House File 2589 H-8144 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- H8128.3709 (3) 88 ss/rh 1/ 6 #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- H8128.3709 (3) 88 ss/rh 2/ 6

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 6, Code 2020, is amended 18 by striking the subsection. 19 Sec. 16. Section 124E.5, subsections 2 and 6, Code 2020, are 20 amended to read as follows: 21 2. The medical cannabidiol board shall convene at least 22 twice but no more than four times per year. 23 6. The medical cannabidiol board may recommend a statutory 24 revision to the definition of medical cannabidiol contained in 25 this chapter that increases the tetrahydrocannabinol level to 26 more than three percent, however, any such recommendation shall 27 be submitted to the general assembly during the regular session 28 of the general assembly following such submission. The general 29 assembly shall have the sole authority to revise the definition 30 of medical cannabidiol for purposes of this chapter . 31 Sec. 17. Section 124E.6, subsection 4, Code 2020, is amended 32 by striking the subsection and inserting in lieu thereof the 33 following: 34 4. A medical cannabidiol manufacturer shall contract with 35 -3- H8128.3709 (3) 88 ss/rh 3/ 6

a laboratory to perform spot-check testing of the medical 1 cannabidiol produced by the medical cannabidiol manufacturer 2 as provided in section 124E.7. The department shall require 3 that the laboratory report testing results to the medical 4 cannabidiol manufacturer and the department as determined by 5 the department by rule. If a medical cannabidiol manufacturer 6 contracts with a laboratory other than the state hygienic 7 laboratory at the university of Iowa in Iowa City, the 8 department shall approve the laboratory to perform testing 9 pursuant to this chapter. 10 Sec. 18. Section 124E.7, subsection 1, Code 2020, is amended 11 by striking the subsection and inserting in lieu thereof the 12 following: 13 1. A medical cannabidiol manufacturer shall contract with 14 a laboratory to perform spot-check testing of the medical 15 cannabidiol produced by the medical cannabidiol manufacturer as 16 to content, contamination, and consistency. The cost of all 17 laboratory testing shall be paid by the medical cannabidiol 18 manufacturer. 19 Sec. 19. Section 124E.9, Code 2020, is amended by adding the 20 following new subsections: 21 NEW SUBSECTION . 13. A medical cannabidiol dispensary 22 shall employ a pharmacist or pharmacy technician licensed or 23 registered pursuant to chapter 155A for the purpose of making 24 dosing recommendations. 25 NEW SUBSECTION . 14. A medical cannabidiol dispensary 26 shall not dispense more than a combined total of fifteen grams 27 of total tetrahydrocannabinol to a patient and the patient’s 28 primary caregiver in a ninety-day period, except as provided 29 in subsection 15. 30 NEW SUBSECTION . 15. A medical cannabidiol dispensary may 31 dispense more than a combined total of fifteen grams of total 32 tetrahydrocannabinol to a patient and the patient’s primary 33 caregiver in a ninety-day period if any of the following apply: 34 a. The health care practitioner who certified the patient to 35 -4- H8128.3709 (3) 88 ss/rh 4/ 6

receive a medical cannabidiol registration card certifies that 1 patient’s debilitating medical condition is a terminal illness 2 with a life expectancy of less than one year. A certification 3 issued pursuant to this paragraph shall include a total 4 tetrahydrocannabinol cap deemed appropriate by the patient’s 5 health care practitioner. 6 b. The health care practitioner who certified the patient to 7 receive a medical cannabidiol registration card certifies that 8 the patient has participated in the medical cannabidiol program 9 and that the health care practitioner has determined that 10 fifteen grams of total tetrahydrocannabinol in a ninety-day 11 period is insufficient to treat the patient’s debilitating 12 medical condition. A certification issued pursuant to this 13 paragraph shall include a total tetrahydrocannabinol cap deemed 14 appropriate by the patient’s health care practitioner. 15 Sec. 20. Section 124E.11, subsection 1, paragraph b, 16 subparagraph (1), subparagraph divisions (a) and (c), Code 17 2020, are amended to read as follows: 18 (a) To authorized employees or agents of the department and 19 the department of transportation as necessary to perform the 20 duties of the department and the department of transportation 21 pursuant to this chapter . 22 (c) To authorized employees of a medical cannabidiol 23 dispensary, but only for the purpose purposes of verifying that 24 a person is lawfully in possession of a medical cannabidiol 25 registration card issued pursuant to this chapter and that a 26 person has not purchased total tetrahydrocannabinol in excess 27 of the amount authorized by this chapter . 28 Sec. 21. Section 124E.11, subsection 1, paragraph b, 29 subparagraph (1), Code 2020, is amended by adding the following 30 new subparagraph division: 31 NEW SUBPARAGRAPH DIVISION . (e) To a health care 32 practitioner for the purpose of determining whether a patient 33 seeking a written certification pursuant to section 124E.3 has 34 already received a written certification from another health 35 -5- H8128.3709 (3) 88 ss/rh 5/ 6

care practitioner. 1 Sec. 22. Section 124E.12, subsection 7, Code 2020, is 2 amended to read as follows: 3 7. Notwithstanding any law to the contrary, the department, 4 the department of transportation, the governor, or any employee 5 of any state agency shall not be held civilly or criminally 6 liable for any injury, loss of property, personal injury, or 7 death caused by any act or omission while acting within the 8 scope of office or employment as authorized under this chapter . 9 Sec. 23. NEW SECTION . 124E.20 Observational effectiveness 10 study. 11 The department may conduct an observational effectiveness 12 study in cooperation with patients and health care 13 practitioners and pursuant to rules of the department in order 14 to study the effectiveness of medical cannabidiol in the 15 treatment of debilitating medical conditions. 16 Sec. 24. PROTECTION OF FEDERAL FUNDING. The department 17 of public health shall request guarantees from the agencies 18 of the federal government providing funding to educational 19 and long-term care facilities that facilities with policies 20 allowing patients to possess medical cannabidiol on the grounds 21 of the facilities consistent with chapter 124E or allowing 22 facility staff to administer medical cannabidiol to a patient 23 shall not lose eligibility for any federal funding due to such 24 policies. 25 Sec. 25. TRANSITION PROVISIONS. A medical cannabidiol 26 registration card issued prior to July 1, 2020, remains 27 effective and continues in effect as issued for the 28 twelve-month period following its issuance. >> 29 ______________________________ KRESSIG of Black Hawk -6- H8128.3709 (3) 88 ss/rh 6/ 6