House File 524 H-1461 Amend the Senate amendment, H-1341, to House File 524, as 1 amended, passed, and reprinted by the House, as follows: 2 1. Page 1, by striking lines 1 through 7 and inserting: 3 < Amend House File 524, as amended, passed, and reprinted by 4 the House, as follows: 5 1. By striking everything after the enacting clause and 6 inserting: 7 < Section 1. NEW SECTION . 124.201A Cannabidiol 8 investigational product —— rules. 9 1. If a cannabidiol investigational product approved as 10 a prescription drug medication by the United States food and 11 drug administration is eliminated from or revised in the 12 federal schedule of controlled substances by the federal drug 13 enforcement agency and notice of the elimination or revision 14 is given to the board, the board shall similarly eliminate 15 or revise the prescription drug medication in the schedule 16 of controlled substances under this chapter. Such action by 17 the board shall be immediately effective upon the date of 18 publication of the final regulation containing the elimination 19 or revision in the federal register. 20 2. The board shall adopt rules pursuant to chapter 17A 21 to administer this section. The board may adopt rules on an 22 emergency basis as provided in section 17A.4, subsection 3, and 23 section 17A.5, subsection 2, to administer this section, and 24 the rules shall be effective immediately upon filing unless 25 a later date is specified in the rules. Any emergency rules 26 adopted in accordance with this section shall also be published 27 as a notice of intended action as provided in section 17A.4, 28 subsection 1. 29 Sec. 2. Section 124.401, subsection 5, unnumbered paragraph 30 3, Code 2017, is amended to read as follows: 31 A person may knowingly or intentionally recommend, possess, 32 use, dispense, deliver, transport, or administer cannabidiol 33 if the recommendation, possession, use, dispensing, delivery, 34 transporting, or administering is in accordance with the 35 -1- H1341.2711 (3) 87 rh/rj 1/ 22 #1.

provisions of chapter 124D 124E . For purposes of this 1 paragraph, “cannabidiol” means the same as defined in section 2 124D.2 124E.2 . 3 Sec. 3. Section 124.553, subsection 8, Code 2017, is amended 4 to read as follows: 5 8. The board may enter into an agreement with a prescription 6 database or monitoring program operated in a state bordering 7 this state or in the state of Kansas any state for the mutual 8 exchange of information. Any agreement entered into pursuant 9 to this subsection shall specify that all the information 10 exchanged pursuant to the agreement shall be used and 11 disseminated in accordance with the laws of this state. 12 Sec. 4. NEW SECTION . 124E.1 Short title. 13 This chapter shall be known and may be cited as the “Medical 14 Cannabidiol Act” . 15 Sec. 5. NEW SECTION . 124E.2 Definitions. 16 As used in this chapter: 17 1. “Bordering state” means the same as defined in section 18 331.910. 19 2. “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) Severe or chronic pain. 24 (2) Nausea or severe vomiting. 25 (3) Cachexia or severe wasting. 26 b. Multiple sclerosis with severe and persistent muscle 27 spasms. 28 c. Seizures, including those characteristic of epilepsy. 29 d. AIDS or HIV as defined in section 141A.1. 30 e. Crohn’s disease. 31 f. Amyotrophic lateral sclerosis. 32 g. Any terminal illness, with a probable life expectancy of 33 under one year, if the illness or its treatment produces one or 34 more of the following: 35 -2- H1341.2711 (3) 87 rh/rj 2/ 22

(1) Severe or chronic pain. 1 (2) Nausea or severe vomiting. 2 (3) Cachexia or severe wasting. 3 h. Parkinson’s disease. 4 i. Untreatable pain. 5 3. “Department” means the department of public health. 6 4. “Disqualifying felony offense” means a violation under 7 federal or state law of a felony under federal or state law, 8 which has as an element the possession, use, or distribution of 9 a controlled substance, as defined in 21 U.S.C. §802(6). 10 5. “Health care practitioner” means an individual licensed 11 under chapter 148 to practice medicine and surgery or 12 osteopathic medicine and surgery who is a patient’s primary 13 care provider. “Health care practitioner” shall not include a 14 physician assistant licensed under chapter 148C or an advanced 15 registered nurse practitioner licensed pursuant to chapter 152 16 or 152E. 17 6. “Medical cannabidiol” means any pharmaceutical 18 grade cannabinoid found in the plant Cannabis sativa L. or 19 Cannabis indica or any other preparation thereof that has 20 a tetrahydrocannabinol level of no more than three percent 21 and that is delivered in a form recommended by the medical 22 cannabidiol board, approved by the board of medicine, and 23 adopted by the department pursuant to rule. 24 7. “Primary caregiver” means a person who is a resident of 25 this state or a bordering state as defined in section 331.910, 26 including but not limited to a parent or legal guardian, at 27 least eighteen years of age, who has been designated by a 28 patient’s health care practitioner as a necessary caretaker 29 taking responsibility for managing the well-being of the 30 patient with respect to the use of medical cannabidiol pursuant 31 to the provisions of this chapter. 32 8. “Untreatable pain” means any pain whose cause cannot be 33 removed and, according to generally accepted medical practice, 34 the full range of pain management modalities appropriate for 35 -3- H1341.2711 (3) 87 rh/rj 3/ 22

the patient has been used without adequate result or with 1 intolerable side effects. 2 9. “Written certification” means a document signed by a 3 health care practitioner, with whom the patient has established 4 a patient-provider relationship, which states that the patient 5 has a debilitating medical condition and identifies that 6 condition and provides any other relevant information. 7 Sec. 6. NEW SECTION . 124E.3 Health care practitioner 8 certification —— duties. 9 1. Prior to a patient’s submission of an application for 10 a medical cannabidiol registration card pursuant to section 11 124E.4, a health care practitioner shall do all of the 12 following: 13 a. Determine, in the health care practitioner’s medical 14 judgment, whether the patient whom the health care practitioner 15 has examined and treated suffers from a debilitating medical 16 condition that qualifies for the use of medical cannabidiol 17 under this chapter, and if so determined, provide the patient 18 with a written certification of that diagnosis. 19 b. Provide explanatory information as provided by the 20 department to the patient about the therapeutic use of medical 21 cannabidiol and the possible risks, benefits, and side effects 22 of the proposed treatment. 23 2. Subsequently, the health care practitioner shall do the 24 following: 25 a. Determine, on an annual basis, if the patient continues 26 to suffer from a debilitating medical condition and, if so, 27 issue the patient a new certification of that diagnosis. 28 b. Otherwise comply with all requirements established by the 29 department pursuant to rule. 30 3. A health care practitioner may provide, but has no duty 31 to provide, a written certification pursuant to this section. 32 Sec. 7. NEW SECTION . 124E.4 Medical cannabidiol 33 registration card. 34 1. Issuance to patient. Subject to subsection 7, the 35 -4- H1341.2711 (3) 87 rh/rj 4/ 22

department may approve the issuance of a medical cannabidiol 1 registration card by the department of transportation to a 2 patient who: 3 a. Is at least eighteen years of age. 4 b. Is a permanent resident of this state. 5 c. Submits a written certification to the department signed 6 by the patient’s health care practitioner that the patient is 7 suffering from a debilitating medical condition. 8 d. Submits an application to the department, on a form 9 created by the department, in consultation with the department 10 of transportation, that contains all of the following: 11 (1) The patient’s full name, Iowa residence address, date 12 of birth, and telephone number. 13 (2) A copy of the patient’s valid photograph 14 identification. 15 (3) Full name, address, and telephone number of the 16 patient’s health care practitioner. 17 (4) Full name, residence address, date of birth, and 18 telephone number of each primary caregiver of the patient, if 19 any. 20 (5) Any other information required by rule. 21 e. Submits a medical cannabidiol registration card fee of 22 one hundred dollars to the department. If the patient attests 23 to receiving social security disability benefits, supplemental 24 security insurance payments, or being enrolled in the medical 25 assistance program, the fee shall be twenty-five dollars. 26 f. Has not been convicted of a disqualifying felony offense. 27 2. Patient card contents. A medical cannabidiol 28 registration card issued to a patient by the department of 29 transportation pursuant to subsection 1 shall contain, at a 30 minimum, all of the following: 31 a. The patient’s full name, Iowa residence address, and date 32 of birth. 33 b. The patient’s photograph. 34 c. The date of issuance and expiration date of the medical 35 -5- H1341.2711 (3) 87 rh/rj 5/ 22

cannabidiol registration card. 1 d. Any other information required by rule. 2 3. Issuance to primary caregiver. For a patient in a 3 primary caregiver’s care, subject to subsection 7, the 4 department may approve the issuance of a medical cannabidiol 5 registration card by the department of transportation to the 6 primary caregiver who: 7 a. Submits a written certification to the department signed 8 by the patient’s health care practitioner that the patient in 9 the primary caregiver’s care is suffering from a debilitating 10 medical condition. 11 b. Submits an application to the department, on a form 12 created by the department, in consultation with the department 13 of transportation, that contains all of the following: 14 (1) The primary caregiver’s full name, residence address, 15 date of birth, and telephone number. 16 (2) The patient’s full name. 17 (3) A copy of the primary caregiver’s valid photograph 18 identification. 19 (4) Full name, address, and telephone number of the 20 patient’s health care practitioner. 21 (5) Any other information required by rule. 22 c. Has not been convicted of a disqualifying felony offense. 23 d. Submits a medical cannabidiol registration card fee of 24 twenty-five dollars to the department. 25 4. Primary caregiver card contents. A medical cannabidiol 26 registration card issued by the department of transportation to 27 a primary caregiver pursuant to subsection 3 shall contain, at 28 a minimum, all of the following: 29 a. The primary caregiver’s full name, residence address, and 30 date of birth. 31 b. The primary caregiver’s photograph. 32 c. The date of issuance and expiration date of the 33 registration card. 34 d. The medical cannabidiol registration card number of each 35 -6- H1341.2711 (3) 87 rh/rj 6/ 22

patient in the primary caregiver’s care. If the patient in the 1 primary caregiver’s care is under the age of eighteen, the full 2 name of the patient’s parent or legal guardian. 3 e. Any other information required by rule. 4 5. Expiration date of card. A medical cannabidiol 5 registration card issued pursuant to this section shall expire 6 one year after the date of issuance and may be renewed. 7 6. Card issuance —— department of transportation. The 8 department may enter into a chapter 28E agreement with the 9 department of transportation to facilitate the issuance of 10 medical cannabidiol registration cards pursuant to subsections 11 1 and 3. 12 7. Federally approved clinical trials. The department shall 13 not approve the issuance of a medical cannabidiol registration 14 card pursuant to this section for a patient who is enrolled 15 in a federally approved clinical trial for the treatment of a 16 debilitating medical condition with medical cannabidiol. 17 Sec. 8. NEW SECTION . 124E.4A Medical cannabidiol board —— 18 duties. 19 1. a. A medical cannabidiol board is created consisting of 20 eight practitioners representing the fields of neurology, pain 21 management, gastroenterology, oncology, psychiatry, pediatrics, 22 family medicine, and pharmacy, and one representative from law 23 enforcement. 24 b. The practitioners shall be licensed in this state and 25 nationally board-certified in their area of specialty and 26 knowledgeable about the use of medical cannabidiol. 27 c. Applicants for membership on the board shall submit a 28 membership application to the department and the governor shall 29 appoint members from the applicant pool. 30 d. For purposes of this subsection, “representative from 31 law enforcement” means a regularly employed member of a police 32 force of a city or county, including a sheriff, or of the state 33 patrol, in this state, who is responsible for the prevention 34 and detection of crime and the enforcement of the criminal laws 35 -7- H1341.2711 (3) 87 rh/rj 7/ 22

of this state. 1 2. The medical cannabidiol board shall convene at least 2 twice but no more than four times per year. 3 3. The duties of the medical cannabidiol board shall include 4 but not be limited to the following: 5 a. Accepting and reviewing petitions to add medical 6 conditions, medical treatments, or debilitating diseases to the 7 list of debilitating medical conditions for which the medical 8 use of cannabidiol would be medically beneficial under this 9 chapter. 10 b. Making recommendations relating to the removal or 11 addition of debilitating medical conditions to the list of 12 allowable debilitating medical conditions for which the medical 13 use of cannabidiol under this chapter would be medically 14 beneficial. 15 c. Working with the department regarding the requirements 16 for the licensure of medical cannabidiol manufacturers 17 and medical cannabidiol dispensaries, including licensure 18 procedures. 19 d. Advising the department regarding the location of medical 20 cannabidiol manufacturers and medical cannabidiol dispensaries 21 throughout the state. 22 e. Making recommendations relating to the form and quantity 23 of allowable medical uses of cannabidiol. 24 4. Recommendations made by the medical cannabidiol board 25 pursuant to section 3, paragraphs “b” and “e” , shall be made to 26 the board of medicine for consideration, and if approved, shall 27 be adopted by the board of medicine by rule. 28 5. On or before January 1 of each year, beginning January 29 1, 2018, the medical cannabidiol board shall submit a report 30 detailing the activities of the board. 31 6. The medical cannabidiol board may recommend a statutory 32 revision to the definition of medical cannabidiol contained in 33 this chapter that increases the tetrahydrocannabinol level to 34 more than three percent, however, any such recommendation shall 35 -8- H1341.2711 (3) 87 rh/rj 8/ 22

be submitted to the general assembly during the regular session 1 of the general assembly following such submission. The general 2 assembly shall have the sole authority to revise the definition 3 of medical cannabidiol for purposes of this chapter. 4 Sec. 9. NEW SECTION . 124E.5 Medical cannabidiol 5 manufacturer licensure. 6 1. a. The department shall issue a request for proposals 7 to select and license by December 1, 2017, up to two medical 8 cannabidiol manufacturers to manufacture and to possess, 9 cultivate, harvest, transport, package, process, or supply 10 medical cannabidiol within this state consistent with the 11 provisions of this chapter. The department shall license new 12 medical cannabidiol manufacturers or relicense the existing 13 medical cannabidiol manufacturers by December 1 of each year. 14 b. Information submitted during the application process 15 shall be confidential until a medical cannabidiol manufacturer 16 is licensed by the department unless otherwise protected from 17 disclosure under state or federal law. 18 2. As a condition for licensure, a medical cannabidiol 19 manufacturer must agree to begin supplying medical cannabidiol 20 to medical cannabidiol dispensaries in this state no later than 21 December 1, 2018. 22 3. The department shall consider the following factors in 23 determining whether to select and license a medical cannabidiol 24 manufacturer: 25 a. The technical expertise of the medical cannabidiol 26 manufacturer regarding medical cannabidiol. 27 b. The qualifications of the medical cannabidiol 28 manufacturer’s employees. 29 c. The long-term financial stability of the medical 30 cannabidiol manufacturer. 31 d. The ability to provide appropriate security measures on 32 the premises of the medical cannabidiol manufacturer. 33 e. Whether the medical cannabidiol manufacturer has 34 demonstrated an ability to meet certain medical cannabidiol 35 -9- H1341.2711 (3) 87 rh/rj 9/ 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 cannabidiol in the manner determined by the department 6 pursuant to rule. 7 f. The medical cannabidiol manufacturer’s projection of 8 and ongoing assessment of fees on patients with debilitating 9 medical conditions. 10 4. The department shall require each medical cannabidiol 11 manufacturer to contract with the state hygienic laboratory at 12 the university of Iowa in Iowa City or an independent medical 13 cannabidiol testing laboratory to perform spot-check testing 14 of the medical cannabidiol produced by the manufacturer as 15 provided in section 124E.6. The department shall require that 16 the laboratory report testing results to the manufacturer in a 17 manner determined by the department pursuant to rule. 18 5. Each entity submitting an application for licensure as 19 a medical cannabidiol manufacturer shall pay a nonrefundable 20 application fee of seven thousand five hundred dollars to the 21 department. 22 Sec. 10. NEW SECTION . 124E.6 Medical cannabidiol 23 manufacturers. 24 1. A medical cannabidiol manufacturer shall contract with 25 the state hygienic laboratory at the university of Iowa in Iowa 26 City or an independent medical cannabidiol testing laboratory 27 to perform spot-check testing of the medical cannabidiol 28 manufactured by the medical cannabidiol manufacturer as to 29 content, contamination, and consistency. The cost of all 30 laboratory testing shall be paid by the medical cannabidiol 31 manufacturer. 32 2. The operating documents of a medical cannabidiol 33 manufacturer shall include all of the following: 34 a. Procedures for the oversight of the medical cannabidiol 35 -10- H1341.2711 (3) 87 rh/rj 10/ 22

manufacturer and procedures to ensure accurate recordkeeping. 1 b. Procedures for the implementation of appropriate security 2 measures to deter and prevent the theft of medical cannabidiol 3 and unauthorized entrance into areas containing medical 4 cannabidiol. 5 3. A medical cannabidiol manufacturer shall implement 6 security requirements, including requirements for protection 7 of each location by a fully operational security alarm system, 8 facility access controls, perimeter intrusion detection 9 systems, and a personnel identification system. 10 4. A medical cannabidiol manufacturer shall not share 11 office space with, refer patients to, or have any financial 12 relationship with a health care practitioner. 13 5. A medical cannabidiol manufacturer shall not permit any 14 person to consume medical cannabidiol on the property of the 15 medical cannabidiol manufacturer. 16 6. A medical cannabidiol manufacturer is subject to 17 reasonable inspection by the department. 18 7. A medical cannabidiol manufacturer shall not employ 19 a person who is under eighteen years of age or who has been 20 convicted of a disqualifying felony offense. An employee 21 of a medical cannabidiol manufacturer shall be subject to a 22 background investigation conducted by the division of criminal 23 investigation of the department of public safety and a national 24 criminal history background check. 25 8. A medical cannabidiol manufacturer owner shall not have 26 been convicted of a disqualifying felony offense and shall be 27 subject to a background investigation conducted by the division 28 of criminal investigation of the department of public safety 29 and a national criminal history background check. 30 9. A medical cannabidiol manufacturer shall not operate at 31 the same physical location as a medical cannabidiol dispensary. 32 10. A medical cannabidiol manufacturer shall not operate 33 in any location, whether for manufacturing, possessing, 34 cultivating, harvesting, transporting, packaging, processing, 35 -11- H1341.2711 (3) 87 rh/rj 11/ 22

or supplying, within one thousand feet of a public or private 1 school existing before the date of the medical cannabidiol 2 manufacturer’s licensure by the department. 3 11. A medical cannabidiol manufacturer shall comply 4 with reasonable restrictions set by the department relating 5 to signage, marketing, display, and advertising of medical 6 cannabidiol. 7 12. a. A medical cannabidiol manufacturer shall provide a 8 reliable and ongoing supply of medical cannabidiol to medical 9 cannabidiol dispensaries pursuant to this chapter. 10 b. All manufacturing, cultivating, harvesting, packaging, 11 and processing of medical cannabidiol shall take place in an 12 enclosed, locked facility at a physical address provided to the 13 department during the licensure process. 14 c. A medical cannabidiol manufacturer shall not manufacture 15 edible medical cannabidiol products. 16 Sec. 11. NEW SECTION . 124E.7 Medical cannabidiol dispensary 17 licensure. 18 1. a. The department shall issue a request for proposals 19 to select and license by April 1, 2018, up to five medical 20 cannabidiol dispensaries to dispense medical cannabidiol within 21 this state consistent with the provisions of this chapter. The 22 department shall license new medical cannabidiol dispensaries 23 or relicense the existing medical cannabidiol dispensaries by 24 December 1 of each year. 25 b. Information submitted during the application process 26 shall be confidential until a medical cannabidiol dispensary 27 is licensed by the department unless otherwise protected from 28 disclosure under state or federal law. 29 2. As a condition for licensure, a medical cannabidiol 30 dispensary must agree to begin supplying medical cannabidiol to 31 patients by December 1, 2018. 32 3. The department shall consider the following factors in 33 determining whether to select and license a medical cannabidiol 34 dispensary: 35 -12- H1341.2711 (3) 87 rh/rj 12/ 22

a. The technical expertise of the medical cannabidiol 1 dispensary regarding medical cannabidiol. 2 b. The qualifications of the medical cannabidiol 3 dispensary’s employees. 4 c. The long-term financial stability of the medical 5 cannabidiol dispensary. 6 d. The ability to provide appropriate security measures on 7 the premises of the medical cannabidiol dispensary. 8 e. The medical cannabidiol dispensary’s projection and 9 ongoing assessment of fees for the purchase of medical 10 cannabidiol on patients with debilitating medical conditions. 11 4. Each entity submitting an application for licensure as 12 a medical cannabidiol dispensary shall pay a nonrefundable 13 application fee of five thousand dollars to the department. 14 Sec. 12. NEW SECTION . 124E.8 Medical cannabidiol 15 dispensaries. 16 1. a. The medical cannabidiol dispensaries shall be located 17 based on geographical need throughout the state to improve 18 patient access. 19 b. A medical cannabidiol dispensary may dispense medical 20 cannabidiol pursuant to the provisions of this chapter but 21 shall not dispense any medical cannabidiol in a form or 22 quantity other than the form or quantity allowed by the 23 department pursuant to rule. 24 2. The operating documents of a medical cannabidiol 25 dispensary shall include all of the following: 26 a. Procedures for the oversight of the medical cannabidiol 27 dispensary and procedures to ensure accurate recordkeeping. 28 b. Procedures for the implementation of appropriate security 29 measures to deter and prevent the theft of medical cannabidiol 30 and unauthorized entrance into areas containing medical 31 cannabidiol. 32 3. A medical cannabidiol dispensary shall implement 33 security requirements, including requirements for protection 34 by a fully operational security alarm system, facility 35 -13- H1341.2711 (3) 87 rh/rj 13/ 22

access controls, perimeter intrusion detection systems, and a 1 personnel identification system. 2 4. A medical cannabidiol dispensary shall not share 3 office space with, refer patients to, or have any financial 4 relationship with a health care practitioner. 5 5. A medical cannabidiol dispensary shall not permit any 6 person to consume medical cannabidiol on the property of the 7 medical cannabidiol dispensary. 8 6. A medical cannabidiol dispensary is subject to 9 reasonable inspection by the department. 10 7. A medical cannabidiol dispensary shall not employ a 11 person who is under eighteen years of age or who has been 12 convicted of a disqualifying felony offense. An employee 13 of a medical cannabidiol dispensary shall be subject to a 14 background investigation conducted by the division of criminal 15 investigation of the department of public safety and a national 16 criminal history background check. 17 8. A medical cannabidiol dispensary owner shall not have 18 been convicted of a disqualifying felony offense and shall be 19 subject to a background investigation conducted by the division 20 of criminal investigation of the department of public safety 21 and a national criminal history background check. 22 9. A medical cannabidiol dispensary shall not operate at the 23 same physical location as a medical cannabidiol manufacturer. 24 10. A medical cannabidiol dispensary shall not operate in 25 any location within one thousand feet of a public or private 26 school existing before the date of the medical cannabidiol 27 dispensary’s licensure by the department. 28 11. A medical cannabidiol dispensary shall comply with 29 reasonable restrictions set by the department relating to 30 signage, marketing, display, and advertising of medical 31 cannabidiol. 32 12. Prior to dispensing of any medical cannabidiol, a 33 medical cannabidiol dispensary shall do all of the following: 34 a. Verify that the medical cannabidiol dispensary has 35 -14- H1341.2711 (3) 87 rh/rj 14/ 22

received a valid medical cannabidiol registration card from a 1 patient or a patient’s primary caregiver, if applicable. 2 b. Assign a tracking number to any medical cannabidiol 3 dispensed from the medical cannabidiol dispensary. 4 c. Properly package medical cannabidiol in compliance 5 with federal law regarding child resistant packaging and 6 exemptions for packaging for elderly patients, and label 7 medical cannabidiol with a list of all active ingredients and 8 individually identifying information. 9 Sec. 13. NEW SECTION . 124E.9 Fees. 10 Medical cannabidiol registration card fees and medical 11 cannabidiol manufacturer and medical cannabidiol dispensary 12 application and annual fees collected by the department 13 pursuant to this chapter shall be retained by the department, 14 shall be considered repayment receipts as defined in section 15 8.2, and shall be used for the purpose of regulating medical 16 cannabidiol manufacturers and medical cannabidiol dispensaries, 17 for the cost of salaries for two agents of the division of 18 criminal investigation of the department of public safety 19 to inspect medical cannabidiol manufacturers and medical 20 cannabidiol dispensaries, and for other expenses necessary for 21 the administration of this chapter. 22 Sec. 14. NEW SECTION . 124E.10 Department duties —— rules. 23 1. a. The department shall maintain a confidential file 24 of the names of each patient to or for whom the department 25 issues a medical cannabidiol registration card and the name of 26 each primary caregiver to whom the department issues a medical 27 cannabidiol registration card under section 124E.4. 28 b. Individual names contained in the file shall be 29 confidential and shall not be subject to disclosure, except as 30 provided in subparagraph (1). 31 (1) Information in the confidential file maintained 32 pursuant to paragraph “a” may be released on an individual basis 33 to the following persons under the following circumstances: 34 (a) To authorized employees or agents of the department and 35 -15- H1341.2711 (3) 87 rh/rj 15/ 22

the department of transportation as necessary to perform the 1 duties of the department and the department of transportation 2 pursuant to this chapter. 3 (b) To authorized employees of law enforcement agencies 4 of a state or political subdivision thereof, but only for the 5 purpose of verifying that a person is lawfully in possession 6 of a medical cannabidiol registration card issued pursuant to 7 this chapter. 8 (c) To authorized employees of a medical cannabidiol 9 dispensary, but only for the purpose of verifying that a person 10 is lawfully in possession of a medical cannabidiol registration 11 card issued pursuant to this chapter. 12 (d) To any other authorized persons recognized by the 13 department by rule, but only for the purpose of verifying that 14 a person is lawfully in possession of a medical cannabidiol 15 registration card issued pursuant to this chapter. 16 (2) Release of information pursuant to subparagraph 17 (1) shall be consistent with the federal Health Insurance 18 Portability and Accountability Act of 1996, Pub. L. No. 19 104-191. 20 2. The department shall adopt rules pursuant to chapter 21 17A to administer this chapter which shall include but not be 22 limited to rules to do all of the following: 23 a. Govern the manner in which the department shall 24 consider applications for new and renewal medical cannabidiol 25 registration cards. 26 b. Ensure that the medical cannabidiol registration card 27 program operates on a self-sustaining basis. 28 c. Establish the form and quantity of medical cannabidiol 29 allowed to be dispensed to a patient or primary caregiver 30 pursuant to this chapter as appropriate to serve the medical 31 needs of patients with debilitating medical conditions, subject 32 to recommendation by the medical cannabidiol board and approval 33 by the board of medicine. 34 d. Establish requirements for the licensure of medical 35 -16- H1341.2711 (3) 87 rh/rj 16/ 22

cannabidiol manufacturers and medical cannabidiol dispensaries 1 and set forth procedures for medical cannabidiol manufacturers 2 and medical cannabidiol dispensaries to obtain licenses. 3 e. Develop a dispensing system for medical cannabidiol 4 within this state that provides for all of the following: 5 (1) Medical cannabidiol dispensaries within this state 6 housed on secured grounds and operated by licensed medical 7 cannabidiol dispensaries. 8 (2) The dispensing of medical cannabidiol to patients and 9 their primary caregivers to occur at locations designated by 10 the department. 11 f. Establish and collect annual fees from medical 12 cannabidiol manufacturers and medical cannabidiol dispensaries 13 to cover the costs associated with regulating and inspecting 14 medical cannabidiol manufacturers and medical cannabidiol 15 dispensaries. 16 g. Specify and implement procedures that address public 17 safety including security procedures and product quality 18 including measures to ensure contaminant-free cultivation of 19 medical cannabidiol, safety, and labeling. 20 h. Establish and implement a real-time, statewide 21 medical cannabidiol registry management sale tracking system 22 that is available to medical cannabidiol dispensaries on a 23 twenty-four-hour-a-day, seven-day-a-week basis for the purpose 24 of verifying that a person is lawfully in possession of a 25 medical cannabidiol registration card issued pursuant to this 26 chapter and for tracking the date of the sale and quantity 27 of medical cannabidiol purchased by a patient or a primary 28 caregiver. 29 i. Establish and implement a medical cannabidiol inventory 30 and delivery tracking system to track medical cannabidiol 31 from production by a medical cannabidiol manufacturer through 32 dispensing at a medical cannabidiol dispensary. 33 Sec. 15. NEW SECTION . 124E.11 Use of medical cannabidiol 34 —— affirmative defenses. 35 -17- H1341.2711 (3) 87 rh/rj 17/ 22

1. A health care practitioner, including any authorized 1 agent or employee thereof, shall not be subject to 2 prosecution for the unlawful certification, possession, or 3 administration of marijuana under the laws of this state for 4 activities arising directly out of or directly related to the 5 certification or use of medical cannabidiol in the treatment 6 of a patient diagnosed with a debilitating medical condition 7 as authorized by this chapter. 8 2. A medical cannabidiol manufacturer, including any 9 authorized agent or employee thereof, shall not be subject 10 to prosecution for manufacturing, possessing, cultivating, 11 harvesting, transporting, packaging, processing, or supplying 12 medical cannabidiol pursuant to this chapter. 13 3. A medical cannabidiol dispensary, including any 14 authorized agent or employee thereof, shall not be subject to 15 prosecution for dispensing medical cannabidiol pursuant to this 16 chapter. 17 4. a. In a prosecution for the unlawful possession of 18 marijuana under the laws of this state for the possession of 19 medical cannabidiol, including but not limited to chapters 20 124 and 453B, it is an affirmative and complete defense to 21 the prosecution that the patient has been diagnosed with a 22 debilitating medical condition, used or possessed medical 23 cannabidiol pursuant to a certification by a health care 24 practitioner as authorized under this chapter, and, for a 25 patient eighteen years of age or older, is in possession of a 26 valid medical cannabidiol registration card issued pursuant to 27 this chapter. 28 b. In a prosecution for the unlawful possession of 29 marijuana under the laws of this state for the possession of 30 medical cannabidiol, including but not limited to chapters 31 124 and 453B, it is an affirmative and complete defense to 32 the prosecution that the person possessed medical cannabidiol 33 because the person is a primary caregiver of a patient who 34 has been diagnosed with a debilitating medical condition and 35 -18- H1341.2711 (3) 87 rh/rj 18/ 22

is in possession of a valid medical cannabidiol registration 1 card issued pursuant to this chapter, and where the primary 2 caregiver’s possession of the medical cannabidiol is on behalf 3 of the patient and for the patient’s use only as authorized 4 under this chapter. 5 c. If a patient or primary caregiver is charged with the 6 unlawful possession of marijuana under the laws of this state 7 for the possession of medical cannabidiol, including but not 8 limited to chapters 124 and 453B, and is not in possession 9 of the person’s medical cannabidiol registration card, any 10 charge or charges filed against the person for the possession 11 of medical cannabidiol 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 cannabidiol registration card issued to that person 14 and valid at the time the person was charged. 15 5. 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 cannabidiol 20 as authorized under this chapter. 21 6. The department, the department of transportation, 22 and any health care practitioner, including any authorized 23 agent or employee thereof, are not subject to any civil 24 or disciplinary penalties by the board of medicine or any 25 business, occupational, or professional licensing board or 26 entity, solely for activities conducted relating to a patient’s 27 possession or use of medical cannabidiol as authorized under 28 this chapter. Nothing in this section affects a professional 29 licensing board from taking action in response to violations of 30 any other section of law. 31 7. Notwithstanding any law to the contrary, the department, 32 the department of transportation, the governor, or any employee 33 of any state agency shall not be held civilly or criminally 34 liable for any injury, loss of property, personal injury, or 35 -19- H1341.2711 (3) 87 rh/rj 19/ 22

death caused by any act or omission while acting within the 1 scope of office or employment as authorized under this chapter. 2 8. An attorney shall not be subject to disciplinary action 3 by the Iowa supreme court or attorney disciplinary board for 4 providing legal assistance to a patient, primary caregiver, or 5 others based upon a patient’s or primary caregiver’s possession 6 or use of medical cannabidiol as authorized under this chapter. 7 9. Possession of a medical cannabidiol registration card or 8 an application for a medical cannabidiol registration card by a 9 person entitled to possess or apply for a medical cannabidiol 10 registration card shall not constitute probable cause or 11 reasonable suspicion, and shall not be used to support a search 12 of the person or property of the person possessing or applying 13 for the medical cannabidiol registration card, or otherwise 14 subject the person or property of the person to inspection by 15 any governmental agency. 16 Sec. 16. NEW SECTION . 12E.12 Medical cannabidiol source. 17 Medical cannabidiol provided exclusively pursuant to a 18 written certification of a health care practitioner, if not 19 legally available in this state or from any other bordering 20 state, shall be obtained from an out-of-state source. 21 Sec. 17. NEW SECTION . 124E.13 Out-of-state medical 22 cannabidiol dispensaries. 23 The department of public health shall utilize a request for 24 proposals process to select and license by December 1, 2017, 25 up to two out-of-state medical cannabidiol dispensaries from a 26 bordering state to sell and dispense medical cannabidiol to a 27 patient or primary caregiver in possession of a valid medical 28 cannabidiol registration card issued under this chapter. 29 Sec. 18. NEW SECTION . 124E.14 Iowa patients and primary 30 caregivers registering in the state of Minnesota. 31 A patient or a primary caregiver with a valid medical 32 cannabidiol registration card issued pursuant to this chapter 33 may register in the state of Minnesota as a visiting qualified 34 patient or primary caregiver and may register with one or more 35 -20- H1341.2711 (3) 87 rh/rj 20/ 22

medical cannabis manufacturers registered under the laws of 1 Minnesota. 2 Sec. 19. NEW SECTION . 124E.15 Penalties. 3 1. A person who knowingly or intentionally possesses or uses 4 medical cannabidiol in violation of the requirements of this 5 chapter is subject to the penalties provided under chapters 124 6 and 453B. 7 2. A medical cannabidiol manufacturer or a medical 8 cannabidiol dispensary shall be assessed a civil penalty of up 9 to one thousand dollars per violation for any violation of this 10 chapter in addition to any other applicable penalties. 11 Sec. 20. NEW SECTION . 124E.16 Use of medical cannabidiol —— 12 smoking prohibited. 13 A patient shall not consume medical cannabidiol possessed 14 or used as authorized under this chapter by smoking medical 15 cannabidiol. 16 Sec. 21. NEW SECTION . 124E.17 Reciprocity. 17 A valid medical cannabidiol registration card, or its 18 equivalent, issued under the laws of another state that allows 19 an out-of-state patient to possess or use medical cannabidiol 20 in the jurisdiction of issuance shall have the same force and 21 effect as a valid medical cannabidiol registration card issued 22 pursuant to this chapter, except that an out-of-state patient 23 in this state shall not obtain medical cannabidiol from a 24 medical cannabidiol dispensary in this state. 25 Sec. 22. Section 730.5, subsection 11, Code 2017, is amended 26 by adding the following new paragraph: 27 NEW PARAGRAPH . f. Testing or taking action against an 28 individual with a confirmed positive test result due to the 29 individual’s use of medical cannabidiol as authorized under 30 chapter 124E. 31 Sec. 23. REPEAL. Chapter 124D, Code 2017, is repealed. 32 Sec. 24. TRANSITION PROVISIONS. A medical cannabidiol 33 registration card issued under chapter 124D prior to the 34 effective date of this Act, remains effective and continues 35 -21- H1341.2711 (3) 87 rh/rj 21/ 22