House File 221 - Introduced HOUSE FILE 221 BY STAED , KACENA , BENNETT , ABDUL-SAMAD , KURTH , LENSING , WESSEL-KROESCHELL , FORBES , JACOBY , BROWN-POWERS , GAINES , OLSON , COHOON , KURTZ , DONAHUE , KONFRST , MASCHER , WOLFE , and STECKMAN 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 1600YH (3) 88 ss/rh

H.F. 221 Section 1. Section 124.204, subsection 4, paragraphs m and 1 u, Code 2019, are amended by striking the paragraphs. 2 Sec. 2. Section 124.204, subsection 7, Code 2019, is amended 3 by striking the subsection. 4 Sec. 3. Section 124.206, subsection 7, Code 2019, 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 35 -1- LSB 1600YH (3) 88 ss/rh 1/ 30

H.F. 221 nabilone: (+-) - 1 trans-3-(1,1-dimethylheptyl)-6,6a,7,8,10,10a-hexahydro-1-hydroxy-6,6- 2 dimethyl-9H-dibenzo[b,d]pyran-9-one]. 3 c. d. Dronabinol [(-)-delta-9-trans-tetrahydrocannabinol] 4 in an oral solution in a drug product approved for marketing by 5 the United States food and drug administration. 6 Sec. 4. Section 124.401, subsection 5, unnumbered paragraph 7 3, Code 2019, is amended to read as follows: 8 A person may knowingly or intentionally recommend, possess, 9 use, dispense, deliver, transport, or administer cannabidiol 10 medical cannabis if the recommendation, possession, use, 11 dispensing, delivery, transporting, or administering is in 12 accordance with the provisions of chapter 124E 124F . For 13 purposes of this paragraph, “cannabidiol” “medical cannabis” 14 means the same as defined in section 124E.2 124F.2 . 15 Sec. 5. NEW SECTION . 124F.1 Short title. 16 This chapter shall be known and may be cited as the 17 “Compassionate Use of Medical Cannabis Act” . 18 Sec. 6. NEW SECTION . 124F.2 Definitions. 19 As used in this chapter: 20 1. “Debilitating medical condition” means any of the 21 following: 22 a. Cancer, if the underlying condition or treatment produces 23 one or more of the following: 24 (1) Intractable pain. 25 (2) Nausea or severe vomiting. 26 (3) Cachexia or severe wasting. 27 b. Multiple sclerosis. 28 c. Epilepsy or seizure disorders. 29 d. AIDS or HIV as defined in section 141A.1. 30 e. Glaucoma. 31 f. Hepatitis C. 32 g. Crohn’s disease or ulcerative colitis. 33 h. Amyotrophic lateral sclerosis. 34 i. Ehlers-Danlos syndrome. 35 -2- LSB 1600YH (3) 88 ss/rh 2/ 30

H.F. 221 j. Post-traumatic stress disorder. 1 k. Tourette’s syndrome. 2 l. Any terminal illness, with a probable life expectancy of 3 under one year, if the illness or its treatment produces one or 4 more of the following: 5 (1) Intractable pain. 6 (2) Nausea or severe vomiting. 7 (3) Cachexia or severe wasting. 8 m. Intractable pain. 9 n. Parkinson’s disease. 10 o. Muscular dystrophy. 11 p. Huntington’s disease. 12 q. Alzheimer’s disease. 13 r. Complex regional pain syndrome, type I and II. 14 s. Rheumatoid arthritis. 15 t. Polyarteritis nodosa. 16 u. Any other chronic or debilitating disease or medical 17 condition or its medical treatment approved by the department 18 pursuant to rule. 19 2. “Department” means the department of public health. 20 3. “Disqualifying felony offense” means a violation under 21 federal or state law of a felony offense, which has as an 22 element the possession, use, or distribution of a controlled 23 substance, as defined in 21 U.S.C. §802(6). 24 4. “Enclosed, locked facility” means a closet, room, 25 greenhouse, or other enclosed area equipped with locks or 26 other security devices that permit access only by authorized 27 personnel. 28 5. “Health care practitioner” means an individual licensed 29 under chapter 148 to practice medicine and surgery or 30 osteopathic medicine and surgery or an individual licensed to 31 practice medicine in any other state who provides specialty 32 care for an Iowa resident for one or more of the debilitating 33 medical conditions provided in this chapter. 34 6. “Intractable pain” means a pain in which the cause of the 35 -3- LSB 1600YH (3) 88 ss/rh 3/ 30

H.F. 221 pain cannot be removed or otherwise treated with the consent 1 of the patient and which, in the generally accepted course of 2 medical practice, no relief or cure of the cause of the pain 3 is possible, or none has been found after reasonable efforts. 4 Reasonable efforts for relieving or curing the cause of the 5 pain may be determined on the basis of but are not limited to 6 any of the following: 7 a. When treating a nonterminally ill patient for intractable 8 pain, evaluation by the attending physician and one or more 9 physicians specializing in pain medicine or the treatment of 10 the area, system, or organ of the body perceived as the source 11 of the pain. 12 b. When treating a terminally ill patient, evaluation by 13 the attending physician who does so in accordance with the 14 level of care, skill, and treatment that would be recognized 15 by a reasonably prudent physician under similar conditions and 16 circumstances. 17 7. “Medical cannabis” means any species of the genus 18 cannabis plant, or any mixture or preparation of them, 19 including whole plant extracts and resins. 20 8. “Medical cannabis dispensary” means an entity licensed 21 under section 124F.8 that acquires medical cannabis from a 22 medical cannabis manufacturer in this state for the purpose 23 of dispensing medical cannabis in this state pursuant to this 24 chapter. 25 9. “Medical cannabis manufacturer” means an entity licensed 26 under section 124F.6 to manufacture and to possess, cultivate, 27 transport, or supply medical cannabis pursuant to the 28 provisions of this chapter. 29 10. “Primary caregiver” means a person, at least eighteen 30 years of age, who has been designated by a patient’s health 31 care practitioner or a person having custody of a patient, as 32 a necessary caretaker taking responsibility for managing the 33 well-being of the patient with respect to the use of medical 34 cannabis pursuant to the provisions of this chapter. 35 -4- LSB 1600YH (3) 88 ss/rh 4/ 30

H.F. 221 11. “Written certification” means a document signed by a 1 health care practitioner, with whom the patient has established 2 a patient-provider relationship, which states that the patient 3 has a debilitating medical condition and identifies that 4 condition and provides any other relevant information. 5 Sec. 7. NEW SECTION . 124F.3 Health care practitioner 6 certification —— duties. 7 1. Prior to a patient’s submission of an application for a 8 medical cannabis registration card pursuant to section 124F.4, 9 a health care practitioner shall do all of the following: 10 a. Determine, in the health care practitioner’s medical 11 judgment, whether the patient whom the health care practitioner 12 has examined and treated suffers from a debilitating medical 13 condition that qualifies for the use of medical cannabis under 14 this chapter, and if so determined, provide the patient with a 15 written certification of that diagnosis. 16 b. Provide explanatory information as provided by the 17 department to the patient about the therapeutic use of medical 18 cannabis. 19 c. Determine, on an annual basis, if the patient continues 20 to suffer from a debilitating medical condition and, if so, 21 issue the patient a new certification of that diagnosis. This 22 paragraph shall not apply if the patient is suffering from an 23 incurable debilitating medical condition. 24 d. Otherwise comply with all requirements established by the 25 department pursuant to rule. 26 2. A health care practitioner may provide, but has no duty 27 to provide, a written certification pursuant to this section. 28 Sec. 8. NEW SECTION . 124F.4 Medical cannabis registration 29 card. 30 1. Issuance to patient. The department may approve the 31 issuance of a medical cannabis registration card by the 32 department of transportation to a patient who: 33 a. Is at least eighteen years of age. 34 b. Is a permanent resident of this state. 35 -5- LSB 1600YH (3) 88 ss/rh 5/ 30

H.F. 221 c. Submits a written certification to the department signed 1 by the patient’s health care practitioner that the patient is 2 suffering from a debilitating medical condition. 3 d. Submits an application to the department, on a form 4 created by the department, in consultation with the department 5 of transportation, that contains all of the following: 6 (1) The patient’s full name, Iowa residence address, date 7 of birth, and telephone number. 8 (2) A copy of the patient’s valid photograph 9 identification. 10 (3) Full name, address, and telephone number of the 11 patient’s health care practitioner. 12 (4) Full name, residence address, date of birth, and 13 telephone number of each primary caregiver of the patient, if 14 any. 15 (5) Any other information required by rule. 16 e. Submits a medical cannabis registration card fee of one 17 hundred dollars to the department. If the patient attests to 18 receiving social security disability benefits, supplemental 19 security insurance payments, or being enrolled in the medical 20 assistance program, the fee shall be twenty-five dollars. 21 2. Patient card contents. A medical cannabis registration 22 card issued to a patient by the department of transportation 23 pursuant to subsection 1 shall contain, at a minimum, all of 24 the following: 25 a. The patient’s full name, Iowa residence address, and date 26 of birth. 27 b. The patient’s photograph. 28 c. The date of issuance and expiration of the registration 29 card. 30 d. Any other information required by rule. 31 3. Issuance to primary caregiver. For a patient in a 32 primary caregiver’s care, the department may approve the 33 issuance of a medical cannabis registration card by the 34 department of transportation to the primary caregiver who: 35 -6- LSB 1600YH (3) 88 ss/rh 6/ 30

H.F. 221 a. Submits a written certification to the department signed 1 by the patient’s health care practitioner that the patient in 2 the primary caregiver’s care is suffering from a debilitating 3 medical condition. 4 b. Submits an application to the department, on a form 5 created by the department, in consultation with the department 6 of transportation, that contains all of the following: 7 (1) The primary caregiver’s full name, residence address, 8 date of birth, and telephone number. 9 (2) The patient’s full name. 10 (3) A copy of the primary caregiver’s valid photograph 11 identification. 12 (4) Full name, address, and telephone number of the 13 patient’s health care practitioner. 14 (5) Any other information required by rule. 15 c. Submits a medical cannabis registration card fee of 16 twenty-five dollars to the department. 17 4. Primary caregiver card contents. A medical cannabis 18 registration card issued by the department of transportation to 19 a primary caregiver pursuant to subsection 3 shall contain, at 20 a minimum, all of the following: 21 a. The primary caregiver’s full name, residence address, and 22 date of birth. 23 b. The primary caregiver’s photograph. 24 c. The date of issuance and expiration of the registration 25 card. 26 d. The registration card number of each patient in the 27 primary caregiver’s care. If the patient in the primary 28 caregiver’s care is under the age of eighteen, the full name of 29 the patient’s parent or legal guardian. 30 e. Any other information required by rule. 31 5. Expiration date of card. A medical cannabis registration 32 card issued pursuant to this section shall expire one year 33 after the date of issuance and may be renewed. 34 6. Card issuance —— department of transportation. 35 -7- LSB 1600YH (3) 88 ss/rh 7/ 30

H.F. 221 a. The department may enter into a chapter 28E agreement 1 with the department of transportation to facilitate the 2 issuance of medical cannabis registration cards pursuant to 3 subsections 1 and 3. 4 b. The department of transportation may issue renewal 5 medical cannabis registration cards through an online or 6 in-person process. 7 Sec. 9. NEW SECTION . 124F.5 Medical advisory board —— 8 duties. 9 1. No later than August 15, 2019, the director of public 10 health shall establish a medical advisory board consisting of 11 nine practitioners representing the fields of neurology, pain 12 management, gastroenterology, oncology, psychiatry, pediatrics, 13 infectious disease, family medicine, and pharmacy, and three 14 patients or primary caregivers with valid medical cannabis 15 registration cards. The practitioners shall be nationally 16 board-certified in their area of specialty and knowledgeable 17 about the use of medical cannabis. 18 2. A quorum of the advisory board shall consist of seven 19 members. 20 3. The duties of the advisory board shall include but not be 21 limited to the following: 22 a. Reviewing and recommending to the department for 23 approval additional chronic or debilitating diseases or 24 medical conditions or their treatments as debilitating medical 25 conditions that qualify for the use of medical cannabis under 26 this chapter. 27 b. Accepting and reviewing petitions to add chronic or 28 debilitating diseases or medical conditions or their medical 29 treatments to the list of debilitating medical conditions that 30 qualify for the use of medical cannabis under this chapter. 31 c. Working with the department regarding the requirements 32 for the licensure of medical cannabis manufacturers and medical 33 cannabis dispensaries, including licensure procedures. 34 d. Advising the department regarding the location of 35 -8- LSB 1600YH (3) 88 ss/rh 8/ 30

H.F. 221 medical cannabis dispensaries throughout the state, the form 1 and quantity of allowable medical cannabis to be dispensed 2 to a patient or primary caregiver, and the general oversight 3 of medical cannabis manufacturers and medical cannabis 4 dispensaries in this state. 5 e. Convening at least twice per year to conduct public 6 hearings and to review and recommend for approval petitions, 7 which shall be maintained as confidential personal health 8 information, to add chronic or debilitating diseases or 9 medical conditions or their medical treatments to the list of 10 debilitating medical conditions that qualify for the use of 11 medical cannabis under this chapter. 12 f. Recommending improvements relating to the effectiveness 13 of the provisions of this chapter. 14 g. In making recommendations pursuant to this section, 15 consideration of the economic and financial impacts on patients 16 and the medical cannabis industry, and making recommendations 17 that minimize the extent of such impacts to the greatest extent 18 practicable. 19 Sec. 10. NEW SECTION . 124F.6 Medical cannabis manufacturer 20 licensure. 21 1. a. The department shall license up to four medical 22 cannabis manufacturers to manufacture medical cannabis within 23 this state consistent with the provisions of this chapter by 24 December 1, 2019. The department shall license new medical 25 cannabis manufacturers or relicense the existing medical 26 cannabis manufacturers by December 1 of each year. 27 b. Information submitted during the application process 28 shall be confidential until the medical cannabis manufacturer 29 is licensed by the department unless otherwise protected from 30 disclosure under state or federal law. 31 2. As a condition for licensure, a medical cannabis 32 manufacturer must agree to begin supplying medical cannabis to 33 medical cannabis dispensaries in this state by July 2, 2020. 34 3. The department shall consider the following factors in 35 -9- LSB 1600YH (3) 88 ss/rh 9/ 30

H.F. 221 determining whether to license a medical cannabis manufacturer: 1 a. The technical expertise of the medical cannabis 2 manufacturer regarding medical cannabis. 3 b. The qualifications of the medical cannabis manufacturer’s 4 ownership and management team. 5 c. The long-term financial stability of the medical cannabis 6 manufacturer. 7 d. The ability to provide appropriate security measures on 8 the premises of the medical cannabis manufacturer. 9 e. Whether the medical cannabis manufacturer has 10 demonstrated an ability to meet certain medical cannabis 11 production needs for medical use regarding the range of 12 recommended dosages for each debilitating medical condition, 13 the range of chemical compositions of any plant of the genus 14 cannabis that will likely be medically beneficial for each 15 of the debilitating medical conditions, and the form of the 16 medical cannabis in the manner determined by the department 17 pursuant to rule. 18 f. The medical cannabis manufacturer’s projection of and 19 ongoing assessment of fees on patients with debilitating 20 medical conditions. 21 g. The medical cannabis manufacturer’s experience in medical 22 cannabis production, plant extraction, and pharmaceutical 23 formulations. 24 4. The department shall require each medical cannabis 25 manufacturer to contract with a laboratory approved by the 26 department to test the medical cannabis produced by the 27 manufacturer. The department shall require that the laboratory 28 report testing results to the manufacturer in a manner 29 determined by the department pursuant to rule. 30 5. Each entity submitting an application for licensure 31 as a medical cannabis manufacturer shall pay a nonrefundable 32 application fee of fifteen thousand dollars to the department. 33 Sec. 11. NEW SECTION . 124F.7 Medical cannabis 34 manufacturers. 35 -10- LSB 1600YH (3) 88 ss/rh 10/ 30

H.F. 221 1. A medical cannabis manufacturer shall contract with a 1 laboratory approved by the department for purposes of testing 2 the medical cannabis manufactured by the medical cannabis 3 manufacturer as to content, contamination, and consistency. 4 The cost of all laboratory testing shall be paid by the medical 5 cannabis manufacturer. 6 2. The operating documents of a medical cannabis 7 manufacturer shall include all of the following: 8 a. Procedures for the oversight of the medical cannabis 9 manufacturer and procedures to ensure accurate recordkeeping. 10 b. Procedures for the implementation of appropriate security 11 measures to deter and prevent the theft of medical cannabis and 12 unauthorized entrance into areas containing medical cannabis. 13 3. A medical cannabis manufacturer shall implement security 14 requirements, including requirements for protection of each 15 location 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 cannabis manufacturer 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 cannabis manufacturer shall not permit any 22 person to consume medical cannabis on the property of the 23 medical cannabis manufacturer. 24 6. A medical cannabis manufacturer is subject to reasonable 25 inspection by the department. 26 7. A medical cannabis manufacturer 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 cannabis manufacturer 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 cannabis manufacturer shall not operate in any 34 location, whether for manufacturing, cultivating, harvesting, 35 -11- LSB 1600YH (3) 88 ss/rh 11/ 30

H.F. 221 packaging, or processing, within one thousand feet of a public 1 or private school existing before the date of the medical 2 cannabis manufacturer’s licensure by the department. 3 9. A medical cannabis manufacturer shall comply with 4 reasonable restrictions set by the department relating to 5 signage, marketing, display, and advertising of medical 6 cannabis. 7 10. a. A medical cannabis manufacturer shall provide a 8 reliable and ongoing supply of medical cannabis to medical 9 cannabis dispensaries pursuant to this chapter. 10 b. All manufacturing, cultivating, harvesting, packaging, 11 and processing of medical cannabis shall take place in an 12 enclosed, locked facility at a physical address provided to the 13 department during the licensure process. 14 c. A medical cannabis manufacturer shall not manufacture 15 edible medical cannabis products utilizing food coloring. 16 d. A medical cannabis manufacturer shall manufacture a 17 reliable and ongoing supply of medical cannabis to treat every 18 debilitating medical condition listed in this chapter. 19 11. The department shall establish and collect an annual 20 fee from a medical cannabis manufacturer not to exceed the cost 21 of regulating and inspecting the manufacturer in the calendar 22 year. 23 Sec. 12. NEW SECTION . 124F.8 Medical cannabis dispensary 24 licensure. 25 1. a. The department shall license by April 2, 2020, twelve 26 medical cannabis dispensaries to dispense medical cannabis 27 within this state consistent with the provisions of this 28 chapter. The department shall license new medical cannabis 29 dispensaries or relicense the existing medical cannabis 30 dispensaries by December 1 of each year. 31 b. Information submitted during the application process 32 shall be confidential until the medical cannabis dispensary 33 is licensed by the department unless otherwise protected from 34 disclosure under state or federal law. 35 -12- LSB 1600YH (3) 88 ss/rh 12/ 30

H.F. 221 2. As a condition for licensure, a medical cannabis 1 dispensary must agree to begin supplying medical cannabis to 2 patients by July 16, 2020. 3 3. The department shall consider the following factors in 4 determining whether to license a medical cannabis dispensary: 5 a. The technical expertise of the medical cannabis 6 dispensary regarding medical cannabis. 7 b. The qualifications of the medical cannabis dispensary’s 8 owners and management team. 9 c. The long-term financial stability of the medical cannabis 10 dispensary. 11 d. The ability to provide appropriate security measures on 12 the premises of the medical cannabis dispensary. 13 e. The medical cannabis dispensary’s projection and ongoing 14 assessment of fees for the purchase of medical cannabis on 15 patients with debilitating medical conditions. 16 4. Each entity submitting an application for licensure 17 as a medical cannabis dispensary shall pay a nonrefundable 18 application fee of fifteen thousand dollars to the department. 19 Sec. 13. NEW SECTION . 124F.9 Medical cannabis dispensaries. 20 1. a. Medical cannabis dispensaries shall be located based 21 on geographical need throughout the state to improve patient 22 access. 23 b. A medical cannabis dispensary may dispense medical 24 cannabis pursuant to the provisions of this chapter but shall 25 not dispense any medical cannabis in a form or quantity other 26 than the form or quantity allowed by the department pursuant 27 to rule. 28 2. The operating documents of a medical cannabis dispensary 29 shall include all of the following: 30 a. Procedures for the oversight of the medical cannabis 31 dispensary and procedures to ensure accurate recordkeeping. 32 b. Procedures for the implementation of appropriate security 33 measures to deter and prevent the theft of medical cannabis and 34 unauthorized entrance into areas containing medical cannabis. 35 -13- LSB 1600YH (3) 88 ss/rh 13/ 30

H.F. 221 3. A medical cannabis dispensary shall implement security 1 requirements, including requirements for protection by a fully 2 operational security alarm system, facility access controls, 3 perimeter intrusion detection systems, and a personnel 4 identification system. 5 4. A medical cannabis dispensary shall not share office 6 space with, refer patients to, or have any financial 7 relationship with a health care practitioner. 8 5. A medical cannabis dispensary shall not permit any person 9 to consume medical cannabis on the property of the medical 10 cannabis dispensary. 11 6. A medical cannabis dispensary is subject to reasonable 12 inspection by the department. 13 7. A medical cannabis dispensary shall not employ a 14 person who is under eighteen years of age or who has been 15 convicted of a disqualifying felony offense. An employee 16 of a medical cannabis dispensary shall be subject to a 17 background investigation conducted by the division of criminal 18 investigation of the department of public safety and a national 19 criminal history background check. 20 8. A medical cannabis dispensary shall not operate in any 21 location within one thousand feet of a public or private school 22 existing before the date of the medical cannabis dispensary’s 23 licensure by the department. 24 9. A medical cannabis dispensary shall comply with 25 reasonable restrictions set by the department relating to 26 signage, marketing, display, and advertising of medical 27 cannabis. 28 10. Prior to dispensing of any medical cannabis, a medical 29 cannabis dispensary shall do all of the following: 30 a. Verify that the medical cannabis dispensary has received 31 a valid medical cannabis registration card from a patient or a 32 patient’s primary caregiver, if applicable. 33 b. Assign a tracking number to any medical cannabis 34 dispensed from the medical cannabis dispensary. 35 -14- LSB 1600YH (3) 88 ss/rh 14/ 30

H.F. 221 c. (1) Properly package medical cannabis in compliance with 1 federal law regarding child resistant packaging and exemptions 2 for packaging for elderly patients, and label medical cannabis 3 with a list of all active ingredients and individually 4 identifying information, including all of the following: 5 (a) The name and date of birth of the patient and the 6 patient’s primary caregiver, if appropriate. 7 (b) The medical cannabis registration card numbers of the 8 patient and the patient’s primary caregiver, if applicable. 9 (c) The chemical composition of the medical cannabis. 10 (2) Proper packaging of medical cannabis shall include but 11 not be limited to all of the following: 12 (a) Warning labels regarding the use of medical cannabis by 13 a woman during pregnancy and while breastfeeding. 14 (b) Clearly labeled packaging indicating that an edible 15 medical cannabis product contains medical cannabis and which 16 packaging shall not imitate candy products or in any way make 17 the product marketable to children. 18 Sec. 14. NEW SECTION . 124F.10 Fees. 19 Medical cannabis registration card fees and medical cannabis 20 manufacturer and medical cannabis dispensary application 21 and annual fees collected by the department pursuant to 22 this chapter shall be retained by the department, shall be 23 considered repayment receipts as defined in section 8.2, and 24 shall be used for the purpose of regulating medical cannabis 25 manufacturers and medical cannabis dispensaries and for other 26 expenses necessary for the administration of this chapter. 27 Sec. 15. NEW SECTION . 124F.11 Department duties —— rules. 28 1. a. The department shall maintain a confidential file of 29 the names of each patient to or for whom the department issues 30 a medical cannabis registration card, the name of each primary 31 caregiver to whom the department issues a medical cannabis 32 registration card under section 124F.4, and the names of each 33 health care practitioner who provides a written certification 34 for medical cannabis pursuant to this chapter. 35 -15- LSB 1600YH (3) 88 ss/rh 15/ 30

H.F. 221 b. Individual names contained in the file shall be 1 confidential and shall not be subject to disclosure, except as 2 provided in subparagraph (1). 3 (1) Information in the confidential file maintained 4 pursuant to paragraph “a” may be released on an individual basis 5 to the following persons under the following circumstances: 6 (a) To authorized employees or agents of the department and 7 the department of transportation as necessary to perform the 8 duties of the department and the department of transportation 9 pursuant to this chapter. 10 (b) To authorized employees of state or local law 11 enforcement agencies, but only for the purpose of verifying 12 that a person is lawfully in possession of a medical cannabis 13 registration card issued pursuant to this chapter. 14 (c) To authorized employees of a medical cannabis 15 dispensary, but only for the purpose of verifying that a person 16 is lawfully in possession of a medical cannabis registration 17 card issued pursuant to this chapter. 18 (d) To any other authorized persons recognized by the 19 department by rule, but only for the purpose of verifying 20 that a person is lawfully in possession of a medical cannabis 21 registration card issued pursuant to this chapter. 22 (2) Release of information pursuant to subparagraph 23 (1) shall be consistent with the federal Health Insurance 24 Portability and Accountability Act of 1996, Pub. L. No. 25 104-191. 26 2. The department shall adopt rules pursuant to chapter 27 17A to administer this chapter which shall include but not be 28 limited to rules to do all of the following: 29 a. Govern the manner in which the department shall consider 30 applications for new and renewal medical cannabis registration 31 cards. 32 b. Identify criteria and set forth procedures for 33 including additional chronic or debilitating diseases or 34 medical conditions or their medical treatments on the list of 35 -16- LSB 1600YH (3) 88 ss/rh 16/ 30

H.F. 221 debilitating medical conditions that qualify for the use of 1 medical cannabis. Procedures shall include a petition process 2 and shall allow for public comment and public hearings before 3 the medical advisory board. 4 c. Set forth additional chronic or debilitating diseases 5 or medical conditions or associated medical treatments for 6 inclusion on the list of debilitating medical conditions that 7 qualify for the use of medical cannabis as recommended by the 8 medical advisory board. 9 d. Establish, in consultation with medical cannabis 10 manufacturers and medical cannabis dispensaries, the form and 11 quantity of medical cannabis allowed to be dispensed to a 12 patient or primary caregiver pursuant to this chapter. The 13 form and quantity of medical cannabis shall be appropriate to 14 serve the medical needs of patients with debilitating medical 15 conditions. 16 e. Establish, in conjunction with the medical advisory 17 board, requirements for the licensure of medical cannabis 18 manufacturers and medical cannabis dispensaries and set forth 19 procedures for medical cannabis manufacturers and medical 20 cannabis dispensaries to obtain licenses. 21 f. Develop a dispensing system for medical cannabis within 22 this state that provides for all of the following: 23 (1) Medical cannabis dispensaries within this state housed 24 on secured grounds and operated by licensed medical cannabis 25 dispensaries. 26 (2) The dispensing of medical cannabis to patients and 27 their primary caregivers to occur at locations designated by 28 the department. 29 g. Establish and collect annual fees from medical cannabis 30 manufacturers and medical cannabis dispensaries to cover 31 the costs associated with regulating and inspecting medical 32 cannabis manufacturers and medical cannabis dispensaries. 33 h. Specify and implement procedures that address public 34 safety including security procedures and product quality 35 -17- LSB 1600YH (3) 88 ss/rh 17/ 30

H.F. 221 including measures to ensure contaminant-free cultivation of 1 medical cannabis, safety, and labeling. 2 i. Establish and implement a medical cannabis inventory 3 and delivery tracking system to track medical cannabis 4 from production by a medical cannabis manufacturer through 5 dispensing at a medical cannabis dispensary. 6 Sec. 16. NEW SECTION . 124F.12 Reciprocity. 7 A valid medical cannabis registration card, or its 8 equivalent, issued under the laws of another state that allows 9 an out-of-state patient to possess or use medical cannabis in 10 the jurisdiction of issuance shall have the same force and 11 effect as a valid medical cannabis registration card issued 12 pursuant to this chapter, except that an out-of-state patient 13 in this state shall not obtain medical cannabis from a medical 14 cannabis dispensary in this state and an out-of-state patient 15 shall not smoke medical cannabis. 16 Sec. 17. NEW SECTION . 124F.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 dispensary, including any authorized 32 agent or employee thereof, shall not be subject to prosecution 33 for transporting, supplying, or dispensing medical cannabis 34 pursuant to this chapter. 35 -18- LSB 1600YH (3) 88 ss/rh 18/ 30

H.F. 221 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 . 124F.14 Penalties. 33 1. A person who knowingly or intentionally possesses or 34 uses medical cannabis in violation of the requirements of this 35 -19- LSB 1600YH (3) 88 ss/rh 19/ 30

H.F. 221 chapter is subject to the penalties provided under chapters 124 1 and 453B. 2 2. A medical cannabis manufacturer or a medical cannabis 3 dispensary shall be assessed a civil penalty of up to one 4 thousand dollars per violation for any violation of this 5 chapter in addition to any other applicable penalties. 6 Sec. 19. NEW SECTION . 124F.15 Use of medical cannabis —— 7 smoking prohibited. 8 A patient shall not consume medical cannabis possessed 9 or used as authorized under this chapter by smoking medical 10 cannabis. 11 Sec. 20. NEW SECTION . 124F.16 Employment. 12 1. An employer in this state may retain, create, reinstate, 13 or enforce a written zero tolerance policy prohibiting the 14 possession or use of medical cannabis or any derivative 15 thereof including cannabidiol by an employee in the employer’s 16 workplace, including but not limited to a policy prohibiting 17 an employee from having any detectable amount of medical 18 cannabis or any derivative thereof including cannabidiol in the 19 employee’s body while at work. 20 2. An employer’s prohibition of the possession or use 21 of medical cannabis or any derivative thereof including 22 cannabidiol under this section shall not be considered to be 23 an unfair or discriminatory employment practice under section 24 216.6. 25 Sec. 21. Section 730.5, subsection 11, paragraph f, Code 26 2019, is amended to read as follows: 27 f. Testing or taking action against an employee or 28 prospective employee with a confirmed positive test result due 29 to the employee’s or prospective employee’s use of medical 30 cannabidiol cannabis as authorized under chapter 124E 124F . 31 Sec. 22. REPEAL. Chapter 124E, Code 2019, is repealed. 32 Sec. 23. EMERGENCY RULES. The department may adopt 33 emergency rules under section 17A.4, subsection 3, and section 34 17A.5, subsection 2, paragraph “b”, to implement the provisions 35 -20- LSB 1600YH (3) 88 ss/rh 20/ 30