House Study Bill 607 - Introduced HOUSE FILE _____ BY (PROPOSED COMMITTEE ON COMMERCE BILL BY CHAIRPERSON COWNIE) A BILL FOR An Act relating to the medical cannabidiol Act, making related 1 modifications, providing for civil and criminal penalties 2 and fees, and including effective date provisions. 3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 4 TLSB 6011YC (3) 86 rh/rj

H.F. _____ Section 1. Section 124.204, subsection 4, paragraphs m and 1 u, Code 2016, are amended by striking the paragraphs. 2 Sec. 2. Section 124.204, subsection 7, Code 2016, is amended 3 by striking the subsection. 4 Sec. 3. Section 124.206, subsection 7, Code 2016, is amended 5 to read as follows: 6 7. Hallucinogenic substances. Unless specifically excepted 7 or unless listed in another schedule, any material, compound, 8 mixture, or preparation which contains any quantity of the 9 following substances , or, for purposes of paragraphs “a” and 10 “b” , which contains any of its salts, isomers, or salts of 11 isomers whenever the existence of such salts, isomers, or salts 12 of isomers is possible within the specific chemical designation 13 (for purposes of this unnumbered paragraph only, the term 14 “isomers” includes the optical, positional, and geometric 15 isomers) : 16 a. Marijuana when used for medicinal purposes pursuant to 17 rules of the board . 18 b. Tetrahydrocannabinols, meaning tetrahydrocannabinols 19 naturally contained in a plant of the genus Cannabis (Cannabis 20 plant) as well as synthetic equivalents of the substances 21 contained in the Cannabis plant, or in the resinous extractives 22 of such plant, and synthetic substances, derivatives, and their 23 isomers with similar chemical structure and pharmacological 24 activity to those substances contained in the plant, such as 25 the following: 26 (1) 1 cis or trans tetrahydrocannabinol, and their optical 27 isomers. 28 (2) 6 cis or trans tetrahydrocannabinol, and their optical 29 isomers. 30 (3) 3,4 cis or trans tetrahydrocannabinol, and their 31 optical isomers. (Since nomenclature of these substances 32 is not internationally standardized, compounds of these 33 structures, regardless of numerical designation of atomic 34 positions covered.) 35 -1- LSB 6011YC (3) 86 rh/rj 1/ 25

H.F. _____ b. c. Nabilone [another name for 1 nabilone: (+-) - 2 trans-3-(1,1-dimethylheptyl)-6,6a,7,8,10,10a-hexahydro-1- 3 hydroxy-6,6-dimethyl-9H-dibenzo[b,d]pyran-9-one]. 4 Sec. 4. Section 124.401, subsection 5, unnumbered paragraph 5 3, Code 2016, is amended to read as follows: 6 A person may knowingly or intentionally recommend, possess, 7 use, dispense, deliver, transport, or administer medical 8 cannabidiol if the recommendation, possession, use, dispensing, 9 delivery, transporting, or administering is in accordance with 10 the provisions of chapter 124D 124E . For purposes of this 11 paragraph, “cannabidiol” “medical cannabidiol” means the same as 12 defined in section 124D.2 124E.2 . 13 Sec. 5. NEW SECTION . 124E.1 Short title. 14 This chapter shall be known and may be cited as the “Medical 15 Cannabidiol Act” . 16 Sec. 6. NEW SECTION . 124E.2 Definitions. 17 As used in this chapter: 18 1. “Debilitating medical condition” means any of the 19 following: 20 a. Cancer, if the underlying condition or treatment produces 21 one or more of the following: 22 (1) Intractable pain. 23 (2) Nausea or severe vomiting. 24 (3) Cachexia or severe wasting. 25 b. Multiple sclerosis. 26 c. Epilepsy or seizure disorders. 27 d. AIDS or HIV as defined in section 141A.1. 28 e. Hepatitis C. 29 f. Crohn’s disease or ulcerative colitis. 30 g. Amyotrophic lateral sclerosis. 31 h. Ehlers-danlos syndrome. 32 i. Post-traumatic stress disorder. 33 j. Any terminal illness, with a probable life expectancy of 34 under one year, if the illness or its treatment produces one or 35 -2- LSB 6011YC (3) 86 rh/rj 2/ 25

H.F. _____ more of the following: 1 (1) Intractable pain. 2 (2) Nausea or severe vomiting. 3 (3) Cachexia or severe wasting. 4 k. Any intractable pain. 5 l. Any other chronic or debilitating disease or medical 6 condition or its medical treatment approved by the department 7 pursuant to rule. 8 2. “Department” means the department of public health. 9 3. “Disqualifying felony offense” means a violation under 10 federal or state law of a felony under federal or state law, 11 which has as an element the possession, use, or distribution of 12 a controlled substance, as defined in 21 U.S.C. §802(6). 13 4. “Enclosed, locked facility” means a closet, room, 14 greenhouse, or other enclosed area equipped with locks or other 15 security devices that permit access only by a cardholder. 16 5. “Health care practitioner” means an individual licensed 17 under chapter 148 to practice medicine and surgery or 18 osteopathic medicine and surgery or an out-of-state licensed 19 physician who provides specialty care for a resident of this 20 state for one or more debilitating medical conditions. 21 6. “Intractable pain” means a pain the cause of which 22 cannot be removed or otherwise treated with the consent of the 23 patient and of or for which, in the generally accepted course 24 of medical practice, no relief or cure is possible or no relief 25 or cure has been found after reasonable efforts. Reasonable 26 efforts for relieving the pain or curing the cause of the pain 27 may be determined on the basis of, but are not limited to, any 28 of the following: 29 a. When treating a non-terminally ill patient for 30 intractable pain, evaluation by the attending physician and 31 one or more physicians specializing in pain medicine or in the 32 treatment of the area, system, or organ of the body perceived 33 as the source of the pain. 34 b. When treating a terminally ill patient, evaluation by 35 -3- LSB 6011YC (3) 86 rh/rj 3/ 25

H.F. _____ the attending physician who treats the patient in accordance 1 with the level of care, skill, and treatment that would be 2 recognized by a reasonably prudent physician under similar 3 conditions and circumstances. 4 7. “Medical cannabidiol” means a nonpsychoactive cannabinoid 5 found in the plant Cannabis sativa L. or Cannabis indica or any 6 other preparation thereof that is essentially free from plant 7 material, and has a tetrahydrocannabinol level of no more than 8 three percent. 9 8. “Medical cannabidiol dispensary” means an entity licensed 10 under section 124E.8 that acquires medical cannabidiol from a 11 medical cannabidiol manufacturer in this state for the purpose 12 of dispensing medical cannabidiol in this state pursuant to 13 this chapter. 14 9. “Medical cannabidiol manufacturer” means an entity 15 licensed by the department to manufacture and to possess, 16 cultivate, transport, or supply medical cannabidiol pursuant to 17 the provisions of this chapter. 18 10. “Primary caregiver” means a person, at least eighteen 19 years of age, who has legal custody of the patient and who has 20 been designated by a patient’s health care practitioner as a 21 necessary caretaker taking responsibility for managing the 22 well-being of the patient with respect to the use of medical 23 cannabidiol pursuant to the provisions of this chapter. 24 11. “Written certification” means a document signed by a 25 health care practitioner, with whom the patient has established 26 a patient-provider relationship, which states that the patient 27 has a debilitating medical condition and identifies that 28 condition and provides any other relevant information. 29 Sec. 7. NEW SECTION . 124E.3 Health care practitioner 30 certification —— duties. 31 1. Prior to a patient’s submission of an application for a 32 medical cannabidiol card pursuant to section 124E.4, a health 33 care practitioner shall do all of the following: 34 a. Determine, in the health care practitioner’s medical 35 -4- LSB 6011YC (3) 86 rh/rj 4/ 25

H.F. _____ judgment, whether the patient whom the health care practitioner 1 has examined and treated suffers from a debilitating medical 2 condition that qualifies for the use of medical cannabidiol 3 under this chapter, and if so determined, provide the patient 4 with a written certification of that diagnosis. 5 b. Provide explanatory information as provided by the 6 department to the patient about the therapeutic use of medical 7 cannabidiol. 8 2. Subsequently, the health care practitioner shall do the 9 following: 10 a. Determine, on an annual basis, if the patient continues 11 to suffer from a debilitating medical condition and, if so, 12 issue the patient a new certification of that diagnosis. 13 b. Otherwise comply with all requirements established by the 14 department pursuant to rule. 15 3. A health care practitioner may provide, but has no duty 16 to provide, a written certification pursuant to this section. 17 Sec. 8. NEW SECTION . 124E.4 Medical cannabidiol 18 registration card. 19 1. Issuance to patient. The department may approve the 20 issuance of a medical cannabidiol registration card by the 21 department of transportation to a patient who: 22 a. Is at least eighteen years of age. 23 b. Is a permanent resident of this state. 24 c. Submits a written certification to the department signed 25 by the patient’s health care practitioner that the patient is 26 suffering from a debilitating medical condition. 27 d. Submits an application to the department, on a form 28 created by the department, in consultation with the department 29 of transportation, that contains all of the following: 30 (1) The patient’s full name, Iowa residence address, date 31 of birth, and telephone number. 32 (2) A copy of the patient’s valid photograph 33 identification. 34 (3) Full name, address, and telephone number of the 35 -5- LSB 6011YC (3) 86 rh/rj 5/ 25

H.F. _____ patient’s health care practitioner. 1 (4) Full name, residence address, date of birth, and 2 telephone number of each primary caregiver of the patient, if 3 any. 4 (5) Any other information required by rule. 5 e. Submits a medical cannabidiol registration card fee of 6 one hundred dollars to the department. If the patient attests 7 to receiving social security disability benefits, supplemental 8 security insurance payments, or being enrolled in the medical 9 assistance program, the fee shall be twenty-five dollars. 10 2. Patient card contents. A medical cannabidiol 11 registration card issued to a patient by the department of 12 transportation pursuant to subsection 1 shall contain, at a 13 minimum, all of the following: 14 a. The patient’s full name, Iowa residence address, and date 15 of birth. 16 b. The patient’s photograph. 17 c. The date of issuance and expiration date of the 18 registration card. 19 d. Any other information required by rule. 20 3. Issuance to primary caregiver. For a patient in a 21 primary caregiver’s care, the department may approve the 22 issuance of a medical cannabidiol registration card by the 23 department of transportation to the primary caregiver who: 24 a. Is at least eighteen years of age. 25 b. Submits a written certification to the department signed 26 by the patient’s health care practitioner that the patient in 27 the primary caregiver’s care is suffering from a debilitating 28 medical condition. 29 c. Submits an application to the department, on a form 30 created by the department, in consultation with the department 31 of transportation, that contains all of the following: 32 (1) The primary caregiver’s full name, residence address, 33 date of birth, and telephone number. 34 (2) The patient’s full name. 35 -6- LSB 6011YC (3) 86 rh/rj 6/ 25

H.F. _____ (3) A copy of the primary caregiver’s valid photograph 1 identification. 2 (4) Full name, address, and telephone number of the 3 patient’s health care practitioner. 4 (5) Any other information required by rule. 5 d. Submits a medical cannabidiol registration card fee of 6 twenty-five dollars to the department. 7 4. Primary caregiver card contents. A medical cannabidiol 8 registration card issued by the department of transportation to 9 a primary caregiver pursuant to subsection 3 shall contain, at 10 a minimum, all of the following: 11 a. The primary caregiver’s full name, residence address, and 12 date of birth. 13 b. The primary caregiver’s photograph. 14 c. The date of issuance and expiration date of the 15 registration card. 16 d. The registration card number of each patient in the 17 primary caregiver’s care. If the patient in the primary 18 caregiver’s care is under the age of eighteen, the full name of 19 the patient’s parent or legal guardian. 20 e. Any other information required by rule. 21 5. Expiration date of card. A medical cannabidiol 22 registration card issued pursuant to this section shall expire 23 one year after the date of issuance and may be renewed. 24 6. Card issuance —— department of transportation. The 25 department may enter into a chapter 28E agreement with the 26 department of transportation to facilitate the issuance of 27 medical cannabidiol registration cards pursuant to subsections 28 1 and 3. 29 Sec. 9. NEW SECTION . 124E.5 Medical advisory board —— 30 duties. 31 1. No later than August 15, 2016, the director of public 32 health shall establish a medical advisory board consisting of 33 nine practitioners representing the fields of neurology, pain 34 management, gastroenterology, oncology, psychiatry, pediatrics, 35 -7- LSB 6011YC (3) 86 rh/rj 7/ 25

H.F. _____ infectious disease, family medicine, and pharmacy, and three 1 patients with valid medical cannabidiol registration cards. 2 The practitioners shall be nationally board-certified in their 3 area of specialty and knowledgeable about the use of medical 4 cannabidiol. 5 2. A quorum of the advisory board shall consist of seven 6 members. 7 3. The duties of the advisory board shall include but not be 8 limited to the following: 9 a. Reviewing and recommending to the department for 10 approval additional chronic or debilitating diseases or 11 medical conditions or their treatments as debilitating medical 12 conditions that qualify for the use of medical cannabidiol 13 under this chapter. 14 b. Accepting and reviewing petitions to add chronic or 15 debilitating diseases or medical conditions or their medical 16 treatments to the list of debilitating medical conditions that 17 qualify for the use of medical cannabidiol under this chapter. 18 c. Advising the department regarding the location of medical 19 cannabidiol dispensaries throughout the state, the form and 20 quantity of allowable medical cannabidiol to be dispensed to 21 a patient or primary caregiver, and the general oversight of 22 medical cannabidiol manufacturers and medical cannabidiol 23 dispensaries in this state. 24 d. Convening at least twice per year to conduct public 25 hearings and to evaluate petitions, which shall be maintained 26 as confidential personal health information, to add chronic or 27 debilitating diseases or medical conditions or their medical 28 treatments to the list of debilitating medical conditions that 29 qualify for the use of medical cannabidiol under this chapter. 30 Sec. 10. NEW SECTION . 124E.6 Medical cannabidiol 31 manufacturer licensure. 32 1. a. The department shall license four medical cannabidiol 33 manufacturers by December 1, 2016, to manufacture medical 34 cannabidiol within this state consistent with the provisions 35 -8- LSB 6011YC (3) 86 rh/rj 8/ 25

H.F. _____ of this chapter. The department shall license new medical 1 cannabidiol manufacturers or relicense the existing medical 2 cannabidiol manufacturers by December 1 of each year. 3 b. Information submitted during the application process 4 shall be confidential until the medical cannabidiol 5 manufacturer is licensed by the department unless otherwise 6 protected from disclosure under state or federal law. 7 2. As a condition for licensure, a medical cannabidiol 8 manufacturer must agree to begin supplying medical cannabidiol 9 to medical cannabidiol dispensaries in this state by July 1, 10 2017. 11 3. The department shall consider the following factors 12 in determining whether to license a medical cannabidiol 13 manufacturer: 14 a. The technical expertise of the medical cannabidiol 15 manufacturer in medical cannabidiol. 16 b. The qualifications of the medical cannabidiol 17 manufacturer’s employees. 18 c. The long-term financial stability of the medical 19 cannabidiol manufacturer. 20 d. The ability to provide appropriate security measures on 21 the premises of the medical cannabidiol manufacturer. 22 e. Whether the medical cannabidiol manufacturer has 23 demonstrated an ability to meet certain medical cannabidiol 24 production needs for medical use regarding the range of 25 recommended dosages for each debilitating medical condition, 26 the range of chemical compositions of any plant of the genus 27 Cannabis that will likely be medically beneficial for each 28 of the debilitating medical conditions, and the form of the 29 medical cannabidiol in the manner determined by the department 30 pursuant to rule. 31 f. The medical cannabidiol manufacturer’s projection of 32 and ongoing assessment of fees on patients with debilitating 33 medical conditions. 34 4. The department shall require each medical cannabidiol 35 -9- LSB 6011YC (3) 86 rh/rj 9/ 25

H.F. _____ manufacturer to contract with the state hygienic laboratory 1 at the university of Iowa in Iowa City to test the medical 2 cannabidiol produced by the manufacturer as to content, 3 contamination, and consistency. The department shall require 4 that the laboratory report testing results to the manufacturer 5 in a manner determined by the department pursuant to rule. 6 5. Each entity submitting an application for licensure as 7 a medical cannabidiol manufacturer shall pay a nonrefundable 8 application fee of ten thousand dollars to the department. 9 Sec. 11. NEW SECTION . 124E.7 Medical cannabidiol 10 manufacturers. 11 1. A medical cannabidiol manufacturer shall pay the cost of 12 all laboratory testing. 13 2. The operating documents of a medical cannabidiol 14 manufacturer shall include all of the following: 15 a. Procedures for the oversight of the medical cannabidiol 16 manufacturer and procedures to ensure accurate record keeping. 17 b. Procedures for the implementation of appropriate security 18 measures to deter and prevent the theft of medical cannabidiol 19 and unauthorized entrance into areas containing medical 20 cannabidiol. 21 3. A medical cannabidiol manufacturer shall implement 22 security requirements, including requirements for protection 23 of each location by a fully operational security alarm system, 24 facility access controls, perimeter intrusion detection 25 systems, and a personnel identification system. 26 4. A medical cannabidiol manufacturer shall not share 27 office space with, refer patients to, or have any financial 28 relationship with a health care practitioner. 29 5. A medical cannabidiol manufacturer shall not permit any 30 person to consume medical cannabidiol on the property of the 31 medical cannabidiol manufacturer. 32 6. A medical cannabidiol manufacturer is subject to 33 reasonable inspection by the department. 34 7. A medical cannabidiol manufacturer shall not employ 35 -10- LSB 6011YC (3) 86 rh/rj 10/ 25

H.F. _____ a person who is under eighteen years of age or who has been 1 convicted of a disqualifying felony offense. An employee 2 of a medical cannabidiol manufacturer shall be subject to a 3 background investigation conducted by the division of criminal 4 investigation of the department of public safety and a national 5 criminal history background check. 6 8. A medical cannabidiol manufacturer shall not operate 7 in any location, whether for manufacturing, cultivating, 8 harvesting, packaging, or processing, within one thousand feet 9 of a public or private school existing before the date of the 10 medical cannabidiol manufacturer’s licensure by the department. 11 9. A medical cannabidiol manufacturer shall comply with 12 reasonable restrictions set by the department relating to 13 signage, marketing, display, and advertising of medical 14 cannabidiol. 15 10. a. A medical cannabidiol manufacturer shall provide a 16 reliable and ongoing supply of medical cannabidiol to medical 17 cannabidiol dispensaries pursuant to this chapter. 18 b. All manufacturing, cultivating, harvesting, packaging, 19 and processing of medical cannabidiol shall take place in an 20 enclosed, locked facility at a physical address provided to the 21 department during the licensure process. 22 c. A medical cannabidiol manufacturer shall not manufacture 23 edible medical cannabidiol products utilizing food coloring. 24 d. A medical cannabidiol manufacturer shall manufacture a 25 reliable and ongoing supply of medical cannabidiol to treat 26 every debilitating medical condition listed in this chapter. 27 11. A medical cannabidiol manufacturer shall pay an 28 annual fee determined by the department equal to the cost of 29 regulating and inspecting the manufacturer during that year. 30 Sec. 12. NEW SECTION . 124E.8 Medical cannabidiol dispensary 31 licensure. 32 1. a. The department shall license by April 1, 2017, 33 twelve medical cannabidiol dispensaries to dispense medical 34 cannabidiol within this state consistent with the provisions 35 -11- LSB 6011YC (3) 86 rh/rj 11/ 25

H.F. _____ of this chapter. The department shall license new medical 1 cannabidiol dispensaries or relicense the existing medical 2 cannabidiol manufacturers by December 1 of each year. 3 b. Information submitted during the application process 4 shall be confidential until the medical cannabidiol dispensary 5 is licensed by the department unless otherwise protected from 6 disclosure under state or federal law. 7 2. As a condition for licensure, a medical cannabidiol 8 dispensary must agree to begin supplying medical cannabidiol to 9 patients by July 1, 2017. 10 3. The department shall consider the following factors 11 in determining whether to license a medical cannabidiol 12 dispensary: 13 a. The technical expertise of the medical cannabidiol 14 dispensary regarding medical cannabidiol. 15 b. The qualifications of the medical cannabidiol 16 dispensary’s employees. 17 c. The long-term financial stability of the medical 18 cannabidiol dispensary. 19 d. The ability to provide appropriate security measures on 20 the premises of the medical cannabidiol dispensary. 21 e. The medical cannabidiol dispensary’s projection and 22 ongoing assessment of fees for the purchase of medical 23 cannabidiol on patients with debilitating medical conditions. 24 4. Each entity submitting an application for licensure as 25 a medical cannabidiol dispensary shall pay a nonrefundable 26 application fee of ten thousand dollars to the department. 27 5. A medical cannabidiol dispensary shall pay an annual fee 28 determined by the department equal to the cost of regulating 29 and inspecting the manufacturer during that year. 30 Sec. 13. NEW SECTION . 124E.9 Medical cannabidiol 31 dispensaries. 32 1. a. The medical cannabidiol dispensaries shall be located 33 based on geographical need throughout the state to improve 34 patient access. 35 -12- LSB 6011YC (3) 86 rh/rj 12/ 25

H.F. _____ b. A medical cannabidiol dispensary may dispense medical 1 cannabidiol pursuant to the provisions of this chapter but 2 shall not dispense any medical cannabidiol in a form or 3 quantity other than the form or quantity allowed by the 4 department pursuant to rule. 5 2. The operating documents of a medical cannabidiol 6 dispensary shall include all of the following: 7 a. Procedures for the oversight of the medical cannabidiol 8 dispensary and procedures to ensure accurate record keeping. 9 b. Procedures for the implementation of appropriate security 10 measures to deter and prevent the theft of medical cannabidiol 11 and unauthorized entrance into areas containing medical 12 cannabidiol. 13 3. A medical cannabidiol dispensary shall implement 14 security requirements, including requirements for protection 15 by a fully operational security alarm system, facility 16 access controls, perimeter intrusion detection systems, and a 17 personnel identification system. 18 4. A medical cannabidiol dispensary shall not share 19 office space with, refer patients to, or have any financial 20 relationship with a health care practitioner. 21 5. A medical cannabidiol dispensary shall not permit any 22 person to consume medical cannabidiol on the property of the 23 medical cannabidiol dispensary. 24 6. A medical cannabidiol dispensary is subject to 25 reasonable inspection by the department. 26 7. A medical cannabidiol dispensary shall not employ a 27 person who is under eighteen years of age or who has been 28 convicted of a disqualifying felony offense. An employee 29 of a medical cannabidiol dispensary shall be subject to a 30 background investigation conducted by the division of criminal 31 investigation of the department of public safety and a national 32 criminal history background check. 33 8. A medical cannabidiol dispensary shall not operate in 34 any location within one thousand feet of a public or private 35 -13- LSB 6011YC (3) 86 rh/rj 13/ 25

H.F. _____ school existing before the date of the medical cannabidiol 1 dispensary’s licensure by the department. 2 9. A medical cannabidiol dispensary shall comply with 3 reasonable restrictions set by the department relating to 4 signage, marketing, display, and advertising of medical 5 cannabidiol. 6 10. Prior to dispensing of any medical cannabidiol, a 7 medical cannabidiol dispensary shall do all of the following: 8 a. Verify that the medical cannabidiol dispensary has 9 received a valid medical cannabidiol registration card from a 10 patient or a patient’s primary caregiver, if applicable. 11 b. Assign a tracking number to any medical cannabidiol 12 dispensed from the medical cannabidiol dispensary. 13 c. (1) Properly package medical cannabidiol in compliance 14 with federal law regarding child resistant packaging and 15 exemptions for packaging for elderly patients, and label 16 medical cannabidiol with a list of all active ingredients and 17 individually identifying information, including all of the 18 following: 19 (a) The name and date of birth of the patient and the 20 patient’s primary caregiver, if appropriate. 21 (b) The medical cannabidiol registration card numbers 22 of the patient and of the patient’s primary caregiver, if 23 applicable. 24 (c) The chemical composition of the medical cannabidiol. 25 (2) Proper packaging of medical cannabidiol shall include 26 but not be limited to all of the following: 27 (a) Warning labels regarding the use of medical cannabidiol 28 by a woman during pregnancy and while breastfeeding. 29 (b) Clearly labeled packaging indicating that an edible 30 medical cannabidiol product contains medical cannabidiol, which 31 packaging shall not imitate candy products or in any way make 32 the product marketable to children. 33 11. A medical cannabidiol dispensary shall employ a 34 pharmacist licensed pursuant to chapter 155A. 35 -14- LSB 6011YC (3) 86 rh/rj 14/ 25

H.F. _____ Sec. 14. NEW SECTION . 124E.10 Fees. 1 Medical cannabidiol registration card fees and medical 2 cannabidiol manufacturer and medical cannabidiol dispensary 3 application and annual fees collected by the department 4 pursuant to this chapter shall be retained by the department, 5 shall be considered repayment receipts as defined in section 6 8.2, and shall be used for the purpose of regulating medical 7 cannabidiol manufacturers and medical cannabidiol dispensaries 8 and for other expenses necessary for the administration of this 9 chapter. 10 Sec. 15. NEW SECTION . 124E.11 Department duties —— rules. 11 1. a. The department shall maintain a confidential file 12 of the names of each patient to or for whom the department 13 issues a medical cannabidiol registration card and the name of 14 each primary caregiver to whom the department issues a medical 15 cannabidiol registration card under section 124E.4. 16 b. Individual names contained in the file shall be 17 confidential and shall not be subject to disclosure, except as 18 provided in subparagraph (1). 19 (1) Information in the confidential file maintained 20 pursuant to paragraph “a” may be released on an individual basis 21 to the following persons under the following circumstances: 22 (a) To authorized employees or agents of the department and 23 the department of transportation as necessary to perform the 24 duties of the department and the department of transportation 25 pursuant to this chapter. 26 (b) To authorized employees of state or local law 27 enforcement agencies, but only for the purpose of verifying 28 that a person is lawfully in possession of a medical 29 cannabidiol registration card issued pursuant to this chapter. 30 (c) To authorized employees of a medical cannabidiol 31 dispensary, but only for the purpose of verifying that a person 32 is lawfully in possession of a medical cannabidiol registration 33 card issued pursuant to this chapter. 34 (2) Release of information pursuant to subparagraph 35 -15- LSB 6011YC (3) 86 rh/rj 15/ 25

H.F. _____ (1) shall be consistent with the federal Health Insurance 1 Portability and Accountability Act of 1996, Pub. L. No. 2 104-191. 3 2. The department shall adopt rules pursuant to chapter 4 17A to administer this chapter which shall include but not be 5 limited to rules to do all of the following: 6 a. Govern the manner in which the department shall 7 consider applications for new and renewal medical cannabidiol 8 registration cards. 9 b. Identify criteria and set forth procedures for 10 including additional chronic or debilitating diseases or 11 medical conditions or their medical treatments on the list 12 of debilitating medical conditions that qualify for the use 13 of medical cannabidiol. Procedures shall include a petition 14 process and shall allow for public comment and public hearings 15 before the medical advisory board. 16 c. Set forth additional chronic or debilitating diseases or 17 medical conditions or their medical treatments for inclusion on 18 the list of debilitating medical conditions that qualify for 19 the use of medical cannabidiol as recommended by the medical 20 advisory board. 21 d. Establish the form and quantity of medical cannabidiol 22 allowed to be dispensed to a patient or primary caregiver 23 pursuant to this chapter. The form and quantity of medical 24 cannabidiol shall be appropriate to serve the medical needs of 25 patients with debilitating medical conditions. 26 e. Establish requirements for the licensure of medical 27 cannabidiol manufacturers and medical cannabidiol dispensaries 28 and set forth procedures for medical cannabidiol manufacturers 29 and medical cannabidiol dispensaries to obtain licenses. 30 f. Develop a dispensing system for medical cannabidiol 31 within this state that provides for all of the following: 32 (1) Medical cannabidiol dispensaries within this state 33 housed on secured grounds and operated by medical cannabidiol 34 dispensaries. 35 -16- LSB 6011YC (3) 86 rh/rj 16/ 25

H.F. _____ (2) The dispensing of medical cannabidiol to patients and 1 their primary caregivers to occur at locations designated by 2 the department. 3 g. Establish and collect annual fees from medical 4 cannabidiol manufacturers and medical cannabidiol dispensaries 5 to cover the costs associated with regulating and inspecting 6 medical cannabidiol manufacturers and medical cannabidiol 7 dispensaries. 8 h. Specify and implement procedures that address public 9 safety including security procedures and product quality 10 including measures to ensure contaminant-free cultivation of 11 medical cannabidiol, safety, and appropriate labeling. 12 i. Establish and implement a real-time, statewide 13 medical cannabidiol registry management sale tracking system 14 that is available to medical cannabidiol dispensaries on a 15 twenty-four-hour-day, seven-day-a-week basis for the purpose of 16 verifying that a person is lawfully in possession of a medical 17 cannabidiol registration card issued pursuant to this chapter 18 and for tracking the date of the sale and quantity of medical 19 cannabidiol purchased by a patient or a primary caregiver. 20 j. Establish and implement a medical cannabidiol inventory 21 and delivery tracking system to track medical cannabidiol 22 from production by a medical cannabidiol manufacturer through 23 dispensing at a medical cannabidiol dispensary. 24 Sec. 16. NEW SECTION . 124E.12 Reciprocity. 25 A valid medical cannabidiol registration card, or its 26 equivalent, issued under the laws of another state that allows 27 an out-of-state patient to possess or use medical cannabidiol 28 in the jurisdiction of issuance shall have the same force and 29 effect as a valid medical cannabidiol registration card issued 30 pursuant to this chapter, except that an out-of-state patient 31 in this state shall not obtain medical cannabidiol from a 32 medical cannabidiol dispensary in this state. 33 Sec. 17. NEW SECTION . 124E.13 Use of medical cannabidiol —— 34 smoking prohibited. 35 -17- LSB 6011YC (3) 86 rh/rj 17/ 25

H.F. _____ A patient, including an out-of-state patient who is in Iowa, 1 shall not consume medical cannabidiol possessed or used as 2 authorized by this chapter by smoking medical cannabidiol. 3 Sec. 18. NEW SECTION . 124E.14 Use of medical cannabidiol 4 —— affirmative defenses. 5 1. A health care practitioner, including any authorized 6 agent or employee thereof, shall not be subject to 7 prosecution for the unlawful certification, possession, or 8 administration of marijuana under the laws of this state for 9 activities arising directly out of or directly related to the 10 certification or use of medical cannabidiol in the treatment 11 of a patient diagnosed with a debilitating medical condition 12 as authorized by this chapter. 13 2. A medical cannabidiol manufacturer, including any 14 authorized agent or employee thereof, shall not be subject 15 to prosecution for manufacturing, possessing, cultivating, 16 harvesting, packaging, processing, transporting, or supplying 17 medical cannabidiol pursuant to this chapter. 18 3. A medical cannabidiol dispensary, including any 19 authorized agent or employee thereof, shall not be subject to 20 prosecution for transporting, supplying, or dispensing medical 21 cannabidiol pursuant to this chapter. 22 4. a. In a prosecution for the unlawful possession of 23 marijuana under the laws of this state, including but not 24 limited to chapters 124 and 453B, it is an affirmative and 25 complete defense to the prosecution that the patient has been 26 diagnosed with a debilitating medical condition, used or 27 possessed medical cannabidiol pursuant to a certification by a 28 health care practitioner as authorized under this chapter, and, 29 for a patient eighteen years of age or older, is in possession 30 of a valid medical cannabidiol registration card. 31 b. In a prosecution for the unlawful possession of marijuana 32 under the laws of this state, including but not limited to 33 chapters 124 and 453B, it is an affirmative and complete 34 defense to the prosecution that the person possessed medical 35 -18- LSB 6011YC (3) 86 rh/rj 18/ 25

H.F. _____ cannabidiol because the person is a primary caregiver of a 1 patient who has been diagnosed with a debilitating medical 2 condition and is in possession of a valid medical cannabidiol 3 registration card, and where the primary caregiver’s possession 4 of the medical cannabidiol is on behalf of the patient and for 5 the patient’s use only as authorized under this chapter. 6 c. If a patient or primary caregiver is charged with the 7 commission of a crime and is not in possession of the person’s 8 medical cannabidiol registration card, any charge or charges 9 filed against the person shall be dismissed by the court if the 10 person produces to the court prior to or at the person’s trial 11 a medical cannabidiol registration card issued to that person 12 and valid at the time the person was charged. 13 5. An agency of this state or a political subdivision 14 thereof, including any law enforcement agency, shall not remove 15 or initiate proceedings to remove a patient under the age 16 of eighteen from the home of a parent based solely upon the 17 parent’s or patient’s possession or use of medical cannabidiol 18 as authorized under this chapter. 19 Sec. 19. NEW SECTION . 124E.15 Penalties. 20 1. A person who knowingly or intentionally possesses or uses 21 medical cannabidiol in violation of the requirements of this 22 chapter is subject to the penalties provided under chapters 124 23 and 453B. 24 2. A medical cannabidiol manufacturer or a medical 25 cannabidiol dispensary shall be assessed a civil penalty of up 26 to one thousand dollars per violation for any violation of this 27 chapter in addition to any other applicable penalties. 28 Sec. 20. TRANSITION PROVISIONS. A medical cannabidiol 29 registration card issued under chapter 124D prior to July 1, 30 2016, remains effective and continues in effect as issued for 31 the twelve-month period following its issuance. This Act does 32 not preclude the permit holder from seeking to renew the permit 33 under this Act prior to the expiration of the twelve-month 34 period. 35 -19- LSB 6011YC (3) 86 rh/rj 19/ 25

H.F. _____ Sec. 21. REPEAL. Chapter 124D, Code 2016, is repealed. 1 Sec. 22. EFFECTIVE UPON ENACTMENT. This Act, being deemed 2 of immediate importance, takes effect upon enactment. 3 EXPLANATION 4 The inclusion of this explanation does not constitute agreement with 5 the explanation’s substance by the members of the general assembly. 6 This bill creates the medical cannabidiol Act and provides 7 for civil and criminal penalties and fees. 8 RECLASSIFICATION —— MARIJUANA. The bill reclassifies 9 marijuana, including tetrahydrocannabinols, as a schedule 10 II controlled substance instead of a schedule I controlled 11 substance and strikes references to the authority of the 12 board of pharmacy to adopt rules for the use of marijuana or 13 tetrahydrocannabinols for medicinal purposes. 14 MEDICAL CANNABIDIOL ACT OVERVIEW. The bill provides 15 that a patient with a debilitating medical condition, who 16 receives written certification from the patient’s health care 17 practitioner that the patient has a debilitating medical 18 condition and who submits the written certification along with 19 an application to the department of public health (department) 20 for a medical cannabidiol registration card, may lawfully use 21 medical cannabidiol to treat the patient’s debilitating medical 22 condition. A patient who is issued a medical cannabidiol 23 registration card will be able to receive medical cannabidiol 24 directly from a licensed medical cannabidiol dispensary in this 25 state. The bill defines “debilitating medical conditions”, 26 “health care practitioner”, “medical cannabidiol”, and other 27 terms. 28 HEALTH CARE PRACTITIONER CERTIFICATION. The bill provides 29 that prior to a patient’s submission of an application for 30 a medical cannabidiol registration card, if a health care 31 practitioner determines that the patient whom the health 32 care practitioner has examined and treated suffers from a 33 debilitating medical condition, the health care practitioner 34 may provide the patient with a written certification of that 35 -20- LSB 6011YC (3) 86 rh/rj 20/ 25