House File 520 H-1423 Amend the amendment, H-1420, to House File 520 as follows: 1 1. By striking page 1, line 1, through page 21, line 20, and 2 inserting: 3 < Amend House File 520 as follows: 4 ___. By striking everything after the enacting clause and 5 inserting: 6 < Section 1. NEW SECTION . 124.201A Cannabidiol 7 investigational product —— rules. 8 1. If a cannabidiol investigational product approved as 9 a prescription drug medication by the United States food and 10 drug administration is eliminated from or revised in the 11 federal schedule of controlled substances by the federal drug 12 enforcement agency and notice of the elimination or revision 13 is given to the board, the board shall similarly eliminate 14 or revise the prescription drug medication in the schedule 15 of controlled substances under this chapter. Such action by 16 the board shall be immediately effective upon the date of 17 publication of the final regulation containing the elimination 18 or revision in the federal register. 19 2. The board shall adopt rules pursuant to chapter 17A 20 to administer this section. The board may adopt rules on an 21 emergency basis as provided in section 17A.4, subsection 3, and 22 section 17A.5, subsection 2, to administer this section, and 23 the rules shall be effective immediately upon filing unless 24 a later date is specified in the rules. Any emergency rules 25 adopted in accordance with this section shall also be published 26 as a notice of intended action as provided in section 17A.4, 27 subsection 1. 28 Sec. 2. Section 124.204, subsection 4, paragraphs m and u, 29 Code 2017, are amended by striking the paragraphs. 30 Sec. 3. Section 124.204, subsection 7, Code 2017, is amended 31 by striking the subsection. 32 Sec. 4. Section 124.206, subsection 7, Code 2017, is amended 33 to read as follows: 34 7. Hallucinogenic substances. Unless specifically excepted 35 -1- H1420.2588 (1) 87 rh/rj 1/ 22 #1.

or unless listed in another schedule, any material, compound, 1 mixture, or preparation which contains any quantity of the 2 following substances , or, for purposes of paragraphs “a” and 3 “b” , which contains any of its salts, isomers, or salts of 4 isomers whenever the existence of such salts, isomers, or salts 5 of isomers is possible within the specific chemical designation 6 (for purposes of this paragraph only, the term “isomer” 7 includes the optical, positional, and geometric isomers) : 8 a. Marijuana when used for medicinal purposes pursuant to 9 rules of the board . 10 b. Tetrahydrocannabinols, meaning tetrahydrocannabinols 11 naturally contained in a plant of the genus cannabis (cannabis 12 plant) as well as synthetic equivalents of the substances 13 contained in the cannabis plant, or in the resinous extractives 14 of such plant, and synthetic substances, derivatives, and their 15 isomers with similar chemical structure and pharmacological 16 activity to those substances contained in the plant, such as 17 the following: 18 (1) 1 cis or trans tetrahydrocannabinol, and their optical 19 isomers. 20 (2) 6 cis or trans tetrahydrocannabinol, and their optical 21 isomers. 22 (3) 3,4 cis or trans tetrahydrocannabinol, and their 23 optical isomers. (Since nomenclature of these substances 24 is not internationally standardized, compounds of these 25 structures, regardless of numerical designation of atomic 26 positions covered.) 27 b. c. Nabilone [another name for nabilone: (+-) - 28 trans-3-(1,1-dimethylheptyl)-6,6a,7,8,10,10a-hexahydro-1- 29 hydroxy-6,6-dimethyl-9H-dibenzo[b,d]pyran-9-one]. 30 Sec. 5. Section 124.401, subsection 5, unnumbered paragraph 31 3, Code 2017, is amended to read as follows: 32 A person may knowingly or intentionally recommend, possess, 33 use, dispense, deliver, transport, or administer cannabidiol 34 medical cannabis if the recommendation, possession, use, 35 -2- H1420.2588 (1) 87 rh/rj 2/ 22

dispensing, delivery, transporting, or administering is in 1 accordance with the provisions of chapter 124D 124E . For 2 purposes of this paragraph, “cannabidiol” ”medical cannabis” 3 means the same as defined in section 124D.2 124E.2 . 4 Sec. 6. NEW SECTION . 124E.1 Short title. 5 This chapter shall be known and may be cited as the 6 “Compassionate Use of Medical Cannabis Act” . 7 Sec. 7. NEW SECTION . 124E.2 Definitions. 8 As used in this chapter: 9 1. “Debilitating medical condition” means any of the 10 following: 11 a. Cancer, if the underlying condition or treatment produces 12 one or more of the following: 13 (1) Intractable pain. 14 (2) Nausea or severe vomiting. 15 (3) Cachexia or severe wasting. 16 b. Multiple sclerosis. 17 c. Epilepsy or seizure disorders. 18 d. AIDS or HIV as defined in section 141A.1. 19 e. Glaucoma. 20 f. Hepatitis C. 21 g. Crohn’s disease or ulcerative colitis. 22 h. Amyotrophic lateral sclerosis. 23 i. Ehlers-Danlos syndrome. 24 j. Post-traumatic stress disorder. 25 k. Tourette’s syndrome. 26 l. Any terminal illness, with a probable life expectancy of 27 under one year, if the illness or its treatment produces one or 28 more of the following: 29 (1) Intractable pain. 30 (2) Nausea or severe vomiting. 31 (3) Cachexia or severe wasting. 32 m. Intractable pain. 33 n. Parkinson’s disease. 34 o. Muscular dystrophy. 35 -3- H1420.2588 (1) 87 rh/rj 3/ 22

p. Huntington’s disease. 1 q. Alzheimer’s disease. 2 r. Complex regional pain syndrome, type I and II. 3 s. Rheumatoid arthritis. 4 t. Polyarteritis nodosa. 5 u. Any other chronic or debilitating disease or medical 6 condition or its medical treatment approved by the department 7 pursuant to rule. 8 2. “Department” means the department of public health. 9 3. “Disqualifying felony offense” means a violation under 10 federal or state law of a felony offense, which has as an 11 element the possession, use, or distribution of a controlled 12 substance, as defined in 21 U.S.C. §802(6). 13 4. “Enclosed, locked facility” means a closet, room, 14 greenhouse, or other enclosed area equipped with locks or 15 other security devices that permit access only by authorized 16 personnel. 17 5. “Health care practitioner” means an individual licensed 18 under chapter 148 to practice medicine and surgery or 19 osteopathic medicine and surgery or an individual licensed to 20 practice medicine in any other state who provides specialty 21 care for an Iowa resident for one or more of the debilitating 22 medical conditions provided in this chapter. 23 6. “Intractable pain” means a pain in which the cause of the 24 pain cannot be removed or otherwise treated with the consent 25 of the patient and which, in the generally accepted course of 26 medical practice, no relief or cure of the cause of the pain 27 is possible, or none has been found after reasonable efforts. 28 Reasonable efforts for relieving or curing the cause of the 29 pain may be determined on the basis of but are not limited to 30 any of the following: 31 a. When treating a nonterminally ill patient for intractable 32 pain, evaluation by the attending physician and one or more 33 physicians specializing in pain medicine or the treatment of 34 the area, system, or organ of the body perceived as the source 35 -4- H1420.2588 (1) 87 rh/rj 4/ 22

of the pain. 1 b. When treating a terminally ill patient, evaluation by 2 the attending physician who does so in accordance with the 3 level of care, skill, and treatment that would be recognized 4 by a reasonably prudent physician under similar conditions and 5 circumstances. 6 7. “Medical cannabis” means any species of the genus 7 cannabis plant, or any mixture or preparation of them, 8 including whole plant extracts and resins. 9 8. “Medical cannabis dispensary” means an entity licensed 10 under section 124E.8 that acquires medical cannabis from a 11 medical cannabis manufacturer in this state for the purpose 12 of dispensing medical cannabis in this state pursuant to this 13 chapter. 14 9. “Medical cannabis manufacturer” means an entity licensed 15 under section 124E.6 to manufacture and to possess, cultivate, 16 transport, or supply medical cannabis pursuant to the 17 provisions of this chapter. 18 10. “Primary caregiver” means a person, at least eighteen 19 years of age, who has been designated by a patient’s health 20 care practitioner or a person having custody of a patient, as 21 a necessary caretaker taking responsibility for managing the 22 well-being of the patient with respect to the use of medical 23 cannabis pursuant to the provisions of this chapter. 24 11. “Written certification” means a document signed by a 25 health care practitioner, with whom the patient has established 26 a patient-provider relationship, which states that the patient 27 has a debilitating medical condition and identifies that 28 condition and provides any other relevant information. 29 Sec. 8. NEW SECTION . 124E.3 Health care practitioner 30 certification —— duties. 31 1. Prior to a patient’s submission of an application for a 32 medical cannabis registration card pursuant to section 124E.4, 33 a health care practitioner shall do all of the following: 34 a. Determine, in the health care practitioner’s medical 35 -5- H1420.2588 (1) 87 rh/rj 5/ 22

judgment, whether the patient whom the health care practitioner 1 has examined and treated suffers from a debilitating medical 2 condition that qualifies for the use of medical cannabis under 3 this chapter, and if so determined, provide the patient with a 4 written certification of that diagnosis. 5 b. Provide explanatory information as provided by the 6 department to the patient about the therapeutic use of medical 7 cannabis. 8 c. Determine, on an annual basis, if the patient continues 9 to suffer from a debilitating medical condition and, if so, 10 issue the patient a new certification of that diagnosis. This 11 paragraph shall not apply if the patient is suffering from an 12 incurable debilitating medical condition. 13 d. Otherwise comply with all requirements established by the 14 department pursuant to rule. 15 2. A health care practitioner may provide, but has no duty 16 to provide, a written certification pursuant to this section. 17 Sec. 9. NEW SECTION . 124E.4 Medical cannabis registration 18 card. 19 1. Issuance to patient. The department may approve the 20 issuance of a medical cannabis registration card by the 21 department of transportation to a patient who: 22 a. Is at least eighteen years of age. 23 b. Is a permanent resident of this state. 24 c. Submits a written certification to the department signed 25 by the patient’s health care practitioner that the patient is 26 suffering from a debilitating medical condition. 27 d. Submits an application to the department, on a form 28 created by the department, in consultation with the department 29 of transportation, that contains all of the following: 30 (1) The patient’s full name, Iowa residence address, date 31 of birth, and telephone number. 32 (2) A copy of the patient’s valid photograph 33 identification. 34 (3) Full name, address, and telephone number of the 35 -6- H1420.2588 (1) 87 rh/rj 6/ 22

patient’s health care practitioner. 1 (4) Full name, residence address, date of birth, and 2 telephone number of each primary caregiver of the patient, if 3 any. 4 (5) Any other information required by rule. 5 e. Submits a medical cannabis registration card fee of one 6 hundred dollars to the department. If the patient attests to 7 receiving social security disability benefits, supplemental 8 security insurance payments, or being enrolled in the medical 9 assistance program, the fee shall be twenty-five dollars. 10 2. Patient card contents. A medical cannabis registration 11 card issued to a patient by the department of transportation 12 pursuant to subsection 1 shall contain, at a minimum, all of 13 the following: 14 a. The patient’s full name, Iowa residence address, and date 15 of birth. 16 b. The patient’s photograph. 17 c. The date of issuance and expiration of the registration 18 card. 19 d. Any other information required by rule. 20 3. Issuance to primary caregiver. For a patient in a 21 primary caregiver’s care, the department may approve the 22 issuance of a medical cannabis registration card by the 23 department of transportation to the primary caregiver who: 24 a. Submits a written certification to the department signed 25 by the patient’s health care practitioner that the patient in 26 the primary caregiver’s care is suffering from a debilitating 27 medical condition. 28 b. Submits an application to the department, on a form 29 created by the department, in consultation with the department 30 of transportation, that contains all of the following: 31 (1) The primary caregiver’s full name, residence address, 32 date of birth, and telephone number. 33 (2) The patient’s full name. 34 (3) A copy of the primary caregiver’s valid photograph 35 -7- H1420.2588 (1) 87 rh/rj 7/ 22

identification. 1 (4) Full name, address, and telephone number of the 2 patient’s health care practitioner. 3 (5) Any other information required by rule. 4 c. Submits a medical cannabis registration card fee of 5 twenty-five dollars to the department. 6 4. Primary caregiver card contents. A medical cannabis 7 registration card issued by the department of transportation to 8 a primary caregiver pursuant to subsection 3 shall contain, at 9 a minimum, all of the following: 10 a. The primary caregiver’s full name, residence address, and 11 date of birth. 12 b. The primary caregiver’s photograph. 13 c. The date of issuance and expiration of the registration 14 card. 15 d. The registration card number of each patient in the 16 primary caregiver’s care. If the patient in the primary 17 caregiver’s care is under the age of eighteen, the full name of 18 the patient’s parent or legal guardian. 19 e. Any other information required by rule. 20 5. Expiration date of card. A medical cannabis registration 21 card issued pursuant to this section shall expire one year 22 after the date of issuance and may be renewed. 23 6. Card issuance —— department of transportation. 24 a. The department may enter into a chapter 28E agreement 25 with the department of transportation to facilitate the 26 issuance of medical cannabis registration cards pursuant to 27 subsections 1 and 3. 28 b. The department of transportation may issue renewal 29 medical cannabis registration cards through an online or 30 in-person process. 31 Sec. 10. NEW SECTION . 124E.5 Medical advisory board —— 32 duties. 33 1. No later than August 15, 2017, the director of public 34 health shall establish a medical advisory board consisting of 35 -8- H1420.2588 (1) 87 rh/rj 8/ 22

nine practitioners representing the fields of neurology, pain 1 management, gastroenterology, oncology, psychiatry, pediatrics, 2 infectious disease, family medicine, and pharmacy, and three 3 patients or primary caregivers with valid medical cannabis 4 registration cards. The practitioners shall be nationally 5 board-certified in their area of specialty and knowledgeable 6 about the use of medical cannabis. 7 2. A quorum of the advisory board shall consist of seven 8 members. 9 3. The duties of the advisory board shall include but not be 10 limited to the following: 11 a. Reviewing and recommending to the department for 12 approval additional chronic or debilitating diseases or 13 medical conditions or their treatments as debilitating medical 14 conditions that qualify for the use of medical cannabis under 15 this chapter. 16 b. Accepting and reviewing petitions to add chronic or 17 debilitating diseases or medical conditions or their medical 18 treatments to the list of debilitating medical conditions that 19 qualify for the use of medical cannabis under this chapter. 20 c. Working with the department regarding the requirements 21 for the licensure of medical cannabis manufacturers and medical 22 cannabis dispensaries, including licensure procedures. 23 d. Advising the department regarding the location of 24 medical cannabis dispensaries throughout the state, the form 25 and quantity of allowable medical cannabis to be dispensed 26 to a patient or primary caregiver, and the general oversight 27 of medical cannabis manufacturers and medical cannabis 28 dispensaries in this state. 29 e. Convening at least twice per year to conduct public 30 hearings and to review and recommend for approval petitions, 31 which shall be maintained as confidential personal health 32 information, to add chronic or debilitating diseases or 33 medical conditions or their medical treatments to the list of 34 debilitating medical conditions that qualify for the use of 35 -9- H1420.2588 (1) 87 rh/rj 9/ 22

medical cannabis under this chapter. 1 f. Recommending improvements relating to the effectiveness 2 of the provisions of this chapter. 3 g. In making recommendations pursuant to this section, 4 consideration of the economic and financial impacts on patients 5 and the medical cannabis industry, and making recommendations 6 that minimize the extent of such impacts to the greatest extent 7 practicable. 8 Sec. 11. NEW SECTION . 124E.6 Medical cannabis manufacturer 9 licensure. 10 1. a. The department shall license up to four medical 11 cannabis manufacturers to manufacture medical cannabis within 12 this state consistent with the provisions of this chapter by 13 December 1, 2017. The department shall license new medical 14 cannabis manufacturers or relicense the existing medical 15 cannabis manufacturers by December 1 of each year. 16 b. Information submitted during the application process 17 shall be confidential until the medical cannabis manufacturer 18 is licensed by the department unless otherwise protected from 19 disclosure under state or federal law. 20 2. As a condition for licensure, a medical cannabis 21 manufacturer must agree to begin supplying medical cannabis to 22 medical cannabis dispensaries in this state by July 2, 2018. 23 3. The department shall consider the following factors in 24 determining whether to license a medical cannabis manufacturer: 25 a. The technical expertise of the medical cannabis 26 manufacturer regarding medical cannabis. 27 b. The qualifications of the medical cannabis manufacturer’s 28 ownership and management team. 29 c. The long-term financial stability of the medical cannabis 30 manufacturer. 31 d. The ability to provide appropriate security measures on 32 the premises of the medical cannabis manufacturer. 33 e. Whether the medical cannabis manufacturer has 34 demonstrated an ability to meet certain medical cannabis 35 -10- H1420.2588 (1) 87 rh/rj 10/ 22

production needs for medical use regarding the range of 1 recommended dosages for each debilitating medical condition, 2 the range of chemical compositions of any plant of the genus 3 cannabis that will likely be medically beneficial for each 4 of the debilitating medical conditions, and the form of the 5 medical cannabis in the manner determined by the department 6 pursuant to rule. 7 f. The medical cannabis manufacturer’s projection of and 8 ongoing assessment of fees on patients with debilitating 9 medical conditions. 10 g. The medical cannabis manufacturer’s experience in medical 11 cannabis production, plant extraction, and pharmaceutical 12 formulations. 13 4. The department shall require each medical cannabis 14 manufacturer to contract with a laboratory approved by the 15 department to test the medical cannabis produced by the 16 manufacturer. The department shall require that the laboratory 17 report testing results to the manufacturer in a manner 18 determined by the department pursuant to rule. 19 5. Each entity submitting an application for licensure 20 as a medical cannabis manufacturer shall pay a nonrefundable 21 application fee of fifteen thousand dollars to the department. 22 Sec. 12. NEW SECTION . 124E.7 Medical cannabis 23 manufacturers. 24 1. A medical cannabis manufacturer shall contract with a 25 laboratory approved by the department for purposes of testing 26 the medical cannabis manufactured by the medical cannabis 27 manufacturer as to content, contamination, and consistency. 28 The cost of all laboratory testing shall be paid by the medical 29 cannabis manufacturer. 30 2. The operating documents of a medical cannabis 31 manufacturer shall include all of the following: 32 a. Procedures for the oversight of the medical cannabis 33 manufacturer and procedures to ensure accurate recordkeeping. 34 b. Procedures for the implementation of appropriate security 35 -11- H1420.2588 (1) 87 rh/rj 11/ 22

measures to deter and prevent the theft of medical cannabis and 1 unauthorized entrance into areas containing medical cannabis. 2 3. A medical cannabis manufacturer shall implement security 3 requirements, including requirements for protection of each 4 location by a fully operational security alarm system, facility 5 access controls, perimeter intrusion detection systems, and a 6 personnel identification system. 7 4. A medical cannabis manufacturer shall not share 8 office space with, refer patients to, or have any financial 9 relationship with a health care practitioner. 10 5. A medical cannabis manufacturer shall not permit any 11 person to consume medical cannabis on the property of the 12 medical cannabis manufacturer. 13 6. A medical cannabis manufacturer is subject to reasonable 14 inspection by the department. 15 7. A medical cannabis manufacturer shall not employ a 16 person who is under eighteen years of age or who has been 17 convicted of a disqualifying felony offense. An employee 18 of a medical cannabis manufacturer shall be subject to a 19 background investigation conducted by the division of criminal 20 investigation of the department of public safety and a national 21 criminal history background check. 22 8. A medical cannabis manufacturer shall not operate in any 23 location, whether for manufacturing, cultivating, harvesting, 24 packaging, or processing, within one thousand feet of a public 25 or private school existing before the date of the medical 26 cannabis manufacturer’s licensure by the department. 27 9. A medical cannabis manufacturer shall comply with 28 reasonable restrictions set by the department relating to 29 signage, marketing, display, and advertising of medical 30 cannabis. 31 10. a. A medical cannabis manufacturer shall provide a 32 reliable and ongoing supply of medical cannabis to medical 33 cannabis dispensaries pursuant to this chapter. 34 b. All manufacturing, cultivating, harvesting, packaging, 35 -12- H1420.2588 (1) 87 rh/rj 12/ 22

and processing of medical cannabis shall take place in an 1 enclosed, locked facility at a physical address provided to the 2 department during the licensure process. 3 c. A medical cannabis manufacturer shall not manufacture 4 edible medical cannabis products utilizing food coloring. 5 d. A medical cannabis manufacturer shall manufacture a 6 reliable and ongoing supply of medical cannabis to treat every 7 debilitating medical condition listed in this chapter. 8 11. The department shall establish and collect an annual 9 fee from a medical cannabis manufacturer not to exceed the cost 10 of regulating and inspecting the manufacturer in the calendar 11 year. 12 Sec. 13. NEW SECTION . 124E.8 Medical cannabis dispensary 13 licensure. 14 1. a. The department shall license by April 2, 2018, twelve 15 medical cannabis dispensaries to dispense medical cannabis 16 within this state consistent with the provisions of this 17 chapter. The department shall license new medical cannabis 18 dispensaries or relicense the existing medical cannabis 19 dispensaries by December 1 of each year. 20 b. Information submitted during the application process 21 shall be confidential until the medical cannabis dispensary 22 is licensed by the department unless otherwise protected from 23 disclosure under state or federal law. 24 2. As a condition for licensure, a medical cannabis 25 dispensary must agree to begin supplying medical cannabis to 26 patients by July 16, 2018. 27 3. The department shall consider the following factors in 28 determining whether to license a medical cannabis dispensary: 29 a. The technical expertise of the medical cannabis 30 dispensary regarding medical cannabis. 31 b. The qualifications of the medical cannabis dispensary’s 32 owners and management team. 33 c. The long-term financial stability of the medical cannabis 34 dispensary. 35 -13- H1420.2588 (1) 87 rh/rj 13/ 22

d. The ability to provide appropriate security measures on 1 the premises of the medical cannabis dispensary. 2 e. The medical cannabis dispensary’s projection and ongoing 3 assessment of fees for the purchase of medical cannabis on 4 patients with debilitating medical conditions. 5 4. Each entity submitting an application for licensure 6 as a medical cannabis dispensary shall pay a nonrefundable 7 application fee of fifteen thousand dollars to the department. 8 Sec. 14. NEW SECTION . 124E.9 Medical cannabis dispensaries. 9 1. a. Medical cannabis dispensaries shall be located based 10 on geographical need throughout the state to improve patient 11 access. 12 b. A medical cannabis dispensary may dispense medical 13 cannabis pursuant to the provisions of this chapter but shall 14 not dispense any medical cannabis in a form or quantity other 15 than the form or quantity allowed by the department pursuant 16 to rule. 17 2. The operating documents of a medical cannabis dispensary 18 shall include all of the following: 19 a. Procedures for the oversight of the medical cannabis 20 dispensary and procedures to ensure accurate recordkeeping. 21 b. Procedures for the implementation of appropriate security 22 measures to deter and prevent the theft of medical cannabis and 23 unauthorized entrance into areas containing medical cannabis. 24 3. A medical cannabis dispensary shall implement security 25 requirements, including requirements for protection by a fully 26 operational security alarm system, facility access controls, 27 perimeter intrusion detection systems, and a personnel 28 identification system. 29 4. A medical cannabis dispensary shall not share office 30 space with, refer patients to, or have any financial 31 relationship with a health care practitioner. 32 5. A medical cannabis dispensary shall not permit any person 33 to consume medical cannabis on the property of the medical 34 cannabis dispensary. 35 -14- H1420.2588 (1) 87 rh/rj 14/ 22

6. A medical cannabis dispensary is subject to reasonable 1 inspection by the department. 2 7. A medical cannabis dispensary shall not employ a 3 person who is under eighteen years of age or who has been 4 convicted of a disqualifying felony offense. An employee 5 of a medical cannabis dispensary shall be subject to a 6 background investigation conducted by the division of criminal 7 investigation of the department of public safety and a national 8 criminal history background check. 9 8. A medical cannabis dispensary shall not operate in any 10 location within one thousand feet of a public or private school 11 existing before the date of the medical cannabis dispensary’s 12 licensure by the department. 13 9. A medical cannabis dispensary shall comply with 14 reasonable restrictions set by the department relating to 15 signage, marketing, display, and advertising of medical 16 cannabis. 17 10. Prior to dispensing of any medical cannabis, a medical 18 cannabis dispensary shall do all of the following: 19 a. Verify that the medical cannabis dispensary has received 20 a valid medical cannabis registration card from a patient or a 21 patient’s primary caregiver, if applicable. 22 b. Assign a tracking number to any medical cannabis 23 dispensed from the medical cannabis dispensary. 24 c. (1) Properly package medical cannabis in compliance with 25 federal law regarding child resistant packaging and exemptions 26 for packaging for elderly patients, and label medical cannabis 27 with a list of all active ingredients and individually 28 identifying information, including all of the following: 29 (a) The name and date of birth of the patient and the 30 patient’s primary caregiver, if appropriate. 31 (b) The medical cannabis registration card numbers of the 32 patient and the patient’s primary caregiver, if applicable. 33 (c) The chemical composition of the medical cannabis. 34 (2) Proper packaging of medical cannabis shall include but 35 -15- H1420.2588 (1) 87 rh/rj 15/ 22

not be limited to all of the following: 1 (a) Warning labels regarding the use of medical cannabis by 2 a woman during pregnancy and while breastfeeding. 3 (b) Clearly labeled packaging indicating that an edible 4 medical cannabis product contains medical cannabis and which 5 packaging shall not imitate candy products or in any way make 6 the product marketable to children. 7 Sec. 15. NEW SECTION . 124E.10 Fees. 8 Medical cannabis registration card fees and medical cannabis 9 manufacturer and medical cannabis dispensary application 10 and annual fees collected by the department pursuant to 11 this chapter shall be retained by the department, shall be 12 considered repayment receipts as defined in section 8.2, and 13 shall be used for the purpose of regulating medical cannabis 14 manufacturers and medical cannabis dispensaries and for other 15 expenses necessary for the administration of this chapter. 16 Sec. 16. NEW SECTION . 124E.11 Department duties —— rules. 17 1. a. The department shall maintain a confidential file of 18 the names of each patient to or for whom the department issues 19 a medical cannabis registration card, the name of each primary 20 caregiver to whom the department issues a medical cannabis 21 registration card under section 124E.4, and the names of each 22 health care practitioner who provides a written certification 23 for medical cannabis pursuant to this chapter. 24 b. Individual names contained in the file shall be 25 confidential and shall not be subject to disclosure, except as 26 provided in subparagraph (1). 27 (1) Information in the confidential file maintained 28 pursuant to paragraph “a” may be released on an individual basis 29 to the following persons under the following circumstances: 30 (a) To authorized employees or agents of the department and 31 the department of transportation as necessary to perform the 32 duties of the department and the department of transportation 33 pursuant to this chapter. 34 (b) To authorized employees of state or local law 35 -16- H1420.2588 (1) 87 rh/rj 16/ 22

enforcement agencies, but only for the purpose of verifying 1 that a person is lawfully in possession of a medical cannabis 2 registration card issued pursuant to this chapter. 3 (c) To authorized employees of a medical cannabis 4 dispensary, but only for the purpose of verifying that a person 5 is lawfully in possession of a medical cannabis registration 6 card issued pursuant to this chapter. 7 (d) To any other authorized persons recognized by the 8 department by rule, but only for the purpose of verifying 9 that a person is lawfully in possession of a medical cannabis 10 registration card issued pursuant to this chapter. 11 (2) Release of information pursuant to subparagraph 12 (1) shall be consistent with the federal Health Insurance 13 Portability and Accountability Act of 1996, Pub. L. No. 14 104-191. 15 2. The department shall adopt rules pursuant to chapter 16 17A to administer this chapter which shall include but not be 17 limited to rules to do all of the following: 18 a. Govern the manner in which the department shall consider 19 applications for new and renewal medical cannabis registration 20 cards. 21 b. Identify criteria and set forth procedures for 22 including additional chronic or debilitating diseases or 23 medical conditions or their medical treatments on the list of 24 debilitating medical conditions that qualify for the use of 25 medical cannabis. Procedures shall include a petition process 26 and shall allow for public comment and public hearings before 27 the medical advisory board. 28 c. Set forth additional chronic or debilitating diseases 29 or medical conditions or associated medical treatments for 30 inclusion on the list of debilitating medical conditions that 31 qualify for the use of medical cannabis as recommended by the 32 medical advisory board. 33 d. Establish, in consultation with medical cannabis 34 manufacturers and medical cannabis dispensaries, the form and 35 -17- H1420.2588 (1) 87 rh/rj 17/ 22

quantity of medical cannabis allowed to be dispensed to a 1 patient or primary caregiver pursuant to this chapter. The 2 form and quantity of medical cannabis shall be appropriate to 3 serve the medical needs of patients with debilitating medical 4 conditions. 5 e. Establish, in conjunction with the medical advisory 6 board, requirements for the licensure of medical cannabis 7 manufacturers and medical cannabis dispensaries and set forth 8 procedures for medical cannabis manufacturers and medical 9 cannabis dispensaries to obtain licenses. 10 f. Develop a dispensing system for medical cannabis within 11 this state that provides for all of the following: 12 (1) Medical cannabis dispensaries within this state housed 13 on secured grounds and operated by licensed medical cannabis 14 dispensaries. 15 (2) The dispensing of medical cannabis to patients and 16 their primary caregivers to occur at locations designated by 17 the department. 18 g. Establish and collect annual fees from medical cannabis 19 manufacturers and medical cannabis dispensaries to cover 20 the costs associated with regulating and inspecting medical 21 cannabis manufacturers and medical cannabis dispensaries. 22 h. Specify and implement procedures that address public 23 safety including security procedures and product quality 24 including measures to ensure contaminant-free cultivation of 25 medical cannabis, safety, and labeling. 26 i. Establish and implement a medical cannabis inventory 27 and delivery tracking system to track medical cannabis 28 from production by a medical cannabis manufacturer through 29 dispensing at a medical cannabis dispensary. 30 Sec. 17. NEW SECTION . 124E.12 Reciprocity. 31 A valid medical cannabis registration card, or its 32 equivalent, issued under the laws of another state that allows 33 an out-of-state patient to possess or use medical cannabis in 34 the jurisdiction of issuance shall have the same force and 35 -18- H1420.2588 (1) 87 rh/rj 18/ 22

effect as a valid medical cannabis registration card issued 1 pursuant to this chapter, except that an out-of-state patient 2 in this state shall not obtain medical cannabis from a medical 3 cannabis dispensary in this state and an out-of-state patient 4 shall not smoke medical cannabis. 5 Sec. 18. NEW SECTION . 124E.13 Use of medical cannabis —— 6 affirmative defenses. 7 1. A health care practitioner, including any authorized 8 agent or employee thereof, shall not be subject to 9 prosecution for the unlawful certification, possession, or 10 administration of marijuana under the laws of this state for 11 activities arising directly out of or directly related to the 12 certification or use of medical cannabis in the treatment of 13 a patient diagnosed with a debilitating medical condition as 14 authorized by this chapter. 15 2. A medical cannabis manufacturer, including any 16 authorized agent or employee thereof, shall not be subject 17 to prosecution for manufacturing, possessing, cultivating, 18 harvesting, packaging, processing, transporting, or supplying 19 medical cannabis pursuant to this chapter. 20 3. A medical cannabis dispensary, including any authorized 21 agent or employee thereof, shall not be subject to prosecution 22 for transporting, supplying, or dispensing medical cannabis 23 pursuant to this chapter. 24 a. In a prosecution for the unlawful possession of marijuana 25 under the laws of this state, including but not limited to 26 chapters 124 and 453B, it is an affirmative and complete 27 defense to the prosecution that the patient has been diagnosed 28 with a debilitating medical condition, used or possessed 29 medical cannabis pursuant to a certification by a health care 30 practitioner as authorized under this chapter, and, for a 31 patient eighteen years of age or older, is in possession of a 32 valid medical cannabis registration card. 33 b. In a prosecution for the unlawful possession of marijuana 34 under the laws of this state, including but not limited to 35 -19- H1420.2588 (1) 87 rh/rj 19/ 22

chapters 124 and 453B, it is an affirmative and complete 1 defense to the prosecution that the person possessed medical 2 cannabis because the person is a primary caregiver of a patient 3 who has been diagnosed with a debilitating medical condition 4 and is in possession of a valid medical cannabis registration 5 card, and where the primary caregiver’s possession of the 6 medical cannabis is on behalf of the patient and for the 7 patient’s use only as authorized under this chapter. 8 c. If a patient or primary caregiver is charged with the 9 commission of a crime and is not in possession of the person’s 10 medical cannabis registration card, any charge or charges filed 11 against the person shall be dismissed by the court if the 12 person produces to the court prior to or at the person’s trial 13 a medical cannabis registration card issued to that person and 14 valid at the time the person was charged. 15 4. An agency of this state or a political subdivision 16 thereof, including any law enforcement agency, shall not remove 17 or initiate proceedings to remove a patient under the age 18 of eighteen from the home of a parent based solely upon the 19 parent’s or patient’s possession or use of medical cannabis as 20 authorized under this chapter. 21 Sec. 19. NEW SECTION . 124E.14 Penalties. 22 1. A person who knowingly or intentionally possesses or 23 uses medical cannabis in violation of the requirements of this 24 chapter is subject to the penalties provided under chapters 124 25 and 453B. 26 2. A medical cannabis manufacturer or a medical cannabis 27 dispensary shall be assessed a civil penalty of up to one 28 thousand dollars per violation for any violation of this 29 chapter in addition to any other applicable penalties. 30 Sec. 20. NEW SECTION . 124E.15 Use of medical cannabis —— 31 smoking prohibited. 32 A patient shall not consume medical cannabis possessed 33 or used as authorized under this chapter by smoking medical 34 cannabis. 35 -20- H1420.2588 (1) 87 rh/rj 20/ 22

Sec. 21. NEW SECTION . 124E.16 Employment. 1 1. An employer in this state may retain, create, reinstate, 2 or enforce a written zero tolerance policy prohibiting the 3 possession or use of medical cannabis or any derivative 4 thereof including cannabidiol by an employee in the employer’s 5 workplace, including but not limited to a policy prohibiting 6 an employee from having any detectable amount of medical 7 cannabis or any derivative thereof including cannabidiol in the 8 employee’s body while at work. 9 2. An employer’s prohibition of the possession or use 10 of medical cannabis or any derivative thereof including 11 cannabidiol under this section shall not be considered to be 12 an unfair or discriminatory employment practice under section 13 216.6. 14 Sec. 22. Section 730.5, subsection 11, Code 2017, is amended 15 by adding the following new paragraph: 16 NEW PARAGRAPH . f. Testing or taking action against an 17 individual with a confirmed positive test result due to the 18 individual’s use of medical cannabis as authorized under 19 chapter 124E. 20 Sec. 23. REPEAL. Chapter 124D, Code 2017, is repealed. 21 Sec. 24. EMERGENCY RULES. The department may adopt 22 emergency rules under section 17A.4, subsection 3, and section 23 17A.5, subsection 2, paragraph “b”, to implement the provisions 24 of this Act and the rules shall be effective immediately upon 25 filing unless a later date is specified in the rules. Any 26 rules adopted in accordance with this section shall also be 27 published as a notice of intended action as provided in section 28 17A.4. 29 Sec. 25. TRANSITION PROVISIONS. A medical cannabidiol 30 registration card issued under chapter 124D prior to the 31 effective date of this Act, remains effective and continues 32 in effect as issued for the twelve-month period following its 33 issuance. This Act does not preclude a medical cannabidiol 34 registration card holder from seeking to renew the registration 35 -21- H1420.2588 (1) 87 rh/rj 21/ 22