Senate File 484 - Introduced SENATE FILE 484 BY COMMITTEE ON WAYS AND MEANS (SUCCESSOR TO SSB 1243) A BILL FOR An Act creating the medical cannabis Act and providing for 1 civil and criminal penalties and fees. 2 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 3 TLSB 2576SV (4) 86 rh/rj

S.F. 484 Section 1. Section 124.401, subsection 5, unnumbered 1 paragraph 3, Code 2015, is amended to read as follows: 2 A person may knowingly or intentionally recommend, possess, 3 use, dispense, deliver, transport, or administer cannabidiol 4 medical cannabis if the recommendation, possession, use, 5 dispensing, delivery, transporting, or administering is in 6 accordance with the provisions of chapter 124D 124E . For 7 purposes of this paragraph, “cannabidiol” “medical cannabis” 8 means the same as defined in section 124D.2 124E.2 . 9 Sec. 2. NEW SECTION . 124E.1 Short title. 10 This chapter shall be known and may be cited as the “Medical 11 Cannabis Act” . 12 Sec. 3. NEW SECTION . 124E.2 Definitions. 13 As used in this chapter: 14 1. “Debilitating medical condition” means any of the 15 following: 16 a. Cancer. 17 b. Multiple sclerosis. 18 c. Epilepsy. 19 d. AIDS or HIV as defined in section 141A.1. 20 e. Glaucoma. 21 f. Hepatitis C. 22 g. Crohn’s disease or ulcerative colitis. 23 h. Amyotrophic lateral sclerosis. 24 i. Ehlers-danlos syndrome. 25 j. Post-traumatic stress disorder. 26 k. Severe, chronic pain caused by an underlying medical 27 condition that is not responsive to conventional treatment or 28 conventional treatment that produces debilitating side effects. 29 l. Any other chronic or debilitating disease or medical 30 condition or its medical treatment approved by the department 31 pursuant to rule. 32 2. “Department” means the department of public health. 33 3. “Disqualifying felony offense” means a violation under 34 federal or state law of a felony offense, which has as an 35 -1- LSB 2576SV (4) 86 rh/rj 1/ 26

S.F. 484 element the possession, use, or distribution of a controlled 1 substance, as defined in 21 U.S.C. §802(6). 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. “Health care practitioner” means an individual licensed 6 under chapter 148 to practice medicine and surgery or 7 osteopathic medicine and surgery, a physician assistant 8 licensed under chapter 148C, or an advanced registered nurse 9 practitioner licensed pursuant to chapter 152 or 152E. 10 6. “Medical cannabis” means any species of the genus 11 cannabis plant, or any mixture or preparation of them, 12 including whole plant extracts and resins. 13 7. “Medical cannabis dispensary” means an entity licensed 14 under section 124E.8 that acquires medical cannabis from a 15 medical cannabis manufacturer in this state for the purpose 16 of dispensing medical cannabis in this state pursuant to this 17 chapter. 18 8. “Medical cannabis manufacturer” means an entity licensed 19 by the department to manufacture and to possess, cultivate, 20 transport, or supply medical cannabis pursuant to the 21 provisions of this chapter. 22 9. “Primary caregiver” means a person, at least eighteen 23 years of age, who has been designated by a patient’s health 24 care practitioner or a person having custody of a patient, as 25 a necessary caretaker taking responsibility for managing the 26 well-being of the patient with respect to the use of medical 27 cannabis pursuant to the provisions of this chapter. 28 10. “Written certification” means a document signed by a 29 health care practitioner, with whom the patient has established 30 a patient-provider relationship, which states that the patient 31 has a debilitating medical condition and identifies that 32 condition and provides any other relevant information. 33 Sec. 4. NEW SECTION . 124E.3 Health care practitioner 34 certification —— duties. 35 -2- LSB 2576SV (4) 86 rh/rj 2/ 26

S.F. 484 1. Prior to a patient’s submission of an application for a 1 medical cannabis card pursuant to section 124E.4, a health care 2 practitioner shall do all of the following: 3 a. Determine, in the health care practitioner’s medical 4 judgment, whether the patient whom the health care practitioner 5 has examined and treated suffers from a debilitating medical 6 condition that qualifies for the use of medical cannabis under 7 this chapter, and if so determined, provide the patient with a 8 written certification of that diagnosis. 9 b. Provide explanatory information as provided by the 10 department to the patient about the therapeutic use of medical 11 cannabis. 12 2. Determine, on an annual basis, if the patient continues 13 to suffer from a debilitating medical condition and, if so, 14 issue the patient a new certification of that diagnosis. 15 3. Otherwise comply with all requirements established by 16 the department pursuant to rule. 17 4. A health care practitioner may provide, but has no duty 18 to provide, a written certification pursuant to this section. 19 Sec. 5. NEW SECTION . 124E.4 Medical cannabis registration 20 card. 21 1. Issuance to patient. The department may approve the 22 issuance of a medical cannabis registration card by the 23 department of transportation to a patient who: 24 a. Is at least eighteen years of age. 25 b. Is a permanent resident of this state. 26 c. Submits a written certification to the department signed 27 by the patient’s health care practitioner that the patient is 28 suffering from a debilitating medical condition. 29 d. 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 patient’s full name, Iowa residence address, date 33 of birth, and telephone number. 34 (2) A copy of the patient’s valid photo identification. 35 -3- LSB 2576SV (4) 86 rh/rj 3/ 26

S.F. 484 (3) Full name, address, and telephone number of the 1 patient’s health care practitioner. 2 (4) Full name, residence address, date of birth, and 3 telephone number of each primary caregiver of the patient, if 4 any. 5 (5) Any other information required by rule. 6 e. Submits a medical cannabis registration card fee of one 7 hundred dollars to the department. If the patient attests to 8 receiving social security disability benefits, supplemental 9 security insurance payments, or being enrolled in medical 10 assistance, the fee shall be twenty-five dollars. 11 2. Patient card contents. A medical cannabis registration 12 card issued to a patient by the department of transportation 13 pursuant to subsection 1 shall contain, at a minimum, all of 14 the following: 15 a. The patient’s full name, Iowa residence address, and date 16 of birth. 17 b. The patient’s photo. 18 c. The date of issuance and expiration date of the 19 registration card. 20 d. Any other information required by rule. 21 3. Issuance to primary caregiver. For a patient in a 22 primary caregiver’s care, the department may approve the 23 issuance of a medical cannabis registration card by the 24 department of transportation to the primary caregiver who: 25 a. Is at least eighteen years of age. 26 b. Submits a written certification to the department signed 27 by the patient’s health care practitioner that the patient in 28 the primary caregiver’s care is suffering from a debilitating 29 medical condition. 30 c. Submits an application to the department, on a form 31 created by the department, in consultation with the department 32 of transportation, that contains all of the following: 33 (1) The primary caregiver’s full name, residence address, 34 date of birth, and telephone number. 35 -4- LSB 2576SV (4) 86 rh/rj 4/ 26

S.F. 484 (2) The patient’s full name. 1 (3) A copy of the primary caregiver’s valid photo 2 identification. 3 (4) Full name, address, and telephone number of the 4 patient’s health care practitioner. 5 (5) Any other information required by rule. 6 d. Submits a medical cannabis registration card fee of 7 twenty-five dollars to the department. 8 4. Primary caregiver card contents. A medical cannabis 9 registration card issued by the department of transportation to 10 a primary caregiver pursuant to subsection 3 shall contain, at 11 a minimum, all of the following: 12 a. The primary caregiver’s full name, residence address, and 13 date of birth. 14 b. The primary caregiver’s photo. 15 c. The date of issuance and expiration date of the 16 registration card. 17 d. The registration card number of each patient in the 18 primary caregiver’s care. If the patient in the primary 19 caregiver’s care is under the age of eighteen, the full name of 20 the patient’s parent or legal guardian. 21 e. Any other information required by rule. 22 5. Expiration date of card. A medical cannabis registration 23 card issued pursuant to this section shall expire one year 24 after the date of issuance and may be renewed. 25 6. Card issuance —— department of transportation. The 26 department may enter into a chapter 28E agreement with the 27 department of transportation to facilitate the issuance of 28 medical cannabis registration cards pursuant to subsections 1 29 and 3. 30 Sec. 6. NEW SECTION . 124E.5 Medical advisory board —— 31 duties. 32 1. No later than August 15, 2015, the director of public 33 health shall establish a medical advisory board consisting of 34 eight practitioners representing the fields of neurology, pain 35 -5- LSB 2576SV (4) 86 rh/rj 5/ 26

S.F. 484 management, gastroenterology, oncology, psychiatry, infectious 1 disease, family medicine, and pharmacy, and three patients with 2 valid medical cannabis registration cards. The practitioners 3 shall be nationally board-certified in their area of specialty 4 and knowledgeable about the use of medical cannabis. 5 2. A quorum of the advisory board shall consist of six 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 cannabis under 13 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 cannabis under this chapter. 18 c. Advising the department regarding the location of 19 medical cannabis dispensaries throughout the state, the form 20 and quantity of allowable medical cannabis to be dispensed 21 to a patient or primary caregiver, and the general oversight 22 of medical cannabis manufacturers and medical cannabis 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 cannabis under this chapter. 30 Sec. 7. NEW SECTION . 124E.6 Medical cannabis manufacturer 31 licensure. 32 1. a. The department shall license four medical cannabis 33 manufacturers to manufacture medical cannabis within this state 34 consistent with the provisions of this chapter by December 35 -6- LSB 2576SV (4) 86 rh/rj 6/ 26

S.F. 484 1, 2015. The department shall license new medical cannabis 1 manufacturers or relicense the existing medical cannabis 2 manufacturers by December 1 of each year. 3 b. Information submitted during the application process 4 shall be confidential until the medical cannabis manufacturer 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 cannabis 8 manufacturer must agree to begin supplying medical cannabis to 9 medical cannabis dispensaries in this state by July 1, 2016. 10 3. The department shall consider the following factors in 11 determining whether to license a medical cannabis manufacturer: 12 a. The technical expertise of the medical cannabis 13 manufacturer in medical cannabis. 14 b. The qualifications of the medical cannabis manufacturer’s 15 employees. 16 c. The long-term financial stability of the medical cannabis 17 manufacturer. 18 d. The ability to provide appropriate security measures on 19 the premises of the medical cannabis manufacturer. 20 e. Whether the medical cannabis manufacturer has 21 demonstrated an ability to meet certain medical cannabis 22 production needs for medical use regarding the range of 23 recommended dosages for each debilitating medical condition, 24 the range of chemical compositions of any plant of the genus 25 cannabis that will likely be medically beneficial for each 26 of the debilitating medical conditions, and the form of the 27 medical cannabis in the manner determined by the department 28 pursuant to rule. 29 f. The medical cannabis manufacturer’s projection of and 30 ongoing assessment of fees on patients with debilitating 31 medical conditions. 32 4. The department shall require each medical cannabis 33 manufacturer to contract with the state hygienic laboratory 34 at the university of Iowa in Iowa City to test the medical 35 -7- LSB 2576SV (4) 86 rh/rj 7/ 26

S.F. 484 cannabis produced by the manufacturer. The department shall 1 require that the laboratory report testing results to the 2 manufacturer in a manner determined by the department pursuant 3 to rule. 4 5. Each entity submitting an application for licensure 5 as a medical cannabis manufacturer shall pay a nonrefundable 6 application fee of seven thousand five hundred dollars to the 7 department. 8 Sec. 8. NEW SECTION . 124E.7 Medical cannabis manufacturers. 9 1. A medical cannabis manufacturer shall contract with the 10 state hygienic laboratory at the university of Iowa in Iowa 11 City for purposes of testing the medical cannabis manufactured 12 by the medical cannabis manufacturer as to content, 13 contamination, and consistency. The cost of all laboratory 14 testing shall be paid by the medical cannabis manufacturer. 15 2. The operating documents of a medical cannabis 16 manufacturer shall include all of the following: 17 a. Procedures for the oversight of the medical cannabis 18 manufacturer and procedures to ensure accurate record keeping. 19 b. Procedures for the implementation of appropriate security 20 measures to deter and prevent the theft of medical cannabis and 21 unauthorized entrance into areas containing medical cannabis. 22 3. A medical cannabis manufacturer shall implement security 23 requirements, including requirements for protection of each 24 location by a fully operational security alarm system, facility 25 access controls, perimeter intrusion detection systems, and a 26 personnel identification system. 27 4. A medical cannabis manufacturer shall not share 28 office space with, refer patients to, or have any financial 29 relationship with a health care practitioner. 30 5. A medical cannabis manufacturer shall not permit any 31 person to consume medical cannabis on the property of the 32 medical cannabis manufacturer. 33 6. A medical cannabis manufacturer is subject to reasonable 34 inspection by the department. 35 -8- LSB 2576SV (4) 86 rh/rj 8/ 26

S.F. 484 7. A medical cannabis manufacturer shall not employ 1 a person under eighteen years of age or who has been 2 convicted of a disqualifying felony offense. An employee 3 of a medical cannabis manufacturer shall be subject to a 4 background investigation conducted by the division of criminal 5 investigation of the department of public safety and a national 6 criminal history background check. 7 8. A medical cannabis manufacturer shall not operate in any 8 location, whether for manufacturing, cultivating, harvesting, 9 packaging, or processing, within one thousand feet of a public 10 or private school existing before the date of the medical 11 cannabis manufacturer’s licensure by the department. 12 9. A medical cannabis manufacturer shall comply with 13 reasonable restrictions set by the department relating to 14 signage, marketing, display, and advertising of medical 15 cannabis. 16 10. a. A medical cannabis manufacturer shall provide a 17 reliable and ongoing supply of medical cannabis to medical 18 cannabis dispensaries pursuant to this chapter. 19 b. All manufacturing, cultivating, harvesting, 20 manufacturing, packaging, and processing of medical cannabis 21 shall take place in an enclosed, locked facility at a physical 22 address provided to the department during the licensure 23 process. 24 Sec. 9. NEW SECTION . 124E.8 Medical cannabis dispensary 25 licensure. 26 1. a. The department shall license by April 1, 2016, twelve 27 medical cannabis dispensaries to dispense medical cannabis 28 within this state consistent with the provisions of this 29 chapter. The department shall license new medical cannabis 30 dispensaries or relicense the existing medical cannabis 31 manufacturers by December 1 of each year. 32 b. Information submitted during the application process 33 shall be confidential until the medical cannabis dispensary 34 is licensed by the department unless otherwise protected from 35 -9- LSB 2576SV (4) 86 rh/rj 9/ 26

S.F. 484 disclosure under state or federal law. 1 2. As a condition for licensure, a medical cannabis 2 dispensary must agree to begin supplying medical cannabis to 3 patients by July 1, 2016. 4 3. The department shall consider the following factors in 5 determining whether to license a medical cannabis dispensary: 6 a. The technical expertise of the medical cannabis 7 dispensary regarding medical cannabis. 8 b. The qualifications of the medical cannabis dispensary’s 9 employees. 10 c. The long-term financial stability of the medical cannabis 11 dispensary. 12 d. The ability to provide appropriate security measures on 13 the premises of the medical cannabis dispensary. 14 e. The medical cannabis dispensary’s projection and ongoing 15 assessment of fees for the purchase of medical cannabis on 16 patients with debilitating medical conditions. 17 4. Each entity submitting an application for licensure 18 as a medical cannabis dispensary shall pay a nonrefundable 19 application fee of five thousand dollars to the department. 20 Sec. 10. NEW SECTION . 124E.9 Medical cannabis dispensaries. 21 1. a. The medical cannabis dispensaries shall be located 22 based on geographical need throughout the state to improve 23 patient access. 24 b. A medical cannabis dispensary may dispense medical 25 cannabis pursuant to the provisions of this chapter but shall 26 not dispense any medical cannabis in a form or quantity other 27 than the form or quantity allowed by the department pursuant 28 to rule. 29 2. The operating documents of a medical cannabis dispensary 30 shall include all of the following: 31 a. Procedures for the oversight of the medical cannabis 32 dispensary and procedures to ensure accurate record keeping. 33 b. Procedures for the implementation of appropriate security 34 measures to deter and prevent the theft of medical cannabis and 35 -10- LSB 2576SV (4) 86 rh/rj 10/ 26

S.F. 484 unauthorized entrance into areas containing medical cannabis. 1 3. A medical cannabis dispensary shall implement security 2 requirements, including requirements for protection by a fully 3 operational security alarm system, facility access controls, 4 perimeter intrusion detection systems, and a personnel 5 identification system. 6 4. A medical cannabis dispensary shall not share office 7 space with, refer patients to, or have any financial 8 relationship with a health care practitioner. 9 5. A medical cannabis dispensary shall not permit any person 10 to consume medical cannabis on the property of the medical 11 cannabis dispensary. 12 6. A medical cannabis dispensary is subject to reasonable 13 inspection by the department. 14 7. A medical cannabis dispensary shall not employ 15 a person under eighteen years of age or who has been 16 convicted of a disqualifying felony offense. An employee 17 of a medical cannabis dispensary shall be subject to a 18 background investigation conducted by the division of criminal 19 investigation of the department of public safety and a national 20 criminal history background check. 21 8. A medical cannabis dispensary shall not operate in any 22 location within one thousand feet of a public or private school 23 existing before the date of the medical cannabis dispensary’s 24 licensure by the department. 25 9. A medical cannabis dispensary shall comply with 26 reasonable restrictions set by the department relating to 27 signage, marketing, display, and advertising of medical 28 cannabis. 29 10. Prior to dispensing of any medical cannabis, a medical 30 cannabis dispensary shall do all of the following: 31 a. Verify that the medical cannabis dispensary has received 32 a valid medical cannabis registration card from a patient or a 33 patient’s primary caregiver, if applicable. 34 b. Assign a tracking number to any medical cannabis 35 -11- LSB 2576SV (4) 86 rh/rj 11/ 26

S.F. 484 dispensed from the medical cannabis dispensary. 1 c. Properly package medical cannabis in compliance with 2 federal law regarding child resistant packaging and exemptions 3 for packaging for elderly patients, and label medical cannabis 4 with a list of all active ingredients and individually 5 identifying information, including all of the following: 6 (1) The name and date of birth of the patient and the 7 patient’s primary caregiver, if appropriate. 8 (2) The medical cannabis registration card numbers of the 9 patient and the patient’s primary caregiver, if applicable. 10 (3) The chemical composition of the medical cannabis. 11 Sec. 11. NEW SECTION . 124E.10 Fees. 12 Medical cannabis registration card fees and medical cannabis 13 manufacturer and medical cannabis dispensary application 14 and annual fees collected by the department pursuant to 15 this chapter shall be retained by the department, shall be 16 considered repayment receipts as defined in section 8.2, and 17 shall be used for the purpose of regulating medical cannabis 18 manufacturers and medical cannabis dispensaries and for other 19 expenses necessary for the administration of this chapter. 20 Sec. 12. NEW SECTION . 124E.11 Department duties —— rules. 21 1. a. The department shall maintain a confidential file 22 of the names of each patient to or for whom the department 23 issues a medical cannabis registration card and the name of 24 each primary caregiver to whom the department issues a medical 25 cannabis registration card under section 124E.4. 26 b. Individual names contained in the file shall be 27 confidential and shall not be subject to disclosure, except as 28 provided in subparagraph (1). 29 (1) Information in the confidential file maintained 30 pursuant to paragraph “a” may be released on an individual basis 31 to the following persons under the following circumstances: 32 (a) To authorized employees or agents of the department and 33 the department of transportation as necessary to perform the 34 duties of the department and the department of transportation 35 -12- LSB 2576SV (4) 86 rh/rj 12/ 26

S.F. 484 pursuant to this chapter. 1 (b) To authorized employees of state or local law 2 enforcement agencies, but only for the purpose of verifying 3 that a person is lawfully in possession of a medical cannabis 4 registration card issued pursuant to this chapter. 5 (c) To authorized employees of a medical cannabis 6 dispensary, but only for the purpose of verifying that a person 7 is lawfully in possession of a medical cannabis registration 8 card issued pursuant to this chapter. 9 (2) Release of information pursuant to subparagraph 10 (1) shall be consistent with the federal Health Insurance 11 Portability and Accountability Act of 1996, Pub. L. No. 12 104-191. 13 2. The department shall adopt rules pursuant to chapter 14 17A to administer this chapter which shall include but not be 15 limited to rules to do all of the following: 16 a. Govern the manner in which the department shall consider 17 applications for new and renewal medical cannabis registration 18 cards. 19 b. Identify criteria and set forth procedures for 20 including additional chronic or debilitating diseases or 21 medical conditions or their medical treatments on the list of 22 debilitating medical conditions that qualify for the use of 23 medical cannabis. Procedures shall include a petition process 24 and shall allow for public comment and public hearings before 25 the medical advisory board. 26 c. Set forth additional chronic or debilitating diseases or 27 medical conditions or their medical treatments for inclusion 28 on the list of debilitating medical conditions that qualify 29 for the use of medical cannabis as recommended by the medical 30 advisory board. 31 d. Establish the form and quantity of medical cannabis 32 allowed to be dispensed to a patient or primary caregiver 33 pursuant to this chapter. The form and quantity of medical 34 cannabis shall be appropriate to serve the medical needs of 35 -13- LSB 2576SV (4) 86 rh/rj 13/ 26

S.F. 484 patients with debilitating conditions. 1 e. Establish requirements for the licensure of medical 2 cannabis manufacturers and medical cannabis dispensaries and 3 set forth procedures for medical cannabis manufacturers and 4 medical cannabis dispensaries to obtain licenses. 5 f. Develop a dispensing system for medical cannabis within 6 this state that provides for all of the following: 7 (1) Medical cannabis dispensaries within this state housed 8 on secured grounds and operated by licensed medical cannabis 9 dispensaries. 10 (2) The dispensing of medical cannabis to patients and 11 their primary caregivers to occur at locations designated by 12 the department. 13 g. Establish and collect annual fees from medical cannabis 14 manufacturers and medical cannabis dispensaries to cover 15 the costs associated with regulating and inspecting medical 16 cannabis manufacturers and medical cannabis dispensaries. 17 h. Specify and implement procedures that address public 18 safety including security procedures and product quality 19 including measures to ensure contaminant-free cultivation of 20 medical cannabis, safety, and labeling. 21 Sec. 13. NEW SECTION . 124E.12 Reciprocity. 22 A valid medical cannabis registration card, or its 23 equivalent, issued under the laws of another state that allows 24 an out-of-state patient to possess or use medical cannabis in 25 the jurisdiction of issuance shall have the same force and 26 effect as a valid medical cannabis registration card issued 27 pursuant to this chapter, except that an out-of-state patient 28 in this state shall not obtain medical cannabis from a medical 29 cannabis dispensary in this state. 30 Sec. 14. NEW SECTION . 124E.13 Use of medical cannabis —— 31 smoking prohibited. 32 A patient shall not consume medical cannabis possessed or 33 used as authorized by this chapter by smoking medical cannabis. 34 Sec. 15. NEW SECTION . 124E.14 Use of medical cannabis —— 35 -14- LSB 2576SV (4) 86 rh/rj 14/ 26

S.F. 484 affirmative defenses. 1 1. A health care practitioner, including any authorized 2 agent or employee thereof, shall not be subject to 3 prosecution for the unlawful certification, possession, or 4 administration of marijuana under the laws of this state for 5 activities arising directly out of or directly related to the 6 certification or use of medical cannabis in the treatment of 7 a patient diagnosed with a debilitating medical condition as 8 authorized by this chapter. 9 2. A medical cannabis manufacturer, including any 10 authorized agent or employee thereof, shall not be subject 11 to prosecution for manufacturing, possessing, cultivating, 12 harvesting, packaging, processing, transporting, or supplying 13 medical cannabis pursuant to this chapter. 14 3. A medical cannabis dispensary, including any authorized 15 agent or employee thereof, shall not be subject to prosecution 16 for transporting, supplying, or dispensing medical cannabis 17 pursuant to this chapter. 18 a. In a prosecution for the unlawful possession of marijuana 19 under the laws of this state, including but not limited to 20 chapters 124 and 453B, it is an affirmative and complete 21 defense to the prosecution that the patient has been diagnosed 22 with a debilitating medical condition, used or possessed 23 medical cannabis pursuant to a certification by a health care 24 practitioner as authorized under this chapter, and, for a 25 patient eighteen years of age or older, is in possession of a 26 valid medical cannabis registration card. 27 b. In a prosecution for the unlawful possession of marijuana 28 under the laws of this state, including but not limited to 29 chapters 124 and 453B, it is an affirmative and complete 30 defense to the prosecution that the person possessed medical 31 cannabis because the person is a primary caregiver of a patient 32 who has been diagnosed with a debilitating medical condition 33 and is in possession of a valid medical cannabis registration 34 card, and where the primary caregiver’s possession of the 35 -15- LSB 2576SV (4) 86 rh/rj 15/ 26

S.F. 484 medical cannabis is on behalf of the patient and for the 1 patient’s use only as authorized under this chapter. 2 c. If a patient or primary caregiver is charged with the 3 commission of a crime and is not in possession of the person’s 4 medical cannabis registration card, any charge or charges filed 5 against the person shall be dismissed by the court if the 6 person produces to the court prior to or at the person’s trial 7 a medical cannabis registration card issued to that person and 8 valid at the time the person was charged. 9 4. An agency of this state or a political subdivision 10 thereof, including any law enforcement agency, shall not remove 11 or initiate proceedings to remove a patient under the age 12 of eighteen from the home of a parent based solely upon the 13 parent’s or patient’s possession or use of medical cannabis as 14 authorized under this chapter. 15 Sec. 16. NEW SECTION . 124E.15 Penalties. 16 1. A person who knowingly or intentionally possesses or 17 uses medical cannabis in violation of the requirements of this 18 chapter is subject to the penalties provided under chapters 124 19 and 453B. 20 2. A medical cannabis manufacturer or a medical cannabis 21 dispensary shall be assessed a civil penalty of up to one 22 thousand dollars per violation for any violation of this 23 chapter in addition to any other applicable penalties. 24 Sec. 17. EMERGENCY RULES. The department may adopt 25 emergency rules under section 17A.4, subsection 3, and section 26 17A.5, subsection 2, paragraph “b”, to implement the provisions 27 of this Act and the rules shall be effective immediately upon 28 filing unless a later date is specified in the rules. Any 29 rules adopted in accordance with this section shall also be 30 published as a notice of intended action as provided in section 31 17A.4. 32 Sec. 18. TRANSITION PROVISIONS. A medical cannabis 33 registration card issued under chapter 124D prior to July 1, 34 2015, remains effective and continues in effect as issued for 35 -16- LSB 2576SV (4) 86 rh/rj 16/ 26

S.F. 484 the twelve-month period following its issuance. This Act does 1 not preclude the permit holder from seeking to renew the permit 2 under this Act prior to the expiration of the twelve-month 3 period. 4 Sec. 19. REPORTS. The university of Iowa Carver college of 5 medicine and college of pharmacy shall, on or before July 1 of 6 each year, beginning July 1, 2016, submit a report detailing 7 the scientific literature, studies, and clinical trials 8 regarding the use of medical cannabis on patients diagnosed 9 with debilitating medical conditions as defined in this Act to 10 the department of public health and the general assembly. 11 Sec. 20. REPEAL. Chapter 124D, Code 2015, is repealed. 12 EXPLANATION 13 The inclusion of this explanation does not constitute agreement with 14 the explanation’s substance by the members of the general assembly. 15 This bill creates the medical cannabis Act and provides for 16 civil and criminal penalties and fees. 17 OVERVIEW. The bill allows a patient with a debilitating 18 medical condition who receives written certification from 19 the patient’s health care practitioner that the patient has 20 a debilitating medical condition and who submits the written 21 certification along with an application to the department of 22 public health (department) for a medical cannabis registration 23 card to allow for the lawful use of medical cannabis to treat 24 the patient’s debilitating medical condition. A patient who 25 is issued a medical cannabis registration card will be able 26 to receive medical cannabis directly from a licensed medical 27 cannabis dispensary in this state. 28 DEFINITIONS. The bill provides the following definitions: 29 “Debilitating medical condition” means cancer; multiple 30 sclerosis; epilepsy; AIDS or HIV; glaucoma; hepatitis C; 31 Crohn’s disease or ulcerative colitis; amyotrophic lateral 32 sclerosis; Ehlers-danlos syndrome; post-traumatic stress 33 disorder; severe, chronic pain caused by an underlying medical 34 condition that is not responsive to conventional treatment or 35 -17- LSB 2576SV (4) 86 rh/rj 17/ 26

S.F. 484 conventional treatment that produces debilitating side effects; 1 and any other chronic or debilitating disease or medical 2 condition or its medical treatment approved by the department 3 by rule. 4 “Health care practitioner” means an individual licensed 5 under Code chapter 148 to practice medicine and surgery 6 or osteopathic medicine and surgery, a physician assistant 7 licensed under Code chapter 148C, or an advanced registered 8 nurse practitioner licensed pursuant to Code chapter 152 or 9 152E. 10 “Medical cannabis” means any species of the genus cannabis 11 plant, or any mixture or preparation of them, including whole 12 plant extracts and resins. 13 “Medical cannabis dispensary” means an entity licensed under 14 the bill that acquires medical cannabis from a medical cannabis 15 manufacturer in this state for the purpose of dispensing 16 medical cannabis in this state pursuant to the provisions of 17 the bill. 18 “Medical cannabis manufacturer” means an entity licensed 19 by the department to manufacture and to possess, cultivate, 20 transport, or supply medical cannabis pursuant to the 21 provisions of the bill. 22 “Primary caregiver” means a person, at least 18 years of age, 23 who has been designated by a patient’s health care practitioner 24 or a person having custody of a patient, as a necessary 25 caretaker taking responsibility for managing the well-being 26 of the patient with respect to the use of medical cannabis 27 pursuant to the bill. 28 “Written certification” means a document signed by a health 29 care practitioner, with whom the patient has established a 30 patient-provider relationship, which states that the patient 31 has a debilitating medical condition and provides any other 32 relevant information. 33 HEALTH CARE PRACTITIONER CERTIFICATION. The bill provides 34 that prior to a patient’s submission of an application 35 -18- LSB 2576SV (4) 86 rh/rj 18/ 26

S.F. 484 for a medical cannabis registration card, if a health care 1 practitioner determines that the patient whom the health 2 care practitioner has examined and treated suffers from a 3 debilitating medical condition, the health care practitioner 4 may provide the patient with a written certification of that 5 diagnosis. If the health care practitioner provides the 6 written certification, the practitioner must also provide 7 explanatory information to the patient about the therapeutic 8 use of medical cannabis, and if the patient continues to suffer 9 from a debilitating medical condition, issue the patient a new 10 certification of that diagnosis on an annual basis. 11 MEDICAL CANNABIS REGISTRATION CARD —— PATIENT AND PRIMARY 12 CAREGIVER. The department may approve the issuance of a 13 medical cannabis registration card by the department of 14 transportation to a patient who is at least 18 years of age and 15 is a permanent resident of this state, who submits a written 16 certification by the patient’s health care practitioner to 17 the department, who submits an application to the department 18 of public health with certain information, and who submits 19 a registration card fee to the department. The department 20 of public health may also approve the issuance of a medical 21 cannabis registration card by the department of transportation 22 to a primary caregiver who is at least 18 years of age, who 23 submits a written certification by the patient’s health care 24 practitioner to the department on behalf of the patient, 25 and submits an application to the department with certain 26 information. A medical cannabis registration card expires one 27 year after the date of issuance and may be renewed. 28 MEDICAL ADVISORY BOARD. The director of public health is 29 directed to establish a medical advisory board, no later than 30 August 15, 2015, to consist of eight practitioners representing 31 the fields of neurology, pain management, gastroenterology, 32 oncology, psychiatry, infectious disease, family medicine, 33 and pharmacy, and three patients with valid medical cannabis 34 registration cards. The practitioners shall be nationally 35 -19- LSB 2576SV (4) 86 rh/rj 19/ 26

S.F. 484 board-certified in their area of specialty and knowledgeable 1 about the use of medical cannabis. The duties of the board 2 include reviewing and recommending to the department for 3 approval additional chronic or debilitating diseases or 4 medical conditions or their treatments as debilitating medical 5 conditions that qualify for the use of medical cannabis under 6 the bill, accepting and reviewing petitions to add chronic or 7 debilitating diseases or medical conditions or their treatments 8 to the list of debilitating medical conditions that qualify 9 for the use of medical cannabis under the bill, and advising 10 the department regarding the location of medical cannabis 11 dispensaries, the form and quantity of allowable medical 12 cannabis to be dispensed to a patient or primary caregiver, and 13 the general oversight of medical cannabis manufacturers and 14 medical cannabis dispensaries. 15 MEDICAL CANNABIS MANUFACTURER LICENSURE. The bill 16 requires the department to license four medical cannabis 17 manufacturers for the manufacture of medical cannabis within 18 this state by December 1, 2015, and to license new medical 19 cannabis manufacturers or relicense existing medical cannabis 20 manufacturers by December 1 of each year. Information 21 submitted during the application process is confidential until 22 the medical cannabis manufacturer is licensed by the department 23 unless otherwise protected from disclosure under state or 24 federal law. As a condition for licensure, a medical cannabis 25 manufacturer must agree to begin supplying medical cannabis to 26 medical cannabis dispensaries in this state by July 1, 2016. 27 The department is directed to consider several factors in 28 determining whether to license a medical cannabis manufacturer 29 including technical expertise, employee qualifications, 30 financial stability, security measures, and production 31 needs and capacity. Each medical cannabis manufacturer is 32 required to contract with the state hygienic laboratory at the 33 university of Iowa to test the medical cannabis produced by 34 the manufacturer and to report testing results to the medical 35 -20- LSB 2576SV (4) 86 rh/rj 20/ 26