House File 2589 H-8142 Amend the amendment, H-8128, to House File 2589 as follows: 1 1. By striking page 1, line 2, through page 9, line 9, and 2 inserting: 3 < 1. By striking everything after the enacting clause and 4 inserting: 5 < Section 1. Section 124E.2, subsection 2, paragraph i, Code 6 2020, is amended to read as follows: 7 i. Untreatable Chronic pain. 8 Sec. 2. Section 124E.2, subsection 2, Code 2020, is amended 9 by adding the following new paragraphs: 10 NEW PARAGRAPH . j. Severe, intractable autism with 11 self-injurious or aggressive behaviors. 12 NEW PARAGRAPH . k. Post-traumatic stress disorder. 13 Sec. 3. Section 124E.2, subsections 5 and 6, Code 2020, are 14 amended to read as follows: 15 5. “Health care practitioner” means an individual licensed 16 under chapter 148 to practice medicine and surgery or 17 osteopathic medicine and surgery , a physician assistant 18 licensed under chapter 148C, an advanced registered nurse 19 practitioner licensed under chapter 152, or an advanced 20 practice registered nurse under chapter 152E, who is a 21 patient’s primary care provider or a podiatrist licensed 22 pursuant to chapter 149 . “Health care practitioner” shall not 23 include a physician assistant licensed under chapter 148C or 24 an advanced registered nurse practitioner licensed pursuant to 25 chapter 152 or 152E . 26 6. “Medical cannabidiol” means any pharmaceutical 27 grade cannabinoid found in the plant Cannabis sativa L. or 28 Cannabis indica or any other preparation thereof that has 29 a tetrahydrocannabinol level of no more than three percent 30 and that is delivered in a form recommended by the medical 31 cannabidiol board, approved by the board of medicine, and 32 adopted by the department pursuant to rule. 33 Sec. 4. Section 124E.2, Code 2020, is amended by adding the 34 following new subsection: 35 -1- H8128.3707 (3) 88 ss/rh 1/ 7 #1.

NEW SUBSECTION . 5A. “Laboratory” means the state hygienic 1 laboratory at the university of Iowa in Iowa City or any other 2 independent medical cannabidiol testing facility accredited 3 to standard ISO/IEC 17025 by an international organization 4 for standards-approved accrediting body, with a controlled 5 substance registration certificate from the United States drug 6 enforcement administration and a certificate of registration 7 from the board of pharmacy. For the purposes of this chapter, 8 an independent laboratory is a laboratory operated by an 9 entity that has no equity ownership in a medical cannabidiol 10 manufacturer. 11 Sec. 5. Section 124E.4, subsection 1, unnumbered paragraph 12 1, Code 2020, is amended to read as follows: 13 Subject to subsection 7 , the department may approve the 14 issuance of issue a medical cannabidiol registration card by 15 the department of transportation to a patient who: 16 Sec. 6. Section 124E.4, subsection 1, paragraph d, 17 unnumbered paragraph 1, Code 2020, is amended to read as 18 follows: 19 Submits an application to the department, on a form created 20 by the department, in consultation with the department of 21 transportation, that contains all of the following: 22 Sec. 7. Section 124E.4, subsection 1, paragraph f, Code 23 2020, is amended by striking the paragraph. 24 Sec. 8. Section 124E.4, subsection 2, unnumbered paragraph 25 1, Code 2020, is amended to read as follows: 26 A medical cannabidiol registration card issued to a patient 27 by the department of transportation pursuant to subsection 1 28 shall contain, at a minimum, all of the following: 29 Sec. 9. Section 124E.4, subsection 2, paragraph b, Code 30 2020, is amended by striking the paragraph. 31 Sec. 10. Section 124E.4, subsection 3, unnumbered paragraph 32 1, Code 2020, is amended to read as follows: 33 For a patient in a primary caregiver’s care, subject to 34 subsection 7 , the department may approve the issuance of issue 35 -2- H8128.3707 (3) 88 ss/rh 2/ 7

a medical cannabidiol registration card by the department of 1 transportation to the primary caregiver who: 2 Sec. 11. Section 124E.4, subsection 3, paragraph b, 3 unnumbered paragraph 1, Code 2020, is amended to read as 4 follows: 5 Submits an application to the department, on a form created 6 by the department, in consultation with the department of 7 transportation, that contains all of the following: 8 Sec. 12. Section 124E.4, subsection 3, paragraph c, Code 9 2020, is amended by striking the paragraph. 10 Sec. 13. Section 124E.4, subsection 4, unnumbered paragraph 11 1, Code 2020, is amended to read as follows: 12 A medical cannabidiol registration card issued by the 13 department of transportation to a primary caregiver pursuant to 14 subsection 3 shall contain, at a minimum, all of the following: 15 Sec. 14. Section 124E.4, subsection 4, paragraph b, Code 16 2020, is amended by striking the paragraph. 17 Sec. 15. Section 124E.4, subsection 5, Code 2020, is amended 18 to read as follows: 19 5. Expiration date of card. A medical cannabidiol 20 registration card issued pursuant to this section shall expire 21 one year three years after the date of issuance and may be 22 renewed. 23 Sec. 16. Section 124E.4, subsection 6, Code 2020, is amended 24 by striking the subsection. 25 Sec. 17. Section 124E.5, subsections 2 and 6, Code 2020, are 26 amended to read as follows: 27 2. The medical cannabidiol board shall convene at least 28 twice but no more than four times per year. 29 6. The medical cannabidiol board may recommend a statutory 30 revision to the definition of medical cannabidiol contained in 31 this chapter that increases the tetrahydrocannabinol level to 32 more than three percent, however, any such recommendation shall 33 be submitted to the general assembly during the regular session 34 of the general assembly following such submission. The general 35 -3- H8128.3707 (3) 88 ss/rh 3/ 7

assembly shall have the sole authority to revise the definition 1 of medical cannabidiol for purposes of this chapter . 2 Sec. 18. Section 124E.6, subsection 4, Code 2020, is amended 3 by striking the subsection and inserting in lieu thereof the 4 following: 5 4. A medical cannabidiol manufacturer shall contract with 6 a laboratory to perform spot-check testing of the medical 7 cannabidiol produced by the medical cannabidiol manufacturer 8 as provided in section 124E.7. The department shall require 9 that the laboratory report testing results to the medical 10 cannabidiol manufacturer and the department as determined by 11 the department by rule. If a medical cannabidiol manufacturer 12 contracts with a laboratory other than the state hygienic 13 laboratory at the university of Iowa in Iowa City, the 14 department shall approve the laboratory to perform testing 15 pursuant to this chapter. 16 Sec. 19. Section 124E.7, subsection 1, Code 2020, is amended 17 by striking the subsection and inserting in lieu thereof the 18 following: 19 1. A medical cannabidiol manufacturer shall contract with 20 a laboratory to perform spot-check testing of the medical 21 cannabidiol produced by the medical cannabidiol manufacturer as 22 to content, contamination, and consistency. The cost of all 23 laboratory testing shall be paid by the medical cannabidiol 24 manufacturer. 25 Sec. 20. Section 124E.9, Code 2020, is amended by adding the 26 following new subsections: 27 NEW SUBSECTION . 13. A medical cannabidiol dispensary 28 shall employ a pharmacist or pharmacy technician licensed or 29 registered pursuant to chapter 155A for the purpose of making 30 dosing recommendations. 31 NEW SUBSECTION . 14. A medical cannabidiol dispensary 32 shall not dispense more than a combined total of fifteen grams 33 of total tetrahydrocannabinol to a patient and the patient’s 34 primary caregiver in a ninety-day period, except as provided 35 -4- H8128.3707 (3) 88 ss/rh 4/ 7

in subsection 15. 1 NEW SUBSECTION . 15. A medical cannabidiol dispensary may 2 dispense more than a combined total of fifteen grams of total 3 tetrahydrocannabinol to a patient and the patient’s primary 4 caregiver in a ninety-day period if any of the following apply: 5 a. The health care practitioner who certified the patient to 6 receive a medical cannabidiol registration card certifies that 7 patient’s debilitating medical condition is a terminal illness 8 with a life expectancy of less than one year. A certification 9 issued pursuant to this paragraph shall include a total 10 tetrahydrocannabinol cap deemed appropriate by the patient’s 11 health care practitioner. 12 b. The health care practitioner who certified the patient to 13 receive a medical cannabidiol registration card certifies that 14 the patient has participated in the medical cannabidiol program 15 and that the health care practitioner has determined that 16 fifteen grams of total tetrahydrocannabinol in a ninety-day 17 period is insufficient to treat the patient’s debilitating 18 medical condition. A certification issued pursuant to this 19 paragraph shall include a total tetrahydrocannabinol cap deemed 20 appropriate by the patient’s health care practitioner. 21 Sec. 21. Section 124E.11, subsection 1, paragraph b, 22 subparagraph (1), subparagraph divisions (a) and (c), Code 23 2020, are amended to read as follows: 24 (a) To authorized employees or agents of the department and 25 the department of transportation as necessary to perform the 26 duties of the department and the department of transportation 27 pursuant to this chapter . 28 (c) To authorized employees of a medical cannabidiol 29 dispensary, but only for the purpose purposes of verifying that 30 a person is lawfully in possession of a medical cannabidiol 31 registration card issued pursuant to this chapter and that a 32 person has not purchased total tetrahydrocannabinol in excess 33 of the amount authorized by this chapter . 34 Sec. 22. Section 124E.11, subsection 1, paragraph b, 35 -5- H8128.3707 (3) 88 ss/rh 5/ 7

subparagraph (1), Code 2020, is amended by adding the following 1 new subparagraph division: 2 NEW SUBPARAGRAPH DIVISION . (e) To a health care 3 practitioner for the purpose of determining whether a patient 4 seeking a written certification pursuant to section 124E.3 has 5 already received a written certification from another health 6 care practitioner. 7 Sec. 23. Section 124E.12, subsection 7, Code 2020, is 8 amended to read as follows: 9 7. Notwithstanding any law to the contrary, the department, 10 the department of transportation, the governor, or any employee 11 of any state agency shall not be held civilly or criminally 12 liable for any injury, loss of property, personal injury, or 13 death caused by any act or omission while acting within the 14 scope of office or employment as authorized under this chapter . 15 Sec. 24. NEW SECTION . 124E.20 Observational effectiveness 16 study. 17 The department may conduct an observational effectiveness 18 study in cooperation with patients and health care 19 practitioners and pursuant to rules of the department in order 20 to study the effectiveness of medical cannabidiol in the 21 treatment of debilitating medical conditions. 22 Sec. 25. PROTECTION OF FEDERAL FUNDING. The department 23 of public health shall request guarantees from the agencies 24 of the federal government providing funding to educational 25 and long-term care facilities that facilities with policies 26 allowing patients to possess medical cannabidiol on the grounds 27 of the facilities consistent with chapter 124E or allowing 28 facility staff to administer medical cannabidiol to a patient 29 shall not lose eligibility for any federal funding due to such 30 policies. 31 Sec. 26. TRANSITION PROVISIONS. A medical cannabidiol 32 registration card issued prior to July 1, 2020, remains 33 effective and continues in effect as issued for the 34 twelve-month period following its issuance. >> 35 -6- H8128.3707 (3) 88 ss/rh 6/ 7