Senate File 484 H-8302 Amend the amendment, H-8300, to Senate File 484, 1 as amended, passed, and reprinted by the Senate, as 2 follows: 3 1. By striking page 1, line 1, through page 22, 4 line 25, and inserting: 5 < Amend Senate File 484, as amended, passed, and 6 reprinted by the Senate, as follows: 7 ___. By striking everything after the enacting 8 clause and inserting: 9 < Section 1. Section 124.204, subsection 4, 10 paragraphs m and u, Code 2016, are amended by striking 11 the paragraphs. 12 Sec. 2. Section 124.204, subsection 7, Code 2016, 13 is amended by striking the subsection. 14 Sec. 3. Section 124.206, subsection 7, Code 2016, 15 is amended to read as follows: 16 7. Hallucinogenic substances. Unless specifically 17 excepted or unless listed in another schedule, any 18 material, compound, mixture, or preparation which 19 contains any quantity of the following substances , 20 or, for purposes of paragraphs “a” and “b” , which 21 contains any of its salts, isomers, or salts of isomers 22 whenever the existence of such salts, isomers, or salts 23 of isomers is possible within the specific chemical 24 designation (for purposes of this paragraph only, the 25 term “isomer” includes the optical, positional, and 26 geometric isomers) : 27 a. Marijuana when used for medicinal purposes 28 pursuant to rules of the board . 29 b. Tetrahydrocannabinols, meaning 30 tetrahydrocannabinols naturally contained in a 31 plant of the genus cannabis (cannabis plant) as well 32 as synthetic equivalents of the substances contained 33 in the cannabis plant, or in the resinous extractives 34 of such plant, and synthetic substances, derivatives, 35 -1- H8300.3892 (1) 86 rh/rj 1/ 23 #1.

and their isomers with similar chemical structure and 1 pharmacological activity to those substances contained 2 in the plant, such as the following: 3 (1) 1 cis or trans tetrahydrocannabinol, and their 4 optical isomers. 5 (2) 6 cis or trans tetrahydrocannabinol, and their 6 optical isomers. 7 (3) 3,4 cis or trans tetrahydrocannabinol, and 8 their optical isomers. (Since nomenclature of these 9 substances is not internationally standardized, 10 compounds of these structures, regardless of numerical 11 designation of atomic positions covered.) 12 b. c. Nabilone [another name for 13 nabilone: (+-) - 14 trans-3-(1,1-dimethylheptyl)-6,6a,7,8,10,10a-hexahydro-1-hydroxy-6,6- 15 dimethyl-9H-dibenzo[b,d]pyran-9-one]. 16 Sec. 4. Section 124.401, subsection 5, unnumbered 17 paragraph 3, Code 2016, is amended to read as follows: 18 A person may knowingly or intentionally recommend, 19 possess, use, dispense, deliver, transport, or 20 administer cannabidiol medical cannabis if the 21 recommendation, possession, use, dispensing, delivery, 22 transporting, or administering is in accordance with 23 the provisions of chapter 124D 124E . For purposes of 24 this paragraph, “cannabidiol” “medical cannabis” means 25 the same as defined in section 124D.2 124E.2 . 26 Sec. 5. NEW SECTION . 124E.1 Short title. 27 This chapter shall be known and may be cited as the 28 “Compassionate Use of Medical Cannabis Act” . 29 Sec. 6. NEW SECTION . 124E.2 Definitions. 30 As used in this chapter: 31 1. “Debilitating medical condition” means any of the 32 following: 33 a. Cancer, if the underlying condition or treatment 34 produces one or more of the following: 35 -2- H8300.3892 (1) 86 rh/rj 2/ 23

(1) Intractable pain. 1 (2) Nausea or severe vomiting. 2 (3) Cachexia or severe wasting. 3 b. Multiple sclerosis. 4 c. Epilepsy or seizure disorders. 5 d. AIDS or HIV as defined in section 141A.1. 6 e. Crohn’s disease or ulcerative colitis. 7 f. Amyotrophic lateral sclerosis. 8 g. Intractable pain. 9 h. Glaucoma. 10 i. Any terminal illness, with a probable life 11 expectancy of under one year, if the illness or its 12 treatment produces one or more of the following: 13 (1) Intractable pain. 14 (2) Nausea or severe vomiting. 15 (3) Cachexia or severe wasting. 16 j. Any other chronic or debilitating disease or 17 medical condition or its medical treatment approved by 18 the department pursuant to rule. 19 2. “Department” means the department of public 20 health. 21 3. “Disqualifying felony offense” means a violation 22 under federal or state law of a felony offense, which 23 has as an element the possession, use, or distribution 24 of a controlled substance, as defined in 21 U.S.C. 25 §802(6). 26 4. “Enclosed, locked facility” means a closet, room, 27 greenhouse, or other enclosed area equipped with locks 28 or other security devices that permit access only by a 29 cardholder. 30 5. “Health care practitioner” means an individual 31 licensed under chapter 148 to practice medicine and 32 surgery or osteopathic medicine and surgery or an 33 individual licensed to prescribe medicine in any other 34 state and provides specialty care for an Iowa resident 35 -3- H8300.3892 (1) 86 rh/rj 3/ 23

for one or more of the debilitating medical conditions 1 provided in this chapter. 2 6. “Intractable pain” means a pain in which the 3 cause of the pain cannot be removed or otherwise 4 treated with the consent of the patient and which, in 5 the generally accepted course of medical practice, no 6 relief or cure of the cause of the pain is possible, 7 or none has been found after reasonable efforts. 8 Reasonable efforts for relieving or curing the cause of 9 the pain may be determined on the basis of but are not 10 limited to any of the following: 11 a. When treating a nonterminally ill patient for 12 intractable pain, evaluation by the attending physician 13 and one or more physicians specializing in pain 14 medicine or the treatment of the area, system, or organ 15 of the body perceived as the source of the pain. 16 b. When treating a terminally ill patient, 17 evaluation by the attending physician who does so in 18 accordance with the level of care, skill, and treatment 19 that would be recognized by a reasonably prudent 20 physician under similar conditions and circumstances. 21 7. “Medical cannabis” means any species of the genus 22 cannabis plant, or any mixture or preparation of them, 23 including whole plant extracts and resins. 24 8. “Medical cannabis manufacturer” means an entity 25 licensed by the department to manufacture and to 26 possess, cultivate, transport, or supply medical 27 cannabis pursuant to the provisions of this chapter. 28 9. “Medical cannabis patient center” means an entity 29 licensed under section 124E.8 that acquires medical 30 cannabis from a medical cannabis manufacturer in this 31 state for the purpose of dispensing medical cannabis in 32 this state pursuant to this chapter. 33 10. “Primary caregiver” means a person, at least 34 eighteen years of age, who has been designated by a 35 -4- H8300.3892 (1) 86 rh/rj 4/ 23

patient’s health care practitioner or a person having 1 custody of a patient, as a necessary caretaker taking 2 responsibility for managing the well-being of the 3 patient with respect to the use of medical cannabis 4 pursuant to the provisions of this chapter. 5 11. “Written certification” means a document signed 6 by a health care practitioner, with whom the patient 7 has established a patient-provider relationship, which 8 states that the patient has a debilitating medical 9 condition and identifies that condition and provides 10 any other relevant information. 11 Sec. 7. NEW SECTION . 124E.3 Health care 12 practitioner certification —— duties. 13 1. Prior to a patient’s submission of an 14 application for a medical cannabis registration card 15 pursuant to section 124E.4, a health care practitioner 16 shall do all of the following: 17 a. Determine, in the health care practitioner’s 18 medical judgment, whether the patient whom the health 19 care practitioner has examined and treated suffers from 20 a debilitating medical condition that qualifies for 21 the use of medical cannabis under this chapter, and 22 if so determined, provide the patient with a written 23 certification of that diagnosis. 24 b. Provide explanatory information as provided by 25 the department to the patient about the therapeutic use 26 of medical cannabis. 27 2. Determine, on an annual basis, if the patient 28 continues to suffer from a debilitating medical 29 condition and, if so, issue the patient a new 30 certification of that diagnosis. 31 3. Otherwise comply with all requirements 32 established by the department pursuant to rule. 33 4. A health care practitioner may provide, but has 34 no duty to provide, a written certification pursuant 35 -5- H8300.3892 (1) 86 rh/rj 5/ 23

to this section. 1 Sec. 8. NEW SECTION . 124E.4 Medical cannabis 2 registration card. 3 1. Issuance to patient. The department may approve 4 the issuance of a medical cannabis registration card by 5 the department of transportation to a patient who: 6 a. Is at least eighteen years of age. 7 b. Is a permanent resident of this state. 8 c. Submits a written certification to the 9 department signed by the patient’s health care 10 practitioner that the patient is suffering from a 11 debilitating medical condition. 12 d. Submits an application to the department, on a 13 form created by the department, in consultation with 14 the department of transportation, that contains all of 15 the following: 16 (1) The patient’s full name, Iowa residence 17 address, date of birth, and telephone number. 18 (2) A copy of the patient’s valid photo 19 identification. 20 (3) Full name, address, and telephone number of the 21 patient’s health care practitioner. 22 (4) Full name, residence address, date of birth, 23 and telephone number of each primary caregiver of the 24 patient, if any. 25 (5) Any other information required by rule. 26 e. Submits a medical cannabis registration card 27 fee of one hundred dollars to the department. If the 28 patient attests to receiving social security disability 29 benefits, supplemental security insurance payments, or 30 being enrolled in medical assistance, the fee shall be 31 twenty-five dollars. 32 2. Patient card contents. A medical cannabis 33 registration card issued to a patient by the department 34 of transportation pursuant to subsection 1 shall 35 -6- H8300.3892 (1) 86 rh/rj 6/ 23

contain, at a minimum, all of the following: 1 a. The patient’s full name, Iowa residence address, 2 and date of birth. 3 b. The patient’s photograph. 4 c. The date of issuance and expiration date of the 5 registration card. 6 d. Any other information required by rule. 7 3. Issuance to primary caregiver. For a patient in 8 a primary caregiver’s care, the department may approve 9 the issuance of a medical cannabis registration card 10 by the department of transportation to the primary 11 caregiver who: 12 a. Is at least eighteen years of age. 13 b. Submits a written certification to the 14 department signed by the patient’s health care 15 practitioner that the patient in the primary 16 caregiver’s care is suffering from a debilitating 17 medical condition. 18 c. Submits an application to the department, on a 19 form created by the department, in consultation with 20 the department of transportation, that contains all of 21 the following: 22 (1) The primary caregiver’s full name, residence 23 address, date of birth, and telephone number. 24 (2) The patient’s full name. 25 (3) A copy of the primary caregiver’s valid photo 26 identification. 27 (4) Full name, address, and telephone number of the 28 patient’s health care practitioner. 29 (5) Any other information required by rule. 30 d. Submits a medical cannabis registration card fee 31 of twenty-five dollars to the department. 32 4. Primary caregiver card contents. A medical 33 cannabis registration card issued by the department 34 of transportation to a primary caregiver pursuant to 35 -7- H8300.3892 (1) 86 rh/rj 7/ 23

subsection 3 shall contain, at a minimum, all of the 1 following: 2 a. The primary caregiver’s full name, residence 3 address, and date of birth. 4 b. The primary caregiver’s photograph. 5 c. The date of issuance and expiration date of the 6 registration card. 7 d. The registration card number of each patient 8 in the primary caregiver’s care. If the patient 9 in the primary caregiver’s care is under the age of 10 eighteen, the full name of the patient’s parent or 11 legal guardian. 12 e. Any other information required by rule. 13 5. Expiration date of card. A medical cannabis 14 registration card issued pursuant to this section shall 15 expire one year after the date of issuance and may be 16 renewed. 17 6. Card issuance —— department of 18 transportation. The department may enter into 19 a chapter 28E agreement with the department of 20 transportation to facilitate the issuance of medical 21 cannabis registration cards pursuant to subsections 1 22 and 3. 23 Sec. 9. NEW SECTION . 124E.5 Medical advisory board 24 —— duties. 25 1. No later than August 15, 2016, the director 26 of public health shall establish a medical advisory 27 board consisting of nine practitioners representing the 28 fields of neurology, pain management, gastroenterology, 29 oncology, psychiatry, pediatrics, infectious disease, 30 family medicine, and pharmacy. The practitioners 31 shall be nationally board-certified in their area of 32 specialty and knowledgeable about the use of medical 33 cannabis. 34 2. A quorum of the advisory board shall consist of 35 -8- H8300.3892 (1) 86 rh/rj 8/ 23

five members. 1 3. The duties of the advisory board shall include 2 but not be limited to the following: 3 a. Reviewing and recommending to the department for 4 approval additional chronic or debilitating diseases or 5 medical conditions or their treatments as debilitating 6 medical conditions that qualify for the use of medical 7 cannabis under this chapter. 8 b. Accepting and reviewing petitions to add chronic 9 or debilitating diseases or medical conditions or their 10 medical treatments to the list of debilitating medical 11 conditions that qualify for the use of medical cannabis 12 under this chapter. 13 c. Advising the department regarding the location 14 and number of necessary medical cannabis patient 15 centers throughout the state on a continuous basis, the 16 form and quantity of allowable medical cannabis to be 17 dispensed to a patient or primary caregiver, and the 18 general oversight of medical cannabis manufacturers and 19 medical cannabis patient centers in this state. 20 d. Convening at least twice per year to conduct 21 public hearings and to evaluate petitions, which 22 shall be maintained as confidential personal health 23 information, to add chronic or debilitating diseases or 24 medical conditions or their medical treatments to the 25 list of debilitating medical conditions that qualify 26 for the use of medical cannabis under this chapter. 27 Sec. 10. NEW SECTION . 124E.6 Medical cannabis 28 manufacturer licensure. 29 1. a. The department shall license up to two 30 medical cannabis manufacturers to manufacture 31 medical cannabis within this state consistent with 32 the provisions of this chapter by December 1, 2016. 33 The department shall license new medical cannabis 34 manufacturers or relicense the existing medical 35 -9- H8300.3892 (1) 86 rh/rj 9/ 23

cannabis manufacturers by December 1 of each year. 1 b. Information submitted during the application 2 process shall be confidential until the medical 3 cannabis manufacturer is licensed by the department 4 unless otherwise protected from disclosure under state 5 or federal law. 6 2. As a condition for licensure, a medical cannabis 7 manufacturer must agree to begin supplying medical 8 cannabis to medical cannabis patient centers in this 9 state by July 1, 2017. 10 3. The department shall consider the following 11 factors in determining whether to license a medical 12 cannabis manufacturer: 13 a. The technical expertise of the medical cannabis 14 manufacturer in medical cannabis. 15 b. The qualifications of the medical cannabis 16 manufacturer’s employees. 17 c. The long-term financial stability of the medical 18 cannabis manufacturer. 19 d. The ability to provide appropriate security 20 measures on the premises of the medical cannabis 21 manufacturer. 22 e. Whether the medical cannabis manufacturer 23 has demonstrated an ability to meet certain medical 24 cannabis production needs for medical use regarding 25 the range of recommended dosages for each debilitating 26 medical condition, the range of chemical compositions 27 of any plant of the genus cannabis that will likely 28 be medically beneficial for each of the debilitating 29 medical conditions, and the form of the medical 30 cannabis in the manner determined by the department 31 pursuant to rule. 32 f. The medical cannabis manufacturer’s projection 33 of and ongoing assessment of fees on patients with 34 debilitating medical conditions. 35 -10- H8300.3892 (1) 86 rh/rj 10/ 23

4. The department shall require each medical 1 cannabis manufacturer to contract with the state 2 hygienic laboratory at the university of Iowa in Iowa 3 City to test the medical cannabis produced by the 4 manufacturer. The department shall require that the 5 laboratory report testing results to the manufacturer 6 in a manner determined by the department pursuant to 7 rule. 8 5. Each entity submitting an application for 9 licensure as a medical cannabis manufacturer shall pay 10 a nonrefundable application fee of seven thousand five 11 hundred dollars to the department. 12 Sec. 11. NEW SECTION . 124E.7 Medical cannabis 13 manufacturers. 14 1. A medical cannabis manufacturer shall contract 15 with the state hygienic laboratory at the university 16 of Iowa in Iowa City for purposes of testing the 17 medical cannabis manufactured by the medical cannabis 18 manufacturer as to content, contamination, and 19 consistency. The cost of all laboratory testing shall 20 be paid by the medical cannabis manufacturer. 21 2. The operating documents of a medical cannabis 22 manufacturer shall include all of the following: 23 a. Procedures for the oversight of the medical 24 cannabis manufacturer and procedures to ensure accurate 25 record keeping. 26 b. Procedures for the implementation of appropriate 27 security measures to deter and prevent the theft of 28 medical cannabis and unauthorized entrance into areas 29 containing medical cannabis. 30 3. A medical cannabis manufacturer shall implement 31 security requirements, including requirements for 32 protection of each location by a fully operational 33 security alarm system, facility access controls, 34 perimeter intrusion detection systems, and a personnel 35 -11- H8300.3892 (1) 86 rh/rj 11/ 23

identification system. 1 4. A medical cannabis manufacturer shall not share 2 office space with, refer patients to, or have any 3 financial relationship with a health care practitioner. 4 5. A medical cannabis manufacturer shall not permit 5 any person to consume medical cannabis on the property 6 of the medical cannabis manufacturer. 7 6. A medical cannabis manufacturer is subject to 8 reasonable inspection by the department. 9 7. A medical cannabis manufacturer shall not 10 employ a person under eighteen years of age or who has 11 been convicted of a disqualifying felony offense. An 12 employee of a medical cannabis manufacturer shall be 13 subject to a background investigation conducted by the 14 division of criminal investigation of the department 15 of public safety and a national criminal history 16 background check. 17 8. A medical cannabis manufacturer shall not 18 operate in any location, whether for manufacturing, 19 cultivating, harvesting, packaging, or processing, 20 within one thousand feet of a public or private school 21 existing before the date of the medical cannabis 22 manufacturer’s licensure by the department. 23 9. A medical cannabis manufacturer shall comply 24 with reasonable restrictions set by the department 25 relating to signage, marketing, display, and 26 advertising of medical cannabis. 27 10. a. A medical cannabis manufacturer shall 28 provide a reliable and ongoing supply of medical 29 cannabis to medical cannabis patient centers pursuant 30 to this chapter. 31 b. All manufacturing, cultivating, harvesting, 32 packaging, and processing of medical cannabis shall 33 take place in an enclosed, locked facility at a 34 physical address provided to the department during the 35 -12- H8300.3892 (1) 86 rh/rj 12/ 23

licensure process. 1 c. A medical cannabis manufacturer shall not 2 manufacture edible medical cannabis products utilizing 3 food coloring. 4 d. A medical cannabis manufacturer shall 5 manufacture a reliable and ongoing supply of medical 6 cannabis to treat every debilitating medical condition 7 listed in this chapter. 8 Sec. 12. NEW SECTION . 124E.8 Medical cannabis 9 patient center licensure. 10 1. a. The department shall license by April 1, 11 2017, up to four medical cannabis patient centers to 12 dispense medical cannabis within this state consistent 13 with the provisions of this chapter. The department 14 shall license new medical cannabis patient centers or 15 relicense the existing medical cannabis manufacturers 16 by December 1 of each year. 17 b. Information submitted during the application 18 process shall be confidential until the medical 19 cannabis patient center is licensed by the department 20 unless otherwise protected from disclosure under state 21 or federal law. 22 2. As a condition for licensure, a medical cannabis 23 patient center must agree to begin supplying medical 24 cannabis to patients by July 1, 2017. 25 3. The department shall consider the following 26 factors in determining whether to license a medical 27 cannabis patient center: 28 a. The technical expertise of the medical cannabis 29 patient center regarding medical cannabis. 30 b. The qualifications of the medical cannabis 31 patient center’s employees. 32 c. The long-term financial stability of the medical 33 cannabis patient center. 34 d. The ability to provide appropriate security 35 -13- H8300.3892 (1) 86 rh/rj 13/ 23

measures on the premises of the medical cannabis 1 patient center. 2 e. The medical cannabis patient center’s projection 3 and ongoing assessment of fees for the purchase of 4 medical cannabis on patients with debilitating medical 5 conditions. 6 4. Each entity submitting an application for 7 licensure as a medical cannabis patient center shall 8 pay a nonrefundable application fee of five thousand 9 dollars to the department. 10 Sec. 13. NEW SECTION . 124E.9 Medical cannabis 11 patient centers. 12 1. a. The medical cannabis patient centers shall 13 be located based on geographical need throughout the 14 state to improve patient access. 15 b. A medical cannabis patient center may dispense 16 medical cannabis pursuant to the provisions of this 17 chapter but shall not dispense any medical cannabis 18 in a form or quantity other than the form or quantity 19 allowed by the department pursuant to rule. 20 2. The operating documents of a medical cannabis 21 patient center shall include all of the following: 22 a. Procedures for the oversight of the medical 23 cannabis patient center and procedures to ensure 24 accurate record keeping. 25 b. Procedures for the implementation of appropriate 26 security measures to deter and prevent the theft of 27 medical cannabis and unauthorized entrance into areas 28 containing medical cannabis. 29 3. A medical cannabis patient center shall 30 implement security requirements, including requirements 31 for protection by a fully operational security alarm 32 system, facility access controls, perimeter intrusion 33 detection systems, and a personnel identification 34 system. 35 -14- H8300.3892 (1) 86 rh/rj 14/ 23

4. A medical cannabis patient center shall not 1 share office space with, refer patients to, or have any 2 financial relationship with a health care practitioner. 3 5. A medical cannabis patient center shall not 4 permit any person to consume medical cannabis on the 5 property of the medical cannabis patient center. 6 6. A medical cannabis patient center is subject to 7 reasonable inspection by the department. 8 7. A medical cannabis patient center shall not 9 employ a person under eighteen years of age or who has 10 been convicted of a disqualifying felony offense. An 11 employee of a medical cannabis patient center shall be 12 subject to a background investigation conducted by the 13 division of criminal investigation of the department 14 of public safety and a national criminal history 15 background check. 16 8. A medical cannabis patient center shall not 17 operate in any location within one thousand feet of a 18 public or private school existing before the date of 19 the medical cannabis patient center’s licensure by the 20 department. 21 9. A medical cannabis patient center shall 22 comply with reasonable restrictions set by the 23 department relating to signage, marketing, display, and 24 advertising of medical cannabis. 25 10. Prior to dispensing of any medical cannabis, 26 a medical cannabis patient center shall do all of the 27 following: 28 a. Verify that the medical cannabis patient center 29 has received a valid medical cannabis registration card 30 from a patient or a patient’s primary caregiver, if 31 applicable. 32 b. Assign a tracking number to any medical cannabis 33 dispensed from the medical cannabis patient center. 34 c. (1) Properly package medical cannabis in 35 -15- H8300.3892 (1) 86 rh/rj 15/ 23

compliance with federal law regarding child resistant 1 packaging and exemptions for packaging for elderly 2 patients, and label medical cannabis with a list of 3 all active ingredients and individually identifying 4 information, including all of the following: 5 (a) The name and date of birth of the patient and 6 the patient’s primary caregiver, if appropriate. 7 (b) The medical cannabis registration card numbers 8 of the patient and the patient’s primary caregiver, if 9 applicable. 10 (c) The chemical composition of the medical 11 cannabis. 12 (2) Proper packaging of medical cannabis shall 13 include but not be limited to all of the following: 14 (a) Warning labels regarding the use of medical 15 cannabis by a woman during pregnancy and while 16 breastfeeding. 17 (b) Clearly labeled packaging indicating that 18 an edible medical cannabis product contains medical 19 cannabis and which packaging shall not imitate candy 20 products or in any way make the product marketable to 21 children. 22 11. A medical cannabis patient center shall employ 23 a pharmacist licensed pursuant to chapter 155A. 24 12. A medical cannabis patient center shall keep 25 a reliable and ongoing supply of medical cannabis to 26 treat every debilitating medical condition listed in 27 this chapter. 28 Sec. 14. NEW SECTION . 124E.10 Department duties 29 —— rules. 30 1. a. The department shall maintain a confidential 31 file of the names of each patient to or for whom the 32 department issues a medical cannabis registration 33 card, the name of each primary caregiver to whom the 34 department issues a medical cannabis registration card 35 -16- H8300.3892 (1) 86 rh/rj 16/ 23

under section 124E.4, and the names of each health care 1 practitioner who provides a written certification for 2 medical cannabis pursuant to this chapter. 3 b. Individual names contained in the file shall be 4 confidential and shall not be subject to disclosure, 5 except as provided in subparagraph (1). 6 (1) Information in the confidential file maintained 7 pursuant to paragraph “a” may be released on an 8 individual basis to the following persons under the 9 following circumstances: 10 (a) To authorized employees or agents of the 11 department and the department of transportation as 12 necessary to perform the duties of the department and 13 the department of transportation pursuant to this 14 chapter. 15 (b) To authorized employees of state or local 16 law enforcement agencies, but only for the purpose of 17 verifying that a person is lawfully in possession of a 18 medical cannabis registration card issued pursuant to 19 this chapter. 20 (c) To authorized employees of a medical cannabis 21 patient center, but only for the purpose of verifying 22 that a person is lawfully in possession of a medical 23 cannabis registration card issued pursuant to this 24 chapter. 25 (2) Release of information pursuant to subparagraph 26 (1) shall be consistent with the federal Health 27 Insurance Portability and Accountability Act of 1996, 28 Pub. L. No. 104-191. 29 2. The department shall adopt rules pursuant to 30 chapter 17A to administer this chapter which shall 31 include but not be limited to rules to do all of the 32 following: 33 a. Govern the manner in which the department shall 34 consider applications for new and renewal medical 35 -17- H8300.3892 (1) 86 rh/rj 17/ 23

cannabis registration cards. 1 b. Identify criteria and set forth procedures for 2 including additional chronic or debilitating diseases 3 or medical conditions or their medical treatments 4 on the list of debilitating medical conditions that 5 qualify for the use of medical cannabis. Procedures 6 shall include a petition process and shall allow for 7 public comment and public hearings before the medical 8 advisory board. 9 c. Set forth additional chronic or debilitating 10 diseases or medical conditions or associated medical 11 treatments for inclusion on the list of debilitating 12 medical conditions that qualify for the use of medical 13 cannabis as recommended by the medical advisory board. 14 d. Establish the form and quantity of medical 15 cannabis allowed to be dispensed to a patient or 16 primary caregiver pursuant to this chapter. The 17 form and quantity of medical cannabis shall be 18 appropriate to serve the medical needs of patients with 19 debilitating conditions. 20 e. Establish requirements for the licensure of 21 medical cannabis manufacturers and medical cannabis 22 patient centers and set forth procedures for medical 23 cannabis manufacturers and medical cannabis patient 24 centers to obtain licenses. 25 f. Develop a dispensing system for medical cannabis 26 within this state that provides for all of the 27 following: 28 (1) Medical cannabis patient centers within 29 this state housed on secured grounds and operated by 30 licensed medical cannabis patient centers. 31 (2) The dispensing of medical cannabis to patients 32 and their primary caregivers to occur at locations 33 designated by the department. 34 g. Specify and implement procedures that address 35 -18- H8300.3892 (1) 86 rh/rj 18/ 23

public safety including security procedures and product 1 quality including measures to ensure contaminant-free 2 cultivation of medical cannabis, safety, and labeling. 3 h. Establish and implement a real-time, statewide 4 medical cannabis registry management sale tracking 5 system that is available to medical cannabis patient 6 centers on a twenty-four-hour-day, seven-day-a-week 7 basis for the purpose of verifying that a person 8 is lawfully in possession of a medical cannabis 9 registration card issued pursuant to this chapter 10 and for tracking the date of the sale and quantity of 11 medical cannabis purchased by a patient or a primary 12 caregiver. 13 i. Establish and implement a medical cannabis 14 inventory and delivery tracking system to track 15 medical cannabis from production by a medical cannabis 16 manufacturer through dispensing at a medical cannabis 17 patient center. 18 Sec. 15. NEW SECTION . 124E.11 Reciprocity. 19 A valid medical cannabis registration card, or its 20 equivalent, issued under the laws of another state 21 that allows an out-of-state patient to possess or 22 use medical cannabis in the jurisdiction of issuance 23 shall have the same force and effect as a valid 24 medical cannabis registration card issued pursuant to 25 this chapter, except that an out-of-state patient in 26 this state shall not obtain medical cannabis from a 27 medical cannabis patient center in this state and an 28 out-of-state patient shall not smoke medical cannabis. 29 Sec. 16. NEW SECTION . 124E.12 Use of medical 30 cannabis —— smoking prohibited. 31 A patient shall not consume medical cannabis 32 possessed or used as authorized by this chapter by 33 smoking medical cannabis. 34 Sec. 17. NEW SECTION . 124E.13 Use of medical 35 -19- H8300.3892 (1) 86 rh/rj 19/ 23

cannabis —— affirmative defenses. 1 1. A health care practitioner, including any 2 authorized agent or employee thereof, shall not be 3 subject to prosecution for the unlawful certification, 4 possession, or administration of marijuana under the 5 laws of this state for activities arising directly 6 out of or directly related to the certification or 7 use of medical cannabis in the treatment of a patient 8 diagnosed with a debilitating medical condition as 9 authorized by this chapter. 10 2. A medical cannabis manufacturer, including any 11 authorized agent or employee thereof, shall not be 12 subject to prosecution for manufacturing, possessing, 13 cultivating, harvesting, packaging, processing, 14 transporting, or supplying medical cannabis pursuant 15 to this chapter. 16 3. A medical cannabis patient center, including 17 any authorized agent or employee thereof, shall not be 18 subject to prosecution for transporting, supplying, or 19 dispensing medical cannabis pursuant to this chapter. 20 a. In a prosecution for the unlawful possession 21 of marijuana under the laws of this state, including 22 but not limited to chapters 124 and 453B, it is an 23 affirmative and complete defense to the prosecution 24 that the patient has been diagnosed with a debilitating 25 medical condition, used or possessed medical 26 cannabis pursuant to a certification by a health care 27 practitioner as authorized under this chapter, and, 28 for a patient eighteen years of age or older, is in 29 possession of a valid medical cannabis registration 30 card. 31 b. In a prosecution for the unlawful possession 32 of marijuana under the laws of this state, including 33 but not limited to chapters 124 and 453B, it is an 34 affirmative and complete defense to the prosecution 35 -20- H8300.3892 (1) 86 rh/rj 20/ 23

that the person possessed medical cannabis because the 1 person is a primary caregiver of a patient who has been 2 diagnosed with a debilitating medical condition and is 3 in possession of a valid medical cannabis registration 4 card, and where the primary caregiver’s possession of 5 the medical cannabis is on behalf of the patient and 6 for the patient’s use only as authorized under this 7 chapter. 8 c. If a patient or primary caregiver is charged 9 with the commission of a crime and is not in possession 10 of the person’s medical cannabis registration card, 11 any charge or charges filed against the person shall 12 be dismissed by the court if the person produces to 13 the court prior to or at the person’s trial a medical 14 cannabis registration card issued to that person and 15 valid at the time the person was charged. 16 4. An agency of this state or a political 17 subdivision thereof, including any law enforcement 18 agency, shall not remove or initiate proceedings to 19 remove a patient under the age of eighteen from the 20 home of a parent based solely upon the parent’s or 21 patient’s possession or use of medical cannabis as 22 authorized under this chapter. 23 Sec. 18. NEW SECTION . 124E.14 Fees. 24 Medical cannabis registration card fees and medical 25 cannabis manufacturer and medical cannabis patient 26 center application and annual fees collected by the 27 department pursuant to this chapter shall be retained 28 by the department, shall be considered repayment 29 receipts as defined in section 8.2, and shall be 30 used for the purpose of regulating medical cannabis 31 manufacturers and medical cannabis patient centers and 32 for other expenses necessary for the administration of 33 this chapter. Notwithstanding section 8.33, moneys 34 that remain unencumbered or unobligated at the end of 35 -21- H8300.3892 (1) 86 rh/rj 21/ 23

the fiscal year shall not revert to the general fund 1 of the state. 2 Sec. 19. NEW SECTION . 124E.15 Penalties. 3 1. A person who knowingly or intentionally 4 possesses or uses medical cannabis in violation of 5 the requirements of this chapter is subject to the 6 penalties provided under chapters 124 and 453B. 7 2. A medical cannabis manufacturer or a medical 8 cannabis patient center shall be assessed a civil 9 penalty of up to one thousand dollars per violation for 10 any violation of this chapter in addition to any other 11 applicable penalties. 12 Sec. 20. REPEAL. Chapter 124D, Code 2016, is 13 repealed. 14 Sec. 21. EMERGENCY RULES. The department may 15 adopt emergency rules under section 17A.4, subsection 16 3, and section 17A.5, subsection 2, paragraph “b”, to 17 implement the provisions of this Act and the rules 18 shall be effective immediately upon filing unless 19 a later date is specified in the rules. Any rules 20 adopted in accordance with this section shall also be 21 published as a notice of intended action as provided 22 in section 17A.4. 23 Sec. 22. TRANSITION PROVISIONS. A medical cannabis 24 registration card issued under chapter 124D prior to 25 July 1, 2016, remains effective and continues in effect 26 as issued for the twelve-month period following its 27 issuance. This Act does not preclude the permit holder 28 from seeking to renew the permit under this Act prior 29 to the expiration of the twelve-month period. 30 Sec. 23. EFFECTIVE UPON ENACTMENT. This Act, being 31 deemed of immediate importance, takes effect upon 32 enactment. > 33 2. Title page, line 2, after < fees > by inserting < , 34 and including effective date provisions >> 35 -22- H8300.3892 (1) 86 rh/rj 22/ 23