S.F. 484 Section 1. Section 124.204, subsection 4, paragraphs m and 1 u, Code 2015, are amended by striking the paragraphs. 2 Sec. 2. Section 124.204, subsection 7, Code 2015, is amended 3 by striking the subsection. 4 Sec. 3. Section 124.206, subsection 7, Code 2015, 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” includes 14 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- SF 484 (5) 86 rh/rj/jh 1/ 19

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

S.F. 484 2. “Department” means the department of public health. 1 3. “Disqualifying felony offense” means a violation under 2 federal or state law of a felony offense, which has as an 3 element the possession, use, or distribution of a controlled 4 substance, as defined in 21 U.S.C. §802(6). 5 4. “Enclosed, locked facility” means a closet, room, 6 greenhouse, or other enclosed area equipped with locks or other 7 security devices that permit access only by a cardholder. 8 5. “Health care practitioner” means an individual licensed 9 under chapter 148 to practice medicine and surgery or 10 osteopathic medicine and surgery, a physician assistant 11 licensed under chapter 148C, or an advanced registered nurse 12 practitioner licensed pursuant to chapter 152 or 152E. 13 6. “Medical cannabis” means any species of the genus 14 cannabis plant, or any mixture or preparation of them, 15 including whole plant extracts and resins. 16 7. “Medical cannabis dispensary” means an entity licensed 17 under section 124E.8 that acquires medical cannabis from a 18 medical cannabis manufacturer in this state for the purpose 19 of dispensing medical cannabis in this state pursuant to this 20 chapter. 21 8. “Medical cannabis manufacturer” means an entity licensed 22 by the department to manufacture and to possess, cultivate, 23 transport, or supply medical cannabis pursuant to the 24 provisions of this chapter. 25 9. “Primary caregiver” means a person, at least eighteen 26 years of age, who has been designated by a patient’s health 27 care practitioner or a person having custody of a patient, as 28 a necessary caretaker taking responsibility for managing the 29 well-being of the patient with respect to the use of medical 30 cannabis pursuant to the provisions of this chapter. 31 10. “Written certification” means a document signed by a 32 health care practitioner, with whom the patient has established 33 a patient-provider relationship, which states that the patient 34 has a debilitating medical condition and identifies that 35 -3- SF 484 (5) 86 rh/rj/jh 3/ 19

S.F. 484 condition and provides any other relevant information. 1 Sec. 7. NEW SECTION . 124E.3 Health care practitioner 2 certification —— duties. 3 1. Prior to a patient’s submission of an application for a 4 medical cannabis card pursuant to section 124E.4, a health care 5 practitioner shall do all of the following: 6 a. Determine, in the health care practitioner’s medical 7 judgment, whether the patient whom the health care practitioner 8 has examined and treated suffers from a debilitating medical 9 condition that qualifies for the use of medical cannabis under 10 this chapter, and if so determined, provide the patient with a 11 written certification of that diagnosis. 12 b. Provide explanatory information as provided by the 13 department to the patient about the therapeutic use of medical 14 cannabis. 15 2. Determine, on an annual basis, if the patient continues 16 to suffer from a debilitating medical condition and, if so, 17 issue the patient a new certification of that diagnosis. 18 3. Otherwise comply with all requirements established by 19 the department pursuant to rule. 20 4. A health care practitioner may provide, but has no duty 21 to provide, a written certification pursuant to this section. 22 Sec. 8. NEW SECTION . 124E.4 Medical cannabis registration 23 card. 24 1. Issuance to patient. The department may approve the 25 issuance of a medical cannabis registration card by the 26 department of transportation to a patient who: 27 a. Is at least eighteen years of age. 28 b. Is a permanent resident of this state. 29 c. Submits a written certification to the department signed 30 by the patient’s health care practitioner that the patient is 31 suffering from a debilitating medical condition. 32 d. Submits an application to the department, on a form 33 created by the department, in consultation with the department 34 of transportation, that contains all of the following: 35 -4- SF 484 (5) 86 rh/rj/jh 4/ 19

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

S.F. 484 of transportation, that contains all of the following: 1 (1) The primary caregiver’s full name, residence address, 2 date of birth, and telephone number. 3 (2) The patient’s full name. 4 (3) A copy of the primary caregiver’s valid photo 5 identification. 6 (4) Full name, address, and telephone number of the 7 patient’s health care practitioner. 8 (5) Any other information required by rule. 9 d. Submits a medical cannabis registration card fee of 10 twenty-five dollars to the department. 11 4. Primary caregiver card contents. A medical cannabis 12 registration card issued by the department of transportation to 13 a primary caregiver pursuant to subsection 3 shall contain, at 14 a minimum, all of the following: 15 a. The primary caregiver’s full name, residence address, and 16 date of birth. 17 b. The primary caregiver’s photo. 18 c. The date of issuance and expiration date of the 19 registration card. 20 d. The registration card number of each patient in the 21 primary caregiver’s care. If the patient in the primary 22 caregiver’s care is under the age of eighteen, the full name of 23 the patient’s parent or legal guardian. 24 e. Any other information required by rule. 25 5. Expiration date of card. A medical cannabis registration 26 card issued pursuant to this section shall expire one year 27 after the date of issuance and may be renewed. 28 6. Card issuance —— department of transportation. The 29 department may enter into a chapter 28E agreement with the 30 department of transportation to facilitate the issuance of 31 medical cannabis registration cards pursuant to subsections 1 32 and 3. 33 Sec. 9. NEW SECTION . 124E.5 Medical advisory board —— 34 duties. 35 -6- SF 484 (5) 86 rh/rj/jh 6/ 19

S.F. 484 1. No later than August 15, 2015, the director of public 1 health shall establish a medical advisory board consisting of 2 nine practitioners representing the fields of neurology, pain 3 management, gastroenterology, oncology, psychiatry, pediatrics, 4 infectious disease, family medicine, and pharmacy, and three 5 patients with valid medical cannabis registration cards. The 6 practitioners shall be nationally board-certified in their 7 area of specialty and knowledgeable about the use of medical 8 cannabis. 9 2. A quorum of the advisory board shall consist of seven 10 members. 11 3. The duties of the advisory board shall include but not be 12 limited to the following: 13 a. Reviewing and recommending to the department for 14 approval additional chronic or debilitating diseases or 15 medical conditions or their treatments as debilitating medical 16 conditions that qualify for the use of medical cannabis under 17 this chapter. 18 b. Accepting and reviewing petitions to add chronic or 19 debilitating diseases or medical conditions or their medical 20 treatments to the list of debilitating medical conditions that 21 qualify for the use of medical cannabis under this chapter. 22 c. Advising the department regarding the location of 23 medical cannabis dispensaries throughout the state, the form 24 and quantity of allowable medical cannabis to be dispensed 25 to a patient or primary caregiver, and the general oversight 26 of medical cannabis manufacturers and medical cannabis 27 dispensaries in this state. 28 d. Convening at least twice per year to conduct public 29 hearings and to evaluate petitions, which shall be maintained 30 as confidential personal health information, to add chronic or 31 debilitating diseases or medical conditions or their medical 32 treatments to the list of debilitating medical conditions that 33 qualify for the use of medical cannabis under this chapter. 34 Sec. 10. NEW SECTION . 124E.6 Medical cannabis manufacturer 35 -7- SF 484 (5) 86 rh/rj/jh 7/ 19

S.F. 484 licensure. 1 1. a. The department shall license four medical cannabis 2 manufacturers to manufacture medical cannabis within this state 3 consistent with the provisions of this chapter by December 4 1, 2015. The department shall license new medical cannabis 5 manufacturers or relicense the existing medical cannabis 6 manufacturers by December 1 of each year. 7 b. Information submitted during the application process 8 shall be confidential until the medical cannabis manufacturer 9 is licensed by the department unless otherwise protected from 10 disclosure under state or federal law. 11 2. As a condition for licensure, a medical cannabis 12 manufacturer must agree to begin supplying medical cannabis to 13 medical cannabis dispensaries in this state by July 1, 2016. 14 3. The department shall consider the following factors in 15 determining whether to license a medical cannabis manufacturer: 16 a. The technical expertise of the medical cannabis 17 manufacturer in medical cannabis. 18 b. The qualifications of the medical cannabis manufacturer’s 19 employees. 20 c. The long-term financial stability of the medical cannabis 21 manufacturer. 22 d. The ability to provide appropriate security measures on 23 the premises of the medical cannabis manufacturer. 24 e. Whether the medical cannabis manufacturer has 25 demonstrated an ability to meet certain medical cannabis 26 production needs for medical use regarding the range of 27 recommended dosages for each debilitating medical condition, 28 the range of chemical compositions of any plant of the genus 29 cannabis that will likely be medically beneficial for each 30 of the debilitating medical conditions, and the form of the 31 medical cannabis in the manner determined by the department 32 pursuant to rule. 33 f. The medical cannabis manufacturer’s projection of and 34 ongoing assessment of fees on patients with debilitating 35 -8- SF 484 (5) 86 rh/rj/jh 8/ 19

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

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

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

S.F. 484 2. The operating documents of a medical cannabis dispensary 1 shall include all of the following: 2 a. Procedures for the oversight of the medical cannabis 3 dispensary and procedures to ensure accurate record keeping. 4 b. Procedures for the implementation of appropriate security 5 measures to deter and prevent the theft of medical cannabis and 6 unauthorized entrance into areas containing medical cannabis. 7 3. A medical cannabis dispensary shall implement security 8 requirements, including requirements for protection by a fully 9 operational security alarm system, facility access controls, 10 perimeter intrusion detection systems, and a personnel 11 identification system. 12 4. A medical cannabis dispensary shall not share office 13 space with, refer patients to, or have any financial 14 relationship with a health care practitioner. 15 5. A medical cannabis dispensary shall not permit any person 16 to consume medical cannabis on the property of the medical 17 cannabis dispensary. 18 6. A medical cannabis dispensary is subject to reasonable 19 inspection by the department. 20 7. A medical cannabis dispensary shall not employ 21 a person under eighteen years of age or who has been 22 convicted of a disqualifying felony offense. An employee 23 of a medical cannabis dispensary shall be subject to a 24 background investigation conducted by the division of criminal 25 investigation of the department of public safety and a national 26 criminal history background check. 27 8. A medical cannabis dispensary shall not operate in any 28 location within one thousand feet of a public or private school 29 existing before the date of the medical cannabis dispensary’s 30 licensure by the department. 31 9. A medical cannabis dispensary shall comply with 32 reasonable restrictions set by the department relating to 33 signage, marketing, display, and advertising of medical 34 cannabis. 35 -12- SF 484 (5) 86 rh/rj/jh 12/ 19

S.F. 484 10. Prior to dispensing of any medical cannabis, a medical 1 cannabis dispensary shall do all of the following: 2 a. Verify that the medical cannabis dispensary has received 3 a valid medical cannabis registration card from a patient or a 4 patient’s primary caregiver, if applicable. 5 b. Assign a tracking number to any medical cannabis 6 dispensed from the medical cannabis dispensary. 7 c. (1) Properly package medical cannabis in compliance with 8 federal law regarding child resistant packaging and exemptions 9 for packaging for elderly patients, and label medical cannabis 10 with a list of all active ingredients and individually 11 identifying information, including all of the following: 12 (a) The name and date of birth of the patient and the 13 patient’s primary caregiver, if appropriate. 14 (b) The medical cannabis registration card numbers of the 15 patient and the patient’s primary caregiver, if applicable. 16 (c) The chemical composition of the medical cannabis. 17 (2) Proper packaging of medical cannabis shall include but 18 not be limited to all of the following: 19 (a) Warning labels regarding the use of medical cannabis by 20 a woman during pregnancy and while breastfeeding. 21 (b) Clearly labeled packaging indicating that an edible 22 medical cannabis product contains medical cannabis and which 23 packaging shall not imitate candy products or in any way make 24 the product marketable to children. 25 11. A medical cannabis dispensary shall employ a pharmacist 26 licensed pursuant to chapter 155A. 27 Sec. 14. NEW SECTION . 124E.10 Fees. 28 Medical cannabis registration card fees and medical cannabis 29 manufacturer and medical cannabis dispensary application 30 and annual fees collected by the department pursuant to 31 this chapter shall be retained by the department, shall be 32 considered repayment receipts as defined in section 8.2, and 33 shall be used for the purpose of regulating medical cannabis 34 manufacturers and medical cannabis dispensaries and for other 35 -13- SF 484 (5) 86 rh/rj/jh 13/ 19

S.F. 484 expenses necessary for the administration of this chapter. 1 Sec. 15. NEW SECTION . 124E.11 Department duties —— rules. 2 1. a. The department shall maintain a confidential file 3 of the names of each patient to or for whom the department 4 issues a medical cannabis registration card and the name of 5 each primary caregiver to whom the department issues a medical 6 cannabis registration card under section 124E.4. 7 b. Individual names contained in the file shall be 8 confidential and shall not be subject to disclosure, except as 9 provided in subparagraph (1). 10 (1) Information in the confidential file maintained 11 pursuant to paragraph “a” may be released on an individual basis 12 to the following persons under the following circumstances: 13 (a) To authorized employees or agents of the department and 14 the department of transportation as necessary to perform the 15 duties of the department and the department of transportation 16 pursuant to this chapter. 17 (b) To authorized employees of state or local law 18 enforcement agencies, but only for the purpose of verifying 19 that a person is lawfully in possession of a medical cannabis 20 registration card issued pursuant to this chapter. 21 (c) To authorized employees of a medical cannabis 22 dispensary, but only for the purpose of verifying that a person 23 is lawfully in possession of a medical cannabis registration 24 card issued pursuant to this chapter. 25 (2) Release of information pursuant to subparagraph 26 (1) shall be consistent with the federal Health Insurance 27 Portability and Accountability Act of 1996, Pub. L. No. 28 104-191. 29 2. The department shall adopt rules pursuant to chapter 30 17A to administer this chapter which shall include but not be 31 limited to rules to do all of the following: 32 a. Govern the manner in which the department shall consider 33 applications for new and renewal medical cannabis registration 34 cards. 35 -14- SF 484 (5) 86 rh/rj/jh 14/ 19

S.F. 484 b. Identify criteria and set forth procedures for 1 including additional chronic or debilitating diseases or 2 medical conditions or their medical treatments on the list of 3 debilitating medical conditions that qualify for the use of 4 medical cannabis. Procedures shall include a petition process 5 and shall allow for public comment and public hearings before 6 the medical advisory board. 7 c. Set forth additional chronic or debilitating diseases or 8 medical conditions or their medical treatments for inclusion 9 on the list of debilitating medical conditions that qualify 10 for the use of medical cannabis as recommended by the medical 11 advisory board. 12 d. Establish the form and quantity of medical cannabis 13 allowed to be dispensed to a patient or primary caregiver 14 pursuant to this chapter. The form and quantity of medical 15 cannabis shall be appropriate to serve the medical needs of 16 patients with debilitating conditions. 17 e. Establish requirements for the licensure of medical 18 cannabis manufacturers and medical cannabis dispensaries and 19 set forth procedures for medical cannabis manufacturers and 20 medical 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 -15- SF 484 (5) 86 rh/rj/jh 15/ 19

S.F. 484 including measures to ensure contaminant-free cultivation of 1 medical cannabis, safety, and labeling. 2 i. Establish and implement a real-time, statewide 3 medical cannabis registry management sale tracking system 4 that is available to medical cannabis dispensaries on a 5 twenty-four-hour-day, seven-day-a-week basis for the purpose of 6 verifying that a person is lawfully in possession of a medical 7 cannabis registration card issued pursuant to this chapter 8 and for tracking the date of the sale and quantity of medical 9 cannabis purchased by a patient or a primary caregiver. 10 j. Establish and implement a medical cannabis inventory 11 and delivery tracking system to track medical cannabis 12 from production by a medical cannabis manufacturer through 13 dispensing at a medical cannabis dispensary. 14 Sec. 16. NEW SECTION . 124E.12 Reciprocity. 15 A valid medical cannabis registration card, or its 16 equivalent, issued under the laws of another state that allows 17 an out-of-state patient to possess or use medical cannabis in 18 the jurisdiction of issuance shall have the same force and 19 effect as a valid medical cannabis registration card issued 20 pursuant to this chapter, except that an out-of-state patient 21 in this state shall not obtain medical cannabis from a medical 22 cannabis dispensary in this state. 23 Sec. 17. NEW SECTION . 124E.13 Use of medical cannabis —— 24 smoking prohibited. 25 A patient shall not consume medical cannabis possessed or 26 used as authorized by this chapter by smoking medical cannabis. 27 Sec. 18. NEW SECTION . 124E.14 Use of medical cannabis —— 28 affirmative defenses. 29 1. A health care practitioner, including any authorized 30 agent or employee thereof, shall not be subject to 31 prosecution for the unlawful certification, possession, or 32 administration of marijuana under the laws of this state for 33 activities arising directly out of or directly related to the 34 certification or use of medical cannabis in the treatment of 35 -16- SF 484 (5) 86 rh/rj/jh 16/ 19

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

S.F. 484 a medical cannabis registration card issued to that person and 1 valid at the time the person was charged. 2 4. An agency of this state or a political subdivision 3 thereof, including any law enforcement agency, shall not remove 4 or initiate proceedings to remove a patient under the age 5 of eighteen from the home of a parent based solely upon the 6 parent’s or patient’s possession or use of medical cannabis as 7 authorized under this chapter. 8 Sec. 19. NEW SECTION . 124E.15 Penalties. 9 1. A person who knowingly or intentionally possesses or 10 uses medical cannabis in violation of the requirements of this 11 chapter is subject to the penalties provided under chapters 124 12 and 453B. 13 2. A medical cannabis manufacturer or a medical cannabis 14 dispensary shall be assessed a civil penalty of up to one 15 thousand dollars per violation for any violation of this 16 chapter in addition to any other applicable penalties. 17 Sec. 20. EMERGENCY RULES. The department may adopt 18 emergency rules under section 17A.4, subsection 3, and section 19 17A.5, subsection 2, paragraph “b”, to implement the provisions 20 of this Act and the rules shall be effective immediately upon 21 filing unless a later date is specified in the rules. Any 22 rules adopted in accordance with this section shall also be 23 published as a notice of intended action as provided in section 24 17A.4. 25 Sec. 21. TRANSITION PROVISIONS. A medical cannabis 26 registration card issued under chapter 124D prior to July 1, 27 2015, remains effective and continues in effect as issued for 28 the twelve-month period following its issuance. This Act does 29 not preclude the permit holder from seeking to renew the permit 30 under this Act prior to the expiration of the twelve-month 31 period. 32 Sec. 22. REPORTS. The university of Iowa Carver college of 33 medicine and college of pharmacy shall, on or before July 1 of 34 each year, beginning July 1, 2016, submit a report detailing 35 -18- SF 484 (5) 86 rh/rj/jh 18/ 19