House File 520 H-1420 Amend House File 520 as follows: 1 1. By striking everything after the enacting clause and 2 inserting: 3 < Section 1. Section 124.204, subsection 4, paragraphs m and 4 u, Code 2017, are amended by striking the paragraphs. 5 Sec. 2. Section 124.204, subsection 7, Code 2017, is amended 6 by striking the subsection. 7 Sec. 3. Section 124.206, subsection 7, Code 2017, is amended 8 to read as follows: 9 7. Hallucinogenic substances. Unless specifically excepted 10 or unless listed in another schedule, any material, compound, 11 mixture, or preparation which contains any quantity of the 12 following substances , or, for purposes of paragraphs “a” and 13 “b” , which contains any of its salts, isomers, or salts of 14 isomers whenever the existence of such salts, isomers, or salts 15 of isomers is possible within the specific chemical designation 16 (for purposes of this paragraph only, the term “isomer” 17 includes the optical, positional, and geometric isomers) : 18 a. Marijuana when used for medicinal purposes pursuant to 19 rules of the board . 20 b. Tetrahydrocannabinols, meaning tetrahydrocannabinols 21 naturally contained in a plant of the genus cannabis (cannabis 22 plant) as well as synthetic equivalents of the substances 23 contained in the cannabis plant, or in the resinous extractives 24 of such plant, and synthetic substances, derivatives, and their 25 isomers with similar chemical structure and pharmacological 26 activity to those substances contained in the plant, such as 27 the following: 28 (1) 1 cis or trans tetrahydrocannabinol, and their optical 29 isomers. 30 (2) 6 cis or trans tetrahydrocannabinol, and their optical 31 isomers. 32 (3) 3,4 cis or trans tetrahydrocannabinol, and their 33 optical isomers. (Since nomenclature of these substances 34 is not internationally standardized, compounds of these 35 -1- HF520.2513 (1) 87 rh/rj 1/ 21 #1.

structures, regardless of numerical designation of atomic 1 positions covered.) 2 b. c. Nabilone [another name for nabilone: (+-) - 3 trans-3-(1,1-dimethylheptyl)-6,6a,7,8,10,10a-hexahydro-1- 4 hydroxy-6,6-dimethyl-9H-dibenzo[b,d]pyran-9-one]. 5 Sec. 4. Section 124.401, subsection 5, unnumbered paragraph 6 3, Code 2017, is amended to read as follows: 7 A person may knowingly or intentionally recommend, possess, 8 use, dispense, deliver, transport, or administer cannabidiol 9 medical cannabis if the recommendation, possession, use, 10 dispensing, delivery, transporting, or administering is in 11 accordance with the provisions of chapter 124D 124E . For 12 purposes of this paragraph, “cannabidiol” ”medical cannabis” 13 means the same as defined in section 124D.2 124E.2 . 14 Sec. 5. NEW SECTION . 124E.1 Short title. 15 This chapter shall be known and may be cited as the 16 “Compassionate Use of Medical Cannabis Act” . 17 Sec. 6. NEW SECTION . 124E.2 Definitions. 18 As used in this chapter: 19 1. “Debilitating medical condition” means any of the 20 following: 21 a. Cancer, if the underlying condition or treatment produces 22 one or more of the following: 23 (1) Intractable pain. 24 (2) Nausea or severe vomiting. 25 (3) Cachexia or severe wasting. 26 b. Multiple sclerosis. 27 c. Epilepsy or seizure disorders. 28 d. AIDS or HIV as defined in section 141A.1. 29 e. Glaucoma. 30 f. Hepatitis C. 31 g. Crohn’s disease or ulcerative colitis. 32 h. Amyotrophic lateral sclerosis. 33 i. Ehlers-Danlos syndrome. 34 j. Post-traumatic stress disorder. 35 -2- HF520.2513 (1) 87 rh/rj 2/ 21

k. Tourette’s syndrome. 1 l. Any terminal illness, with a probable life expectancy of 2 under one year, if the illness or its treatment produces one or 3 more of the following: 4 (1) Intractable pain. 5 (2) Nausea or severe vomiting. 6 (3) Cachexia or severe wasting. 7 m. Intractable pain. 8 n. Parkinson’s disease. 9 o. Muscular dystrophy. 10 p. Huntington’s disease. 11 q. Alzheimer’s disease. 12 r. Complex regional pain syndrome, type I and II. 13 s. Rheumatoid arthritis. 14 t. Polyarteritis nodosa. 15 u. Any other chronic or debilitating disease or medical 16 condition or its medical treatment approved by the department 17 pursuant to rule. 18 2. “Department” means the department of public health. 19 3. “Disqualifying felony offense” means a violation under 20 federal or state law of a felony offense, which has as an 21 element the possession, use, or distribution of a controlled 22 substance, as defined in 21 U.S.C. §802(6). 23 4. “Enclosed, locked facility” means a closet, room, 24 greenhouse, or other enclosed area equipped with locks or 25 other security devices that permit access only by authorized 26 personnel. 27 5. “Health care practitioner” means an individual licensed 28 under chapter 148 to practice medicine and surgery or 29 osteopathic medicine and surgery or an individual licensed to 30 practice medicine in any other state who provides specialty 31 care for an Iowa resident for one or more of the debilitating 32 medical conditions provided in this chapter. 33 6. “Intractable pain” means a pain in which the cause of the 34 pain cannot be removed or otherwise treated with the consent 35 -3- HF520.2513 (1) 87 rh/rj 3/ 21

of the patient and which, in the generally accepted course of 1 medical practice, no relief or cure of the cause of the pain 2 is possible, or none has been found after reasonable efforts. 3 Reasonable efforts for relieving or curing the cause of the 4 pain may be determined on the basis of but are not limited to 5 any of the following: 6 a. When treating a nonterminally ill patient for intractable 7 pain, evaluation by the attending physician and one or more 8 physicians specializing in pain medicine or the treatment of 9 the area, system, or organ of the body perceived as the source 10 of the pain. 11 b. When treating a terminally ill patient, evaluation by 12 the attending physician who does so in accordance with the 13 level of care, skill, and treatment that would be recognized 14 by a reasonably prudent physician under similar conditions and 15 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 dispensary” means an entity licensed 20 under section 124E.8 that acquires medical cannabis from a 21 medical cannabis manufacturer in this state for the purpose 22 of dispensing medical cannabis in this state pursuant to this 23 chapter. 24 9. “Medical cannabis manufacturer” means an entity licensed 25 under section 124E.6 to manufacture and to possess, cultivate, 26 transport, or supply medical cannabis pursuant to the 27 provisions of this chapter. 28 10. “Primary caregiver” means a person, at least eighteen 29 years of age, who has been designated by a patient’s health 30 care practitioner or a person having custody of a patient, as 31 a necessary caretaker taking responsibility for managing the 32 well-being of the patient with respect to the use of medical 33 cannabis pursuant to the provisions of this chapter. 34 11. “Written certification” means a document signed by a 35 -4- HF520.2513 (1) 87 rh/rj 4/ 21

health care practitioner, with whom the patient has established 1 a patient-provider relationship, which states that the patient 2 has a debilitating medical condition and identifies that 3 condition and provides any other relevant information. 4 Sec. 7. NEW SECTION . 124E.3 Health care practitioner 5 certification —— duties. 6 1. Prior to a patient’s submission of an application for a 7 medical cannabis registration card pursuant to section 124E.4, 8 a health care practitioner shall do all of the following: 9 a. Determine, in the health care practitioner’s medical 10 judgment, whether the patient whom the health care practitioner 11 has examined and treated suffers from a debilitating medical 12 condition that qualifies for the use of medical cannabis under 13 this chapter, and if so determined, provide the patient with a 14 written certification of that diagnosis. 15 b. Provide explanatory information as provided by the 16 department to the patient about the therapeutic use of medical 17 cannabis. 18 c. Determine, on an annual basis, if the patient continues 19 to suffer from a debilitating medical condition and, if so, 20 issue the patient a new certification of that diagnosis. This 21 paragraph shall not apply if the patient is suffering from an 22 incurable debilitating medical condition. 23 d. Otherwise comply with all requirements established by the 24 department pursuant to rule. 25 2. A health care practitioner may provide, but has no duty 26 to provide, a written certification pursuant to this section. 27 Sec. 8. NEW SECTION . 124E.4 Medical cannabis registration 28 card. 29 1. Issuance to patient. The department may approve the 30 issuance of a medical cannabis registration card by the 31 department of transportation to a patient who: 32 a. Is at least eighteen years of age. 33 b. Is a permanent resident of this state. 34 c. Submits a written certification to the department signed 35 -5- HF520.2513 (1) 87 rh/rj 5/ 21

by the patient’s health care practitioner that the patient is 1 suffering from a debilitating medical condition. 2 d. Submits an application to the department, on a form 3 created by the department, in consultation with the department 4 of transportation, that contains all of the following: 5 (1) The patient’s full name, Iowa residence address, date 6 of birth, and telephone number. 7 (2) A copy of the patient’s valid photograph 8 identification. 9 (3) Full name, address, and telephone number of the 10 patient’s health care practitioner. 11 (4) Full name, residence address, date of birth, and 12 telephone number of each primary caregiver of the patient, if 13 any. 14 (5) Any other information required by rule. 15 e. Submits a medical cannabis registration card fee of one 16 hundred dollars to the department. If the patient attests to 17 receiving social security disability benefits, supplemental 18 security insurance payments, or being enrolled in the medical 19 assistance program, the fee shall be twenty-five dollars. 20 2. Patient card contents. A medical cannabis registration 21 card issued to a patient by the department of transportation 22 pursuant to subsection 1 shall contain, at a minimum, all of 23 the following: 24 a. The patient’s full name, Iowa residence address, and date 25 of birth. 26 b. The patient’s photograph. 27 c. The date of issuance and expiration of the registration 28 card. 29 d. Any other information required by rule. 30 3. Issuance to primary caregiver. For a patient in a 31 primary caregiver’s care, the department may approve the 32 issuance of a medical cannabis registration card by the 33 department of transportation to the primary caregiver who: 34 a. Submits a written certification to the department signed 35 -6- HF520.2513 (1) 87 rh/rj 6/ 21

by the patient’s health care practitioner that the patient in 1 the primary caregiver’s care is suffering from a debilitating 2 medical condition. 3 b. Submits an application to the department, on a form 4 created by the department, in consultation with the department 5 of transportation, that contains all of the following: 6 (1) The primary caregiver’s full name, residence address, 7 date of birth, and telephone number. 8 (2) The patient’s full name. 9 (3) A copy of the primary caregiver’s valid photograph 10 identification. 11 (4) Full name, address, and telephone number of the 12 patient’s health care practitioner. 13 (5) Any other information required by rule. 14 c. Submits a medical cannabis registration card fee of 15 twenty-five dollars to the department. 16 4. Primary caregiver card contents. A medical cannabis 17 registration card issued by the department of transportation to 18 a primary caregiver pursuant to subsection 3 shall contain, at 19 a minimum, all of the following: 20 a. The primary caregiver’s full name, residence address, and 21 date of birth. 22 b. The primary caregiver’s photograph. 23 c. The date of issuance and expiration of the registration 24 card. 25 d. The registration card number of each patient in the 26 primary caregiver’s care. If the patient in the primary 27 caregiver’s care is under the age of eighteen, the full name of 28 the patient’s parent or legal guardian. 29 e. Any other information required by rule. 30 5. Expiration date of card. A medical cannabis registration 31 card issued pursuant to this section shall expire one year 32 after the date of issuance and may be renewed. 33 6. Card issuance —— department of transportation. 34 a. The department may enter into a chapter 28E agreement 35 -7- HF520.2513 (1) 87 rh/rj 7/ 21

with the department of transportation to facilitate the 1 issuance of medical cannabis registration cards pursuant to 2 subsections 1 and 3. 3 b. The department of transportation may issue renewal 4 medical cannabis registration cards through an online or 5 in-person process. 6 Sec. 9. NEW SECTION . 124E.5 Medical advisory board —— 7 duties. 8 1. No later than August 15, 2017, the director of public 9 health shall establish a medical advisory board consisting of 10 nine practitioners representing the fields of neurology, pain 11 management, gastroenterology, oncology, psychiatry, pediatrics, 12 infectious disease, family medicine, and pharmacy, and three 13 patients or primary caregivers with valid medical cannabis 14 registration cards. The practitioners shall be nationally 15 board-certified in their area of specialty and knowledgeable 16 about the use of medical cannabis. 17 2. A quorum of the advisory board shall consist of seven 18 members. 19 3. The duties of the advisory board shall include but not be 20 limited to the following: 21 a. Reviewing and recommending to the department for 22 approval additional chronic or debilitating diseases or 23 medical conditions or their treatments as debilitating medical 24 conditions that qualify for the use of medical cannabis under 25 this chapter. 26 b. Accepting and reviewing petitions to add chronic or 27 debilitating diseases or medical conditions or their medical 28 treatments to the list of debilitating medical conditions that 29 qualify for the use of medical cannabis under this chapter. 30 c. Working with the department regarding the requirements 31 for the licensure of medical cannabis manufacturers and medical 32 cannabis dispensaries, including licensure procedures. 33 d. Advising the department regarding the location of 34 medical cannabis dispensaries throughout the state, the form 35 -8- HF520.2513 (1) 87 rh/rj 8/ 21

and quantity of allowable medical cannabis to be dispensed 1 to a patient or primary caregiver, and the general oversight 2 of medical cannabis manufacturers and medical cannabis 3 dispensaries in this state. 4 e. Convening at least twice per year to conduct public 5 hearings and to review and recommend for approval petitions, 6 which shall be maintained as confidential personal health 7 information, to add chronic or debilitating diseases or 8 medical conditions or their medical treatments to the list of 9 debilitating medical conditions that qualify for the use of 10 medical cannabis under this chapter. 11 f. Recommending improvements relating to the effectiveness 12 of the provisions of this chapter. 13 g. In making recommendations pursuant to this section, 14 consideration of the economic and financial impacts on patients 15 and the medical cannabis industry, and making recommendations 16 that minimize the extent of such impacts to the greatest extent 17 practicable. 18 Sec. 10. NEW SECTION . 124E.6 Medical cannabis manufacturer 19 licensure. 20 1. a. The department shall license up to four medical 21 cannabis manufacturers to manufacture medical cannabis within 22 this state consistent with the provisions of this chapter by 23 December 1, 2017. The department shall license new medical 24 cannabis manufacturers or relicense the existing medical 25 cannabis manufacturers by December 1 of each year. 26 b. Information submitted during the application process 27 shall be confidential until the medical cannabis manufacturer 28 is licensed by the department unless otherwise protected from 29 disclosure under state or federal law. 30 2. As a condition for licensure, a medical cannabis 31 manufacturer must agree to begin supplying medical cannabis to 32 medical cannabis dispensaries in this state by July 2, 2018. 33 3. The department shall consider the following factors in 34 determining whether to license a medical cannabis manufacturer: 35 -9- HF520.2513 (1) 87 rh/rj 9/ 21

a. The technical expertise of the medical cannabis 1 manufacturer regarding medical cannabis. 2 b. The qualifications of the medical cannabis manufacturer’s 3 ownership and management team. 4 c. The long-term financial stability of the medical cannabis 5 manufacturer. 6 d. The ability to provide appropriate security measures on 7 the premises of the medical cannabis manufacturer. 8 e. Whether the medical cannabis manufacturer has 9 demonstrated an ability to meet certain medical cannabis 10 production needs for medical use regarding the range of 11 recommended dosages for each debilitating medical condition, 12 the range of chemical compositions of any plant of the genus 13 cannabis that will likely be medically beneficial for each 14 of the debilitating medical conditions, and the form of the 15 medical cannabis in the manner determined by the department 16 pursuant to rule. 17 f. The medical cannabis manufacturer’s projection of and 18 ongoing assessment of fees on patients with debilitating 19 medical conditions. 20 g. The medical cannabis manufacturer’s experience in medical 21 cannabis production, plant extraction, and pharmaceutical 22 formulations. 23 4. The department shall require each medical cannabis 24 manufacturer to contract with a laboratory approved by the 25 department to test the medical cannabis produced by the 26 manufacturer. The department shall require that the laboratory 27 report testing results to the manufacturer in a manner 28 determined by the department pursuant to rule. 29 5. Each entity submitting an application for licensure 30 as a medical cannabis manufacturer shall pay a nonrefundable 31 application fee of fifteen thousand dollars to the department. 32 Sec. 11. NEW SECTION . 124E.7 Medical cannabis 33 manufacturers. 34 1. A medical cannabis manufacturer shall contract with a 35 -10- HF520.2513 (1) 87 rh/rj 10/ 21

laboratory approved by the department for purposes of testing 1 the medical cannabis manufactured by the medical cannabis 2 manufacturer as to content, contamination, and consistency. 3 The cost of all laboratory testing shall be paid by the medical 4 cannabis manufacturer. 5 2. The operating documents of a medical cannabis 6 manufacturer shall include all of the following: 7 a. Procedures for the oversight of the medical cannabis 8 manufacturer and procedures to ensure accurate recordkeeping. 9 b. Procedures for the implementation of appropriate security 10 measures to deter and prevent the theft of medical cannabis and 11 unauthorized entrance into areas containing medical cannabis. 12 3. A medical cannabis manufacturer shall implement security 13 requirements, including requirements for protection of each 14 location by a fully operational security alarm system, facility 15 access controls, perimeter intrusion detection systems, and a 16 personnel identification system. 17 4. A medical cannabis manufacturer shall not share 18 office space with, refer patients to, or have any financial 19 relationship with a health care practitioner. 20 5. A medical cannabis manufacturer shall not permit any 21 person to consume medical cannabis on the property of the 22 medical cannabis manufacturer. 23 6. A medical cannabis manufacturer is subject to reasonable 24 inspection by the department. 25 7. A medical cannabis manufacturer shall not employ a 26 person who is under eighteen years of age or who has been 27 convicted of a disqualifying felony offense. An employee 28 of a medical cannabis manufacturer shall be subject to a 29 background investigation conducted by the division of criminal 30 investigation of the department of public safety and a national 31 criminal history background check. 32 8. A medical cannabis manufacturer shall not operate in any 33 location, whether for manufacturing, cultivating, harvesting, 34 packaging, or processing, within one thousand feet of a public 35 -11- HF520.2513 (1) 87 rh/rj 11/ 21

or private school existing before the date of the medical 1 cannabis manufacturer’s licensure by the department. 2 9. A medical cannabis manufacturer shall comply with 3 reasonable restrictions set by the department relating to 4 signage, marketing, display, and advertising of medical 5 cannabis. 6 10. a. A medical cannabis manufacturer shall provide a 7 reliable and ongoing supply of medical cannabis to medical 8 cannabis dispensaries pursuant to this chapter. 9 b. All manufacturing, cultivating, harvesting, packaging, 10 and processing of medical cannabis shall take place in an 11 enclosed, locked facility at a physical address provided to the 12 department during the licensure process. 13 c. A medical cannabis manufacturer shall not manufacture 14 edible medical cannabis products utilizing food coloring. 15 d. A medical cannabis manufacturer shall manufacture a 16 reliable and ongoing supply of medical cannabis to treat every 17 debilitating medical condition listed in this chapter. 18 11. The department shall establish and collect an annual 19 fee from a medical cannabis manufacturer not to exceed the cost 20 of regulating and inspecting the manufacturer in the calendar 21 year. 22 Sec. 12. NEW SECTION . 124E.8 Medical cannabis dispensary 23 licensure. 24 1. a. The department shall license by April 2, 2018, twelve 25 medical cannabis dispensaries to dispense medical cannabis 26 within this state consistent with the provisions of this 27 chapter. The department shall license new medical cannabis 28 dispensaries or relicense the existing medical cannabis 29 dispensaries by December 1 of each year. 30 b. Information submitted during the application process 31 shall be confidential until the medical cannabis dispensary 32 is licensed by the department unless otherwise protected from 33 disclosure under state or federal law. 34 2. As a condition for licensure, a medical cannabis 35 -12- HF520.2513 (1) 87 rh/rj 12/ 21

dispensary must agree to begin supplying medical cannabis to 1 patients by July 16, 2018. 2 3. The department shall consider the following factors in 3 determining whether to license a medical cannabis dispensary: 4 a. The technical expertise of the medical cannabis 5 dispensary regarding medical cannabis. 6 b. The qualifications of the medical cannabis dispensary’s 7 owners and management team. 8 c. The long-term financial stability of the medical cannabis 9 dispensary. 10 d. The ability to provide appropriate security measures on 11 the premises of the medical cannabis dispensary. 12 e. The medical cannabis dispensary’s projection and ongoing 13 assessment of fees for the purchase of medical cannabis on 14 patients with debilitating medical conditions. 15 4. Each entity submitting an application for licensure 16 as a medical cannabis dispensary shall pay a nonrefundable 17 application fee of fifteen thousand dollars to the department. 18 Sec. 13. NEW SECTION . 124E.9 Medical cannabis dispensaries. 19 1. a. Medical cannabis dispensaries shall be located based 20 on geographical need throughout the state to improve patient 21 access. 22 b. A medical cannabis dispensary may dispense medical 23 cannabis pursuant to the provisions of this chapter but shall 24 not dispense any medical cannabis in a form or quantity other 25 than the form or quantity allowed by the department pursuant 26 to rule. 27 2. The operating documents of a medical cannabis dispensary 28 shall include all of the following: 29 a. Procedures for the oversight of the medical cannabis 30 dispensary and procedures to ensure accurate recordkeeping. 31 b. Procedures for the implementation of appropriate security 32 measures to deter and prevent the theft of medical cannabis and 33 unauthorized entrance into areas containing medical cannabis. 34 3. A medical cannabis dispensary shall implement security 35 -13- HF520.2513 (1) 87 rh/rj 13/ 21

requirements, including requirements for protection by a fully 1 operational security alarm system, facility access controls, 2 perimeter intrusion detection systems, and a personnel 3 identification system. 4 4. A medical cannabis dispensary shall not share office 5 space with, refer patients to, or have any financial 6 relationship with a health care practitioner. 7 5. A medical cannabis dispensary shall not permit any person 8 to consume medical cannabis on the property of the medical 9 cannabis dispensary. 10 6. A medical cannabis dispensary is subject to reasonable 11 inspection by the department. 12 7. A medical cannabis dispensary shall not employ a 13 person who is under eighteen years of age or who has been 14 convicted of a disqualifying felony offense. An employee 15 of a medical cannabis dispensary shall be subject to a 16 background investigation conducted by the division of criminal 17 investigation of the department of public safety and a national 18 criminal history background check. 19 8. A medical cannabis dispensary shall not operate in any 20 location within one thousand feet of a public or private school 21 existing before the date of the medical cannabis dispensary’s 22 licensure by the department. 23 9. A medical cannabis dispensary shall comply with 24 reasonable restrictions set by the department relating to 25 signage, marketing, display, and advertising of medical 26 cannabis. 27 10. Prior to dispensing of any medical cannabis, a medical 28 cannabis dispensary shall do all of the following: 29 a. Verify that the medical cannabis dispensary has received 30 a valid medical cannabis registration card from a patient or a 31 patient’s primary caregiver, if applicable. 32 b. Assign a tracking number to any medical cannabis 33 dispensed from the medical cannabis dispensary. 34 c. (1) Properly package medical cannabis in compliance with 35 -14- HF520.2513 (1) 87 rh/rj 14/ 21

federal law regarding child resistant packaging and exemptions 1 for packaging for elderly patients, and label medical cannabis 2 with a list of all active ingredients and individually 3 identifying information, including all of the following: 4 (a) The name and date of birth of the patient and the 5 patient’s primary caregiver, if appropriate. 6 (b) The medical cannabis registration card numbers of the 7 patient and the patient’s primary caregiver, if applicable. 8 (c) The chemical composition of the medical cannabis. 9 (2) Proper packaging of medical cannabis shall include but 10 not be limited to all of the following: 11 (a) Warning labels regarding the use of medical cannabis by 12 a woman during pregnancy and while breastfeeding. 13 (b) Clearly labeled packaging indicating that an edible 14 medical cannabis product contains medical cannabis and which 15 packaging shall not imitate candy products or in any way make 16 the product marketable to children. 17 Sec. 14. NEW SECTION . 124E.10 Fees. 18 Medical cannabis registration card fees and medical cannabis 19 manufacturer and medical cannabis dispensary application 20 and annual fees collected by the department pursuant to 21 this chapter shall be retained by the department, shall be 22 considered repayment receipts as defined in section 8.2, and 23 shall be used for the purpose of regulating medical cannabis 24 manufacturers and medical cannabis dispensaries and for other 25 expenses necessary for the administration of this chapter. 26 Sec. 15. NEW SECTION . 124E.11 Department duties —— rules. 27 1. a. The department shall maintain a confidential file of 28 the names of each patient to or for whom the department issues 29 a medical cannabis registration card, the name of each primary 30 caregiver to whom the department issues a medical cannabis 31 registration card under section 124E.4, and the names of each 32 health care practitioner who provides a written certification 33 for medical cannabis pursuant to this chapter. 34 b. Individual names contained in the file shall be 35 -15- HF520.2513 (1) 87 rh/rj 15/ 21

confidential and shall not be subject to disclosure, except as 1 provided in subparagraph (1). 2 (1) Information in the confidential file maintained 3 pursuant to paragraph “a” may be released on an individual basis 4 to the following persons under the following circumstances: 5 (a) To authorized employees or agents of the department and 6 the department of transportation as necessary to perform the 7 duties of the department and the department of transportation 8 pursuant to this chapter. 9 (b) To authorized employees of state or local law 10 enforcement agencies, but only for the purpose of verifying 11 that a person is lawfully in possession of a medical cannabis 12 registration card issued pursuant to this chapter. 13 (c) To authorized employees of a medical cannabis 14 dispensary, but only for the purpose of verifying that a person 15 is lawfully in possession of a medical cannabis registration 16 card issued pursuant to this chapter. 17 (d) To any other authorized persons recognized by the 18 department by rule, but only for the purpose of verifying 19 that a person is lawfully in possession of a medical cannabis 20 registration card issued pursuant to this chapter. 21 (2) Release of information pursuant to subparagraph 22 (1) shall be consistent with the federal Health Insurance 23 Portability and Accountability Act of 1996, Pub. L. No. 24 104-191. 25 2. The department shall adopt rules pursuant to chapter 26 17A to administer this chapter which shall include but not be 27 limited to rules to do all of the following: 28 a. Govern the manner in which the department shall consider 29 applications for new and renewal medical cannabis registration 30 cards. 31 b. Identify criteria and set forth procedures for 32 including additional chronic or debilitating diseases or 33 medical conditions or their medical treatments on the list of 34 debilitating medical conditions that qualify for the use of 35 -16- HF520.2513 (1) 87 rh/rj 16/ 21

medical cannabis. Procedures shall include a petition process 1 and shall allow for public comment and public hearings before 2 the medical advisory board. 3 c. Set forth additional chronic or debilitating diseases 4 or medical conditions or associated medical treatments for 5 inclusion on the list of debilitating medical conditions that 6 qualify for the use of medical cannabis as recommended by the 7 medical advisory board. 8 d. Establish, in consultation with medical cannabis 9 manufacturers and medical cannabis dispensaries, the form and 10 quantity of medical cannabis allowed to be dispensed to a 11 patient or primary caregiver pursuant to this chapter. The 12 form and quantity of medical cannabis shall be appropriate to 13 serve the medical needs of patients with debilitating medical 14 conditions. 15 e. Establish, in conjunction with the medical advisory 16 board, requirements for the licensure of medical cannabis 17 manufacturers and medical cannabis dispensaries and set forth 18 procedures for medical cannabis manufacturers and medical 19 cannabis dispensaries to obtain licenses. 20 f. Develop a dispensing system for medical cannabis within 21 this state that provides for all of the following: 22 (1) Medical cannabis dispensaries within this state housed 23 on secured grounds and operated by licensed medical cannabis 24 dispensaries. 25 (2) The dispensing of medical cannabis to patients and 26 their primary caregivers to occur at locations designated by 27 the department. 28 g. Establish and collect annual fees from medical cannabis 29 manufacturers and medical cannabis dispensaries to cover 30 the costs associated with regulating and inspecting medical 31 cannabis manufacturers and medical cannabis dispensaries. 32 h. Specify and implement procedures that address public 33 safety including security procedures and product quality 34 including measures to ensure contaminant-free cultivation of 35 -17- HF520.2513 (1) 87 rh/rj 17/ 21

medical cannabis, safety, and labeling. 1 i. Establish and implement a medical cannabis inventory 2 and delivery tracking system to track medical cannabis 3 from production by a medical cannabis manufacturer through 4 dispensing at a medical cannabis dispensary. 5 Sec. 16. NEW SECTION . 124E.12 Reciprocity. 6 A valid medical cannabis registration card, or its 7 equivalent, issued under the laws of another state that allows 8 an out-of-state patient to possess or use medical cannabis in 9 the jurisdiction of issuance shall have the same force and 10 effect as a valid medical cannabis registration card issued 11 pursuant to this chapter, except that an out-of-state patient 12 in this state shall not obtain medical cannabis from a medical 13 cannabis dispensary in this state and an out-of-state patient 14 shall not smoke medical cannabis. 15 Sec. 17. NEW SECTION . 124E.13 Use of medical cannabis —— 16 affirmative defenses. 17 1. A health care practitioner, including any authorized 18 agent or employee thereof, shall not be subject to 19 prosecution for the unlawful certification, possession, or 20 administration of marijuana under the laws of this state for 21 activities arising directly out of or directly related to the 22 certification or use of medical cannabis in the treatment of 23 a patient diagnosed with a debilitating medical condition as 24 authorized by this chapter. 25 2. A medical cannabis manufacturer, including any 26 authorized agent or employee thereof, shall not be subject 27 to prosecution for manufacturing, possessing, cultivating, 28 harvesting, packaging, processing, transporting, or supplying 29 medical cannabis pursuant to this chapter. 30 3. A medical cannabis dispensary, including any authorized 31 agent or employee thereof, shall not be subject to prosecution 32 for transporting, supplying, or dispensing medical cannabis 33 pursuant to this chapter. 34 a. In a prosecution for the unlawful possession of marijuana 35 -18- HF520.2513 (1) 87 rh/rj 18/ 21

under the laws of this state, including but not limited to 1 chapters 124 and 453B, it is an affirmative and complete 2 defense to the prosecution that the patient has been diagnosed 3 with a debilitating medical condition, used or possessed 4 medical cannabis pursuant to a certification by a health care 5 practitioner as authorized under this chapter, and, for a 6 patient eighteen years of age or older, is in possession of a 7 valid medical cannabis registration card. 8 b. In a prosecution for the unlawful possession of marijuana 9 under the laws of this state, including but not limited to 10 chapters 124 and 453B, it is an affirmative and complete 11 defense to the prosecution that the person possessed medical 12 cannabis because the person is a primary caregiver of a patient 13 who has been diagnosed with a debilitating medical condition 14 and is in possession of a valid medical cannabis registration 15 card, and where the primary caregiver’s possession of the 16 medical cannabis is on behalf of the patient and for the 17 patient’s use only as authorized under this chapter. 18 c. If a patient or primary caregiver is charged with the 19 commission of a crime and is not in possession of the person’s 20 medical cannabis registration card, any charge or charges filed 21 against the person shall be dismissed by the court if the 22 person produces to the court prior to or at the person’s trial 23 a medical cannabis registration card issued to that person and 24 valid at the time the person was charged. 25 4. An agency of this state or a political subdivision 26 thereof, including any law enforcement agency, shall not remove 27 or initiate proceedings to remove a patient under the age 28 of eighteen from the home of a parent based solely upon the 29 parent’s or patient’s possession or use of medical cannabis as 30 authorized under this chapter. 31 Sec. 18. NEW SECTION . 124E.14 Penalties. 32 1. A person who knowingly or intentionally possesses or 33 uses medical cannabis in violation of the requirements of this 34 chapter is subject to the penalties provided under chapters 124 35 -19- HF520.2513 (1) 87 rh/rj 19/ 21

and 453B. 1 2. A medical cannabis manufacturer or a medical cannabis 2 dispensary shall be assessed a civil penalty of up to one 3 thousand dollars per violation for any violation of this 4 chapter in addition to any other applicable penalties. 5 Sec. 19. NEW SECTION . 124E.15 Use of medical cannabis —— 6 smoking prohibited. 7 A patient shall not consume medical cannabis possessed 8 or used as authorized under this chapter by smoking medical 9 cannabis. 10 Sec. 20. NEW SECTION . 124E.16 Employment. 11 1. An employer in this state may retain, create, reinstate, 12 or enforce a written zero tolerance policy prohibiting the 13 possession or use of medical cannabis or any derivative 14 thereof including cannabidiol by an employee in the employer’s 15 workplace, including but not limited to a policy prohibiting 16 an employee from having any detectable amount of medical 17 cannabis or any derivative thereof including cannabidiol in the 18 employee’s body while at work. 19 2. An employer’s prohibition of the possession or use 20 of medical cannabis or any derivative thereof including 21 cannabidiol under this section shall not be considered to be 22 an unfair or discriminatory employment practice under section 23 216.6. 24 Sec. 21. Section 730.5, subsection 11, Code 2017, is amended 25 by adding the following new paragraph: 26 NEW PARAGRAPH . f. Testing or taking action against an 27 individual with a confirmed positive test result due to the 28 individual’s use of medical cannabis as authorized under 29 chapter 124E. 30 Sec. 22. REPEAL. Chapter 124D, Code 2017, is repealed. 31 Sec. 23. EMERGENCY RULES. The department may adopt 32 emergency rules under section 17A.4, subsection 3, and section 33 17A.5, subsection 2, paragraph “b”, to implement the provisions 34 of this Act and the rules shall be effective immediately upon 35 -20- HF520.2513 (1) 87 rh/rj 20/ 21

filing unless a later date is specified in the rules. Any 1 rules adopted in accordance with this section shall also be 2 published as a notice of intended action as provided in section 3 17A.4. 4 Sec. 24. TRANSITION PROVISIONS. A medical cannabidiol 5 registration card issued under chapter 124D prior to the 6 effective date of this Act, remains effective and continues 7 in effect as issued for the twelve-month period following its 8 issuance. This Act does not preclude a medical cannabidiol 9 registration card holder from seeking to renew the registration 10 card under this Act prior to the expiration of the twelve-month 11 period. 12 Sec. 25. EFFECTIVE UPON ENACTMENT. This Act, being deemed 13 of immediate importance, takes effect upon enactment. > 14 2. Title page, by striking lines 1 through 4 and inserting 15 < An Act concerning the compassionate use of medical cannabis 16 Act, reclassifying marijuana, including tetrahydrocannabinols, 17 from a schedule I controlled substance to a schedule II 18 controlled substance, providing for civil and criminal 19 penalties and fees, and including effective date provisions. > 20 ______________________________ M. SMITH of Marshall -21- HF520.2513 (1) 87 rh/rj 21/ 21 #2.