Senate File 484 H-8300 Amend Senate File 484, as amended, passed, and 1 reprinted by the Senate, as follows: 2 1. By striking everything after the enacting clause 3 and inserting: 4 < Section 1. Section 124.204, subsection 4, 5 paragraphs m and u, Code 2016, are amended by striking 6 the paragraphs. 7 Sec. 2. Section 124.204, subsection 7, Code 2016, 8 is amended by striking the subsection. 9 Sec. 3. Section 124.206, subsection 7, Code 2016, 10 is amended to read as follows: 11 7. Hallucinogenic substances. Unless specifically 12 excepted or unless listed in another schedule, any 13 material, compound, mixture, or preparation which 14 contains any quantity of the following substances , 15 or, for purposes of paragraphs “a” and “b” , which 16 contains any of its salts, isomers, or salts of isomers 17 whenever the existence of such salts, isomers, or salts 18 of isomers is possible within the specific chemical 19 designation (for purposes of this paragraph only, the 20 term “isomer” includes the optical, positional, and 21 geometric isomers) : 22 a. Marijuana when used for medicinal purposes 23 pursuant to rules of the board . 24 b. Tetrahydrocannabinols, meaning 25 tetrahydrocannabinols naturally contained in a 26 plant of the genus cannabis (cannabis plant) as well 27 as synthetic equivalents of the substances contained 28 in the cannabis plant, or in the resinous extractives 29 of such plant, and synthetic substances, derivatives, 30 and their isomers with similar chemical structure and 31 pharmacological activity to those substances contained 32 in the plant, such as the following: 33 (1) 1 cis or trans tetrahydrocannabinol, and their 34 optical isomers. 35 -1- SF484.3886 (2) 86 rh/rj 1/ 22 #1.

(2) 6 cis or trans tetrahydrocannabinol, and their 1 optical isomers. 2 (3) 3,4 cis or trans tetrahydrocannabinol, and 3 their optical isomers. (Since nomenclature of these 4 substances is not internationally standardized, 5 compounds of these structures, regardless of numerical 6 designation of atomic positions covered.) 7 b. c. Nabilone [another name for 8 nabilone: (+-) - 9 trans-3-(1,1-dimethylheptyl)-6,6a,7,8,10,10a-hexahydro-1-hydroxy-6,6- 10 dimethyl-9H-dibenzo[b,d]pyran-9-one]. 11 Sec. 4. Section 124.401, subsection 5, unnumbered 12 paragraph 3, Code 2016, is amended to read as follows: 13 A person may knowingly or intentionally recommend, 14 possess, use, dispense, deliver, transport, or 15 administer cannabidiol medical cannabis if the 16 recommendation, possession, use, dispensing, delivery, 17 transporting, or administering is in accordance with 18 the provisions of chapter 124D 124E . For purposes of 19 this paragraph, “cannabidiol” “medical cannabis” means 20 the same as defined in section 124D.2 124E.2 . 21 Sec. 5. NEW SECTION . 124E.1 Short title. 22 This chapter shall be known and may be cited as the 23 “Compassionate Use of Medical Cannabis Act” . 24 Sec. 6. NEW SECTION . 124E.2 Definitions. 25 As used in this chapter: 26 1. “Debilitating medical condition” means any of the 27 following: 28 a. Cancer, if the underlying condition or treatment 29 produces one or more of the following: 30 (1) Intractable pain. 31 (2) Nausea or severe vomiting. 32 (3) Cachexia or severe wasting. 33 b. Multiple sclerosis. 34 c. Epilepsy or seizure disorders. 35 -2- SF484.3886 (2) 86 rh/rj 2/ 22

d. AIDS or HIV as defined in section 141A.1. 1 e. Crohn’s disease or ulcerative colitis. 2 f. Amyotrophic lateral sclerosis. 3 g. Intractable pain. 4 h. Glaucoma. 5 i. Any terminal illness, with a probable life 6 expectancy of under one year, if the illness or its 7 treatment produces one or more of the following: 8 (1) Intractable pain. 9 (2) Nausea or severe vomiting. 10 (3) Cachexia or severe wasting. 11 j. Any other chronic or debilitating disease or 12 medical condition or its medical treatment approved by 13 the department pursuant to rule. 14 2. “Department” means the department of public 15 health. 16 3. “Disqualifying felony offense” means a violation 17 under federal or state law of a felony offense, which 18 has as an element the possession, use, or distribution 19 of a controlled substance, as defined in 21 U.S.C. 20 §802(6). 21 4. “Enclosed, locked facility” means a closet, room, 22 greenhouse, or other enclosed area equipped with locks 23 or other security devices that permit access only by a 24 cardholder. 25 5. “Health care practitioner” means an individual 26 licensed under chapter 148 to practice medicine and 27 surgery or osteopathic medicine and surgery or an 28 individual licensed to prescribe medicine in any other 29 state and provides specialty care for an Iowa resident 30 for one or more of the debilitating medical conditions 31 provided in this chapter. 32 6. “Intractable pain” means a pain in which the 33 cause of the pain cannot be removed or otherwise 34 treated with the consent of the patient and which, in 35 -3- SF484.3886 (2) 86 rh/rj 3/ 22

the generally accepted course of medical practice, no 1 relief or cure of the cause of the pain is possible, 2 or none has been found after reasonable efforts. 3 Reasonable efforts for relieving or curing the cause of 4 the pain may be determined on the basis of but are not 5 limited to any of the following: 6 a. When treating a nonterminally ill patient for 7 intractable pain, evaluation by the attending physician 8 and one or more physicians specializing in pain 9 medicine or the treatment of the area, system, or organ 10 of the body perceived as the source of the pain. 11 b. When treating a terminally ill patient, 12 evaluation by the attending physician who does so in 13 accordance with the level of care, skill, and treatment 14 that would be recognized by a reasonably prudent 15 physician under similar conditions and circumstances. 16 7. “Medical cannabis” means any species of the genus 17 cannabis plant, or any mixture or preparation of them, 18 including whole plant extracts and resins. 19 8. “Medical cannabis manufacturer” means an entity 20 licensed by the department to manufacture and to 21 possess, cultivate, transport, or supply medical 22 cannabis pursuant to the provisions of this chapter. 23 9. “Medical cannabis patient center” means an entity 24 licensed under section 124E.8 that acquires medical 25 cannabis from a medical cannabis manufacturer in this 26 state for the purpose of dispensing medical cannabis in 27 this state pursuant to this chapter. 28 10. “Primary caregiver” means a person, at least 29 eighteen years of age, who has been designated by a 30 patient’s health care practitioner or a person having 31 custody of a patient, as a necessary caretaker taking 32 responsibility for managing the well-being of the 33 patient with respect to the use of medical cannabis 34 pursuant to the provisions of this chapter. 35 -4- SF484.3886 (2) 86 rh/rj 4/ 22

11. “Written certification” means a document signed 1 by a health care practitioner, with whom the patient 2 has established a patient-provider relationship, which 3 states that the patient has a debilitating medical 4 condition and identifies that condition and provides 5 any other relevant information. 6 Sec. 7. NEW SECTION . 124E.3 Health care 7 practitioner certification —— duties. 8 1. Prior to a patient’s submission of an 9 application for a medical cannabis registration card 10 pursuant to section 124E.4, a health care practitioner 11 shall do all of the following: 12 a. Determine, in the health care practitioner’s 13 medical judgment, whether the patient whom the health 14 care practitioner has examined and treated suffers from 15 a debilitating medical condition that qualifies for 16 the use of medical cannabis under this chapter, and 17 if so determined, provide the patient with a written 18 certification of that diagnosis. 19 b. Provide explanatory information as provided by 20 the department to the patient about the therapeutic use 21 of medical cannabis. 22 2. Determine, on an annual basis, if the patient 23 continues to suffer from a debilitating medical 24 condition and, if so, issue the patient a new 25 certification of that diagnosis. 26 3. Otherwise comply with all requirements 27 established by the department pursuant to rule. 28 4. A health care practitioner may provide, but has 29 no duty to provide, a written certification pursuant 30 to this section. 31 Sec. 8. NEW SECTION . 124E.4 Medical cannabis 32 registration card. 33 1. Issuance to patient. The department may approve 34 the issuance of a medical cannabis registration card by 35 -5- SF484.3886 (2) 86 rh/rj 5/ 22

the department of transportation to a patient who: 1 a. Is at least eighteen years of age. 2 b. Is a permanent resident of this state. 3 c. Submits a written certification to the 4 department signed by the patient’s health care 5 practitioner that the patient is suffering from a 6 debilitating medical condition. 7 d. Submits an application to the department, on a 8 form created by the department, in consultation with 9 the department of transportation, that contains all of 10 the following: 11 (1) The patient’s full name, Iowa residence 12 address, date of birth, and telephone number. 13 (2) A copy of the patient’s valid photo 14 identification. 15 (3) Full name, address, and telephone number of the 16 patient’s health care practitioner. 17 (4) Full name, residence address, date of birth, 18 and telephone number of each primary caregiver of the 19 patient, if any. 20 (5) Any other information required by rule. 21 e. Submits a medical cannabis registration card 22 fee of one hundred dollars to the department. If the 23 patient attests to receiving social security disability 24 benefits, supplemental security insurance payments, or 25 being enrolled in medical assistance, the fee shall be 26 twenty-five dollars. 27 2. Patient card contents. A medical cannabis 28 registration card issued to a patient by the department 29 of transportation pursuant to subsection 1 shall 30 contain, at a minimum, all of the following: 31 a. The patient’s full name, Iowa residence address, 32 and date of birth. 33 b. The patient’s photograph. 34 c. The date of issuance and expiration date of the 35 -6- SF484.3886 (2) 86 rh/rj 6/ 22

registration card. 1 d. Any other information required by rule. 2 3. Issuance to primary caregiver. For a patient in 3 a primary caregiver’s care, the department may approve 4 the issuance of a medical cannabis registration card 5 by the department of transportation to the primary 6 caregiver who: 7 a. Is at least eighteen years of age. 8 b. Submits a written certification to the 9 department signed by the patient’s health care 10 practitioner that the patient in the primary 11 caregiver’s care is suffering from a debilitating 12 medical condition. 13 c. Submits an application to the department, on a 14 form created by the department, in consultation with 15 the department of transportation, that contains all of 16 the following: 17 (1) The primary caregiver’s full name, residence 18 address, date of birth, and telephone number. 19 (2) The patient’s full name. 20 (3) A copy of the primary caregiver’s valid photo 21 identification. 22 (4) Full name, address, and telephone number of the 23 patient’s health care practitioner. 24 (5) Any other information required by rule. 25 d. Submits a medical cannabis registration card fee 26 of twenty-five dollars to the department. 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- SF484.3886 (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. 9. NEW SECTION . 124E.5 Medical advisory board 19 —— 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- SF484.3886 (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. 10. 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- SF484.3886 (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- SF484.3886 (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 5. Each entity submitting an application for 4 licensure as a medical cannabis manufacturer shall pay 5 a nonrefundable application fee of seven thousand five 6 hundred dollars to the department. 7 Sec. 11. NEW SECTION . 124E.7 Medical cannabis 8 manufacturers. 9 1. A medical cannabis manufacturer shall contract 10 with the state hygienic laboratory at the university 11 of Iowa in Iowa City for purposes of testing the 12 medical cannabis manufactured by the medical cannabis 13 manufacturer as to content, contamination, and 14 consistency. The cost of all laboratory testing shall 15 be paid by the medical cannabis manufacturer. 16 2. The operating documents of a medical cannabis 17 manufacturer shall include all of the following: 18 a. Procedures for the oversight of the medical 19 cannabis manufacturer and procedures to ensure accurate 20 record keeping. 21 b. Procedures for the implementation of appropriate 22 security measures to deter and prevent the theft of 23 medical cannabis and unauthorized entrance into areas 24 containing medical cannabis. 25 3. A medical cannabis manufacturer shall implement 26 security requirements, including requirements for 27 protection of each location by a fully operational 28 security alarm system, facility access controls, 29 perimeter intrusion detection systems, and a personnel 30 identification system. 31 4. A medical cannabis manufacturer shall not share 32 office space with, refer patients to, or have any 33 financial relationship with a health care practitioner. 34 5. A medical cannabis manufacturer shall not permit 35 -11- SF484.3886 (2) 86 rh/rj 11/ 22

any person to consume medical cannabis on the property 1 of the medical cannabis manufacturer. 2 6. A medical cannabis manufacturer is subject to 3 reasonable inspection by the department. 4 7. A medical cannabis manufacturer shall not 5 employ a person under eighteen years of age or who has 6 been convicted of a disqualifying felony offense. An 7 employee of a medical cannabis manufacturer shall be 8 subject to a background investigation conducted by the 9 division of criminal investigation of the department 10 of public safety and a national criminal history 11 background check. 12 8. A medical cannabis manufacturer shall not 13 operate in any location, whether for manufacturing, 14 cultivating, harvesting, packaging, or processing, 15 within one thousand feet of a public or private school 16 existing before the date of the medical cannabis 17 manufacturer’s licensure by the department. 18 9. A medical cannabis manufacturer shall comply 19 with reasonable restrictions set by the department 20 relating to signage, marketing, display, and 21 advertising of medical cannabis. 22 10. a. A medical cannabis manufacturer shall 23 provide a reliable and ongoing supply of medical 24 cannabis to medical cannabis patient centers pursuant 25 to this chapter. 26 b. All manufacturing, cultivating, harvesting, 27 packaging, and processing of medical cannabis shall 28 take place in an enclosed, locked facility at a 29 physical address provided to the department during the 30 licensure process. 31 c. A medical cannabis manufacturer shall not 32 manufacture edible medical cannabis products utilizing 33 food coloring. 34 d. A medical cannabis manufacturer shall 35 -12- SF484.3886 (2) 86 rh/rj 12/ 22

manufacture a reliable and ongoing supply of medical 1 cannabis to treat every debilitating medical condition 2 listed in this chapter. 3 Sec. 12. NEW SECTION . 124E.8 Medical cannabis 4 patient center licensure. 5 1. a. The department shall license by April 1, 6 2017, up to four medical cannabis patient centers to 7 dispense medical cannabis within this state consistent 8 with the provisions of this chapter. The department 9 shall license new medical cannabis patient centers or 10 relicense the existing medical cannabis manufacturers 11 by December 1 of each year. 12 b. Information submitted during the application 13 process shall be confidential until the medical 14 cannabis patient center is licensed by the department 15 unless otherwise protected from disclosure under state 16 or federal law. 17 2. As a condition for licensure, a medical cannabis 18 patient center must agree to begin supplying medical 19 cannabis to patients by July 1, 2017. 20 3. The department shall consider the following 21 factors in determining whether to license a medical 22 cannabis patient center: 23 a. The technical expertise of the medical cannabis 24 patient center regarding medical cannabis. 25 b. The qualifications of the medical cannabis 26 patient center’s employees. 27 c. The long-term financial stability of the medical 28 cannabis patient center. 29 d. The ability to provide appropriate security 30 measures on the premises of the medical cannabis 31 patient center. 32 e. The medical cannabis patient center’s projection 33 and ongoing assessment of fees for the purchase of 34 medical cannabis on patients with debilitating medical 35 -13- SF484.3886 (2) 86 rh/rj 13/ 22

conditions. 1 4. Each entity submitting an application for 2 licensure as a medical cannabis patient center shall 3 pay a nonrefundable application fee of five thousand 4 dollars to the department. 5 Sec. 13. NEW SECTION . 124E.9 Medical cannabis 6 patient centers. 7 1. a. The medical cannabis patient centers shall 8 be located based on geographical need throughout the 9 state to improve patient access. 10 b. A medical cannabis patient center may dispense 11 medical cannabis pursuant to the provisions of this 12 chapter but shall not dispense any medical cannabis 13 in a form or quantity other than the form or quantity 14 allowed by the department pursuant to rule. 15 2. The operating documents of a medical cannabis 16 patient center shall include all of the following: 17 a. Procedures for the oversight of the medical 18 cannabis patient center and procedures to ensure 19 accurate record keeping. 20 b. Procedures for the implementation of appropriate 21 security measures to deter and prevent the theft of 22 medical cannabis and unauthorized entrance into areas 23 containing medical cannabis. 24 3. A medical cannabis patient center shall 25 implement security requirements, including requirements 26 for protection by a fully operational security alarm 27 system, facility access controls, perimeter intrusion 28 detection systems, and a personnel identification 29 system. 30 4. A medical cannabis patient center shall not 31 share office space with, refer patients to, or have any 32 financial relationship with a health care practitioner. 33 5. A medical cannabis patient center shall not 34 permit any person to consume medical cannabis on the 35 -14- SF484.3886 (2) 86 rh/rj 14/ 22

property of the medical cannabis patient center. 1 6. A medical cannabis patient center is subject to 2 reasonable inspection by the department. 3 7. A medical cannabis patient center shall not 4 employ a person under eighteen years of age or who has 5 been convicted of a disqualifying felony offense. An 6 employee of a medical cannabis patient center shall be 7 subject to a background investigation conducted by the 8 division of criminal investigation of the department 9 of public safety and a national criminal history 10 background check. 11 8. A medical cannabis patient center shall not 12 operate in any location within one thousand feet of a 13 public or private school existing before the date of 14 the medical cannabis patient center’s licensure by the 15 department. 16 9. A medical cannabis patient center shall 17 comply with reasonable restrictions set by the 18 department relating to signage, marketing, display, and 19 advertising of medical cannabis. 20 10. Prior to dispensing of any medical cannabis, 21 a medical cannabis patient center shall do all of the 22 following: 23 a. Verify that the medical cannabis patient center 24 has received a valid medical cannabis registration card 25 from a patient or a patient’s primary caregiver, if 26 applicable. 27 b. Assign a tracking number to any medical cannabis 28 dispensed from the medical cannabis patient center. 29 c. (1) Properly package medical cannabis in 30 compliance with federal law regarding child resistant 31 packaging and exemptions for packaging for elderly 32 patients, and label medical cannabis with a list of 33 all active ingredients and individually identifying 34 information, including all of the following: 35 -15- SF484.3886 (2) 86 rh/rj 15/ 22

(a) The name and date of birth of the patient and 1 the patient’s primary caregiver, if appropriate. 2 (b) The medical cannabis registration card numbers 3 of the patient and the patient’s primary caregiver, if 4 applicable. 5 (c) The chemical composition of the medical 6 cannabis. 7 (2) Proper packaging of medical cannabis shall 8 include but not be limited to all of the following: 9 (a) Warning labels regarding the use of medical 10 cannabis by a woman during pregnancy and while 11 breastfeeding. 12 (b) Clearly labeled packaging indicating that 13 an edible medical cannabis product contains medical 14 cannabis and which packaging shall not imitate candy 15 products or in any way make the product marketable to 16 children. 17 11. A medical cannabis patient center shall employ 18 a pharmacist licensed pursuant to chapter 155A. 19 12. A medical cannabis patient center shall keep 20 a reliable and ongoing supply of medical cannabis to 21 treat every debilitating medical condition listed in 22 this chapter. 23 Sec. 14. NEW SECTION . 124E.10 Department duties 24 —— rules. 25 1. a. The department shall maintain a confidential 26 file of the names of each patient to or for whom the 27 department issues a medical cannabis registration 28 card, the name of each primary caregiver to whom the 29 department issues a medical cannabis registration card 30 under section 124E.4, and the names of each health care 31 practitioner who provides a written certification for 32 medical cannabis pursuant to this chapter. 33 b. Individual names contained in the file shall be 34 confidential and shall not be subject to disclosure, 35 -16- SF484.3886 (2) 86 rh/rj 16/ 22

except as provided in subparagraph (1). 1 (1) Information in the confidential file maintained 2 pursuant to paragraph “a” may be released on an 3 individual basis to the following persons under the 4 following circumstances: 5 (a) To authorized employees or agents of the 6 department and the department of transportation as 7 necessary to perform the duties of the department and 8 the department of transportation pursuant to this 9 chapter. 10 (b) To authorized employees of state or local 11 law enforcement agencies, but only for the purpose of 12 verifying that a person is lawfully in possession of a 13 medical cannabis registration card issued pursuant to 14 this chapter. 15 (c) To authorized employees of a medical cannabis 16 patient center, but only for the purpose of verifying 17 that a person is lawfully in possession of a medical 18 cannabis registration card issued pursuant to this 19 chapter. 20 (2) Release of information pursuant to subparagraph 21 (1) shall be consistent with the federal Health 22 Insurance Portability and Accountability Act of 1996, 23 Pub. L. No. 104-191. 24 2. The department shall adopt rules pursuant to 25 chapter 17A to administer this chapter which shall 26 include but not be limited to rules to do all of the 27 following: 28 a. Govern the manner in which the department shall 29 consider applications for new and renewal medical 30 cannabis registration cards. 31 b. Identify criteria and set forth procedures for 32 including additional chronic or debilitating diseases 33 or medical conditions or their medical treatments 34 on the list of debilitating medical conditions that 35 -17- SF484.3886 (2) 86 rh/rj 17/ 22

qualify for the use of medical cannabis. Procedures 1 shall include a petition process and shall allow for 2 public comment and public hearings before the medical 3 advisory board. 4 c. Set forth additional chronic or debilitating 5 diseases or medical conditions or associated medical 6 treatments for inclusion on the list of debilitating 7 medical conditions that qualify for the use of medical 8 cannabis as recommended by the medical advisory board. 9 d. Establish the form and quantity of medical 10 cannabis allowed to be dispensed to a patient or 11 primary caregiver pursuant to this chapter. The 12 form and quantity of medical cannabis shall be 13 appropriate to serve the medical needs of patients with 14 debilitating conditions. 15 e. Establish requirements for the licensure of 16 medical cannabis manufacturers and medical cannabis 17 patient centers and set forth procedures for medical 18 cannabis manufacturers and medical cannabis patient 19 centers to obtain licenses. 20 f. Develop a dispensing system for medical cannabis 21 within this state that provides for all of the 22 following: 23 (1) Medical cannabis patient centers within 24 this state housed on secured grounds and operated by 25 licensed medical cannabis patient centers. 26 (2) The dispensing of medical cannabis to patients 27 and their primary caregivers to occur at locations 28 designated by the department. 29 g. Specify and implement procedures that address 30 public safety including security procedures and product 31 quality including measures to ensure contaminant-free 32 cultivation of medical cannabis, safety, and labeling. 33 h. Establish and implement a real-time, statewide 34 medical cannabis registry management sale tracking 35 -18- SF484.3886 (2) 86 rh/rj 18/ 22

system that is available to medical cannabis patient 1 centers on a twenty-four-hour-day, seven-day-a-week 2 basis for the purpose of verifying that a person 3 is lawfully in possession of a medical cannabis 4 registration card issued pursuant to this chapter 5 and for tracking the date of the sale and quantity of 6 medical cannabis purchased by a patient or a primary 7 caregiver. 8 i. Establish and implement a medical cannabis 9 inventory and delivery tracking system to track 10 medical cannabis from production by a medical cannabis 11 manufacturer through dispensing at a medical cannabis 12 patient center. 13 Sec. 15. NEW SECTION . 124E.11 Reciprocity. 14 A valid medical cannabis registration card, or its 15 equivalent, issued under the laws of another state 16 that allows an out-of-state patient to possess or 17 use medical cannabis in the jurisdiction of issuance 18 shall have the same force and effect as a valid 19 medical cannabis registration card issued pursuant to 20 this chapter, except that an out-of-state patient in 21 this state shall not obtain medical cannabis from a 22 medical cannabis patient center in this state and an 23 out-of-state patient shall not smoke medical cannabis. 24 Sec. 16. NEW SECTION . 124E.12 Use of medical 25 cannabis —— smoking prohibited. 26 A patient shall not consume medical cannabis 27 possessed or used as authorized by this chapter by 28 smoking medical cannabis. 29 Sec. 17. NEW SECTION . 124E.13 Use of medical 30 cannabis —— affirmative defenses. 31 1. A health care practitioner, including any 32 authorized agent or employee thereof, shall not be 33 subject to prosecution for the unlawful certification, 34 possession, or administration of marijuana under the 35 -19- SF484.3886 (2) 86 rh/rj 19/ 22

laws of this state for activities arising directly 1 out of or directly related to the certification or 2 use of medical cannabis in the treatment of a patient 3 diagnosed with a debilitating medical condition as 4 authorized by this chapter. 5 2. A medical cannabis manufacturer, including any 6 authorized agent or employee thereof, shall not be 7 subject to prosecution for manufacturing, possessing, 8 cultivating, harvesting, packaging, processing, 9 transporting, or supplying medical cannabis pursuant 10 to this chapter. 11 3. A medical cannabis patient center, including 12 any authorized agent or employee thereof, shall not be 13 subject to prosecution for transporting, supplying, or 14 dispensing medical cannabis pursuant to this chapter. 15 a. In a prosecution for the unlawful possession 16 of marijuana under the laws of this state, including 17 but not limited to chapters 124 and 453B, it is an 18 affirmative and complete defense to the prosecution 19 that the patient has been diagnosed with a debilitating 20 medical condition, used or possessed medical 21 cannabis pursuant to a certification by a health care 22 practitioner as authorized under this chapter, and, 23 for a patient eighteen years of age or older, is in 24 possession of a valid medical cannabis registration 25 card. 26 b. In a prosecution for the unlawful possession 27 of marijuana under the laws of this state, including 28 but not limited to chapters 124 and 453B, it is an 29 affirmative and complete defense to the prosecution 30 that the person possessed medical cannabis because the 31 person is a primary caregiver of a patient who has been 32 diagnosed with a debilitating medical condition and is 33 in possession of a valid medical cannabis registration 34 card, and where the primary caregiver’s possession of 35 -20- SF484.3886 (2) 86 rh/rj 20/ 22

the medical cannabis is on behalf of the patient and 1 for the patient’s use only as authorized under this 2 chapter. 3 c. If a patient or primary caregiver is charged 4 with the commission of a crime and is not in possession 5 of the person’s medical cannabis registration card, 6 any charge or charges filed against the person shall 7 be dismissed by the court if the person produces to 8 the court prior to or at the person’s trial a medical 9 cannabis registration card issued to that person and 10 valid at the time the person was charged. 11 4. An agency of this state or a political 12 subdivision thereof, including any law enforcement 13 agency, shall not remove or initiate proceedings to 14 remove a patient under the age of eighteen from the 15 home of a parent based solely upon the parent’s or 16 patient’s possession or use of medical cannabis as 17 authorized under this chapter. 18 Sec. 18. NEW SECTION . 124E.14 Fees. 19 Medical cannabis registration card fees and medical 20 cannabis manufacturer and medical cannabis patient 21 center application and annual fees collected by the 22 department pursuant to this chapter shall be retained 23 by the department, shall be considered repayment 24 receipts as defined in section 8.2, and shall be 25 used for the purpose of regulating medical cannabis 26 manufacturers and medical cannabis patient centers and 27 for other expenses necessary for the administration of 28 this chapter. Notwithstanding section 8.33, moneys 29 that remain unencumbered or unobligated at the end of 30 the fiscal year shall not revert to the general fund 31 of the state. 32 Sec. 19. NEW SECTION . 124E.15 Penalties. 33 1. A person who knowingly or intentionally 34 possesses or uses medical cannabis in violation of 35 -21- SF484.3886 (2) 86 rh/rj 21/ 22

the requirements of this chapter is subject to the 1 penalties provided under chapters 124 and 453B. 2 2. A medical cannabis manufacturer or a medical 3 cannabis patient center shall be assessed a civil 4 penalty of up to one thousand dollars per violation for 5 any violation of this chapter in addition to any other 6 applicable penalties. 7 Sec. 20. REPEAL. Chapter 124D, Code 2016, is 8 repealed. 9 Sec. 21. EMERGENCY RULES. The department may 10 adopt emergency rules under section 17A.4, subsection 11 3, and section 17A.5, subsection 2, paragraph “b”, to 12 implement the provisions of this Act and the rules 13 shall be effective immediately upon filing unless 14 a later date is specified in the rules. Any rules 15 adopted in accordance with this section shall also be 16 published as a notice of intended action as provided 17 in section 17A.4. 18 Sec. 22. TRANSITION PROVISIONS. A medical cannabis 19 registration card issued under chapter 124D prior to 20 July 1, 2016, remains effective and continues in effect 21 as issued for the twelve-month period following its 22 issuance. This Act does not preclude the permit holder 23 from seeking to renew the permit under this Act prior 24 to the expiration of the twelve-month period. > 25 ______________________________ FORBES of Polk ______________________________ KRESSIG of Black Hawk -22- SF484.3886 (2) 86 rh/rj 22/ 22