SF 2360 (LSB 6227SV (2) 85)

SENATE FILE 2360

BY  COMMITTEE ON WAYS AND MEANS

(SUCCESSOR TO SSB 3222)

A BILL FOR

An Act creating the medical cannabidiol Act and providing penalties and including effective date provisions.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

    Section 1.  Section 124.401, subsection 5, Code 2014, is amended by adding the following new unnumbered paragraph after unnumbered paragraph 2:
   NEW UNNUMBERED PARAGRAPH.  A person may knowingly or intentionally recommend, possess, use, dispense, deliver, transport, or administer cannabidiol if the recommendation, possession, use, dispensing, delivery, transporting, or administering is in accordance with the provisions of chapter 124D. For purposes of this paragraph, “cannabidiol” means the same as defined in section 124D.2.
    Sec. 2.  NEW SECTION.  124D.1  Short title.

   This chapter shall be known and may be cited as the “Medical Cannabidiol Act”.
    Sec. 3.  NEW SECTION.  124D.2  Definitions.

   As used in this chapter:

   1.  “Cannabidiol” means a nonpsychoactive cannabinoid found in the plant Cannabis sativa L. or Cannabis indica or any other preparation thereof that is essentially free from plant material, and has a tetrahydrocannabinol level of no more than three percent. 
   2.  “Department” means the department of public health.
   3.  “Intractable epilepsy” means an epileptic seizure disorder for which standard medical treatment does not prevent or significantly ameliorate recurring, uncontrolled seizures or for which standard medical treatment results in harmful side effects.
   4.  “Neurologist” means an allopathic or osteopathic physician board-certified in neurology in good standing and licensed under chapter 148 or an allopathic or osteopathic physician board-certified in neurology in good standing and licensed in any other state.
   5.  a.  “Primary caregiver” means a person, at least eighteen years of age, who has been designated by a patient’s neurologist or a person having custody of a patient, as being necessary to take responsibility for managing the well-being of the patient with respect to the medical use of cannabidiol pursuant to the provisions of this chapter. A patient may have one or more designated primary caregivers.
   b.  “Primary caregiver” includes but is not limited to the following:
   (1)  An employee of a hospice program, if the employee meets the definition of a primary caregiver under paragraph “a”.
   (2)  An individual providing home and community-based services, and including a home health agency, licensed, certified, or otherwise authorized or permitted by the law of this state or another state to administer health care in the ordinary course of business or in the practice of a profession, if the individual meets the definition of a primary caregiver under paragraph “a”.
    Sec. 4.  NEW SECTION.  124D.3  Neurologist recommendation —— medical use of cannabidiol.

   A neurologist who has examined and treated a patient suffering from intractable epilepsy may provide but has no duty to provide a written recommendation for the patient’s medical use of cannabidiol to treat or alleviate symptoms of intractable epilepsy if no other satisfactory alternative treatment options exist for the patient and all of the following conditions apply:

   1.  The patient is a permanent resident of this state.
   2.  The neurologist or another neurologist has treated the patient for intractable epilepsy for at least six months.
   3.  The neurologist has tried alternative treatment options that have not alleviated the patient’s symptoms. 
   4.  The neurologist determines the risks of recommending the medical use of cannabidiol are reasonable in light of the potential benefit for the patient.
   5.  The neurologist maintains a patient treatment plan.
    Sec. 5.  NEW SECTION.  124D.4  Cannabidiol registration card.
   1.  Issuance to patient.  The department may approve the issuance of a cannabidiol registration card by the department of transportation to a patient who:
   a.  Is at least eighteen years of age.
   b.  Is a permanent resident of this state.
   c.  Provides the department with a written recommendation signed by a neurologist that the patient may benefit from the medical use of cannabidiol pursuant to section 124D.3.
   d.  Submits an application to the department, on a form created by the department, in consultation with the department of transportation, that contains all of the following:
   (1)  The patient’s full name, Iowa residence address, date of birth, and telephone number.
   (2)  A copy of the patient’s valid photo identification.
   (3)  Full name, address, and telephone number of the patient’s neurologist.
   (4)  Full name, residence address, date of birth, and telephone number of each primary caregiver of the patient, if any.
   (5)  Any other information required by rule.
   2.  Patient card contents.  A cannabidiol registration card issued to a patient by the department of transportation pursuant to subsection 1 shall contain, at a minimum, all of the following:
   a.  The patient’s full name, Iowa residence address, and date of birth.
   b.  The patient’s photo.
   c.  The date of issuance and expiration date of the registration card.
   d.  Any other information required by rule.
   3.  Issuance to primary caregiver.  For a patient in a primary caregiver’s care, the department may approve the issuance of a cannabidiol registration card by the department of transportation to the primary caregiver who:
   a.  Is at least eighteen years of age.
   b.  Provides the department with a written recommendation signed by a neurologist that a patient in the primary caregiver’s care may benefit from the medical use of cannabidiol pursuant to section 124D.3.
   c.  Submits an application to the department, on a form created by the department, in consultation with the department of transportation, that contains all of the following:
   (1)  The primary caregiver’s full name, residence address, date of birth, and telephone number.
   (2)  The patient’s full name.
   (3)  A copy of the primary caregiver’s valid photo identification.
   (4)  Full name, address, and telephone number of the patient’s neurologist.
   (5)  Any other information required by rule.
   4.  Primary caregiver card contents.  A cannabidiol registration card issued by the department of transportation to a primary caregiver pursuant to subsection 3 shall contain, at a minimum, all of the following:
   a.  The primary caregiver’s full name, residence address, and date of birth.
   b.  The primary caregiver’s photo.
   c.  The date of issuance and expiration date of the registration card.
   d.  The full name of each patient in the primary caregiver’s care.
   e.  Any other information required by rule.
   5.  Expiration date of card.  A cannabidiol registration card issued pursuant to this section shall expire one year after the date of issuance and may be renewed.
   6.  Card issuance —— department of transportation.  

The department may enter into a chapter 28E agreement with the department of transportation to facilitate the issuance of a cannabidiol registration card pursuant to subsections 1 and 3.
   7.  Validity of card issued in another jurisdiction.  A cannabidiol registration card, or its equivalent, that is issued under the laws of another state, district, territory, or possession of the United States that allows a patient to possess or use cannabidiol for only intractable epilepsy in the jurisdiction of issuance has the same force and effect when held by the patient while in this state as a cannabidiol registration card issued by the department of transportation in this state.
    Sec. 6.  NEW SECTION.  124D.5  Department duties —— rules.
   1.  a.  The department shall maintain a confidential file of the names of each patient to or for whom the department issues a cannabidiol registration card and the name of each primary caregiver to whom the department issues a cannabidiol registration card under section 124D.4.
   b.  Individual names contained in the file shall be confidential and shall not be subject to disclosure, except as provided in subparagraph (1).
   (1)  Information in the confidential file maintained pursuant to paragraph “a” may be released to the following persons under the following circumstances:
   (a)  To authorized employees or agents of the department and the department of transportation as necessary to perform the duties of the department and the department of transportation pursuant to this chapter.
   (b)  To authorized employees of state or local law enforcement agencies, but only for the purpose of verifying that a person is lawfully in possession of a cannabidiol registration card issued pursuant to this chapter. 
   (2)  Release of information pursuant to subparagraph (1) shall be consistent with the federal Health Insurance Portability and Accountability Act of 1996, Pub. L. No. 104-191.
   2.  a.  The department, in consultation with the department of transportation, shall adopt administrative rules under section 17A.4, subsection 3, and section 17A.5, subsection 2, paragraph “b”, to implement the provisions of this chapter, subject to the prior approval of the administrative rules coordinator and the administrative rules review committee. Such rules shall become effective July 1, 2014, unless the effective date is delayed by the administrative rules review committee and shall expire one hundred eighty days after the effective date.
   b.  The rules adopted pursuant to this subsection shall include but not be limited to rules to establish the manner in which the department shall consider applications for new and renewal cannabidiol registration cards.
    Sec. 7.  NEW SECTION.  124D.6  Medical use of cannabidiol —— affirmative defense.
   1.  a.  A recommendation for the possession or use of cannabidiol as authorized by this chapter shall be provided exclusively by a neurologist for a patient who has been diagnosed with intractable epilepsy. 
   b.  Cannabidiol provided exclusively pursuant to the recommendation of a neurologist shall be obtained from an out-of-state source and shall only be recommended for oral or transdermal administration.
   c.  A neurologist shall be the sole authorized recommender as part of the treatment plan by the neurologist of a patient diagnosed with intractable epilepsy. A neurologist shall have the sole authority to recommend the use or amount of cannabidiol, if any, in the treatment plan of a patient diagnosed with intractable epilepsy.
   2.  A neurologist, including any authorized agent thereof, shall not be subject to prosecution for the unlawful recommendation, possession, or administration of marijuana under the laws of this state for activities arising directly out of or directly related to the recommendation or use of cannabidiol in the treatment of a patient diagnosed with intractable epilepsy.
   3.  a.  In a prosecution for the unlawful possession of marijuana under the laws of this state, including but not limited to chapters 124 and 453B, it is an affirmative and complete defense to the prosecution that the patient has been diagnosed with intractable epilepsy, used or possessed cannabidiol pursuant to a recommendation by a neurologist as authorized under this chapter, and, for a patient eighteen years of age or older, is in possession of a valid cannabidiol registration card.
   b.  In a prosecution for the unlawful possession of marijuana under the laws of this state, including but not limited to chapters 124 and 453B, it is an affirmative and complete defense to the prosecution that the person possessed cannabidiol because the person is a primary caregiver of a patient who has been diagnosed with intractable epilepsy and is in possession of a valid cannabidiol registration card, and where the primary caregiver’s possession of the cannabidiol is on behalf of the patient and for the patient’s use only as authorized under this chapter.
   c.  If a patient or primary caregiver is charged with the commission of a crime and is not in possession of the person’s cannabidiol registration card, any charge or charges filed against the person shall be dismissed by the court if the person produces to the court at the person’s trial a cannabidiol registration card issued to that person and valid at the time the person was charged.
   4.  An agency of this state or a political subdivision thereof, including any law enforcement agency, shall not remove or initiate proceedings to remove a patient under the age of eighteen from the home of a parent based solely upon the parent’s or patient’s possession or use of cannabidiol as authorized under this chapter.
    Sec. 8.  NEW SECTION.  124D.7  Penalties.

   A person who knowingly or intentionally possesses or uses cannabidiol in violation of the requirements of this chapter is subject to the penalties provided under chapters 124 and 453B.
    Sec. 9.  NEW SECTION.  124D.8  Repeal.

   This chapter is repealed July 1, 2017.
    Sec. 10.  EFFECTIVE UPON ENACTMENT.  The provision of this Act enacting section 124D.5, subsection 2, being deemed of immediate importance, takes effect upon enactment.
EXPLANATION
The inclusion of this explanation does not constitute agreement with

the explanation’s substance by the members of the general assembly.
   This bill creates a medical cannabidiol Act and makes penalties applicable.
   The bill establishes new Code chapter 124D, the medical cannabidiol Act, to allow for the medical use of cannabidiol for alleviating symptoms caused by intractable epilepsy. The bill defines “cannabidiol” to mean a nonpsychoactive cannabinoid found in the plant Cannabis sativa L. or Cannabis indica or any other preparation thereof that is essentially free from plant material, and has a tetrahydrocannabinol level of no more than 3 percent, “intractable epilepsy” to mean an epileptic seizure disorder for which standard medical treatment does not prevent or significantly ameliorate recurring, uncontrolled seizures or for which standard medical treatment results in harmful side effects, “neurologist” to mean an allopathic or osteopathic physician board-certified in neurology in good standing and licensed in Iowa or an allopathic or osteopathic physician board-certified in neurology in good standing and licensed in any other state, and “primary caregiver” to mean a person, at least 18 years of age, who has been designated by a patient’s neurologist or a person having custody of a patient, as being necessary to take responsibility for managing the well-being of the patient with respect to the medical use of cannabidiol pursuant to the bill.
   MEDICAL USE OF CANNABIDIOL —— WRITTEN RECOMMENDATION. The bill provides that a neurologist who has examined and treated a patient suffering from intractable epilepsy may provide a written recommendation for the patient’s medical use of cannabidiol to treat or alleviate symptoms of intractable epilepsy if no other satisfactory alternative treatment options exist for the patient and if the patient is a permanent resident of this state, the neurologist or another neurologist has treated the patient for intractable epilepsy for at least six months, the neurologist has tried alternative treatment options that have not alleviated the patient’s symptoms, the neurologist determines the risks of recommending the medical use of cannabidiol are reasonable in light of the potential benefit for the patient, and the neurologist maintains a patient treatment plan.
   CANNABIDIOL REGISTRATION CARD. The bill provides that the department of public health may approve the issuance of a cannabidiol registration card by the department of transportation to a patient who is at least 18 years of age and is a permanent resident of this state, who provides the department with a written recommendation signed by a neurologist that the patient may benefit from the medical use of cannabidiol pursuant to the bill, and who submits an application to the department with certain information. The department may also approve the issuance of a cannabidiol registration card by the department of transportation to a primary caregiver who is at least 18 years of age, provides the department with a written recommendation signed by a neurologist that a patient in the primary caregiver’s care may benefit from the medical use of cannabidiol pursuant to the bill, and submits an application to the department with certain information.
   A cannabidiol registration card shall expire one year after the date of issuance and may be renewed. 
   RECIPROCITY. The bill provides that a cannabidiol registration card, or its equivalent, that is issued under the laws of another state, district, territory, or possession of the United States that allows a patient to possess or use cannabidiol for only intractable epilepsy in the jurisdiction of issuance has the same force and effect when held by the patient while in this state as a cannabidiol registration card issued by the department of transportation.
   CONFIDENTIALITY. The bill requires the department to maintain a confidential file of the names of each patient to or for whom the department issues a cannabidiol registration card and the name of each primary caregiver who is issued a cannabidiol registration card. Individual names contained in the file shall be confidential and shall not be subject to disclosure, except that information in the confidential file may be released to authorized employees or agents of the department and the department of transportation as necessary to perform the duties of the department or the department of transportation pursuant to the bill, to authorized employees of state or local law enforcement agencies for the purpose of verifying that a person is lawfully in possession of a cannabidiol registration card. Release of information must also be consistent with federal Health Insurance Portability and Accountability Act regulations.
   DEPARTMENT RULES. The bill provides that the department, in consultation with the department of transportation, shall adopt emergency rules to implement the provisions of the bill, subject to the prior approval of the administrative rules coordinator and the administrative rules review committee, to be effective July 1, 2014, unless otherwise provided, and shall expire six months after the effective date. The rules adopted shall include but not be limited to rules to establish the manner in which the department shall consider applications for new and renewal cannabidiol registration cards. This provision takes effect upon enactment.
   MEDICAL USE OF CANNABIDIOL —— AFFIRMATIVE DEFENSE. The bill provides that a recommendation for the possession or use of cannabidiol as authorized by the bill shall be provided exclusively by a neurologist for a patient who has been diagnosed with intractable epilepsy. Cannabidiol provided exclusively pursuant to a neurologist’s recommendation shall be obtained from an out-of-state source and shall only be recommended for oral or transdermal administration. A neurologist shall be the sole authorized recommender as part of the treatment plan by the neurologist of a patient diagnosed with intractable epilepsy. A neurologist has the sole authority to recommend the use or amount of cannabidiol, if any, in the patient’s treatment plan.
   The bill provides that a neurologist, including any authorized agent thereof, shall not be subject to prosecution for the unlawful recommendation, possession, or administration of marijuana under the laws of this state for activities arising directly out of or directly related to the recommendation or use of cannabidiol in the treatment of a patient diagnosed with intractable epilepsy. 
   In a prosecution for the unlawful possession of marijuana under the laws of this state, it is an affirmative and complete defense to the prosecution that the patient has been diagnosed with intractable epilepsy, used or possessed cannabidiol pursuant to a recommendation by a neurologist, and if the patient is 18 years of age or older, is in possession of a valid cannabidiol registration card. 
   In a prosecution for the unlawful possession of marijuana under the laws of this state, it is an affirmative and complete defense to the prosecution that the person possessed cannabidiol because the person is the primary caregiver of a patient who has been diagnosed with intractable epilepsy and who has a recommendation for the possession and use of cannabidiol as recommended by a neurologist and is in possession of a valid cannabidiol registration card and where the primary caregiver’s possession of the cannabidiol is on behalf of the patient and for the patient’s use only. 
   An agency of this state or a political subdivision thereof, including any law enforcement agency, shall not remove or initiate proceedings to remove a patient from the home of a parent based solely upon the parent’s or patient’s possession or use of cannabidiol.
   The bill amends Code section 124.401, relating to prohibited acts involving controlled substances, to provide that it is lawful for a person to knowingly or intentionally recommend, possess, use, distribute, dispense, deliver, transport, or administer marijuana if the recommendation, possession, use, distribution, dispensing, delivery, transporting, or administering is in accordance with the provisions of the bill.
   The bill provides that a person who knowingly or intentionally possesses or uses cannabidiol in violation of the bill is subject to the penalties of Code chapters 124 (controlled substances Act) and 453B (excise tax on unlawful dealing in certain substances).
   The new Code chapter created by the bill is repealed July 1, 2017.