3) Cachexia or severe wasting. 19 j. Any other chronic or debilitating disease or 20 medical condition or its medical treatment approved by 21 the department pursuant to rule. 22 2. “Department” means the department of public 23 health. 24 3. “Disqualifying felony offense” means a violation 25 under federal or state law of a felony offense, which 26 has as an element the possession, use, or distribution 27 of a controlled substance, as defined in 21 U.S.C. 28 §802(6). 29 4. “Enclosed, locked facility” means a closet, room, 30 greenhouse, or other enclosed area equipped with locks 31 or other security devices that permit access only by a 32 cardholder. 33 5. “Health care practitioner” means an individual 34 licensed under chapter 148 to practice medicine and 35 -3- H8293.3874 (2) 86 rh/rj 3/ 22

surgery or osteopathic medicine and surgery or an 1 individual licensed to prescribe medicine in any other 2 state and provides specialty care for an Iowa resident 3 for one or more of the debilitating medical conditions 4 provided in this chapter. 5 6. “Intractable pain” means a pain in which the 6 cause of the pain cannot be removed or otherwise 7 treated with the consent of the patient and which, in 8 the generally accepted course of medical practice, no 9 relief or cure of the cause of the pain is possible, 10 or none has been found after reasonable efforts. 11 Reasonable efforts for relieving or curing the cause of 12 the pain may be determined on the basis of but are not 13 limited to any of the following: 14 a. When treating a nonterminally ill patient for 15 intractable pain, evaluation by the attending physician 16 and one or more physicians specializing in pain 17 medicine or the treatment of the area, system, or organ 18 of the body perceived as the source of the pain. 19 b. When treating a terminally ill patient, 20 evaluation by the attending physician who does so in 21 accordance with the level of care, skill, and treatment 22 that would be recognized by a reasonably prudent 23 physician under similar conditions and circumstances. 24 7. “Medical cannabis” means any species of the genus 25 cannabis plant, or any mixture or preparation of them, 26 including whole plant extracts and resins. 27 8. “Medical cannabis manufacturer” means an entity 28 licensed by the department to manufacture and to 29 possess, cultivate, transport, or supply medical 30 cannabis pursuant to the provisions of this chapter. 31 9. “Medical cannabis patient center” means an entity 32 licensed under section 124E.8 that acquires medical 33 cannabis from a medical cannabis manufacturer in this 34 state for the purpose of dispensing medical cannabis in 35 -4- H8293.3874 (2) 86 rh/rj 4/ 22

this state pursuant to this chapter. 1 10. “Primary caregiver” means a person, at least 2 eighteen years of age, who has been designated by a 3 patient’s health care practitioner or a person having 4 custody of a patient, as a necessary caretaker taking 5 responsibility for managing the well-being of the 6 patient with respect to the use of medical cannabis 7 pursuant to the provisions of this chapter. 8 11. “Written certification” means a document signed 9 by a health care practitioner, with whom the patient 10 has established a patient-provider relationship, which 11 states that the patient has a debilitating medical 12 condition and identifies that condition and provides 13 any other relevant information. 14 Sec. ___. NEW SECTION . 124E.3 Health care 15 practitioner certification —— duties. 16 1. Prior to a patient’s submission of an 17 application for a medical cannabis registration card 18 pursuant to section 124E.4, a health care practitioner 19 shall do all of the following: 20 a. Determine, in the health care practitioner’s 21 medical judgment, whether the patient whom the health 22 care practitioner has examined and treated suffers from 23 a debilitating medical condition that qualifies for 24 the use of medical cannabis under this chapter, and 25 if so determined, provide the patient with a written 26 certification of that diagnosis. 27 b. Provide explanatory information as provided by 28 the department to the patient about the therapeutic use 29 of medical cannabis. 30 2. Determine, on an annual basis, if the patient 31 continues to suffer from a debilitating medical 32 condition and, if so, issue the patient a new 33 certification of that diagnosis. 34 3. Otherwise comply with all requirements 35 -5- H8293.3874 (2) 86 rh/rj 5/ 22

established by the department pursuant to rule. 1 4. A health care practitioner may provide, but has 2 no duty to provide, a written certification pursuant 3 to this section. 4 Sec. ___. NEW SECTION . 124E.4 Medical cannabis 5 registration card. 6 1. Issuance to patient. The department may approve 7 the issuance of a medical cannabis registration card by 8 the department of transportation to a patient who: 9 a. Is at least eighteen years of age. 10 b. Is a permanent resident of this state. 11 c. Submits a written certification to the 12 department signed by the patient’s health care 13 practitioner that the patient is suffering from a 14 debilitating medical condition. 15 d. Submits an application to the department, on a 16 form created by the department, in consultation with 17 the department of transportation, that contains all of 18 the following: 19 (1) The patient’s full name, Iowa residence 20 address, date of birth, and telephone number. 21 (2) A copy of the patient’s valid photo 22 identification. 23 (3) Full name, address, and telephone number of the 24 patient’s health care practitioner. 25 (4) Full name, residence address, date of birth, 26 and telephone number of each primary caregiver of the 27 patient, if any. 28 (5) Any other information required by rule. 29 2. Patient card contents. A medical cannabis 30 registration card issued to a patient by the department 31 of transportation pursuant to subsection 1 shall 32 contain, at a minimum, all of the following: 33 a. The patient’s full name, Iowa residence address, 34 and date of birth. 35 -6- H8293.3874 (2) 86 rh/rj 6/ 22

b. The patient’s photograph. 1 c. The date of issuance and expiration date of the 2 registration card. 3 d. Any other information required by rule. 4 3. Issuance to primary caregiver. For a patient in 5 a primary caregiver’s care, the department may approve 6 the issuance of a medical cannabis registration card 7 by the department of transportation to the primary 8 caregiver who: 9 a. Is at least eighteen years of age. 10 b. Submits a written certification to the 11 department signed by the patient’s health care 12 practitioner that the patient in the primary 13 caregiver’s care is suffering from a debilitating 14 medical condition. 15 c. Submits an application to the department, on a 16 form created by the department, in consultation with 17 the department of transportation, that contains all of 18 the following: 19 (1) The primary caregiver’s full name, residence 20 address, date of birth, and telephone number. 21 (2) The patient’s full name. 22 (3) A copy of the primary caregiver’s valid photo 23 identification. 24 (4) Full name, address, and telephone number of the 25 patient’s health care practitioner. 26 (5) Any other information required by rule. 27 4. Primary caregiver card contents. A medical 28 cannabis registration card issued by the department 29 of transportation to a primary caregiver pursuant to 30 subsection 3 shall contain, at a minimum, all of the 31 following: 32 a. The primary caregiver’s full name, residence 33 address, and date of birth. 34 b. The primary caregiver’s photograph. 35 -7- H8293.3874 (2) 86 rh/rj 7/ 22

c. The date of issuance and expiration date of the 1 registration card. 2 d. The registration card number of each patient 3 in the primary caregiver’s care. If the patient 4 in the primary caregiver’s care is under the age of 5 eighteen, the full name of the patient’s parent or 6 legal guardian. 7 e. Any other information required by rule. 8 5. Expiration date of card. A medical cannabis 9 registration card issued pursuant to this section shall 10 expire one year after the date of issuance and may be 11 renewed. 12 6. Card issuance —— department of 13 transportation. The department may enter into 14 a chapter 28E agreement with the department of 15 transportation to facilitate the issuance of medical 16 cannabis registration cards pursuant to subsections 1 17 and 3. 18 Sec. ___. NEW SECTION . 124E.5 Medical advisory 19 board —— duties. 20 1. No later than August 15, 2016, the director 21 of public health shall establish a medical advisory 22 board consisting of nine practitioners representing the 23 fields of neurology, pain management, gastroenterology, 24 oncology, psychiatry, pediatrics, infectious disease, 25 family medicine, and pharmacy. The practitioners 26 shall be nationally board-certified in their area of 27 specialty and knowledgeable about the use of medical 28 cannabis. 29 2. A quorum of the advisory board shall consist of 30 five members. 31 3. The duties of the advisory board shall include 32 but not be limited to the following: 33 a. Reviewing and recommending to the department for 34 approval additional chronic or debilitating diseases or 35 -8- H8293.3874 (2) 86 rh/rj 8/ 22

medical conditions or their treatments as debilitating 1 medical conditions that qualify for the use of medical 2 cannabis under this chapter. 3 b. Accepting and reviewing petitions to add chronic 4 or debilitating diseases or medical conditions or their 5 medical treatments to the list of debilitating medical 6 conditions that qualify for the use of medical cannabis 7 under this chapter. 8 c. Advising the department regarding the location 9 and number of necessary medical cannabis patient 10 centers throughout the state on a continuous basis, the 11 form and quantity of allowable medical cannabis to be 12 dispensed to a patient or primary caregiver, and the 13 general oversight of medical cannabis manufacturers and 14 medical cannabis patient centers in this state. 15 d. Convening at least twice per year to conduct 16 public hearings and to evaluate petitions, which 17 shall be maintained as confidential personal health 18 information, to add chronic or debilitating diseases or 19 medical conditions or their medical treatments to the 20 list of debilitating medical conditions that qualify 21 for the use of medical cannabis under this chapter. 22 Sec. ___. NEW SECTION . 124E.6 Medical cannabis 23 manufacturer licensure. 24 1. a. The department shall license up to two 25 medical cannabis manufacturers to manufacture 26 medical cannabis within this state consistent with 27 the provisions of this chapter by December 1, 2016. 28 The department shall license new medical cannabis 29 manufacturers or relicense the existing medical 30 cannabis manufacturers by December 1 of each year. 31 b. Information submitted during the application 32 process shall be confidential until the medical 33 cannabis manufacturer is licensed by the department 34 unless otherwise protected from disclosure under state 35 -9- H8293.3874 (2) 86 rh/rj 9/ 22

or federal law. 1 2. As a condition for licensure, a medical cannabis 2 manufacturer must agree to begin supplying medical 3 cannabis to medical cannabis patient centers in this 4 state by July 1, 2017. 5 3. The department shall consider the following 6 factors in determining whether to license a medical 7 cannabis manufacturer: 8 a. The technical expertise of the medical cannabis 9 manufacturer in medical cannabis. 10 b. The qualifications of the medical cannabis 11 manufacturer’s employees. 12 c. The long-term financial stability of the medical 13 cannabis manufacturer. 14 d. The ability to provide appropriate security 15 measures on the premises of the medical cannabis 16 manufacturer. 17 e. Whether the medical cannabis manufacturer 18 has demonstrated an ability to meet certain medical 19 cannabis production needs for medical use regarding 20 the range of recommended dosages for each debilitating 21 medical condition, the range of chemical compositions 22 of any plant of the genus cannabis that will likely 23 be medically beneficial for each of the debilitating 24 medical conditions, and the form of the medical 25 cannabis in the manner determined by the department 26 pursuant to rule. 27 f. The medical cannabis manufacturer’s projection 28 of and ongoing assessment of fees on patients with 29 debilitating medical conditions. 30 4. The department shall require each medical 31 cannabis manufacturer to contract with the state 32 hygienic laboratory at the university of Iowa in Iowa 33 City to test the medical cannabis produced by the 34 manufacturer. The department shall require that the 35 -10- H8293.3874 (2) 86 rh/rj 10/ 22

laboratory report testing results to the manufacturer 1 in a manner determined by the department pursuant to 2 rule. 3 Sec. ___. NEW SECTION . 124E.7 Medical cannabis 4 manufacturers. 5 1. A medical cannabis manufacturer shall contract 6 with the state hygienic laboratory at the university 7 of Iowa in Iowa City for purposes of testing the 8 medical cannabis manufactured by the medical cannabis 9 manufacturer as to content, contamination, and 10 consistency. The cost of all laboratory testing shall 11 be paid by the medical cannabis manufacturer. 12 2. The operating documents of a medical cannabis 13 manufacturer shall include all of the following: 14 a. Procedures for the oversight of the medical 15 cannabis manufacturer and procedures to ensure accurate 16 record keeping. 17 b. Procedures for the implementation of appropriate 18 security measures to deter and prevent the theft of 19 medical cannabis and unauthorized entrance into areas 20 containing medical cannabis. 21 3. A medical cannabis manufacturer shall implement 22 security requirements, including requirements for 23 protection of each location by a fully operational 24 security alarm system, facility access controls, 25 perimeter intrusion detection systems, and a personnel 26 identification system. 27 4. A medical cannabis manufacturer shall not share 28 office space with, refer patients to, or have any 29 financial relationship with a health care practitioner. 30 5. A medical cannabis manufacturer shall not permit 31 any person to consume medical cannabis on the property 32 of the medical cannabis manufacturer. 33 6. A medical cannabis manufacturer is subject to 34 reasonable inspection by the department. 35 -11- H8293.3874 (2) 86 rh/rj 11/ 22

7. A medical cannabis manufacturer shall not 1 employ a person under eighteen years of age or who has 2 been convicted of a disqualifying felony offense. An 3 employee of a medical cannabis manufacturer shall be 4 subject to a background investigation conducted by the 5 division of criminal investigation of the department 6 of public safety and a national criminal history 7 background check. 8 8. A medical cannabis manufacturer shall not 9 operate in any location, whether for manufacturing, 10 cultivating, harvesting, packaging, or processing, 11 within one thousand feet of a public or private school 12 existing before the date of the medical cannabis 13 manufacturer’s licensure by the department. 14 9. A medical cannabis manufacturer shall comply 15 with reasonable restrictions set by the department 16 relating to signage, marketing, display, and 17 advertising of medical cannabis. 18 10. a. A medical cannabis manufacturer shall 19 provide a reliable and ongoing supply of medical 20 cannabis to medical cannabis patient centers pursuant 21 to this chapter. 22 b. All manufacturing, cultivating, harvesting, 23 packaging, and processing of medical cannabis shall 24 take place in an enclosed, locked facility at a 25 physical address provided to the department during the 26 licensure process. 27 c. A medical cannabis manufacturer shall not 28 manufacture edible medical cannabis products utilizing 29 food coloring. 30 d. A medical cannabis manufacturer shall 31 manufacture a reliable and ongoing supply of medical 32 cannabis to treat every debilitating medical condition 33 listed in this chapter. 34 Sec. ___. NEW SECTION . 124E.8 Medical cannabis 35 -12- H8293.3874 (2) 86 rh/rj 12/ 22

patient center licensure. 1 1. a. The department shall license by April 1, 2 2017, up to four medical cannabis patient centers to 3 dispense medical cannabis within this state consistent 4 with the provisions of this chapter. The department 5 shall license new medical cannabis patient centers or 6 relicense the existing medical cannabis manufacturers 7 by December 1 of each year. 8 b. Information submitted during the application 9 process shall be confidential until the medical 10 cannabis patient center is licensed by the department 11 unless otherwise protected from disclosure under state 12 or federal law. 13 2. As a condition for licensure, a medical cannabis 14 patient center must agree to begin supplying medical 15 cannabis to patients by July 1, 2017. 16 3. The department shall consider the following 17 factors in determining whether to license a medical 18 cannabis patient center: 19 a. The technical expertise of the medical cannabis 20 patient center regarding medical cannabis. 21 b. The qualifications of the medical cannabis 22 patient center’s employees. 23 c. The long-term financial stability of the medical 24 cannabis patient center. 25 d. The ability to provide appropriate security 26 measures on the premises of the medical cannabis 27 patient center. 28 e. The medical cannabis patient center’s projection 29 and ongoing assessment of fees for the purchase of 30 medical cannabis on patients with debilitating medical 31 conditions. 32 Sec. ___. NEW SECTION . 124E.9 Medical cannabis 33 patient centers. 34 1. a. The medical cannabis patient centers shall 35 -13- H8293.3874 (2) 86 rh/rj 13/ 22

be located based on geographical need throughout the 1 state to improve patient access. 2 b. A medical cannabis patient center may dispense 3 medical cannabis pursuant to the provisions of this 4 chapter but shall not dispense any medical cannabis 5 in a form or quantity other than the form or quantity 6 allowed by the department pursuant to rule. 7 2. The operating documents of a medical cannabis 8 patient center shall include all of the following: 9 a. Procedures for the oversight of the medical 10 cannabis patient center and procedures to ensure 11 accurate record keeping. 12 b. Procedures for the implementation of appropriate 13 security measures to deter and prevent the theft of 14 medical cannabis and unauthorized entrance into areas 15 containing medical cannabis. 16 3. A medical cannabis patient center shall 17 implement security requirements, including requirements 18 for protection by a fully operational security alarm 19 system, facility access controls, perimeter intrusion 20 detection systems, and a personnel identification 21 system. 22 4. A medical cannabis patient center shall not 23 share office space with, refer patients to, or have any 24 financial relationship with a health care practitioner. 25 5. A medical cannabis patient center shall not 26 permit any person to consume medical cannabis on the 27 property of the medical cannabis patient center. 28 6. A medical cannabis patient center is subject to 29 reasonable inspection by the department. 30 7. A medical cannabis patient center shall not 31 employ a person under eighteen years of age or who has 32 been convicted of a disqualifying felony offense. An 33 employee of a medical cannabis patient center shall be 34 subject to a background investigation conducted by the 35 -14- H8293.3874 (2) 86 rh/rj 14/ 22

division of criminal investigation of the department 1 of public safety and a national criminal history 2 background check. 3 8. A medical cannabis patient center shall not 4 operate in any location within one thousand feet of a 5 public or private school existing before the date of 6 the medical cannabis patient center’s licensure by the 7 department. 8 9. A medical cannabis patient center shall 9 comply with reasonable restrictions set by the 10 department relating to signage, marketing, display, and 11 advertising of medical cannabis. 12 10. Prior to dispensing of any medical cannabis, 13 a medical cannabis patient center shall do all of the 14 following: 15 a. Verify that the medical cannabis patient center 16 has received a valid medical cannabis registration card 17 from a patient or a patient’s primary caregiver, if 18 applicable. 19 b. Assign a tracking number to any medical cannabis 20 dispensed from the medical cannabis patient center. 21 c. (1) Properly package medical cannabis in 22 compliance with federal law regarding child resistant 23 packaging and exemptions for packaging for elderly 24 patients, and label medical cannabis with a list of 25 all active ingredients and individually identifying 26 information, including all of the following: 27 (a) The name and date of birth of the patient and 28 the patient’s primary caregiver, if appropriate. 29 (b) The medical cannabis registration card numbers 30 of the patient and the patient’s primary caregiver, if 31 applicable. 32 (c) The chemical composition of the medical 33 cannabis. 34 (2) Proper packaging of medical cannabis shall 35 -15- H8293.3874 (2) 86 rh/rj 15/ 22

include but not be limited to all of the following: 1 (a) Warning labels regarding the use of medical 2 cannabis by a woman during pregnancy and while 3 breastfeeding. 4 (b) Clearly labeled packaging indicating that 5 an edible medical cannabis product contains medical 6 cannabis and which packaging shall not imitate candy 7 products or in any way make the product marketable to 8 children. 9 11. A medical cannabis patient center shall employ 10 a pharmacist licensed pursuant to chapter 155A. 11 12. A medical cannabis patient center shall keep 12 a reliable and ongoing supply of medical cannabis to 13 treat every debilitating medical condition listed in 14 this chapter. 15 Sec. ___. NEW SECTION . 124E.10 Department duties 16 —— rules. 17 1. a. The department shall maintain a confidential 18 file of the names of each patient to or for whom the 19 department issues a medical cannabis registration 20 card, the name of each primary caregiver to whom the 21 department issues a medical cannabis registration card 22 under section 124E.4, and the names of each health care 23 practitioner who provides a written certification for 24 medical cannabis pursuant to this chapter. 25 b. Individual names contained in the file shall be 26 confidential and shall not be subject to disclosure, 27 except as provided in subparagraph (1). 28 (1) Information in the confidential file maintained 29 pursuant to paragraph “a” may be released on an 30 individual basis to the following persons under the 31 following circumstances: 32 (a) To authorized employees or agents of the 33 department and the department of transportation as 34 necessary to perform the duties of the department and 35 -16- H8293.3874 (2) 86 rh/rj 16/ 22

the department of transportation pursuant to this 1 chapter. 2 (b) To authorized employees of state or local 3 law enforcement agencies, but only for the purpose of 4 verifying that a person is lawfully in possession of a 5 medical cannabis registration card issued pursuant to 6 this chapter. 7 (c) To authorized employees of a medical cannabis 8 patient center, but only for the purpose of verifying 9 that a person is lawfully in possession of a medical 10 cannabis registration card issued pursuant to this 11 chapter. 12 (2) Release of information pursuant to subparagraph 13 (1) shall be consistent with the federal Health 14 Insurance Portability and Accountability Act of 1996, 15 Pub. L. No. 104-191. 16 2. The department shall adopt rules pursuant to 17 chapter 17A to administer this chapter which shall 18 include but not be limited to rules to do all of the 19 following: 20 a. Govern the manner in which the department shall 21 consider applications for new and renewal medical 22 cannabis registration cards. 23 b. Identify criteria and set forth procedures for 24 including additional chronic or debilitating diseases 25 or medical conditions or their medical treatments 26 on the list of debilitating medical conditions that 27 qualify for the use of medical cannabis. Procedures 28 shall include a petition process and shall allow for 29 public comment and public hearings before the medical 30 advisory board. 31 c. Set forth additional chronic or debilitating 32 diseases or medical conditions or associated medical 33 treatments for inclusion on the list of debilitating 34 medical conditions that qualify for the use of medical 35 -17- H8293.3874 (2) 86 rh/rj 17/ 22

cannabis as recommended by the medical advisory board. 1 d. Establish the form and quantity of medical 2 cannabis allowed to be dispensed to a patient or 3 primary caregiver pursuant to this chapter. The 4 form and quantity of medical cannabis shall be 5 appropriate to serve the medical needs of patients with 6 debilitating conditions. 7 e. Establish requirements for the licensure of 8 medical cannabis manufacturers and medical cannabis 9 patient centers and set forth procedures for medical 10 cannabis manufacturers and medical cannabis patient 11 centers to obtain licenses. 12 f. Develop a dispensing system for medical cannabis 13 within this state that provides for all of the 14 following: 15 (1) Medical cannabis patient centers within 16 this state housed on secured grounds and operated by 17 licensed medical cannabis patient centers. 18 (2) The dispensing of medical cannabis to patients 19 and their primary caregivers to occur at locations 20 designated by the department. 21 g. Specify and implement procedures that address 22 public safety including security procedures and product 23 quality including measures to ensure contaminant-free 24 cultivation of medical cannabis, safety, and labeling. 25 h. Establish and implement a real-time, statewide 26 medical cannabis registry management sale tracking 27 system that is available to medical cannabis patient 28 centers on a twenty-four-hour-day, seven-day-a-week 29 basis for the purpose of verifying that a person 30 is lawfully in possession of a medical cannabis 31 registration card issued pursuant to this chapter 32 and for tracking the date of the sale and quantity of 33 medical cannabis purchased by a patient or a primary 34 caregiver. 35 -18- H8293.3874 (2) 86 rh/rj 18/ 22

i. Establish and implement a medical cannabis 1 inventory and delivery tracking system to track 2 medical cannabis from production by a medical cannabis 3 manufacturer through dispensing at a medical cannabis 4 patient center. 5 Sec. ___. NEW SECTION . 124E.11 Reciprocity. 6 A valid medical cannabis registration card, or its 7 equivalent, issued under the laws of another state 8 that allows an out-of-state patient to possess or 9 use medical cannabis in the jurisdiction of issuance 10 shall have the same force and effect as a valid 11 medical cannabis registration card issued pursuant to 12 this chapter, except that an out-of-state patient in 13 this state shall not obtain medical cannabis from a 14 medical cannabis patient center in this state and an 15 out-of-state patient shall not smoke medical cannabis. 16 Sec. ___. NEW SECTION . 124E.12 Use of medical 17 cannabis —— smoking prohibited. 18 A patient shall not consume medical cannabis 19 possessed or used as authorized by this chapter by 20 smoking medical cannabis. 21 Sec. ___. NEW SECTION . 124E.13 Use of medical 22 cannabis —— affirmative defenses. 23 1. A health care practitioner, including any 24 authorized agent or employee thereof, shall not be 25 subject to prosecution for the unlawful certification, 26 possession, or administration of marijuana under the 27 laws of this state for activities arising directly 28 out of or directly related to the certification or 29 use of medical cannabis in the treatment of a patient 30 diagnosed with a debilitating medical condition as 31 authorized by this chapter. 32 2. A medical cannabis manufacturer, including any 33 authorized agent or employee thereof, shall not be 34 subject to prosecution for manufacturing, possessing, 35 -19- H8293.3874 (2) 86 rh/rj 19/ 22

cultivating, harvesting, packaging, processing, 1 transporting, or supplying medical cannabis pursuant 2 to this chapter. 3 3. A medical cannabis patient center, including 4 any authorized agent or employee thereof, shall not be 5 subject to prosecution for transporting, supplying, or 6 dispensing medical cannabis pursuant to this chapter. 7 a. In a prosecution for the unlawful possession 8 of marijuana under the laws of this state, including 9 but not limited to chapters 124 and 453B, it is an 10 affirmative and complete defense to the prosecution 11 that the patient has been diagnosed with a debilitating 12 medical condition, used or possessed medical 13 cannabis pursuant to a certification by a health care 14 practitioner as authorized under this chapter, and, 15 for a patient eighteen years of age or older, is in 16 possession of a valid medical cannabis registration 17 card. 18 b. In a prosecution for the unlawful possession 19 of marijuana under the laws of this state, including 20 but not limited to chapters 124 and 453B, it is an 21 affirmative and complete defense to the prosecution 22 that the person possessed medical cannabis because the 23 person is a primary caregiver of a patient who has been 24 diagnosed with a debilitating medical condition and is 25 in possession of a valid medical cannabis registration 26 card, and where the primary caregiver’s possession of 27 the medical cannabis is on behalf of the patient and 28 for the patient’s use only as authorized under this 29 chapter. 30 c. If a patient or primary caregiver is charged 31 with the commission of a crime and is not in possession 32 of the person’s medical cannabis registration card, 33 any charge or charges filed against the person shall 34 be dismissed by the court if the person produces to 35 -20- H8293.3874 (2) 86 rh/rj 20/ 22

the court prior to or at the person’s trial a medical 1 cannabis registration card issued to that person and 2 valid at the time the person was charged. 3 4. An agency of this state or a political 4 subdivision thereof, including any law enforcement 5 agency, shall not remove or initiate proceedings to 6 remove a patient under the age of eighteen from the 7 home of a parent based solely upon the parent’s or 8 patient’s possession or use of medical cannabis as 9 authorized under this chapter. 10 Sec. ___. REPEAL. Chapter 124D, Code 2016, is 11 repealed. 12 Sec. ___. EMERGENCY RULES. The department may 13 adopt emergency rules under section 17A.4, subsection 14 3, and section 17A.5, subsection 2, paragraph “b”, 15 to implement the provisions of this division of this 16 Act and the rules shall be effective immediately upon 17 filing unless a later date is specified in the rules. 18 Any rules adopted in accordance with this section shall 19 also be published as a notice of intended action as 20 provided in section 17A.4. 21 Sec. ___. TRANSITION PROVISIONS. A medical 22 cannabis registration card issued under chapter 124D 23 prior to July 1, 2016, remains effective and continues 24 in effect as issued for the twelve-month period 25 following its issuance. This division of this Act does 26 not preclude the permit holder from seeking to renew 27 the permit under this division of this Act prior to the 28 expiration of the twelve-month period. 29 Sec. ___. EFFECTIVE UPON ENACTMENT. This division 30 of this Act, being deemed of immediate importance, 31 takes effect upon enactment. > 32 3. Title page, by striking lines 1 and 2 and 33 inserting < An Act relating to statewide programs 34 for the health and safety of Iowa residents, making 35 -21- H8293.3874 (2) 86 rh/rj 21/ 22