House File 2589 H-8143 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- H8128.3718 (1) 88 ss/rh 1/ 8 #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. NEW SECTION . 124E.3A State medical director 12 certification —— rules. 13 1. The department shall establish by rule by January 1, 14 2021, a process for a patient who has been denied a written 15 certification by a health care practitioner pursuant to section 16 124E.3 to receive a written certification from the state 17 medical director of the department. 18 2. The process established pursuant to subsection 1 shall 19 include all of the following provisions: 20 a. The patient shall submit the patient’s medical records 21 to the state medical director. 22 b. The state medical director shall verify that the 23 patient’s health care practitioner refused to provide a written 24 certification to the patient pursuant to section 124E.3. 25 c. The state medical director shall determine whether 26 the patient suffers from a debilitating medical condition 27 that qualifies for the use of medical cannabidiol under this 28 chapter. 29 d. The state medical director shall determine whether the 30 patient may benefit from the use of medical cannabidiol. 31 e. If the state medical director determines that the patient 32 suffers from a debilitating medical condition, that the patient 33 may benefit from the use of medical cannabidiol, and that the 34 patient’s health care practitioner refused to provide a written 35 -2- H8128.3718 (1) 88 ss/rh 2/ 8
certification to the patient, the state medical director shall 1 provide a written certification to the patient. 2 3. The custodian of a patient’s medical records shall 3 provide the patient’s medical records to the state medical 4 director or the patient for the purpose of obtaining a written 5 certification pursuant to this section without charge to the 6 patient or the state medical director. 7 4. The state medical director shall keep confidential all 8 medical records provided to the state medical director pursuant 9 to this section. 10 Sec. 6. Section 124E.4, subsection 1, unnumbered paragraph 11 1, Code 2020, is amended to read as follows: 12 Subject to subsection 7 , the department may approve the 13 issuance of issue a medical cannabidiol registration card by 14 the department of transportation to a patient who: 15 Sec. 7. Section 124E.4, subsection 1, paragraph c, Code 16 2020, is amended to read as follows: 17 c. Submits a written certification to the department signed 18 by the patient’s health care practitioner or the state medical 19 director that the patient is suffering from a debilitating 20 medical condition. 21 Sec. 8. Section 124E.4, subsection 1, paragraph d, 22 unnumbered paragraph 1, Code 2020, is amended to read as 23 follows: 24 Submits an application to the department, on a form created 25 by the department, in consultation with the department of 26 transportation, that contains all of the following: 27 Sec. 9. Section 124E.4, subsection 1, paragraph f, Code 28 2020, is amended by striking the paragraph. 29 Sec. 10. Section 124E.4, subsection 2, unnumbered paragraph 30 1, Code 2020, is amended to read as follows: 31 A medical cannabidiol registration card issued to a patient 32 by the department of transportation pursuant to subsection 1 33 shall contain, at a minimum, all of the following: 34 Sec. 11. Section 124E.4, subsection 2, paragraph b, Code 35 -3- H8128.3718 (1) 88 ss/rh 3/ 8
2020, is amended by striking the paragraph. 1 Sec. 12. Section 124E.4, subsection 3, unnumbered paragraph 2 1, Code 2020, is amended to read as follows: 3 For a patient in a primary caregiver’s care, subject to 4 subsection 7 , the department may approve the issuance of issue 5 a medical cannabidiol registration card by the department of 6 transportation to the primary caregiver who: 7 Sec. 13. Section 124E.4, subsection 3, paragraph a, Code 8 2020, is amended to read as follows: 9 a. Submits a written certification to the department signed 10 by the patient’s health care practitioner or the state medical 11 director that the patient in the primary caregiver’s care is 12 suffering from a debilitating medical condition. 13 Sec. 14. Section 124E.4, subsection 3, paragraph b, 14 unnumbered paragraph 1, Code 2020, is amended to read as 15 follows: 16 Submits an application to the department, on a form created 17 by the department, in consultation with the department of 18 transportation, that contains all of the following: 19 Sec. 15. Section 124E.4, subsection 3, paragraph c, Code 20 2020, is amended by striking the paragraph. 21 Sec. 16. Section 124E.4, subsection 4, unnumbered paragraph 22 1, Code 2020, is amended to read as follows: 23 A medical cannabidiol registration card issued by the 24 department of transportation to a primary caregiver pursuant to 25 subsection 3 shall contain, at a minimum, all of the following: 26 Sec. 17. Section 124E.4, subsection 4, paragraph b, Code 27 2020, is amended by striking the paragraph. 28 Sec. 18. Section 124E.4, subsection 6, Code 2020, is amended 29 by striking the subsection. 30 Sec. 19. Section 124E.5, subsections 2 and 6, Code 2020, are 31 amended to read as follows: 32 2. The medical cannabidiol board shall convene at least 33 twice but no more than four times per year. 34 6. The medical cannabidiol board may recommend a statutory 35 -4- H8128.3718 (1) 88 ss/rh 4/ 8
revision to the definition of medical cannabidiol contained in 1 this chapter that increases the tetrahydrocannabinol level to 2 more than three percent, however, any such recommendation shall 3 be submitted to the general assembly during the regular session 4 of the general assembly following such submission. The general 5 assembly shall have the sole authority to revise the definition 6 of medical cannabidiol for purposes of this chapter . 7 Sec. 20. Section 124E.6, subsection 4, Code 2020, is amended 8 by striking the subsection and inserting in lieu thereof the 9 following: 10 4. A medical cannabidiol manufacturer shall contract with 11 a laboratory to perform spot-check testing of the medical 12 cannabidiol produced by the medical cannabidiol manufacturer 13 as provided in section 124E.7. The department shall require 14 that the laboratory report testing results to the medical 15 cannabidiol manufacturer and the department as determined by 16 the department by rule. If a medical cannabidiol manufacturer 17 contracts with a laboratory other than the state hygienic 18 laboratory at the university of Iowa in Iowa City, the 19 department shall approve the laboratory to perform testing 20 pursuant to this chapter. 21 Sec. 21. Section 124E.7, subsection 1, Code 2020, is amended 22 by striking the subsection and inserting in lieu thereof the 23 following: 24 1. A medical cannabidiol manufacturer shall contract with 25 a laboratory to perform spot-check testing of the medical 26 cannabidiol produced by the medical cannabidiol manufacturer as 27 to content, contamination, and consistency. The cost of all 28 laboratory testing shall be paid by the medical cannabidiol 29 manufacturer. 30 Sec. 22. Section 124E.9, Code 2020, is amended by adding the 31 following new subsections: 32 NEW SUBSECTION . 13. A medical cannabidiol dispensary 33 shall employ a pharmacist or pharmacy technician licensed or 34 registered pursuant to chapter 155A for the purpose of making 35 -5- H8128.3718 (1) 88 ss/rh 5/ 8
dosing recommendations. 1 NEW SUBSECTION . 14. A medical cannabidiol dispensary 2 shall not dispense more than a combined total of fifteen grams 3 of total tetrahydrocannabinol to a patient and the patient’s 4 primary caregiver in a ninety-day period, except as provided 5 in subsection 15. 6 NEW SUBSECTION . 15. A medical cannabidiol dispensary may 7 dispense more than a combined total of fifteen grams of total 8 tetrahydrocannabinol to a patient and the patient’s primary 9 caregiver in a ninety-day period if any of the following apply: 10 a. The health care practitioner who certified the patient to 11 receive a medical cannabidiol registration card certifies that 12 patient’s debilitating medical condition is a terminal illness 13 with a life expectancy of less than one year. A certification 14 issued pursuant to this paragraph shall include a total 15 tetrahydrocannabinol cap deemed appropriate by the patient’s 16 health care practitioner. 17 b. The health care practitioner who certified the patient to 18 receive a medical cannabidiol registration card certifies that 19 the patient has participated in the medical cannabidiol program 20 and that the health care practitioner has determined that 21 fifteen grams of total tetrahydrocannabinol in a ninety-day 22 period is insufficient to treat the patient’s debilitating 23 medical condition. A certification issued pursuant to this 24 paragraph shall include a total tetrahydrocannabinol cap deemed 25 appropriate by the patient’s health care practitioner. 26 Sec. 23. Section 124E.11, subsection 1, paragraph b, 27 subparagraph (1), subparagraph divisions (a) and (c), Code 28 2020, are amended to read as follows: 29 (a) To authorized employees or agents of the department and 30 the department of transportation as necessary to perform the 31 duties of the department and the department of transportation 32 pursuant to this chapter . 33 (c) To authorized employees of a medical cannabidiol 34 dispensary, but only for the purpose purposes of verifying that 35 -6- H8128.3718 (1) 88 ss/rh 6/ 8
a person is lawfully in possession of a medical cannabidiol 1 registration card issued pursuant to this chapter and that a 2 person has not purchased total tetrahydrocannabinol in excess 3 of the amount authorized by this chapter . 4 Sec. 24. Section 124E.11, subsection 1, paragraph b, 5 subparagraph (1), Code 2020, is amended by adding the following 6 new subparagraph division: 7 NEW SUBPARAGRAPH DIVISION . (e) To a health care 8 practitioner for the purpose of determining whether a patient 9 seeking a written certification pursuant to section 124E.3 has 10 already received a written certification from another health 11 care practitioner. 12 Sec. 25. Section 124E.12, subsection 1, Code 2020, is 13 amended to read as follows: 14 1. A health care practitioner, including any authorized 15 agent or employee thereof, or the state medical director, 16 including any authorized agent or employee thereof, shall not 17 be subject to prosecution for the unlawful certification, 18 possession, or administration of marijuana under the laws of 19 this state for activities arising directly out of or directly 20 related to the certification or use of medical cannabidiol 21 in the treatment of a patient diagnosed with a debilitating 22 medical condition as authorized by this chapter . 23 Sec. 26. Section 124E.12, subsection 7, Code 2020, is 24 amended to read as follows: 25 7. Notwithstanding any law to the contrary, the department, 26 the department of transportation, the governor, or any employee 27 of any state agency shall not be held civilly or criminally 28 liable for any injury, loss of property, personal injury, or 29 death caused by any act or omission while acting within the 30 scope of office or employment as authorized under this chapter . 31 Sec. 27. NEW SECTION . 124E.20 Observational effectiveness 32 study. 33 The department may conduct an observational effectiveness 34 study in cooperation with patients and health care 35 -7- H8128.3718 (1) 88 ss/rh 7/ 8
practitioners and pursuant to rules of the department in order 1 to study the effectiveness of medical cannabidiol in the 2 treatment of debilitating medical conditions. 3 Sec. 28. PROTECTION OF FEDERAL FUNDING. The department 4 of public health shall request guarantees from the agencies 5 of the federal government providing funding to educational 6 and long-term care facilities that facilities with policies 7 allowing patients to possess medical cannabidiol on the grounds 8 of the facilities consistent with chapter 124E or allowing 9 facility staff to administer medical cannabidiol to a patient 10 shall not lose eligibility for any federal funding due to such 11 policies. 12 Sec. 29. TRANSITION PROVISIONS. A medical cannabidiol 13 registration card issued prior to July 1, 2020, remains 14 effective and continues in effect as issued for the 15 twelve-month period following its issuance. >> 16 ______________________________ ISENHART of Dubuque -8- H8128.3718 (1) 88 ss/rh 8/ 8