House File 199 - Introduced HOUSE FILE 199 BY KRESSIG , FORBES , COHOON , T. TAYLOR , WOLFE , KEARNS , WINCKLER , LENSING , NIELSEN , HUNTER , THEDE , GASKILL , HANSON , KACENA , STAED , MASCHER , STECKMAN , OURTH , BEARINGER , HALL , M. SMITH , BROWN-POWERS , MEYER , GAINES , McCONKEY , WESSEL-KROESCHELL , PRICHARD , OLSON , ABDUL-SAMAD , MILLER , and JACOBY A BILL FOR An Act relating to the compassionate use of medical 1 cannabis Act, reclassifying marijuana, including 2 tetrahydrocannabinols, from a schedule I controlled 3 substance to a schedule II controlled substance, providing 4 for civil and criminal penalties and fees, and including 5 effective date provisions. 6 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 7 TLSB 1756YH (10) 87 rh/rj

H.F. 199 Section 1. Section 124.204, subsection 4, paragraphs m and 1 u, Code 2017, are amended by striking the paragraphs. 2 Sec. 2. Section 124.204, subsection 7, Code 2017, is amended 3 by striking the subsection. 4 Sec. 3. Section 124.206, subsection 7, Code 2017, 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 paragraph only, the term “isomer” 14 includes the optical, positional, and geometric isomers) : 15 a. Marijuana when used for medicinal purposes pursuant to 16 rules of the board . 17 b. Tetrahydrocannabinols, meaning tetrahydrocannabinols 18 naturally contained in a plant of the genus cannabis (cannabis 19 plant) as well as synthetic equivalents of the substances 20 contained in the cannabis plant, or in the resinous extractives 21 of such plant, and synthetic substances, derivatives, and their 22 isomers with similar chemical structure and pharmacological 23 activity to those substances contained in the plant, such as 24 the following: 25 (1) 1 cis or trans tetrahydrocannabinol, and their optical 26 isomers. 27 (2) 6 cis or trans tetrahydrocannabinol, and their optical 28 isomers. 29 (3) 3,4 cis or trans tetrahydrocannabinol, and their 30 optical isomers. (Since nomenclature of these substances 31 is not internationally standardized, compounds of these 32 structures, regardless of numerical designation of atomic 33 positions covered.) 34 b. c. Nabilone [another name for nabilone: (+-) - 35 -1- LSB 1756YH (10) 87 rh/rj 1/ 28

H.F. 199 trans-3-(1,1-dimethylheptyl)-6,6a,7,8,10,10a-hexahydro-1- 1 hydroxy-6,6-dimethyl-9H-dibenzo[b,d]pyran-9-one]. 2 Sec. 4. Section 124.401, subsection 5, unnumbered paragraph 3 3, Code 2017, is amended to read as follows: 4 A person may knowingly or intentionally recommend, possess, 5 use, dispense, deliver, transport, or administer cannabidiol 6 medical cannabis if the recommendation, possession, use, 7 dispensing, delivery, transporting, or administering is in 8 accordance with the provisions of chapter 124D 124E . For 9 purposes of this paragraph, “cannabidiol” ”medical cannabis” 10 means the same as defined in section 124D.2 124E.2 . 11 Sec. 5. NEW SECTION . 124E.1 Short title. 12 This chapter shall be known and may be cited as the 13 “Compassionate Use of Medical Cannabis Act” . 14 Sec. 6. NEW SECTION . 124E.2 Definitions. 15 As used in this chapter: 16 1. “Debilitating medical condition” means any of the 17 following: 18 a. Cancer, if the underlying condition or treatment produces 19 one or more of the following: 20 (1) Intractable pain. 21 (2) Nausea or severe vomiting. 22 (3) Cachexia or severe wasting. 23 b. Multiple sclerosis. 24 c. Epilepsy or seizure disorders. 25 d. AIDS or HIV as defined in section 141A.1. 26 e. Crohn’s disease or ulcerative colitis. 27 f. Amyotrophic lateral sclerosis. 28 g. Intractable pain. 29 h. Glaucoma. 30 i. Any terminal illness, with a probable life expectancy of 31 under one year, if the illness or its treatment produces one or 32 more of the following: 33 (1) Intractable pain. 34 (2) Nausea or severe vomiting. 35 -2- LSB 1756YH (10) 87 rh/rj 2/ 28

H.F. 199 (3) Cachexia or severe wasting. 1 j. Any other chronic or debilitating disease or medical 2 condition or its medical treatment approved by the department 3 pursuant to rule. 4 2. “Department” means the department of public health. 5 3. “Disqualifying felony offense” means a violation under 6 federal or state law of a felony offense, which has as an 7 element the possession, use, or distribution of a controlled 8 substance, as defined in 21 U.S.C. §802(6). 9 4. “Enclosed, locked facility” means a closet, room, 10 greenhouse, or other enclosed area equipped with locks or other 11 security devices that permit access only by a cardholder. 12 5. “Health care practitioner” means an individual licensed 13 under chapter 148 to practice medicine and surgery or 14 osteopathic medicine and surgery or an individual licensed to 15 prescribe medicine in any other state who provides specialty 16 care for an Iowa resident for one or more of the debilitating 17 medical conditions provided in this chapter. 18 6. “Intractable pain” means a pain in which the cause of the 19 pain cannot be removed or otherwise treated with the consent 20 of the patient and which, in the generally accepted course of 21 medical practice, no relief or cure of the cause of the pain 22 is possible, or none has been found after reasonable efforts. 23 Reasonable efforts for relieving or curing the cause of the 24 pain may be determined on the basis of but are not limited to 25 any of the following: 26 a. When treating a nonterminally ill patient for intractable 27 pain, evaluation by the attending physician and one or more 28 physicians specializing in pain medicine or the treatment of 29 the area, system, or organ of the body perceived as the source 30 of the pain. 31 b. When treating a terminally ill patient, evaluation by 32 the attending physician who does so in accordance with the 33 level of care, skill, and treatment that would be recognized 34 by a reasonably prudent physician under similar conditions and 35 -3- LSB 1756YH (10) 87 rh/rj 3/ 28

H.F. 199 circumstances. 1 7. “Medical cannabis” means any species of the genus 2 cannabis plant, or any mixture or preparation of them, 3 including whole plant extracts and resins. 4 8. “Medical cannabis manufacturer” means an entity licensed 5 by the department to manufacture and to possess, cultivate, 6 transport, or supply medical cannabis pursuant to the 7 provisions of this chapter. 8 9. “Medical cannabis patient center” means an entity 9 licensed under section 124E.8 that acquires medical cannabis 10 from a medical cannabis manufacturer in this state for the 11 purpose of dispensing medical cannabis in this state pursuant 12 to this chapter. 13 10. “Primary caregiver” means a person, at least eighteen 14 years of age, who has been designated by a patient’s health 15 care practitioner or a person having custody of a patient, as 16 a necessary caretaker taking responsibility for managing the 17 well-being of the patient with respect to the use of medical 18 cannabis pursuant to the provisions of this chapter. 19 11. “Written certification” means a document signed by a 20 health care practitioner, with whom the patient has established 21 a patient-provider relationship, which states that the patient 22 has a debilitating medical condition and identifies that 23 condition and provides any other relevant information. 24 Sec. 7. NEW SECTION . 124E.3 Health care practitioner 25 certification —— duties. 26 1. Prior to a patient’s submission of an application for a 27 medical cannabis registration card pursuant to section 124E.4, 28 a health care practitioner shall do all of the following: 29 a. Determine, in the health care practitioner’s medical 30 judgment, whether the patient whom the health care practitioner 31 has examined and treated suffers from a debilitating medical 32 condition that qualifies for the use of medical cannabis under 33 this chapter, and if so determined, provide the patient with a 34 written certification of that diagnosis. 35 -4- LSB 1756YH (10) 87 rh/rj 4/ 28

H.F. 199 b. Provide explanatory information as provided by the 1 department to the patient about the therapeutic use of medical 2 cannabis. 3 c. Determine, on an annual basis, if the patient continues 4 to suffer from a debilitating medical condition and, if so, 5 issue the patient a new certification of that diagnosis. 6 d. Otherwise comply with all requirements established by the 7 department pursuant to rule. 8 2. A health care practitioner may provide, but has no duty 9 to provide, a written certification pursuant to this section. 10 Sec. 8. NEW SECTION . 124E.4 Medical cannabis registration 11 card. 12 1. Issuance to patient. The department may approve the 13 issuance of a medical cannabis registration card by the 14 department of transportation to a patient who: 15 a. Is at least eighteen years of age. 16 b. Is a permanent resident of this state. 17 c. Submits a written certification to the department signed 18 by the patient’s health care practitioner that the patient is 19 suffering from a debilitating medical condition. 20 d. Submits an application to the department, on a form 21 created by the department, in consultation with the department 22 of transportation, that contains all of the following: 23 (1) The patient’s full name, Iowa residence address, date 24 of birth, and telephone number. 25 (2) A copy of the patient’s valid photograph 26 identification. 27 (3) Full name, address, and telephone number of the 28 patient’s health care practitioner. 29 (4) Full name, residence address, date of birth, and 30 telephone number of each primary caregiver of the patient, if 31 any. 32 (5) Any other information required by rule. 33 e. Submits a medical cannabis registration card fee of one 34 hundred dollars to the department. If the patient attests to 35 -5- LSB 1756YH (10) 87 rh/rj 5/ 28

H.F. 199 receiving social security disability benefits, supplemental 1 security insurance payments, or being enrolled in the medical 2 assistance program, the fee shall be twenty-five dollars. 3 2. Patient card contents. A medical cannabis registration 4 card issued to a patient by the department of transportation 5 pursuant to subsection 1 shall contain, at a minimum, all of 6 the following: 7 a. The patient’s full name, Iowa residence address, and date 8 of birth. 9 b. The patient’s photograph. 10 c. The date of issuance and expiration of the registration 11 card. 12 d. Any other information required by rule. 13 3. Issuance to primary caregiver. For a patient in a 14 primary caregiver’s care, the department may approve the 15 issuance of a medical cannabis registration card by the 16 department of transportation to the primary caregiver who: 17 a. Is at least eighteen years of age. 18 b. Submits a written certification to the department signed 19 by the patient’s health care practitioner that the patient in 20 the primary caregiver’s care is suffering from a debilitating 21 medical condition. 22 c. Submits an application to the department, on a form 23 created by the department, in consultation with the department 24 of transportation, that contains all of the following: 25 (1) The primary caregiver’s full name, residence address, 26 date of birth, and telephone number. 27 (2) The patient’s full name. 28 (3) A copy of the primary caregiver’s valid photograph 29 identification. 30 (4) Full name, address, and telephone number of the 31 patient’s health care practitioner. 32 (5) Any other information required by rule. 33 d. Submits a medical cannabis registration card fee of 34 twenty-five dollars to the department. 35 -6- LSB 1756YH (10) 87 rh/rj 6/ 28

H.F. 199 4. Primary caregiver card contents. A medical cannabis 1 registration card issued by the department of transportation to 2 a primary caregiver pursuant to subsection 3 shall contain, at 3 a minimum, all of the following: 4 a. The primary caregiver’s full name, residence address, and 5 date of birth. 6 b. The primary caregiver’s photograph. 7 c. The date of issuance and expiration of the registration 8 card. 9 d. The registration card number of each patient in the 10 primary caregiver’s care. If the patient in the primary 11 caregiver’s care is under the age of eighteen, the full name of 12 the patient’s parent or legal guardian. 13 e. Any other information required by rule. 14 5. Expiration date of card. A medical cannabis registration 15 card issued pursuant to this section shall expire one year 16 after the date of issuance and may be renewed. 17 6. Card issuance —— department of transportation. The 18 department may enter into a chapter 28E agreement with the 19 department of transportation to facilitate the issuance of 20 medical cannabis registration cards pursuant to subsections 1 21 and 3. 22 Sec. 9. NEW SECTION . 124E.5 Medical advisory council —— 23 duties. 24 1. No later than August 15, 2017, the director of public 25 health shall establish a medical advisory council consisting 26 of nine practitioners representing the fields of neurology, 27 pain management, gastroenterology, oncology, psychiatry, 28 pediatrics, infectious disease, family medicine, and pharmacy. 29 The practitioners shall be nationally board-certified in their 30 area of specialty and knowledgeable about the use of medical 31 cannabis. 32 2. A quorum of the advisory council shall consist of five 33 members. 34 3. The duties of the advisory council shall include but not 35 -7- LSB 1756YH (10) 87 rh/rj 7/ 28

H.F. 199 be limited to the following: 1 a. Reviewing and recommending to the department for 2 approval additional chronic or debilitating diseases or 3 medical conditions or their treatments as debilitating medical 4 conditions that qualify for the use of medical cannabis under 5 this chapter. 6 b. Accepting and reviewing petitions to add chronic or 7 debilitating diseases or medical conditions or their medical 8 treatments to the list of debilitating medical conditions that 9 qualify for the use of medical cannabis under this chapter. 10 c. Advising the department regarding the location and number 11 of necessary medical cannabis patient centers throughout the 12 state on a continuous basis, the form and quantity of allowable 13 medical cannabis to be dispensed to a patient or primary 14 caregiver, and the general oversight of medical cannabis 15 manufacturers and medical cannabis patient centers in this 16 state. 17 d. Convening at least twice per year to conduct public 18 hearings and to review and recommend for approval petitions, 19 which shall be maintained as confidential personal health 20 information, to add chronic or debilitating diseases or 21 medical conditions or their medical treatments to the list of 22 debilitating medical conditions that qualify for the use of 23 medical cannabis under this chapter. 24 Sec. 10. NEW SECTION . 124E.6 Medical cannabis manufacturer 25 licensure. 26 1. a. The department shall license up to two medical 27 cannabis manufacturers to manufacture medical cannabis within 28 this state consistent with the provisions of this chapter by 29 December 1, 2017. The department shall license new medical 30 cannabis manufacturers or relicense the existing medical 31 cannabis manufacturers by December 1 of each year. 32 b. Information submitted during the application process 33 shall be confidential until the medical cannabis manufacturer 34 is licensed by the department unless otherwise protected from 35 -8- LSB 1756YH (10) 87 rh/rj 8/ 28

H.F. 199 disclosure under state or federal law. 1 2. As a condition for licensure, a medical cannabis 2 manufacturer must agree to begin supplying medical cannabis to 3 medical cannabis patient centers in this state by July 1, 2018. 4 3. The department shall consider the following factors in 5 determining whether to license a medical cannabis manufacturer: 6 a. The technical expertise of the medical cannabis 7 manufacturer regarding medical cannabis. 8 b. The qualifications of the medical cannabis manufacturer’s 9 employees. 10 c. The long-term financial stability of the medical cannabis 11 manufacturer. 12 d. The ability to provide appropriate security measures on 13 the premises of the medical cannabis manufacturer. 14 e. Whether the medical cannabis manufacturer has 15 demonstrated an ability to meet certain medical cannabis 16 production needs for medical use regarding the range of 17 recommended dosages for each debilitating medical condition, 18 the range of chemical compositions of any plant of the genus 19 cannabis that will likely be medically beneficial for each 20 of the debilitating medical conditions, and the form of the 21 medical cannabis in the manner determined by the department 22 pursuant to rule. 23 f. The medical cannabis manufacturer’s projection of and 24 ongoing assessment of fees on patients with debilitating 25 medical conditions. 26 4. The department shall require each medical cannabis 27 manufacturer to contract with the state hygienic laboratory 28 at the university of Iowa in Iowa City to test the medical 29 cannabis produced by the manufacturer as provided in section 30 124E.7. The department shall require that the laboratory 31 report testing results to the manufacturer in a manner 32 determined by the department pursuant to rule. 33 5. Each entity submitting an application for licensure 34 as a medical cannabis manufacturer shall pay a nonrefundable 35 -9- LSB 1756YH (10) 87 rh/rj 9/ 28

H.F. 199 application fee of seven thousand five hundred dollars to the 1 department. 2 Sec. 11. NEW SECTION . 124E.7 Medical cannabis 3 manufacturers. 4 1. A medical cannabis manufacturer shall contract with the 5 state hygienic laboratory at the university of Iowa in Iowa 6 City for purposes of testing the medical cannabis manufactured 7 by the medical cannabis manufacturer as to content, 8 contamination, and consistency. The cost of all laboratory 9 testing shall be paid by the medical cannabis manufacturer. 10 2. The operating documents of a medical cannabis 11 manufacturer shall include all of the following: 12 a. Procedures for the oversight of the medical cannabis 13 manufacturer and procedures to ensure accurate record keeping. 14 b. Procedures for the implementation of appropriate security 15 measures to deter and prevent the theft of medical cannabis and 16 unauthorized entrance into areas containing medical cannabis. 17 3. A medical cannabis manufacturer shall implement security 18 requirements, including requirements for protection of each 19 location by a fully operational security alarm system, facility 20 access controls, perimeter intrusion detection systems, and a 21 personnel identification system. 22 4. A medical cannabis manufacturer shall not share 23 office space with, refer patients to, or have any financial 24 relationship with a health care practitioner. 25 5. A medical cannabis manufacturer shall not permit any 26 person to consume medical cannabis on the property of the 27 medical cannabis manufacturer. 28 6. A medical cannabis manufacturer is subject to reasonable 29 inspection by the department. 30 7. A medical cannabis manufacturer shall not employ a 31 person who is under eighteen years of age or who has been 32 convicted of a disqualifying felony offense. An employee 33 of a medical cannabis manufacturer shall be subject to a 34 background investigation conducted by the division of criminal 35 -10- LSB 1756YH (10) 87 rh/rj 10/ 28

H.F. 199 investigation of the department of public safety and a national 1 criminal history background check. 2 8. A medical cannabis manufacturer shall not operate in any 3 location, whether for manufacturing, cultivating, harvesting, 4 packaging, or processing, within one thousand feet of a public 5 or private school existing before the date of the medical 6 cannabis manufacturer’s licensure by the department. 7 9. A medical cannabis manufacturer shall comply with 8 reasonable restrictions set by the department relating to 9 signage, marketing, display, and advertising of medical 10 cannabis. 11 10. a. A medical cannabis manufacturer shall provide a 12 reliable and ongoing supply of medical cannabis to medical 13 cannabis patient centers pursuant to this chapter. 14 b. All manufacturing, cultivating, harvesting, packaging, 15 and processing of medical cannabis shall take place in an 16 enclosed, locked facility at a physical address provided to the 17 department during the licensure process. 18 c. A medical cannabis manufacturer shall not manufacture 19 edible medical cannabis products utilizing food coloring. 20 d. A medical cannabis manufacturer shall manufacture a 21 reliable and ongoing supply of medical cannabis to treat every 22 debilitating medical condition listed in this chapter. 23 Sec. 12. NEW SECTION . 124E.8 Medical cannabis patient 24 center licensure. 25 1. a. The department shall license by April 1, 2018, up 26 to four medical cannabis patient centers to dispense medical 27 cannabis within this state consistent with the provisions 28 of this chapter. The department shall license new medical 29 cannabis patient centers or relicense the existing medical 30 cannabis patient centers by December 1 of each year. 31 b. Information submitted during the application process 32 shall be confidential until the medical cannabis patient center 33 is licensed by the department unless otherwise protected from 34 disclosure under state or federal law. 35 -11- LSB 1756YH (10) 87 rh/rj 11/ 28

H.F. 199 2. As a condition for licensure, a medical cannabis patient 1 center must agree to begin supplying medical cannabis to 2 patients by July 15, 2018. 3 3. The department shall consider the following factors 4 in determining whether to license a medical cannabis patient 5 center: 6 a. The technical expertise of the medical cannabis patient 7 center regarding medical cannabis. 8 b. The qualifications of the medical cannabis patient 9 center’s employees. 10 c. The long-term financial stability of the medical cannabis 11 patient center. 12 d. The ability to provide appropriate security measures on 13 the premises of the medical cannabis patient center. 14 e. The medical cannabis patient center’s projection and 15 ongoing assessment of fees for the purchase of medical cannabis 16 on patients with debilitating medical conditions. 17 4. Each entity submitting an application for licensure as 18 a medical cannabis patient center shall pay a nonrefundable 19 application fee of five thousand dollars to the department. 20 Sec. 13. NEW SECTION . 124E.9 Medical cannabis patient 21 centers. 22 1. a. The medical cannabis patient centers shall be located 23 based on geographical need throughout the state to improve 24 patient access. 25 b. A medical cannabis patient center may dispense medical 26 cannabis pursuant to the provisions of this chapter but shall 27 not dispense any medical cannabis in a form or quantity other 28 than the form or quantity allowed by the department pursuant 29 to rule. 30 2. The operating documents of a medical cannabis patient 31 center shall include all of the following: 32 a. Procedures for the oversight of the medical cannabis 33 patient center and procedures to ensure accurate record 34 keeping. 35 -12- LSB 1756YH (10) 87 rh/rj 12/ 28

H.F. 199 b. Procedures for the implementation of appropriate security 1 measures to deter and prevent the theft of medical cannabis and 2 unauthorized entrance into areas containing medical cannabis. 3 3. A medical cannabis patient center shall implement 4 security requirements, including requirements for protection 5 by a fully operational security alarm system, facility 6 access controls, perimeter intrusion detection systems, and a 7 personnel identification system. 8 4. A medical cannabis patient center shall not share 9 office space with, refer patients to, or have any financial 10 relationship with a health care practitioner. 11 5. A medical cannabis patient center shall not permit any 12 person to consume medical cannabis on the property of the 13 medical cannabis patient center. 14 6. A medical cannabis patient center is subject to 15 reasonable inspection by the department. 16 7. A medical cannabis patient center shall not employ a 17 person who is under eighteen years of age or who has been 18 convicted of a disqualifying felony offense. An employee 19 of a medical cannabis patient center shall be subject to a 20 background investigation conducted by the division of criminal 21 investigation of the department of public safety and a national 22 criminal history background check. 23 8. A medical cannabis patient center shall not operate in 24 any location within one thousand feet of a public or private 25 school existing before the date of the medical cannabis patient 26 center’s licensure by the department. 27 9. A medical cannabis patient center shall comply with 28 reasonable restrictions set by the department relating to 29 signage, marketing, display, and advertising of medical 30 cannabis. 31 10. Prior to dispensing of any medical cannabis, a medical 32 cannabis patient center shall do all of the following: 33 a. Verify that the medical cannabis patient center has 34 received a valid medical cannabis registration card from a 35 -13- LSB 1756YH (10) 87 rh/rj 13/ 28

H.F. 199 patient or a patient’s primary caregiver, if applicable. 1 b. Assign a tracking number to any medical cannabis 2 dispensed from the medical cannabis patient center. 3 c. (1) Properly package medical cannabis in compliance with 4 federal law regarding child resistant packaging and exemptions 5 for packaging for elderly patients, and label medical cannabis 6 with a list of all active ingredients and individually 7 identifying information, including all of the following: 8 (a) The name and date of birth of the patient and the 9 patient’s primary caregiver, if appropriate. 10 (b) The medical cannabis registration card numbers of the 11 patient and the patient’s primary caregiver, if applicable. 12 (c) The chemical composition of the medical cannabis. 13 (2) Proper packaging of medical cannabis shall include but 14 not be limited to all of the following: 15 (a) Warning labels regarding the use of medical cannabis by 16 a woman during pregnancy and while breastfeeding. 17 (b) Clearly labeled packaging indicating that an edible 18 medical cannabis product contains medical cannabis and which 19 packaging shall not imitate candy products or in any way make 20 the product marketable to children. 21 11. A medical cannabis patient center shall employ a 22 pharmacist licensed pursuant to chapter 155A. 23 12. A medical cannabis patient center shall keep a 24 reliable and ongoing supply of medical cannabis to treat every 25 debilitating medical condition listed in this chapter. 26 Sec. 14. NEW SECTION . 124E.10 Department duties —— rules. 27 1. a. The department shall maintain a confidential file of 28 the names of each patient to or for whom the department issues 29 a medical cannabis registration card, the name of each primary 30 caregiver to whom the department issues a medical cannabis 31 registration card under section 124E.4, and the names of each 32 health care practitioner who provides a written certification 33 for medical cannabis pursuant to this chapter. 34 b. Individual names contained in the file shall be 35 -14- LSB 1756YH (10) 87 rh/rj 14/ 28

H.F. 199 confidential and shall not be subject to disclosure, except as 1 provided in subparagraph (1). 2 (1) Information in the confidential file maintained 3 pursuant to paragraph “a” may be released on an individual basis 4 to the following persons under the following circumstances: 5 (a) To authorized employees or agents of the department and 6 the department of transportation as necessary to perform the 7 duties of the department and the department of transportation 8 pursuant to this chapter. 9 (b) To authorized employees of state or local law 10 enforcement agencies, but only for the purpose of verifying 11 that a person is lawfully in possession of a medical cannabis 12 registration card issued pursuant to this chapter. 13 (c) To authorized employees of a medical cannabis patient 14 center, but only for the purpose of verifying that a person is 15 lawfully in possession of a medical cannabis registration card 16 issued pursuant to this chapter. 17 (2) Release of information pursuant to subparagraph 18 (1) shall be consistent with the federal Health Insurance 19 Portability and Accountability Act of 1996, Pub. L. No. 20 104-191. 21 2. The department shall adopt rules pursuant to chapter 22 17A to administer this chapter which shall include but not be 23 limited to rules to do all of the following: 24 a. Govern the manner in which the department shall consider 25 applications for new and renewal medical cannabis registration 26 cards. 27 b. Identify criteria and set forth procedures for 28 including additional chronic or debilitating diseases or 29 medical conditions or their medical treatments on the list of 30 debilitating medical conditions that qualify for the use of 31 medical cannabis. Procedures shall include a petition process 32 and shall allow for public comment and public hearings before 33 the medical advisory council. 34 c. Set forth additional chronic or debilitating diseases 35 -15- LSB 1756YH (10) 87 rh/rj 15/ 28

H.F. 199 or medical conditions or associated medical treatments for 1 inclusion on the list of debilitating medical conditions that 2 qualify for the use of medical cannabis as recommended by the 3 medical advisory council. 4 d. Establish the form and quantity of medical cannabis 5 allowed to be dispensed to a patient or primary caregiver 6 pursuant to this chapter. The form and quantity of medical 7 cannabis shall be appropriate to serve the medical needs of 8 patients with debilitating medical conditions. 9 e. Establish requirements for the licensure of medical 10 cannabis manufacturers and medical cannabis patient centers and 11 set forth procedures for medical cannabis manufacturers and 12 medical cannabis patient centers to obtain licenses. 13 f. Develop a dispensing system for medical cannabis within 14 this state that provides for all of the following: 15 (1) Medical cannabis patient centers within this state 16 housed on secured grounds and operated by licensed medical 17 cannabis patient centers. 18 (2) The dispensing of medical cannabis to patients and 19 their primary caregivers to occur at locations designated by 20 the department. 21 g. Specify and implement procedures that address public 22 safety including security procedures and product quality 23 including measures to ensure contaminant-free cultivation of 24 medical cannabis, safety, and labeling. 25 h. Establish and implement a real-time, statewide 26 medical cannabis registry management sale tracking system 27 that is available to medical cannabis patient centers on a 28 twenty-four-hour-day, seven-day-a-week basis for the purpose of 29 verifying that a person is lawfully in possession of a medical 30 cannabis registration card issued pursuant to this chapter 31 and for tracking the date of the sale and quantity of medical 32 cannabis purchased by a patient or a primary caregiver. 33 i. Establish and implement a medical cannabis inventory 34 and delivery tracking system to track medical cannabis 35 -16- LSB 1756YH (10) 87 rh/rj 16/ 28

H.F. 199 from production by a medical cannabis manufacturer through 1 dispensing at a medical cannabis patient center. 2 Sec. 15. NEW SECTION . 124E.11 Reciprocity. 3 A valid medical cannabis registration card, or its 4 equivalent, issued under the laws of another state that allows 5 an out-of-state patient to possess or use medical cannabis in 6 the jurisdiction of issuance shall have the same force and 7 effect as a valid medical cannabis registration card issued 8 pursuant to this chapter, except that an out-of-state patient 9 in this state shall not obtain medical cannabis from a medical 10 cannabis patient center in this state and an out-of-state 11 patient shall not smoke medical cannabis. 12 Sec. 16. NEW SECTION . 124E.12 Use of medical cannabis —— 13 smoking prohibited. 14 A patient shall not consume medical cannabis possessed or 15 used as authorized by this chapter by smoking medical cannabis. 16 Sec. 17. NEW SECTION . 124E.13 Use of medical cannabis —— 17 affirmative defenses. 18 1. A health care practitioner, including any authorized 19 agent or employee thereof, shall not be subject to 20 prosecution for the unlawful certification, possession, or 21 administration of marijuana under the laws of this state for 22 activities arising directly out of or directly related to the 23 certification or use of medical cannabis in the treatment of 24 a patient diagnosed with a debilitating medical condition as 25 authorized by this chapter. 26 2. A medical cannabis manufacturer, including any 27 authorized agent or employee thereof, shall not be subject 28 to prosecution for manufacturing, possessing, cultivating, 29 harvesting, packaging, processing, transporting, or supplying 30 medical cannabis pursuant to this chapter. 31 3. A medical cannabis patient center, including any 32 authorized agent or employee thereof, shall not be subject to 33 prosecution for transporting, supplying, or dispensing medical 34 cannabis pursuant to this chapter. 35 -17- LSB 1756YH (10) 87 rh/rj 17/ 28

H.F. 199 a. In a prosecution for the unlawful possession of marijuana 1 under the laws of this state, including but not limited to 2 chapters 124 and 453B, it is an affirmative and complete 3 defense to the prosecution that the patient has been diagnosed 4 with a debilitating medical condition, used or possessed 5 medical cannabis pursuant to a certification by a health care 6 practitioner as authorized under this chapter, and, for a 7 patient eighteen years of age or older, is in possession of a 8 valid medical cannabis registration card. 9 b. In a prosecution for the unlawful possession of marijuana 10 under the laws of this state, including but not limited to 11 chapters 124 and 453B, it is an affirmative and complete 12 defense to the prosecution that the person possessed medical 13 cannabis because the person is a primary caregiver of a patient 14 who has been diagnosed with a debilitating medical condition 15 and is in possession of a valid medical cannabis registration 16 card, and where the primary caregiver’s possession of the 17 medical cannabis is on behalf of the patient and for the 18 patient’s use only as authorized under this chapter. 19 c. If a patient or primary caregiver is charged with the 20 commission of a crime and is not in possession of the person’s 21 medical cannabis registration card, any charge or charges filed 22 against the person shall be dismissed by the court if the 23 person produces to the court prior to or at the person’s trial 24 a medical cannabis registration card issued to that person and 25 valid at the time the person was charged. 26 4. An agency of this state or a political subdivision 27 thereof, including any law enforcement agency, shall not remove 28 or initiate proceedings to remove a patient under the age 29 of eighteen from the home of a parent based solely upon the 30 parent’s or patient’s possession or use of medical cannabis as 31 authorized under this chapter. 32 Sec. 18. NEW SECTION . 124E.14 Fees. 33 Medical cannabis registration card fees and medical cannabis 34 manufacturer and medical cannabis patient center application 35 -18- LSB 1756YH (10) 87 rh/rj 18/ 28

H.F. 199 and annual fees collected by the department pursuant to 1 this chapter shall be retained by the department, shall be 2 considered repayment receipts as defined in section 8.2, and 3 shall be used for the purpose of regulating medical cannabis 4 manufacturers and medical cannabis patient centers and for 5 other expenses necessary for the administration of this 6 chapter. Notwithstanding section 8.33, moneys retained by the 7 department that remain unencumbered or unobligated at the end 8 of the fiscal year shall not revert to the general fund of the 9 state. 10 Sec. 19. NEW SECTION . 124E.15 Penalties. 11 1. A person who knowingly or intentionally possesses or 12 uses medical cannabis in violation of the requirements of this 13 chapter is subject to the penalties provided under chapters 124 14 and 453B. 15 2. A medical cannabis manufacturer or a medical cannabis 16 patient center shall be assessed a civil penalty of up to 17 one thousand dollars per violation for any violation of this 18 chapter in addition to any other applicable penalties. 19 Sec. 20. REPEAL. Chapter 124D, Code 2017, is repealed. 20 Sec. 21. EMERGENCY RULES. The department may adopt 21 emergency rules under section 17A.4, subsection 3, and section 22 17A.5, subsection 2, paragraph “b” , to implement the provisions 23 of this Act and the rules shall be effective immediately upon 24 filing unless a later date is specified in the rules. Any 25 rules adopted in accordance with this section shall also be 26 published as a notice of intended action as provided in section 27 17A.4. 28 Sec. 22. TRANSITION PROVISIONS. A medical cannabis 29 registration card issued under chapter 124D prior to the 30 effective date of this Act, remains effective and continues 31 in effect as issued for the twelve-month period following 32 its issuance. This Act does not preclude the permit holder 33 from seeking to renew the permit under this Act prior to the 34 expiration of the twelve-month period. 35 -19- LSB 1756YH (10) 87 rh/rj 19/ 28

H.F. 199 Sec. 23. EFFECTIVE UPON ENACTMENT. This Act, being deemed 1 of immediate importance, takes effect upon enactment. 2 EXPLANATION 3 The inclusion of this explanation does not constitute agreement with 4 the explanation’s substance by the members of the general assembly. 5 This bill creates the compassionate use of medical cannabis 6 Act, reclassifies marijuana, including tetrahydrocannabinols, 7 from a schedule I controlled substance to a schedule II 8 controlled substance, and provides for civil and criminal 9 penalties and fees. 10 OVERVIEW. The bill allows a patient with a debilitating 11 medical condition who receives a written certification from 12 the patient’s health care practitioner that the patient has 13 a debilitating medical condition and who submits the written 14 certification along with an application to the department of 15 public health (department) for a medical cannabis registration 16 card to allow for the lawful use of medical cannabis to treat 17 the patient’s debilitating medical condition. A patient who 18 is issued a medical cannabis registration card will be able 19 to receive medical cannabis directly from a medical cannabis 20 patient center operated and licensed in this state. 21 RECLASSIFICATION. The bill reclassifies marijuana, 22 including tetrahydrocannabinols as a schedule II controlled 23 substance instead of a schedule I controlled substance and 24 strikes references to the authority of the board of pharmacy to 25 adopt rules for the use of marijuana or tetrahydrocannabinols 26 for medicinal purposes. 27 A schedule I controlled substance is a highly addictive 28 substance that has no accepted medical use in the United States 29 and a schedule II controlled substance is a highly addictive 30 substance that has an accepted medical use in the United 31 States. The reclassification of marijuana from a schedule I 32 controlled substance to a schedule II controlled substance 33 would allow a physician to issue a prescription for marijuana 34 under state law. However, federal regulations may prohibit 35 -20- LSB 1756YH (10) 87 rh/rj 20/ 28