Senate File 266 - Introduced SENATE FILE 266 BY BOLKCOM A BILL FOR An Act relating to the creation of a medical marijuana Act 1 including the creation of nonprofit dispensaries, and 2 providing for civil and criminal penalties and fees. 3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 4 TLSB 1768XS (15) 84 rh/nh

S.F. 266 Section 1. Section 124.401, subsection 5, Code 2011, is 1 amended by adding the following new unnumbered paragraph: 2 NEW UNNUMBERED PARAGRAPH . A person may knowingly or 3 intentionally possess marijuana if the possession is in 4 accordance with the provisions of chapter 124D. 5 Sec. 2. NEW SECTION . 124D.1 Citation. 6 This chapter shall be known and may be cited as the “Medical 7 Marijuana Act” . 8 Sec. 3. NEW SECTION . 124D.2 Definitions. 9 As used in this chapter, the following definitions shall 10 apply: 11 1. “Cardholder” means a qualifying patient, a primary 12 caregiver, or a principal officer, board member, employee, 13 or agent of a nonprofit dispensary who has been issued and 14 possesses a valid registry identification card. 15 2. “Debilitating medical condition” means any of the 16 following: 17 a. Cancer, glaucoma, positive status for human 18 immunodeficiency virus, acquired immune deficiency syndrome, 19 hepatitis C, amyotrophic lateral sclerosis, Crohn’s disease, 20 agitation of Alzheimer’s disease, nail patella, or the 21 treatment of any of these conditions. 22 b. A chronic or debilitating disease or medical condition 23 or its treatment that produces intractable pain, which is pain 24 that has not responded to ordinary medical or surgical measures 25 for more than six months. 26 c. A chronic or debilitating disease or medical condition or 27 its treatment that produces any of the following: 28 (1) Cachexia or wasting syndrome. 29 (2) Severe nausea. 30 (3) Seizures, including but not limited to those 31 characteristic of epilepsy. 32 (4) Severe and persistent muscle spasms, including but not 33 limited to those characteristic of multiple sclerosis. 34 d. Any other medical condition or its treatment approved by 35 -1- LSB 1768XS (15) 84 rh/nh 1/ 24

S.F. 266 the department. 1 3. “Department” means the department of public health. 2 4. “Enclosed, locked facility” means a closet, room, 3 greenhouse, or other enclosed area equipped with locks or other 4 security devices that permit access only by a cardholder. 5 5. “Felony drug offense” means a violation of a state or 6 federal controlled substance law that was classified as a 7 felony in the jurisdiction where the person was convicted. 8 “Felony drug offense” does not include any of the following: 9 a. An offense for which the sentence, including any term of 10 probation, incarceration, or supervised release, was completed 11 ten or more years earlier. 12 b. An offense that involved conduct that would have been 13 permitted under this chapter. 14 6. “Marijuana” means the same as defined in section 124.101, 15 subsection 19. 16 7. “Medical use” means the acquisition, possession, 17 cultivation, manufacture, use, delivery, transfer, or 18 transportation of marijuana or paraphernalia relating to the 19 administration of marijuana to treat or alleviate a registered 20 qualifying patient’s debilitating medical condition or symptoms 21 associated with the patient’s debilitating medical condition. 22 8. “Nonprofit dispensary” means a not-for-profit entity 23 registered under section 124D.4 that acquires, possesses, 24 cultivates, manufactures, delivers, transfers, transports, 25 sells, supplies, or dispenses marijuana or related supplies and 26 educational materials to cardholders. A nonprofit dispensary 27 is a primary caregiver. 28 9. “Physician” means an individual licensed under the 29 provisions of chapter 148 to practice medicine and surgery or 30 osteopathic medicine and surgery. 31 10. “Primary caregiver” means a person twenty-one years 32 of age or older who has agreed to assist with a qualifying 33 patient’s medical use of marijuana and who has never been 34 convicted of a felony drug offense, and includes a nonprofit 35 -2- LSB 1768XS (15) 84 rh/nh 2/ 24

S.F. 266 dispensary. Unless the primary caregiver is a nonprofit 1 dispensary, the primary caregiver shall not assist more than 2 five qualifying patients with their medical use of marijuana. 3 11. “Qualifying patient” means a person who has been 4 diagnosed by a physician with a debilitating medical condition. 5 12. “Registered nonprofit dispensary” means a nonprofit 6 dispensary registered by the department pursuant to section 7 124D.4. 8 13. “Registry identification card” means a document issued 9 by the department that identifies a person as a registered 10 qualifying patient, registered primary caregiver, or a 11 principal officer, board member, employee, or agent of a 12 nonprofit dispensary. 13 14. “Unusable marijuana” means marijuana seeds, stalks, 14 seedlings, and unusable roots. “Seedling” means a marijuana 15 plant without flowers which is less than twelve inches in 16 height and less than twelve inches in diameter. 17 15. “Usable marijuana” means the dried leaves and flowers of 18 the marijuana plant, and any mixture or preparation thereof, 19 but does not include the seeds, stalks, and roots of the 20 plant and does not include the weight of other ingredients in 21 marijuana prepared for consumption as food. 22 16. “Visiting qualifying patient” means a patient with a 23 debilitating medical condition who is not a resident of this 24 state or who has been a resident of this state for less than 25 thirty days. 26 17. “Written certification” means a document signed by 27 a physician, stating that in the physician’s professional 28 opinion the patient is likely to receive therapeutic or 29 palliative benefit from the medical use of marijuana to treat 30 or alleviate the patient’s debilitating medical condition or 31 symptoms associated with the debilitating medical condition. 32 A written certification shall be made only in the course of a 33 bona fide physician-patient relationship after the physician 34 has completed a full assessment of the qualifying patient’s 35 -3- LSB 1768XS (15) 84 rh/nh 3/ 24

S.F. 266 medical history. The written certification shall specify the 1 qualifying patient’s debilitating medical condition. 2 Sec. 4. NEW SECTION . 124D.3 Medical use of marijuana. 3 1. A qualifying patient who has been issued and possesses a 4 registry identification card shall not be subject to arrest, 5 prosecution, or penalty in any manner, or denied any right 6 or privilege, including but not limited to a civil penalty 7 or disciplinary action by a business or occupational or 8 professional licensing board or bureau, for the medical use 9 of marijuana in accordance with this chapter, provided the 10 marijuana possessed by the qualifying patient: 11 a. Is not more than two and one-half ounces of usable 12 marijuana. 13 b. If the qualifying patient has not designated a primary 14 caregiver to cultivate marijuana for the qualifying patient, 15 does not exceed six marijuana plants, which must be kept in 16 an enclosed, locked facility unless the plants are being 17 transported because the qualifying patient is moving or the 18 plants are being transported to the qualifying patient’s 19 property. 20 2. A primary caregiver other than a nonprofit dispensary who 21 has been issued and possesses a registry identification card 22 shall not be subject to arrest, prosecution, or penalty in any 23 manner, or denied any right or privilege, including but not 24 limited to a civil penalty or disciplinary action by a business 25 or occupational or professional licensing board or bureau, for 26 assisting a qualifying patient to whom the primary caregiver is 27 connected through the department’s registration process with 28 the medical use of marijuana in accordance with this chapter, 29 provided that the marijuana possessed by the primary caregiver: 30 a. Is not more than two and one-half ounces of usable 31 marijuana for each qualifying patient to whom the primary 32 caregiver is connected through the department’s registration 33 process. 34 b. For each qualifying patient who has designated the 35 -4- LSB 1768XS (15) 84 rh/nh 4/ 24

S.F. 266 primary caregiver to cultivate marijuana for the qualifying 1 patient, does not exceed six marijuana plants, which must be 2 kept in an enclosed, locked facility unless the plants are 3 being transported because the primary caregiver is moving. 4 3. Any incidental amount of seeds, stalks, and unusable 5 roots shall be allowed and shall not be included in the amounts 6 specified in subsections 1 and 2. 7 4. a. There shall be a presumption that a qualifying 8 patient or primary caregiver is engaged in the medical use of 9 marijuana pursuant to this chapter if the qualifying patient or 10 primary caregiver does both of the following: 11 (1) Possesses a registry identification card. 12 (2) Possesses an amount of marijuana that does not exceed 13 the amount allowed under this chapter. 14 b. The presumption may be rebutted by evidence that 15 conduct related to marijuana use or possession was not for the 16 purpose of treating or alleviating the qualifying patient’s 17 debilitating medical condition or symptoms associated with 18 the debilitating medical condition, in accordance with this 19 chapter. 20 5. A cardholder shall not be subject to arrest, prosecution, 21 or penalty in any manner, or denied any right or privilege, 22 including but not limited to civil penalty or disciplinary 23 action by a business or occupational or professional licensing 24 board or bureau, for giving an amount of marijuana the person 25 is allowed to possess under subsection 1 or 2 to a cardholder 26 for a registered qualifying patient’s medical use where nothing 27 of value is transferred in return, or to offer to do the same. 28 6. A school, employer, or landlord shall not refuse to 29 enroll, employ, or lease to, or otherwise penalize, a person 30 solely on the basis of the person’s status as a registered 31 qualifying patient or a registered primary caregiver, unless 32 failing to do so would put the school, employer, or landlord 33 in violation of federal law or cause the school, employer, or 34 landlord to lose a federal contract or funding. 35 -5- LSB 1768XS (15) 84 rh/nh 5/ 24

S.F. 266 7. A person shall not be denied custody or visitation of 1 a minor for acting in accordance with this chapter, unless 2 the person’s behavior is such that it creates an unreasonable 3 danger to the minor that can be clearly articulated and 4 substantiated. 5 8. A registered primary caregiver may receive compensation 6 for costs associated with assisting a registered qualifying 7 patient’s medical use of marijuana, provided that the 8 registered primary caregiver is connected to the registered 9 qualifying patient through the department’s registration 10 process. Any such compensation shall not constitute the sale 11 of controlled substances. 12 9. A physician shall not be subject to arrest, prosecution, 13 or penalty in any manner, or denied any right or privilege, 14 including but not limited to a civil penalty or disciplinary 15 action by the board of medicine or by any other business or 16 occupational or professional licensing board or bureau, solely 17 for providing written certifications or for otherwise stating 18 that, in the physician’s professional opinion, a patient is 19 likely to receive therapeutic benefit from the medical use of 20 marijuana to treat or alleviate the patient’s debilitating 21 medical condition or symptoms associated with the debilitating 22 medical condition, provided that nothing shall prevent a 23 professional licensing board from sanctioning a physician for 24 failing to properly evaluate a patient’s medical condition or 25 otherwise violating the standard of care for evaluating medical 26 conditions. 27 10. A person shall not be subject to arrest, prosecution, 28 or penalty in any manner, or denied any right or privilege, 29 including but not limited to a civil penalty or disciplinary 30 action by a business or occupational or professional licensing 31 board or bureau, for providing a registered qualifying patient 32 or a registered primary caregiver with marijuana paraphernalia 33 for purposes of a qualifying patient’s medical use of 34 marijuana. 35 -6- LSB 1768XS (15) 84 rh/nh 6/ 24

S.F. 266 11. Any marijuana, marijuana paraphernalia, licit property, 1 or interest in licit property that is possessed, owned, or used 2 in connection with the medical use of marijuana, as allowed 3 under this chapter, or property incidental to such use, shall 4 not be seized or forfeited. 5 12. A person shall not be subject to arrest, prosecution, 6 or penalty in any manner, or denied any right or privilege, 7 including but not limited to a civil penalty or disciplinary 8 action by a business or occupational or professional licensing 9 board or bureau, simply for being in the presence or vicinity 10 of the medical use of marijuana as allowed under this chapter, 11 or for assisting a registered qualifying patient with using or 12 administering marijuana. 13 13. A registry identification card, or its equivalent, that 14 is issued under the laws of another state, district, territory, 15 commonwealth, or insular possession of the United States that 16 allows the medical use of marijuana by a visiting qualifying 17 patient, shall have the same force and effect as a registry 18 identification card issued by the department for purposes of 19 this chapter. 20 Sec. 5. NEW SECTION . 124D.4 Nonprofit dispensaries. 21 1. The department shall register and issue a registration 22 certificate to a nonprofit dispensary within thirty days of 23 receiving an application for registration of a nonprofit 24 dispensary if the prospective nonprofit dispensary provided all 25 of the following, in accordance with the department’s rules: 26 a. An application fee of five thousand dollars. 27 b. The legal name of the nonprofit dispensary. 28 c. The physical address of the nonprofit dispensary and 29 the physical address of one additional location, if any, where 30 marijuana will be cultivated. 31 d. The name, address, and date of birth of each principal 32 officer and board member of the nonprofit dispensary. 33 e. The name, address, and date of birth of any person who is 34 an agent of or employed by the nonprofit dispensary. 35 -7- LSB 1768XS (15) 84 rh/nh 7/ 24

S.F. 266 2. The department shall track the number of registered 1 qualifying patients who designate a nonprofit dispensary as 2 a primary caregiver and issue to each nonprofit dispensary 3 a written statement of the number of qualifying patients 4 who have designated the nonprofit dispensary to cultivate 5 marijuana for them. This statement shall be updated each time 6 a registered qualifying patient newly designates the nonprofit 7 dispensary or ceases to designate the nonprofit dispensary and 8 may be transmitted electronically if the department’s rules so 9 provide. The department may provide by rule that the updated 10 written statements may not be issued more frequently than once 11 each week. 12 3. Except as provided in subsection 4, the department shall 13 issue each principal officer, board member, agent, or employee 14 of a nonprofit dispensary a registry identification card within 15 ten days of receipt of the person’s name, address, date of 16 birth, and a fee in an amount established by the department. 17 Each registry identification card shall specify that the 18 cardholder is a principal officer, board member, agent, or 19 employee of a nonprofit dispensary and shall contain all of the 20 following information: 21 a. The name, address, and date of birth of the principal 22 officer, board member, agent, or employee. 23 b. The legal name of the nonprofit dispensary with which 24 the principal officer, board member, agent, or employee is 25 affiliated. 26 c. A random identification number that is unique to the 27 cardholder. 28 d. The date of issuance and expiration date of the registry 29 identification card. 30 e. A photograph, if the department requires inclusion of a 31 photograph by rule. 32 4. The department shall not issue a registry identification 33 card to any principal officer, board member, agent, or employee 34 of a nonprofit dispensary who has been convicted of a felony 35 -8- LSB 1768XS (15) 84 rh/nh 8/ 24

S.F. 266 drug offense. The department may conduct a background check 1 of each principal officer, board member, agent, or employee 2 in order to carry out this subsection. The department shall 3 notify the nonprofit dispensary in writing of the reason for 4 denying the registry identification card. 5 5. a. A nonprofit dispensary registration certificate and 6 the registry identification card for each principal officer, 7 board member, agent, or employee shall expire one year after 8 the date of issuance. The department shall issue a renewal 9 nonprofit dispensary registration certificate or renewal 10 registry identification card within ten days to any person who 11 complies with the requirements in subsection 3. 12 b. A registry identification card of a principal officer, 13 board member, agent, or employee shall expire ten days after 14 notification by a nonprofit dispensary that such person ceases 15 to work at the nonprofit dispensary. 16 6. A nonprofit dispensary is subject to reasonable 17 inspection by the department. The department shall give 18 reasonable notice of an inspection. 19 7. a. A nonprofit dispensary shall be operated on a 20 not-for-profit basis for the mutual benefit of its members 21 and patrons. The bylaws of a nonprofit dispensary and its 22 contracts with patrons shall contain such provisions relative 23 to the disposition of revenues and receipts as may be necessary 24 and appropriate to establish and maintain its not-for-profit 25 status. However, a nonprofit dispensary need not be recognized 26 as tax-exempt by the Internal Revenue Service and is not 27 required to incorporate pursuant to chapter 504. 28 b. A nonprofit dispensary shall notify the department within 29 ten days of when a principal officer, board member, agent, or 30 employee ceases to work at the nonprofit dispensary. 31 c. A nonprofit dispensary shall notify the department in 32 writing of the name, address, and date of birth of any new 33 principal officer, board member, agent, or employee and shall 34 submit a fee in an amount established by the department for 35 -9- LSB 1768XS (15) 84 rh/nh 9/ 24

S.F. 266 a new registry identification card before the new principal 1 officer, board member, agent, or employee begins working at the 2 nonprofit dispensary. 3 d. A nonprofit dispensary shall implement appropriate 4 security measures to deter and prevent unauthorized entrance 5 into areas containing marijuana and the theft of marijuana. 6 e. The operating documents of a nonprofit dispensary 7 shall include procedures for the oversight of the nonprofit 8 dispensary and procedures to ensure accurate recordkeeping. 9 f. A nonprofit dispensary is prohibited from acquiring, 10 possessing, cultivating, manufacturing, delivering, 11 transferring, transporting, supplying, or dispensing marijuana 12 for any purpose except to assist registered qualifying patients 13 with the medical use of marijuana directly or through the 14 qualifying patients’ other primary caregivers. 15 g. All principal officers and board members of a nonprofit 16 dispensary shall be residents of the state of Iowa. 17 h. All cultivation of marijuana shall take place in an 18 enclosed, locked facility. 19 i. A nonprofit dispensary shall not be located within 20 five hundred feet of the property line of a public or private 21 school. 22 8. A nonprofit dispensary or a principal officer, board 23 member, agent, or employee of a nonprofit dispensary shall not 24 dispense more than two and one-half ounces of usable marijuana 25 to a qualifying patient or to a primary caregiver on behalf of 26 a qualifying patient during a fifteen-day period. 27 9. a. A nonprofit dispensary shall not be subject to 28 prosecution, search, seizure, or penalty, or be denied any 29 right or privilege, including but not limited to a civil 30 penalty or disciplinary action by a business, occupational, or 31 licensing board or entity, solely for acting in accordance with 32 this chapter to provide usable marijuana or to otherwise assist 33 registered qualifying patients connected with the nonprofit 34 dispensary with the medical use of marijuana. 35 -10- LSB 1768XS (15) 84 rh/nh 10/ 24

S.F. 266 b. A principal officer, board member, agent, or employee 1 of a registered nonprofit dispensary shall not be subject 2 to arrest, prosecution, search, seizure, or penalty in any 3 manner or denied any right or privilege, including but not 4 limited to a civil penalty or disciplinary action by a court or 5 occupational or professional licensing board or entity, solely 6 for acting in accordance with this chapter and department rules 7 to acquire, possess, cultivate, manufacture, deliver, transfer, 8 transport, supply, or dispense marijuana or related supplies 9 and educational materials to registered qualifying patients, 10 to registered primary caregivers on behalf of registered 11 qualifying patients, or to other nonprofit dispensaries. 12 10. a. A nonprofit dispensary shall not possess more 13 than six live marijuana plants for each registered qualifying 14 patient who has designated the nonprofit dispensary as a 15 primary caregiver and has designated that the nonprofit 16 dispensary will be permitted to cultivate marijuana for the 17 registered qualifying patient’s medical use. 18 b. A principal officer, board member, employee, or agent 19 of a nonprofit dispensary shall not dispense, deliver, 20 or otherwise transfer marijuana to a person other than a 21 qualifying patient who has designated the nonprofit dispensary 22 as a primary caregiver. 23 c. The department shall immediately revoke the registry 24 identification card of a principal officer, board member, 25 employee, or agent of a nonprofit dispensary who is found to 26 be in violation of paragraph “b” , and such a person shall be 27 disqualified from serving as a principal officer, board member, 28 agent, or employee of a nonprofit dispensary. 29 d. Except as otherwise provided, a person who has been 30 convicted of an offense that was classified as a felony in 31 the jurisdiction where the person was convicted shall not be 32 eligible to be a principal officer, board member, agent, or 33 employee of a nonprofit dispensary. 34 (1) A person who is a principal officer, board member, 35 -11- LSB 1768XS (15) 84 rh/nh 11/ 24

S.F. 266 agent, or employee of a nonprofit dispensary in violation of 1 this paragraph “d” is subject to a civil penalty of up to one 2 thousand dollars. 3 (2) A person who is a principal officer, board member, 4 agent, or employee of a nonprofit dispensary in violation 5 of this paragraph “d” and who, at the time of the violation, 6 has been previously found to have been in violation of this 7 paragraph “d” commits a class “D” felony. 8 e. A nonprofit dispensary shall not acquire usable marijuana 9 or mature marijuana plants except through the cultivation of 10 marijuana by that nonprofit dispensary. 11 Sec. 6. NEW SECTION . 124D.5 Departmental rules. 12 1. Not later than one hundred twenty days after the 13 effective date of this Act, the department shall adopt rules to 14 carry out the purposes of this chapter. 15 2. Not later than one hundred twenty days after the 16 effective date of this Act, the department shall adopt 17 rules that govern the manner in which the department shall 18 consider petitions from the public to add medical conditions 19 or treatments to the list of debilitating medical conditions 20 set forth in section 124D.2, subsection 2. In considering 21 such petitions, the department shall include public notice 22 of, and an opportunity to comment in, a public hearing upon 23 such petitions. The department shall, after hearing, approve 24 or deny such petitions within one hundred eighty days of 25 their submission. The approval or denial of such a petition 26 constitutes final agency action, subject to judicial review. 27 3. Not later than one hundred twenty days after the 28 effective date of this Act, the department shall adopt rules 29 governing the manner in which it considers applications for and 30 renewals of registry identification cards. The department’s 31 rules must establish application and renewal fees that generate 32 revenues sufficient to offset all expenses of implementing 33 and administering this chapter. The department may establish 34 a sliding scale of application and renewal fees based upon 35 -12- LSB 1768XS (15) 84 rh/nh 12/ 24

S.F. 266 a qualifying patient’s income. The department may accept 1 donations from private sources to reduce application and 2 renewal fees. 3 Sec. 7. NEW SECTION . 124D.6 Registry identification cards 4 —— application —— fee —— penalty. 5 1. The department shall issue a registry identification 6 card to a qualifying patient who submits an application 7 containing all of the following: 8 a. A written certification. 9 b. An application or renewal fee. 10 c. The name, address, and date of birth of the qualifying 11 patient except that if the applicant is homeless, no address 12 is required. 13 d. The name, address, and telephone number of the qualifying 14 patient’s physician. 15 e. The name, address, and date of birth of each primary 16 caregiver, if any, of the qualifying patient. A qualifying 17 patient may designate only one primary caregiver unless 18 the qualifying patient is under eighteen years of age and 19 requires a parent to serve as a primary caregiver or the 20 qualifying patient designates a nonprofit dispensary to 21 cultivate marijuana for the qualifying patient’s medical use 22 and the qualifying patient requests the assistance of a second 23 caregiver to assist with the qualifying patient’s medical use. 24 f. If the qualifying patient designates one or more primary 25 caregivers, a designation as to who will be allowed under state 26 law to cultivate marijuana plants for the qualifying patient’s 27 medical use. Only one person may be allowed to cultivate 28 marijuana plants for a qualifying patient. 29 2. The department shall not issue a registry identification 30 card to a qualifying patient who is under the age of eighteen 31 unless all of the following requirements are met: 32 a. The qualifying patient’s physician has explained the 33 potential risks and benefits of the medical use of marijuana 34 to the qualifying patient and to a parent, guardian, or legal 35 -13- LSB 1768XS (15) 84 rh/nh 13/ 24

S.F. 266 custodian of the qualifying patient. 1 b. The parent, guardian, or person having legal custody 2 consents in writing to all of the following: 3 (1) Allowing the qualifying patient’s medical use of 4 marijuana. 5 (2) Serving as the qualifying patient’s primary caregiver. 6 (3) Controlling the acquisition of the marijuana, the 7 dosage, and the frequency of the medical use of marijuana by 8 the qualifying patient. 9 3. The department shall verify the information contained 10 in an application or renewal application submitted pursuant 11 to this section, and shall approve or deny an application 12 or renewal application within thirty days of receiving the 13 application or renewal application. The department may deny 14 an application or a renewal application only if the applicant 15 fails to provide the information required pursuant to this 16 section, or the department determines that the information 17 provided was falsified. Rejection of an application or a 18 renewal application is considered a final agency action subject 19 to judicial review pursuant to chapter 17A. 20 4. The department shall issue a registry identification 21 card to the primary caregiver, if any, who is named in 22 a qualifying patient’s approved application or renewal 23 application, up to a maximum of one primary caregiver per 24 qualifying patient, provided the primary caregiver meets the 25 requirements of section 124D.2, subsection 10. 26 5. The department shall issue a registry identification 27 card to a qualifying patient and to the primary caregiver 28 within five days of approving an application or a renewal 29 application, which shall expire one year after the date of 30 issuance. A registry identification card shall contain all of 31 the following: 32 a. The name, address, and date of birth of the qualifying 33 patient. 34 b. The name, address, and date of birth of the primary 35 -14- LSB 1768XS (15) 84 rh/nh 14/ 24

S.F. 266 caregiver, if any, of the qualifying patient. 1 c. The date of issuance and expiration date of the registry 2 identification card. 3 d. A random identification number. 4 e. A photograph, if the department requires a photograph. 5 f. A clear designation indicating whether the cardholder 6 shall be allowed under law to cultivate marijuana plants for 7 the qualifying patient’s medical use, to be determined based 8 upon the qualifying patient’s preference. 9 6. a. A registered qualifying patient shall notify the 10 department of any change in the registered qualifying patient’s 11 name, address, or primary caregiver, preference regarding who 12 may cultivate marijuana for the registered qualifying patient, 13 or if the registered qualifying patient ceases to have a 14 debilitating medical condition, within ten days of such change. 15 b. A registered qualifying patient who fails to notify the 16 department of any of the changes in paragraph “a” is subject 17 to a civil penalty of up to one hundred fifty dollars. If 18 the registered qualifying patient’s certifying physician 19 notifies the department in writing that the registered 20 qualifying patient no longer suffers from a debilitating 21 medical condition, the registered qualifying patient’s registry 22 identification card shall become void upon notification by the 23 department to the qualifying patient. 24 c. A registered primary caregiver shall notify the 25 department of any change in the registered primary caregiver’s 26 name or address within ten days of such change. A registered 27 primary caregiver who fails to notify the department of such 28 change is subject to a civil penalty of up to one hundred fifty 29 dollars. 30 d. When a registered qualifying patient or registered 31 primary caregiver notifies the department of any changes 32 listed in this subsection and submits a fee of ten dollars, 33 the department shall issue the cardholder a new registry 34 identification card within ten days of receiving the updated 35 -15- LSB 1768XS (15) 84 rh/nh 15/ 24

S.F. 266 information. 1 e. When a registered qualifying patient changes the 2 registered qualifying patient’s registered primary caregiver, 3 the department shall notify the primary caregiver within 4 ten days. The registered primary caregiver’s protections 5 as provided in this chapter shall expire ten days after 6 notification by the department. 7 f. If a cardholder loses the cardholder’s registry 8 identification card, the cardholder shall notify the department 9 and submit a fee of ten dollars within ten days of losing the 10 card. Within five days after such notification, the department 11 shall issue a new registry identification card with a new 12 random identification number to the cardholder. 13 7. Possession of, or application for, a registry 14 identification card shall not constitute probable cause or 15 reasonable suspicion and shall not be used to support the 16 search of the person or property of the person possessing or 17 applying for the registry identification card. The possession 18 of or application for a registry identification card does not 19 prevent the issuance of a warrant if probable cause exists on 20 other grounds. 21 8. The following confidentiality rules shall apply: 22 a. Applications and supporting information submitted by 23 a qualifying patient, including information regarding the 24 qualifying patient’s primary caregiver and physician, are 25 confidential. 26 b. Applications and supporting information submitted by a 27 primary caregiver operating in compliance with this chapter, 28 including the physical address of a nonprofit dispensary, are 29 confidential. 30 c. The department shall maintain a confidential list 31 of the persons to whom the department has issued registry 32 identification cards. Individual names and other identifying 33 information on the list shall be confidential and not subject 34 to disclosure, except to authorized employees of the department 35 -16- LSB 1768XS (15) 84 rh/nh 16/ 24

S.F. 266 as necessary to perform official duties of the department. 1 d. The department shall verify to law enforcement personnel 2 whether a registry identification card is valid without 3 disclosing more information than is reasonably necessary to 4 verify the authenticity of the registry identification card. 5 e. (1) A person, including an employee or official of the 6 department or another state agency or local government, who 7 breaches the confidentiality of information obtained pursuant 8 to this chapter commits a serious misdemeanor punishable by 9 imprisonment of up to one hundred days and a fine of up to one 10 thousand dollars. 11 (2) Notwithstanding this paragraph “e” , department employees 12 may notify law enforcement about falsified or fraudulent 13 information submitted to the department, if the employee who 14 suspects that falsified or fraudulent information has been 15 submitted confers with the employee’s supervisor and the 16 employee and the employee’s supervisor agree that circumstances 17 exist that warrant reporting. 18 9. A cardholder who sells marijuana to a person who is not 19 allowed to possess marijuana for medical purposes under this 20 chapter shall have the cardholder’s registry identification 21 card revoked and is subject to any other penalties for the 22 sale of marijuana. The department shall revoke the registry 23 identification card of any cardholder who violates this chapter 24 and the cardholder is subject to any other penalties for the 25 violation. 26 10. The department shall submit an annual report to 27 the general assembly by January 15 of each year that does 28 not disclose any identifying information about cardholders 29 or physicians, but does contain, at a minimum, all of the 30 following information: 31 a. The number of applications and renewal applications 32 submitted for registry identification cards. 33 b. The number of registered qualifying patients and 34 registered primary caregivers in each county. 35 -17- LSB 1768XS (15) 84 rh/nh 17/ 24

S.F. 266 c. The nature of the debilitating medical conditions of the 1 qualifying patients. 2 d. The number of registry identification cards revoked. 3 e. The number of physicians providing written certifications 4 for qualifying patients. 5 f. The number of registered nonprofit dispensaries. 6 g. The number of principal officers, board members, 7 employees, and agents of nonprofit dispensaries. 8 11. The application for a qualifying patient’s registry 9 identification card shall include a question on whether the 10 patient would like the department to notify the patient about 11 any clinical studies regarding marijuana’s risks or efficacy 12 that seek human subjects. 13 Sec. 8. NEW SECTION . 124D.7 Scope of chapter. 14 1. This chapter does not permit any person to do any of the 15 following: 16 a. Undertake any task under the influence of marijuana, 17 when doing so would constitute negligence or professional 18 malpractice. 19 b. Possess marijuana, or otherwise engage in the medical use 20 of marijuana, in any of the following places: 21 (1) In a school bus. 22 (2) On the grounds of any preschool or primary or secondary 23 school. 24 (3) In any correctional facility. 25 c. Smoke marijuana in any of the following: 26 (1) Any form of public transportation. 27 (2) Any public place. 28 d. Operate, navigate, or be in actual physical control 29 of any motor vehicle, aircraft, or motorboat while under the 30 influence of marijuana. 31 e. Use marijuana if that person does not have a debilitating 32 medical condition. 33 2. Nothing in this chapter shall be construed to require any 34 of the following: 35 -18- LSB 1768XS (15) 84 rh/nh 18/ 24

S.F. 266 a. A government medical assistance program or private health 1 insurer to reimburse a person for costs associated with the 2 medical use of marijuana. 3 b. An employer to accommodate the ingestion of marijuana in 4 any workplace or any employee working while under the influence 5 of marijuana. 6 3. Fraudulent representation to a law enforcement official 7 of any fact or circumstance relating to the medical use 8 of marijuana to avoid arrest or prosecution is a simple 9 misdemeanor, punishable by a fine of five hundred dollars, 10 in addition to any other penalties that may apply for making 11 a false statement or for the use of marijuana other than use 12 undertaken pursuant to this chapter. 13 Sec. 9. NEW SECTION . 124D.8 Affirmative defenses —— 14 dismissal. 15 1. Except as provided in section 124D.7, a qualifying 16 patient and a qualifying patient’s primary caregiver, other 17 than a nonprofit dispensary, may assert the medical purpose for 18 using marijuana as a defense to any prosecution of an offense 19 involving marijuana intended for the patient’s medical use, and 20 this defense shall be presumed valid where the evidence shows 21 all of the following: 22 a. A physician has stated that, in the physician’s 23 professional opinion, after having completed a full assessment 24 of the patient’s medical history and current medical 25 condition made in the course of a bona fide physician-patient 26 relationship, the qualifying patient is likely to receive 27 therapeutic or palliative benefit from the medical use of 28 marijuana to treat or alleviate the qualifying patient’s 29 debilitating medical condition or symptoms associated with the 30 qualifying patient’s debilitating medical condition. 31 b. The qualifying patient and the qualifying patient’s 32 primary caregiver, if any, were collectively in possession of 33 a quantity of marijuana that was not more than was reasonably 34 necessary to ensure the uninterrupted availability of marijuana 35 -19- LSB 1768XS (15) 84 rh/nh 19/ 24

S.F. 266 for the purpose of treating or alleviating the qualifying 1 patient’s debilitating medical condition or symptoms associated 2 with the qualifying patient’s debilitating medical condition. 3 c. The qualifying patient and the qualifying patient’s 4 primary caregiver were engaged in the acquisition, possession, 5 cultivation, manufacture, use, delivery, transfer, or 6 transportation of marijuana or paraphernalia relating to the 7 administration of marijuana solely to treat or alleviate the 8 qualifying patient’s debilitating medical condition or symptoms 9 associated with the qualifying patient’s debilitating medical 10 condition. 11 2. A person may assert the medical purpose for using 12 marijuana in a motion to dismiss and the charges shall be 13 dismissed following an evidentiary hearing where the person 14 shows all of the elements listed in subsection 1. 15 3. If a qualifying patient or a patient’s primary caregiver 16 demonstrates the qualifying patient’s medical purpose for using 17 marijuana pursuant to this section, the qualifying patient and 18 the patient’s primary caregiver shall not be subject to any of 19 the following for the qualifying patient’s use of marijuana for 20 medical purposes: 21 a. Disciplinary action by a business or occupational or 22 professional licensing board or bureau. 23 b. Forfeiture of any interest in or right to nonmarijuana, 24 licit property. 25 Sec. 10. NEW SECTION . 124D.9 Enforcement. 26 1. If the department fails to adopt rules to implement the 27 requirements of this chapter within one hundred twenty days 28 of the effective date of this Act, a qualifying patient may 29 commence an action in district court to compel the department 30 to perform the department’s duties pursuant to this chapter. 31 2. If the department fails to issue a valid registry 32 identification card or a registration certificate in response 33 to a valid application or renewal application submitted 34 pursuant to this chapter within forty-five days of its 35 -20- LSB 1768XS (15) 84 rh/nh 20/ 24